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Pre-operative fasting in children: A guideline from the European Society of Anaesthesiology and Intensive Care

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

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  • Peter Frykholm
  • Nicola Disma
  • Hanna Andersson
  • Christiane Beck
  • Lionel Bouvet
  • Eloise Cercueil
  • Elizabeth Elliott
  • Jan Hofmann
  • Rebecca Isserman
  • Anna Klaucane
  • Fabian Kuhn
  • Mathilde de Queiroz Siqueira
  • David Rosen
  • Diana Rudolph
  • Alexander R Schmidt
  • Achim Schmitz
  • Daniel Stocki
  • Robert Sümpelmann
  • Paul A Stricker
  • Mark Thomas
  • Francis Veyckemans
  • Arash Afshari
Vis graf over relationer

Current paediatric anaesthetic fasting guidelines have recommended conservative fasting regimes for many years and have not altered much in the last decades. Recent publications have employed more liberal fasting regimes with no evidence of increased aspiration or regurgitation rates. In this first solely paediatric European Society of Anaesthesiology and Intensive Care (ESAIC) pre-operative fasting guideline, we aim to present aggregated and evidence-based summary recommendations to assist clinicians, healthcare providers, patients and parents. We identified six main topics for the literature search: studies comparing liberal with conservative regimens; impact of food composition; impact of comorbidity; the use of gastric ultrasound as a clinical tool; validation of gastric ultrasound for gastric content and gastric emptying studies; and early postoperative feeding. The literature search was performed by a professional librarian in collaboration with the ESAIC task force. Recommendations for reducing clear fluid fasting to 1 h, reducing breast milk fasting to 3 h, and allowing early postoperative feeding were the main results, with GRADE 1C or 1B evidence. The available evidence suggests that gastric ultrasound may be useful for clinical decision-making, and that allowing a 'light breakfast' may be well tolerated if the intake is well controlled. More research is needed in these areas as well as evaluation of how specific patient or treatment-related factors influence gastric emptying.

OriginalsprogEngelsk
TidsskriftEuropean Journal of Anaesthesiology
Vol/bind39
Udgave nummer1
Sider (fra-til)4-25
Antal sider22
ISSN0265-0215
DOI
StatusUdgivet - 1 jan. 2022

Bibliografisk note

Copyright © 2021 European Society of Anaesthesiology and Intensive Care. Unauthorized reproduction of this article is prohibited.

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