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

Title: Pre-operative fasting in children ; A guideline from the European Society of Anaesthesiology and Intensive Care
Authors: Frykholm, Peter; Disma, Nicola; Andersson, Hanna; Beck, Christiane; Bouvet, Lionel; Cercueil, Eloise; Elliott, Elizabeth; Hofmann, Jan; Isserman, Rebecca; Klaucane, Anna; Kuhn, Fabian; de Queiroz Siqueira, Mathilde; Rosen, David; Rudolph, Diana; Schmidt, Alexander R.; Schmitz, Achim; Stocki, Daniel; Sümpelmann, Robert; Stricker, Paul A.; Thomas, Mark; Veyckemans, Francis; Afshari, Arash
Source: European Journal of Anaesthesiology ; volume 39, issue 1, page 4-25 ; ISSN 0265-0215 1365-2346
Publisher Information: Ovid Technologies (Wolters Kluwer Health)
Publication Year: 2022
Description: 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.
Document Type: article in journal/newspaper
Language: English
DOI: 10.1097/eja.0000000000001599
DOI: 10.1097/EJA.0000000000001599
Availability: https://doi.org/10.1097/eja.0000000000001599; https://journals.lww.com/10.1097/EJA.0000000000001599
Accession Number: edsbas.80FDA95F
Database: BASE