Gastric residual volume in patients with obesity receiving GLP-1 receptor agonists: A comparative gastric ultrasound pilot study.
5 affiliations
- 1Anaesthesia Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
- 2Anaesthesia Department, College of Medicine, Umm AI-Qura University, Makkah, Saudi Arabia.
- 3Anesthesia Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
- 4Endocrine Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
- 5Anesthesia Department, College of Medicine, Assiut University, Egypt.
Abstract
Background
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) enhance insulin secretion, suppress glucagon release, promote satiety, and may slow gastric emptying. Introduced in 2005 for the treatment of type 2 diabetes and obesity, these agents have prompted interest in assessing delayed gastric emptying as a potential biomarker to predict treatment response and to guide decisions regarding long-term therapy. Point-of-care gastric ultrasound (POCUS) offers a bedside method to assess gastric contents.Objectives
To compare gastric residual volume (GRV) on gastric ultrasound among patients with obesity receiving GLP-1 RAs and nonusers and those with prior weight loss surgeries.Methods
In this comparative cross-sectional pilot study, gastric POCUS was done on patients with obesity who took GLP-1 RAs and other patients with obesity with no history of taking GLP-1 RAs prior to surgery in the supine and lateral decubitus positions. Antral cross-sectional area and GRV were measured using validated mathematical models.Results
Patients receiving GLP-1 RAs demonstrated higher estimated GRV compared with nonusers. A higher proportion of GLP-1 RA users met ultrasound criteria for a full stomach.Conclusion
Among patients with obesity, GLP-1 RA therapy was associated with enlargement of the gastric antrum, increased gastric volume, and greater residual gastric contents, leading to an elevated estimated risk of aspiration. This increased risk is primarily determined by gastric ultrasound findings rather than patient characteristics, comorbidities, or duration of treatment. Gastric ultrasound may support individualized perioperative decision-making regarding aspiration precautions.
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BibTeX
@article{ahmad2026gastric,
title = {{Gastric residual volume in patients with obesity receiving GLP-1 receptor agonists: A comparative gastric ultrasound pilot study.}},
author = {Abdulaziz Ejaz Ahmad and Nada Tariq Yamani and Abdulaziz Fahad Alaqaili and Sadeem Saleh Aldawas and Najla Qatnan Alotaib and Abdelazeem Ali Eldawlatly},
journal = {Saudi journal of anaesthesia},
year = {2026},
month = oct,
doi = {10.4103/sja.sja_177_26},
url = {https://europepmc.org/article/MED/42960038},
note = {CC BY-NC-SA},
}
RIS
TY - JOUR
TI - Gastric residual volume in patients with obesity receiving GLP-1 receptor agonists: A comparative gastric ultrasound pilot study.
AU - Abdulaziz Ejaz Ahmad
AU - Nada Tariq Yamani
AU - Abdulaziz Fahad Alaqaili
AU - Sadeem Saleh Aldawas
AU - Najla Qatnan Alotaib
AU - Abdelazeem Ali Eldawlatly
PY - 2026
DA - 2026/10/01
JO - Saudi journal of anaesthesia
DO - 10.4103/sja.sja_177_26
UR - https://europepmc.org/article/MED/42960038
AB - Background Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) enhance insulin secretion, suppress glucagon release, promote satiety, and may slow gastric emptying. Introduced in 2005 for the treatment of type 2 diabetes and obesity, these agents have prompted interest in assessing delayed gastric emptying as a potential biomarker to predict treatment response and to guide decisions regarding long-term therapy. Point-of-care gastric ultrasound (POCUS) offers a bedside method to assess gastric contents.Objectives To compare gastric residual volume (GRV) on gastric ultrasound among patients with obesity receiving GLP-1 RAs and nonusers and those with prior weight loss surgeries.Methods In this comparative cross-sectional pilot study, gastric POCUS was done on patients with obesity who took GLP-1 RAs and other patients with obesity with no history of taking GLP-1 RAs prior to surgery in the supine and lateral decubitus positions. Antral cross-sectional area and GRV were measured using validated mathematical models.Results Patients receiving GLP-1 RAs demonstrated higher estimated GRV compared with nonusers. A higher proportion of GLP-1 RA users met ultrasound criteria for a full stomach.Conclusion Among patients with obesity, GLP-1 RA therapy was associated with enlargement of the gastric antrum, increased gastric volume, and greater residual gastric contents, leading to an elevated estimated risk of aspiration. This increased risk is primarily determined by gastric ultrasound findings rather than patient characteristics, comorbidities, or duration of treatment. Gastric ultrasound may support individualized perioperative decision-making regarding aspiration precautions.
SN - 1658-354X
SN - 0975-3125
ER -