PMID- 33218382
OWN - NLM
STAT- MEDLINE
DCOM- 20210806
LR  - 20210806
IS  - 2162-5239 (Electronic)
IS  - 0094-6354 (Linking)
VI  - 88
IP  - 6
DP  - 2020 Dec
TI  - Type 2 Diabetes Mellitus: Relationships Between Preoperative Physiologic Stress, 
      Gastric Content Volume and Quality, and Risk of Pulmonary Aspiration.
PG  - 465-471
AB  - Pulmonary aspiration is a potentially fatal anesthetic complication occurring 
      when gastric contents enter the respiratory system. Fasting guidelines aim to 
      decrease the risk of pulmonary aspiration by recommending a timeframe in which 
      patients abstain from food and drink before surgery. Fasting guidelines 
      recommended for healthy individuals fail to account for patients with type 2 
      diabetes mellitus (T2DM). Gastroparesis, a common condition associated with T2DM, 
      is exacerbated during stress such as an impending surgery. This study sought to 
      determine whether a relationship exists between stress levels and gastric 
      contents in fasting patients with T2DM presenting for an elective surgical or 
      diagnostic procedure. The quality and quantity of gastric contents and 
      preoperative stress were evaluated using gastric ultrasonography and salivary 
      alpha-amylase levels. No relationship existed between preoperative stress and gastric 
      contents; however, glycated hemoglobin levels of 7% or greater were associated 
      with increased gastric fluid, which was the most significant finding in this 
      study. In addition, there was a significant difference between the mean gastric 
      volume in healthy individuals and patients with T2DM. Performance of gastric 
      ultrasonography preoperatively provides objective data that could influence the 
      anesthetic plan and decrease the risk of pulmonary aspiration in patients with 
      T2DM.
CI  - Copyright (c) by the American Association of Nurse Anesthetists.
FAU - Reed, Amy M
AU  - Reed AM
AD  - is the assistant program director at the York College of Pennsylvania/WellSpan 
      Health Nurse Anesthetist Program, York, Pennsylvania. This study was conducted in 
      partial fulfillment for the degree of Doctor of Philosophy at The Catholic 
      University of America, Washington, DC. Email: areed14@ycp.edu.
FAU - Haas, Richard E
AU  - Haas RE
AD  - is the principal of Eastern Consulting LLC, York, Pennsylvania.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - AANA J
JT  - AANA journal
JID - 0431420
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - *Diabetes Mellitus, Type 2
MH  - *Fasting
MH  - Female
MH  - *Gastric Emptying
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Nurse Anesthetists
MH  - Pneumonia, Aspiration/nursing/*prevention & control
MH  - Preoperative Period
MH  - *Stress, Physiological
OTO - NOTNLM
OT  - Gastric contents
OT  - gastric ultrasonography
OT  - preoperative stress
OT  - pulmonary aspiration
OT  - salivary alpha-amylase
COIS- The study was funded by a grant from the AANA Foundation, Park Ridge, Illinois.
EDAT- 2020/11/22 06:00
MHDA- 2021/08/07 06:00
CRDT- 2020/11/21 05:22
PHST- 2020/11/21 05:22 [entrez]
PHST- 2020/11/22 06:00 [pubmed]
PHST- 2021/08/07 06:00 [medline]
PST - ppublish
SO  - AANA J. 2020 Dec;88(6):465-471.