Stomach Processing and Emptying Evaluation With Diet and Ultrasound

NCT ID: NCT06988397

Last Updated: 2025-05-23

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-06-01

Study Completion Date

2026-06-01

Brief Summary

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Gastric content is a key risk factor for aspiration during anesthesia. Although standard fasting times are recommended, various factors-including GLP-1 receptor agonists,-can delay gastric emptying. Gastric ultrasound enables real-time, non-invasive assessment of gastric volume and can help tailor perioperative management. The aim of this study explores the effects of different meal types and physical activity on gastric emptying in healthy individuals.

Detailed Description

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Pulmonary aspiration of gastric contents is a serious and potentially life-threatening complication of anesthesia. Despite adherence to preoperative fasting guidelines issued by the American Society of Anesthesiologists (ASA), certain medical conditions-such as diabetes mellitus-or medications like GLP-1 receptor agonists may significantly delay gastric emptying beyond standard expectations. This creates a need for individualized assessment of gastric contents prior to anesthesia, especially in patients considered at increased risk.

Gastric ultrasound is a non-invasive, point-of-care technique that allows for real-time assessment of gastric volume and content. It may provide a more reliable indicator of aspiration risk than fasting time alone.

This randomized, prospective study aims to evaluate the effects of different types of meals and physical activity levels on gastric emptying time in healthy adult volunteers, using ultrasound-based measurement of the gastric antrum.

Sixty participants aged 18-40 years will be recruited via registration forms provided by the study team. Each participant will provide written informed consent, including acknowledgment of potential food allergens present in the study meals. The day prior to each session, participants will receive a phone call to remind them of dietary restrictions: no clear liquids for 2 hours, no solid foods for 6 hours, and no fatty meals for 8 hours before the study.

Each participant will take part in two separate sessions, conducted on different days. On both days, the participant will arrive fasting and undergo a baseline gastric ultrasound to confirm an empty stomach. If gastric content is detected, the session will be rescheduled.

Participants will be randomly assigned (via computer-generated allocation) to one of three meal groups: high-fat, dairy-based, or fruit/vegetable. Meals will be standardized in volume and composition within each group. The examiner performing the ultrasound will be blinded to the meal group allocation.

In each session, participants will consume the assigned meal within 10 minutes. Gastric ultrasound measurements will be performed at 15 minutes, 3 hours, and 6 hours post-meal. On one of the days, participants will remain in a resting position between measurements. On the other day, participants will walk at a moderate pace for 30 minutes between each measurement interval (i.e., between 0-3 hours and 3-6 hours post-meal). The order of active vs. resting day will be randomized and counterbalanced across participants.

Ultrasound will be performed in the right lateral decubitus position using a convex transducer (2-8 MHz) with an abdominal preset. The antral cross-sectional area (CSA) will be measured using standard landmarks (aorta, SMA, left lobe of liver), and gastric volume will be estimated using a validated formula:

GV = 27.0 + 14.6 × right lateral CSA (cm²) - 1.28 × age (years).

Conditions

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Gastric Emptying Preoperative Risk Assessment Healthy Volunteer Study

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

SINGLE

Investigators

Study Groups

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Gastric Ultrasound in Participants Consuming Different Meal Types with Physical Acivity

Participants assigned to this arm will undergo an initial gastric ultrasound to confirm fasting status. They will then consume one of three types of meals: vegetable-based, meat-based, or dairy-based. A gastric ultrasound will be performed 15 minutes after meal ingestion. This will be followed by standardized physical activity (walking a predefined distance). Subsequent gastric ultrasound assessments will be performed at 3 hours and 6 hours post-meal, each followed by the same standardized physical activity. The purpose is to evaluate the impact of food type and intermittent physical activity on gastric emptying, as assessed by ultrasound.

Group Type EXPERIMENTAL

Physical activity after different type of meals

Intervention Type BEHAVIORAL

Standardized physical activity (walking) after consuming one of three meal types (vegetable-based, meat-based, dairy-based). Ultrasound of gastric volume will be performed at 3 and 6 hour between walking sessions.

