Gastric emptying after athletic carbohydrate supplementation: implications for orthopaedic trauma patients.

Abstract

Preoperative carbohydrate drinks are standard protocols for elective cases, but are often avoided before orthopaedic trauma surgery over concern for delayed gastric emptying and aspiration risk. Endurance-athlete carbohydrate formulations are engineered for rapid gastric emptying and may offer metabolic support without added aspiration risk. This study assessed gastric emptying in healthy volunteers to establish baseline profiles before trauma-patient testing. Sixteen healthy adults received 1 or 2 products (Maurten or Precision Fuel & Hydration [PFH]). In carbohydrate gel supplementation phase, participants consumed a gel, fasted ≥ 8 h, then underwent baseline gastric ultrasound. In carbohydrate liquid supplementation phase, they consumed a 500 mL drink, with gastric ultrasounds every 15 min for up to 2 h. The primary endpoint was gastric volume < 1.5 mL/kg (low aspiration risk); the secondary endpoint additionally required clear or empty gastric content. Gastric volumes were compared with linear regression; time to threshold used restricted mean time estimation. In phase 1, 15/16 (94%) had gastric volumes < 1.5 mL/kg after gel (median, 0.7 mL/kg; IQR, 0.5 to 1.1), with no significant difference between products (mean difference, 0.1 mL/kg; 95% CI - 0.2 to 0.4; p = 0.45). In phase 2, 14/16 (88%) reached the threshold within a restricted mean time of 68 min (95% CI 49 to 88). Maurten reached it 33 min faster than PFH (95% CI 0 to 66; p = 0.05). In healthy volunteers, these gels and drinks reached low-aspiration-risk gastric volumes within clinically meaningful timelines, supporting evaluation for preoperative metabolic support in orthopaedic trauma patients.