GLP1-R-related Disease, Upper Endoscopy
Conditions
Keywords
GLP1 receptor agonists, upper endoscopy
Brief summary
The aim of this study is to determine whether a modified fasting protocol can reduce the potential risk of aspiration for patients currently prescribed GLP1-RAs.
Detailed description
The overall objective of this project is to identify a reasonable means by which patients on GLP1-RAs can be safely cared for in the perioperative period that can be agreed upon by all groups involved in perioperative patient care. This will be assessed in patients undergoing upper endoscopy specifically since assessment of gastric contents would be minimally invasive for this patient population receiving anesthetic care.
Interventions
OTHERModified Fasting Guidelines
Patients will follow a full-liquid diet 48 hours prior to their procedure, clear liquid diet 24 hours prior to their procedure, and nothing by mouth (NPO) after midnight on the day of their procedure
Sponsors
Mayo Clinic
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
PREVENTION
Masking
SINGLE (Outcomes Assessor)
Intervention model description
This study has 3 arms, but two of them are historical cohorts (i.e. previous patients who have already been taken care of). One group will consist of patients who are not on GLP1 medications who underwent upper endoscopy, and another group will consist of patients who are on GLP1 medications who underwent upper endoscopy. The third group is the prospective group who are being enrolled and recruited - this group will consist of patients who are on GLP1 medications who abide by a modified fasting guideline consisting of a full-liquid diet 48 hours prior to procedure, clear liquid diet 24 hours prior to procedure, and no liquids or solids after midnight on the day of upper endoscopy.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients undergoing elective upper endoscopy with gastroenterology team
Exclusion criteria
* Urgent or emergent procedure * Inclusion of colonoscopy or antegrade small bowel enteroscopy in planned procedure * Upper GI barium study performed in past 24 hours. * Gastroparesis * Achalasia * Pancreatitis * Use of outpatient pro-motility medications * Patient refusal * Inability for patient to provide own consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Gastric contents | Baseline | Number of patients who were found to have gastric contents within the stomach during the upper endoscopy. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Diagnosis of aspiration within 72 hours of procedure | From the time of upper endoscopy until 72 hours post-procedure. | Whether or not a patient was diagnosed with aspiration will be determined via chart review for 72 hours after the completion of upper endoscopy. A note documenting aspiration or an ICD code associated with aspiration will indicate that this outcome occurred. |
| Aspiration pneumonitis diagnosis postoperatively | 72 hours after completion of upper endoscopy | The number of patients who have a diagnosis of aspiration pneumonitis, as identified by the presence of ICD codes J69.0 or J69.8, postoperatively. |
| Postprocedural ICU admission | Immediately after upper endoscopy | The number of patients who were admitted to the ICU immediately after upper endoscopy. |
Countries
United States
Contacts
CONTACTKrishnan Ramanujan, MD
Outcome results
None listed