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Semaglutide, delayed gastric emptying, and intraoperative pulmonary aspiration: a case report
Open accessAbstract
Purpose We report a case in which the use of semaglutide for weight loss was associated with delayed gastric emptying and intraoperative pulmonary aspiration of gastric contents. Clinical features A 42-yr-old patient with Barrett's esophagus underwent repeat upper gastrointestinal endoscopy and ablation of dysplastic mucosa. Two months earlier, the patient had started weekly injections of semaglutide for weight loss. Despite having fasted for 18 hr, and differing from the findings of prior procedures, endoscopy revealed substantial gastric content, which was suctioned before endotracheal intubation. Food remains were removed from the trachea and bronchi using bronchoscopy. The patient was extubated four hours later and remained asymptomatic. Conclusion Patients using semaglutide and other glucagon-like peptide 1 agonists for weight management may require specific precautions during induction of anesthesia to prevent pulmonary aspiration of gastric contents.
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“These drugs may be associated with risks of peri‐operative pulmonary aspiration or euglycaemic ketoacidosis.”
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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“For instance, Klein et al. [43] described a 42-year-old male patient receiving once-weekly semaglutide for weight loss who aspirated a substantial amount of solid and liquid gastric contents during anesthesia induction despite an 18-hour fasting period.”
From Delayed gastric emptying induced by glucagon-like peptide-1 receptor agonists and its implications for perioperative risk during anesthesia (2026) · cites this paper as [43]
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“These medications may be associated with nausea, vomiting, and delayed gastric emptying, and there have been case reports of pulmonary aspiration during general anesthesia and deep sedation (154).”
From 16. Diabetes Care in the Hospital: Standards of Care in Diabetes—2026 (2026) · cites this paper as [154]
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“The correlation between delayed gastric emptying and GLP-1 RAs raises concerns about the possible negative effects in the periprocedural setting, as evidenced by case reports of aspiration events occurring during procedural anesthesia in patients administered GLP-1 RAs [14,15].”
From Exploring the Side Effects of GLP-1 Receptor Agonist: To Ensure Its Optimal Positioning (2025) · cites this paper as [15]
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Metadata
- Authors
- Klein, S. R., & Hobai, I. A.
- Affiliations
- Massachusetts General Hospital (US)
- Harvard University (US)
- Corresponding author
- Hobai, Ion A.
- ORCID
- Hobai, Ion A.
- Venue
- Canadian Journal of Anesthesia/Journal canadien d'anesthésie
- Published
- 2023-03-28
- Volume
- 70
- Issue
- 8
- Pages
- 1394-1396
- ISSN
- 0832-610X (ISSN-L)
- 1496-8975
- OpenAlex
- W4361212412
- Cited by
- 207
- References
- 12
- Citations by year
- 2026: 55 · 2025: 58 · 2024: 70 · 2023: 24
- FWCI
- 68.56
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Canadian Journal of Anesthesia/Journal canadien d anesthésie (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Airway Management and Intubation Techniques
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Anesthesia and Sedative Agents
- Health Sciences › Medicine › Surgery › Enhanced Recovery After Surgery
- Keywords
- semaglutide, delayed gastric emptying, GLP-1 receptor agonists, weight loss, Barrett's esophagus, upper gastrointestinal endoscopy, anesthesia induction, endotracheal intubation, bronchial aspiration, bronchoscopy
- MeSH terms
- Semaglutide, Diabetes Mellitus, Type 2, Glucagon-Like Peptides, Humans, Weight Loss, Endoscopy, Gastrointestinal, Gastroparesis
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