Preoperative fasting in children: review of existing guidelines and recent developments
This paper provides a concise review of current literature on preoperative fasting in children, including the physiological rationale.
The key points presented are:
- Pulmonary aspiration in adults is rare, but can be associated with devastating consequences
- Pulmonary aspiration in children is rare, morbidity or mortality have NOT been reported
- Rate of gastric emptying in children is quick, although highly variable
- Current fasting recommendations are most commonly 6-4-2
- Children are often fasted for longer than instructed
- Prolonged fasting has negative metabolic consequences
The author concludes that the evidence supports a reduction in paediatric fasting times for clear fluids prior to elective surgery in paediatric hospitals. To what degree remains controversial.
Reviewed by: Bae Corlette