Gastric Ultrasound in Participants Consuming Different Meal Types with Subsequent Rest

Participants in this arm will first undergo a baseline gastric ultrasound to confirm fasting status. They will then consume one of three types of meals: vegetable-based, meat-based, or dairy-based. Gastric ultrasound will be performed 15 minutes after meal ingestion. Unlike the other arm, participants in this group will remain at rest throughout the study period and will not perform any physical activity. Additional gastric ultrasound assessments will be performed at 3 hours and 6 hours post-meal, with participants remaining sedentary between each measurement. This arm will serve to assess the isolated effect of food type on gastric emptying over time without the influence of physical activity.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Physical activity after different type of meals

Standardized physical activity (walking) after consuming one of three meal types (vegetable-based, meat-based, dairy-based). Ultrasound of gastric volume will be performed at 3 and 6 hour between walking sessions.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Age between 18 and 40 years
* Ability and willingness to provide written informed consent
* Agreement to comply with study procedures, including pre-study dietary restrictions
* No history of gastrointestinal disease
* No recent abdominal surgery

Exclusion Criteria

* Lack of informed consent
* Allergy or intolerance to any of the foods used in the study meals
* Medical conditions known to delay gastric emptying, including:
* Obesity (BMI \> 30 kg/m²)
* Diabetes mellitus
* Gastroesophageal reflux disease (GERD)
* Hiatal hernia
* Bowel obstruction
* Tube feeding
* Active gastrointestinal disease
* History of gastrointestinal surgery
* Current pregnancy or breastfeeding
* Use of medications affecting gastric motility (e.g., opioids, anticholinergics, GLP-1 receptor agonists)
* Neuromuscular disorders impairing ability to remain in supine position for 6 hours or to walk for 30 minutes
Minimum Eligible Age

18 Years

Maximum Eligible Age

40 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Medical University of Warsaw

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Mateusz Zawadka

Role: PRINCIPAL_INVESTIGATOR

2nd Department of Anesthesiology and Intensive Care, Medical University of Warsaw, Poland

Locations

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Medical University of Warsaw

Warsaw, Masovian Voivodeship, Poland

Site Status

Countries

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Poland

Central Contacts

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Mateusz Zawadka, MD, PhD

Role: CONTACT

00485992002

Aleksandra Barabasz

Role: CONTACT

Facility Contacts

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Mateusz Zawadka, MD, PhD

Role: primary

00485992002

References

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Van de Putte P, Perlas A. Ultrasound assessment of gastric content and volume. Br J Anaesth. 2014 Jul;113(1):12-22. doi: 10.1093/bja/aeu151. Epub 2014 Jun 3.

Reference Type BACKGROUND
PMID: 24893784 (View on PubMed)

Bolondi L, Bortolotti M, Santi V, Calletti T, Gaiani S, Labo G. Measurement of gastric emptying time by real-time ultrasonography. Gastroenterology. 1985 Oct;89(4):752-9. doi: 10.1016/0016-5085(85)90569-4.

Reference Type BACKGROUND
PMID: 3896910 (View on PubMed)

Perlas A, Chan VW, Lupu CM, Mitsakakis N, Hanbidge A. Ultrasound assessment of gastric content and volume. Anesthesiology. 2009 Jul;111(1):82-9. doi: 10.1097/ALN.0b013e3181a97250.

Reference Type BACKGROUND
PMID: 19512861 (View on PubMed)

Sumpelmann AE, Sumpelmann R, Lorenz M, Eberwien I, Dennhardt N, Boethig D, Russo SG. Ultrasound assessment of gastric emptying after breakfast in healthy preschool children. Paediatr Anaesth. 2017 Aug;27(8):816-820. doi: 10.1111/pan.13172. Epub 2017 Jul 4.

Reference Type BACKGROUND
PMID: 28675504 (View on PubMed)

Pimenta GP, de Aguilar-Nascimento JE. Prolonged preoperative fasting in elective surgical patients: why should we reduce it? Nutr Clin Pract. 2014 Feb;29(1):22-8. doi: 10.1177/0884533613514277. Epub 2013 Dec 11.

Reference Type BACKGROUND
PMID: 24336400 (View on PubMed)

Practice Guidelines for Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration: Application to Healthy Patients Undergoing Elective Procedures: An Updated Report by the American Society of Anesthesiologists Task Force on Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration. Anesthesiology. 2017 Mar;126(3):376-393. doi: 10.1097/ALN.0000000000001452. No abstract available.

Reference Type BACKGROUND
PMID: 28045707 (View on PubMed)

Other Identifiers

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KB/6/2025

Identifier Type: -

Identifier Source: org_study_id

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