Pre-operative fasting in children
Peter FrykholmFrom the Department of Surgical Sciences, Section of Anaesthesiology and Intensive Care Medicine, Uppsala University, Uppsala, Sweden (PF, HA, AK), the Unit for Research & Innovation, Department of Paediatric Anaesthesia, Istituto Giannina Gaslini, Genova, Italy (ND), the Clinic of Anesthesiology and Intensive Care Medicine, Hannover Medical School, Hannover, Germany (CB, RS), the Department of Anaesthesiology and Intensive Care, Hospices Civils de Lyon, Femme Mère Enfant Hospital, Lyon, France (LB, EC, MDQS), the Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA (EE, RI, PAS), the Department of Anesthesia, University Children's Hospital, Zurich, Switzerland (JH, FK, ASc), the Children's Hospital of Eastern Ontario, University of Ottawa (DRo), the University of Ottawa, Ottawa, Ontario, Canada (DRo), the Department of Anesthesia, Pediatric Intensive Care and Emergency Medicine, Auf der Bult ChildrenNicola Dismathe Department of Surgical Sciences, Section of Anaesthesiology and Intensive Care Medicine, Uppsala University, Uppsala, Sweden (PF, HA, AK), the Unit for Research & Innovation, Department of Paediatric Anaesthesia, Istituto Giannina Gaslini, Genova, Italy (ND), the Clinic of Anesthesiology and Intensive Care Medicine, Hannover Medical School, Hannover, Germany (CB, RS), the Department of Anaesthesiology and Intensive Care, Hospices Civils de Lyon, Femme Mère Enfant Hospital, Lyon, France (LB, EC, MDQS), the Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA (EE, RI, PAS), the Department of Anesthesia, University Children's Hospital, Zurich, Switzerland (JH, FK, ASc), the Children's Hospital of Eastern Ontario, University of Ottawa (DRo), the University of Ottawa, Ottawa, Ontario, Canada (DRo), the Department of Anesthesia, Pediatric Intensive Care and Emergency Medicine, Auf der Bult Children's Hospital, Hannover, Germany (DRu), Stanford University - School of Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Palo Alto, California, USA (ARS), the Sackler Faculty of Medicine, Tel Aviv University, Israel - Division of Anesthesia, Pain and Intensive Care, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel (DS), Great Ormond St. Hospital, London, United Kingdom (MT), the Clinique d'Anesthésie Pédiatrique, Hôpital Jeanne de Flandre, CHRU de Lille, France (FV), the Department of Paediatric and Obstetric Anaesthesia, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark (AA)Hanna AnderssonSupplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (www.ejanaesthesiology.com)Christiane E. Beckthe Department of Surgical Sciences, Section of Anaesthesiology and Intensive Care Medicine, Uppsala University, Uppsala, Sweden (PF, HA, AK), the Unit for Research & Innovation, Department of Paediatric Anaesthesia, Istituto Giannina Gaslini, Genova, Italy (ND), the Clinic of Anesthesiology and Intensive Care Medicine, Hannover Medical School, Hannover, Germany (CB, RS), the Department of Anaesthesiology and Intensive Care, Hospices Civils de Lyon, Femme Mère Enfant Hospital, Lyon, France (LB, EC, MDQS), the Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA (EE, RI, PAS), the Department of Anesthesia, University Children's Hospital, Zurich, Switzerland (JH, FK, ASc), the Children's Hospital of Eastern Ontario, University of Ottawa (DRo), the University of Ottawa, Ottawa, Ontario, Canada (DRo), the Department of Anesthesia, Pediatric Intensive Care and Emergency Medicine, Auf der Bult Children's Hospital, Hannover, Germany (DRu), Stanford University - School of Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Palo Alto, California, USA (ARS), the Sackler Faculty of Medicine, Tel Aviv University, Israel - Division of Anesthesia, Pain and Intensive Care, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel (DS), Great Ormond St. Hospital, London, United Kingdom (MT), the Clinique d'Anesthésie Pédiatrique, Hôpital Jeanne de Flandre, CHRU de Lille, France (FV), the Department of Paediatric and Obstetric Anaesthesia, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark (AA)Lionel BouvetSupplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (www.ejanaesthesiology.com)Éloïse Cercueilthe Department of Surgical Sciences, Section of Anaesthesiology and Intensive Care Medicine, Uppsala University, Uppsala, Sweden (PF, HA, AK), the Unit for Research & Innovation, Department of Paediatric Anaesthesia, Istituto Giannina Gaslini, Genova, Italy (ND), the Clinic of Anesthesiology and Intensive Care Medicine, Hannover Medical School, Hannover, Germany (CB, RS), the Department of Anaesthesiology and Intensive Care, Hospices Civils de Lyon, Femme Mère Enfant Hospital, Lyon, France (LB, EC, MDQS), the Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA (EE, RI, PAS), the Department of Anesthesia, University Children's Hospital, Zurich, Switzerland (JH, FK, ASc), the Children's Hospital of Eastern Ontario, University of Ottawa (DRo), the University of Ottawa, Ottawa, Ontario, Canada (DRo), the Department of Anesthesia, Pediatric Intensive Care and Emergency Medicine, Auf der Bult Children's Hospital, Hannover, Germany (DRu), Stanford University - School of Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Palo Alto, California, USA (ARS), the Sackler Faculty of Medicine, Tel Aviv University, Israel - Division of Anesthesia, Pain and Intensive Care, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel (DS), Great Ormond St. Hospital, London, United Kingdom (MT), the Clinique d'Anesthésie Pédiatrique, Hôpital Jeanne de Flandre, CHRU de Lille, France (FV), the Department of Paediatric and Obstetric Anaesthesia, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark (AA)Elizabeth ElliottSupplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (www.ejanaesthesiology.com)Jan HofmannSupplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (www.ejanaesthesiology.com)Rebecca S. Issermanthe Department of Surgical Sciences, Section of Anaesthesiology and Intensive Care Medicine, Uppsala University, Uppsala, Sweden (PF, HA, AK), the Unit for Research & Innovation, Department of Paediatric Anaesthesia, Istituto Giannina Gaslini, Genova, Italy (ND), the Clinic of Anesthesiology and Intensive Care Medicine, Hannover Medical School, Hannover, Germany (CB, RS), the Department of Anaesthesiology and Intensive Care, Hospices Civils de Lyon, Femme Mère Enfant Hospital, Lyon, France (LB, EC, MDQS), the Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA (EE, RI, PAS), the Department of Anesthesia, University Children's Hospital, Zurich, Switzerland (JH, FK, ASc), the Children's Hospital of Eastern Ontario, University of Ottawa (DRo), the University of Ottawa, Ottawa, Ontario, Canada (DRo), the Department of Anesthesia, Pediatric Intensive Care and Emergency Medicine, Auf der Bult Children's Hospital, Hannover, Germany (DRu), Stanford University - School of Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Palo Alto, California, USA (ARS), the Sackler Faculty of Medicine, Tel Aviv University, Israel - Division of Anesthesia, Pain and Intensive Care, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel (DS), Great Ormond St. Hospital, London, United Kingdom (MT), the Clinique d'Anesthésie Pédiatrique, Hôpital Jeanne de Flandre, CHRU de Lille, France (FV), the Department of Paediatric and Obstetric Anaesthesia, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark (AA)Anna KlaucaneSupplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (www.ejanaesthesiology.com)Fabian KuhnSupplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (www.ejanaesthesiology.com)Mathilde De Queiroz SiqueiraSupplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (www.ejanaesthesiology.com)David W. Rosenthe Department of Surgical Sciences, Section of Anaesthesiology and Intensive Care Medicine, Uppsala University, Uppsala, Sweden (PF, HA, AK), the Unit for Research & Innovation, Department of Paediatric Anaesthesia, Istituto Giannina Gaslini, Genova, Italy (ND), the Clinic of Anesthesiology and Intensive Care Medicine, Hannover Medical School, Hannover, Germany (CB, RS), the Department of Anaesthesiology and Intensive Care, Hospices Civils de Lyon, Femme Mère Enfant Hospital, Lyon, France (LB, EC, MDQS), the Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA (EE, RI, PAS), the Department of Anesthesia, University Children's Hospital, Zurich, Switzerland (JH, FK, ASc), the Children's Hospital of Eastern Ontario, University of Ottawa (DRo), the University of Ottawa, Ottawa, Ontario, Canada (DRo), the Department of Anesthesia, Pediatric Intensive Care and Emergency Medicine, Auf der Bult Children's Hospital, Hannover, Germany (DRu), Stanford University - School of Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Palo Alto, California, USA (ARS), the Sackler Faculty of Medicine, Tel Aviv University, Israel - Division of Anesthesia, Pain and Intensive Care, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel (DS), Great Ormond St. Hospital, London, United Kingdom (MT), the Clinique d'Anesthésie Pédiatrique, Hôpital Jeanne de Flandre, CHRU de Lille, France (FV), the Department of Paediatric and Obstetric Anaesthesia, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark (AA)Diana RudolphSupplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (www.ejanaesthesiology.com)Alexander R. SchmidtSupplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (www.ejanaesthesiology.com)A. SchmitzSupplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (www.ejanaesthesiology.com)Daniel StockiSupplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (www.ejanaesthesiology.com)Robert Sümpelmannthe Department of Surgical Sciences, Section of Anaesthesiology and Intensive Care Medicine, Uppsala University, Uppsala, Sweden (PF, HA, AK), the Unit for Research & Innovation, Department of Paediatric Anaesthesia, Istituto Giannina Gaslini, Genova, Italy (ND), the Clinic of Anesthesiology and Intensive Care Medicine, Hannover Medical School, Hannover, Germany (CB, RS), the Department of Anaesthesiology and Intensive Care, Hospices Civils de Lyon, Femme Mère Enfant Hospital, Lyon, France (LB, EC, MDQS), the Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA (EE, RI, PAS), the Department of Anesthesia, University Children's Hospital, Zurich, Switzerland (JH, FK, ASc), the Children's Hospital of Eastern Ontario, University of Ottawa (DRo), the University of Ottawa, Ottawa, Ontario, Canada (DRo), the Department of Anesthesia, Pediatric Intensive Care and Emergency Medicine, Auf der Bult Children's Hospital, Hannover, Germany (DRu), Stanford University - School of Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Palo Alto, California, USA (ARS), the Sackler Faculty of Medicine, Tel Aviv University, Israel - Division of Anesthesia, Pain and Intensive Care, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel (DS), Great Ormond St. Hospital, London, United Kingdom (MT), the Clinique d'Anesthésie Pédiatrique, Hôpital Jeanne de Flandre, CHRU de Lille, France (FV), the Department of Paediatric and Obstetric Anaesthesia, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark (AA)Paul A. StrickerSupplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (www.ejanaesthesiology.com)Mark ThomasSupplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (www.ejanaesthesiology.com)Francis VeyckemansSupplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (www.ejanaesthesiology.com)Arash Afsharithe Department of Surgical Sciences, Section of Anaesthesiology and Intensive Care Medicine, Uppsala University, Uppsala, Sweden (PF, HA, AK), the Unit for Research & Innovation, Department of Paediatric Anaesthesia, Istituto Giannina Gaslini, Genova, Italy (ND), the Clinic of Anesthesiology and Intensive Care Medicine, Hannover Medical School, Hannover, Germany (CB, RS), the Department of Anaesthesiology and Intensive Care, Hospices Civils de Lyon, Femme Mère Enfant Hospital, Lyon, France (LB, EC, MDQS), the Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA (EE, RI, PAS), the Department of Anesthesia, University Children's Hospital, Zurich, Switzerland (JH, FK, ASc), the Children's Hospital of Eastern Ontario, University of Ottawa (DRo), the University of Ottawa, Ottawa, Ontario, Canada (DRo), the Department of Anesthesia, Pediatric Intensive Care and Emergency Medicine, Auf der Bult Children's Hospital, Hannover, Germany (DRu), Stanford University - School of Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Palo Alto, California, USA (ARS), the Sackler Faculty of Medicine, Tel Aviv University, Israel - Division of Anesthesia, Pain and Intensive Care, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel (DS), Great Ormond St. Hospital, London, United Kingdom (MT), the Clinique d'Anesthésie Pédiatrique, Hôpital Jeanne de Flandre, CHRU de Lille, France (FV), the Department of Paediatric and Obstetric Anaesthesia, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark (AA)
2021en
ABI
Аннотация
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.
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