Diabetic Patients, Assessment of Preoperative Gastric Contents, and Potential Reduction of Risk of Pulmonary Aspiration

The use of gastric ultrasonography to assess stomach contents preoperatively and reduce the risk of perioperative pulmonary aspiration has been advocated for more than three decades,¹  but initial reception into clinical practice was limited. That began to change in 2009 when a team led by Dr. Anahi Perlas at the University of Toronto began targeted studies to determine the efficacy and practicality of using ultrasound to identify patients who have liquid or solid stomach contents present immediately before their anesthetics.²  In this month’s Anesthesiology, Perlas et al.³  have taken their studies a step further as they have attempted to answer a persistent question that confronts all anesthesia providers: “Do current preoperative fasting guidelines work for patients who have diabetes as well as they work for healthy patients?” The current preoperative fasting guidelines have proven to work well in reducing the fasting period from the traditional “...