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Because glucagon-like peptide-1 (GLP-1)–receptor agonists delay gastric emptying, an ongoing controversy is whether they confer risk for pulmonary aspiration in patients who undergo upper endoscopy or receive general anesthesia for surgical procedures. Use of GLP-1 agonists has been associated with retained gastric contents in such patients in several studies (e.g., NEJM JW Gen Med Aug 1 2024 and JAMA Surg 2024; 159:598), but whether this effect raises risk for clinically evident pulmonary aspiration has been unclear.
Two new retrospective studies — one using claims databases and the other using electronic health records — addressed this issue in patients with diabetes who underwent upper endoscopy (BMJ 2024; 387:e080340 and Anesthesiology 2…