Medicine, Faculty of Medicine, University of Alberta, Edmonton, AB, Canada.
Library and Information Services, University Health Network, Toronto, ON, Canada.
Br J Anaesth. 2021 Aug;127(2):224-235. doi: 10.1016/j.bja.2021.04.008. Epub 2021 May 20.
Gastric emptying may be delayed in patients with diabetes mellitus (DM). However, the incidence of full stomach in fasting patients with DM and their risk of pulmonary aspiration under anaesthesia is not well understood.
A scoping review was undertaken to map the literature on aspiration risk in DM. A search was conducted in seven bibliographic databases, including MEDLINE and Embase, for original articles that studied aspiration risk, gastric emptying, or gastric content and volume. Selection and characterisation were performed by two independent reviewers using a predefined protocol registered externally.
The search identified 5063 unique records, and 16 studies (totalling 775 patients with DM) were selected: nine studied gastric emptying and seven studied gastric content or volume. There were no studies reporting the incidence of aspiration in subjects with DM. All nine studies reported delayed emptying in patients with DM compared with healthy controls. Amongst the seven studies that compared gastric residual content/volume (GRV) in the perioperative period, five reported clinically negligible GRV in both patients with DM and controls, whereas two observed a higher incidence of 'full' stomach in patients with DM.
The evidence concerning the aspiration risk for surgical patients with DM is based on a limited number of studies, mostly unblinded, reporting physiological data on gastric emptying and gastric volume as surrogate markers of aspiration risk. Data on fasting gastric content and volume in patients with DM are limited and contradictory; hence, the true risk of aspiration in fasting patients with DM is unknown.
糖尿病（DM）患者的胃排空可能会延迟。然而，空腹 DM 患者胃内充满的发生率及其在麻醉下发生肺吸入的风险尚不清楚。
进行了范围性综述，以绘制有关 DM 患者吸入风险的文献图。在七个书目数据库（包括 MEDLINE 和 Embase）中进行了搜索，以查找研究吸入风险、胃排空或胃内容物和体积的原始文章。选择和特征描述由两名独立的审查员使用预先确定的协议进行，该协议在外部进行了注册。
搜索确定了 5063 条独特的记录，选择了 16 项研究（总共涉及 775 例 DM 患者）：9 项研究胃排空，7 项研究胃内容物或体积。没有研究报告 DM 患者中吸入的发生率。所有 9 项研究均报告与健康对照组相比，DM 患者排空延迟。在比较围手术期胃残留量/体积（GRV）的七项研究中，五项研究报告 DM 患者和对照组的 GRV 均具有临床可忽略的意义，而两项研究观察到 DM 患者“满胃”的发生率更高。
有关接受手术治疗的 DM 患者吸入风险的证据基于少数几项研究，这些研究大多为非盲法，报告了胃排空和胃体积的生理学数据，作为吸入风险的替代标志物。有关 DM 患者空腹胃内容物和体积的数据有限且相互矛盾；因此，空腹 DM 患者吸入的真实风险尚不清楚。
