Best Practice & Research Clinical Anaesthesiology
Volume 20, Issue 3 , Pages 471-481 , September 2006

Modern fasting guidelines in children

  • Scott D. Cook-Sather, MD (Associate Professor of Anesthesiology)

      Affiliations

    • Corresponding Author InformationCorresponding author. Tel.: +1 215 590 1447; Fax: +1 215 590 1415.
  • ,
  • Ronald S. Litman, DO (Associate Professor of Anesthesiology and Pediatrics)

References 

  1. Phillips S, Daborn AK, Hatch DJ. Preoperative fasting for paediatric anaesthesia. British Journal of Anaesthesia. 1994;73:529–536
  2. Splinter WM, Schreiner MS. Preoperative fasting in children. Anesthesia and Analgesia. 1999;89:80–89
  3. Olsson GL, Hallen B, Hambraeus-Jonzon K. Aspiration during anaesthesia: a computer-aided study of 185,358 anaesthetics. Acta Anaesthesiologica Scandinavica. 1986;30:84–92
  4. Borland LM, Sereika SM, Woelfel SK, et al. Pulmonary aspiration in pediatric patients during general anesthesia: incidence and outcome. Journal of Clinical Anesthesia. 1998;10:95–102
  5. Warner MA, Warner ME, Warner DO, et al. Perioperative pulmonary aspiration in infants and children. Anesthesiology. 1999;90:66–71
  6. Tiret L, Nivoche Y, Hatton F, et al. Complications related to anaesthesia in infants and children. A prospective survey of 40240 anaesthetics. British Journal of Anaesthesia. 1988;61:263–269
  7. Kluger MT, Short TG. Aspiration during anaesthesia: a review of 133 cases from the Australian Anaesthetic Incident Monitoring Study (AIMS). Anaesthesia. 1999;54:19–26
  8. Marik PE. Aspiration pneumonitis and aspiration pneumonia. The New England Journal of Medicine. 2001;344:665–671
  9. Moore FA. Treatment of aspiration in intensive care unit patients. JPEN. Journal of Parenteral and Enteral Nutrition. 2002;26:S69–S74
  10. Warner MA, Warner ME, Weber JG. Clinical significance of pulmonary aspiration during the perioperative period. Anesthesiology. 1993;78:56–62
  11. Harrison GG. Death attributable to anaesthesia. A 10-year survey (1967–1976). British Journal of Anaesthesia. 1978;50:1041–1046
  12. Castillo-Zamora C, Castillo-Peralta LA, Nava-Ocampo AA. Randomized trial comparing overnight preoperative fasting period Vs oral administration of apple juice at 06:00-06:30 am in pediatric orthopedic surgical patients. Paediatric Anaesthesia. 2005;15:638–642
  13. Friesen RH, Wurl JL, Friesen RM. Duration of preoperative fast correlates with arterial blood pressure response to halothane in infants. Anesthesia and Analgesia. 2002;95:1572–1576table
  14. Wodey E, Pladys P, Copin C, et al. Comparative hemodynamic depression of sevoflurane versus halothane in infants. Anesthesiology. 1997;87:795–800
  15. Thomas DK. Hypoglycaemia in children before operation: its incidence and prevention. British Journal of Anaesthesia. 1974;46:66–68
  16. Welborn LG, McGill WA, Hannallah RS, et al. Perioperative blood glucose concentrations in pediatric outpatients. Anesthesiology. 1986;65:543–547
  17. Bush GH, Steward DJ. Severe hypoglycaemia associated with preoperative fasting and intraoperative propranolol. A case report and discussion. Paediatric Anaesthesia. 1996;6:415–417
  18. Welborn LG, Norden JM, Seiden N, et al. Effect of minimizing preoperative fasting on perioperative blood glucose homeostasis in children. Paediatric Anaesthesia. 1993;3:167–171
  19. Nishina K, Mikawa K, Maekawa N, et al. Effects of exogenous intravenous glucose on plasma glucose and lipid homeostasis in anesthetized infants. Anesthesiology. 1995;83:258–263
  20. Maekawa N, Mikawa K, Yaku H, et al. Effects of 2-, 4-, and 12-hour fasting intervals on preoperative gastric fluid pH and volume, and plasma glucose and lipid homeostasis in children. Acta Anaesthesiologica Scandinavica. 1993;37:783–787
  21. Schreiner MS, Triebwasser A, Keon TP. Ingestion of liquids compared with preoperative fasting in pediatric outpatients. Anesthesiology. 1990;72:593–597
  22. Cook-Sather SD, Harris KA, Chiavacci R, et al. A liberalized fasting guideline for formula-fed infants does not increase average gastric fluid volume before elective surgery. Anesthesia and Analgesia. 2003;96:965–969
  23. Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: application to healthy patients undergoing elective procedures: a report by the American Society of Anesthesiologist Task Force on Preoperative Fasting. Anesthesiology. 1999;90:896–905
  24. Schreiner MS. Gastric fluid volume: is it really a risk factor for pulmonary aspiration?. Anesthesia and Analgesia. 1998;87:754–756
  25. Milross JG, Negus BH, Street NE, Gaskin KJ. Gastro-oesophageal reflux and adverse respiratory events in children under anaesthesia. Anaesthesia and Intensive Care. 1995;23:587–590
  26. Plourde G, Hardy J. Aspiration pneumonia: assessing the risk of regurgitation in the cat. Canadian Anaesthetists' Society Journal. 1986;33:345–348
  27. Nordgren B. The rate of secretion and electrolyte content of normal gastric juice. Acta Physiologica Scandinavica. 1963;58(supplement 202):1–83
  28. Moore JG, Christian PE, Coleman RE. Gastric emptying of varying meal weight and composition in man. Evaluation by dual liquid- and solid-phase isotopic method. Digestive Diseases and Sciences. 1981;26:16–22
  29. McClelland GR, Sutton JA. Epigastric impedance: a non-invasive method for the assessment of gastric emptying and motility. Gut. 1985;26:607–614
  30. Emerson BM, Wrigley SR, Newton M. Pre-operative fasting for paediatric anaesthesia. A survey of current practice. Anaesthesia. 1998;53:326–330
  31. Ferrari LR, Rooney FM, Rockoff MA. Preoperative fasting practices in pediatrics. Anesthesiology. 1999;90:978–980
  32. Splinter WM, Stewart JA, Muir JG. Large volumes of apple juice preoperatively do not affect gastric pH and volume in children. Canadian Journal of Anaesthesia. 1990;37:36–39
  33. Splinter WM, Schaefer JD. Unlimited clear fluid ingestion two hours before surgery in children does not affect volume or pH of stomach contents. Anaesthesia and Intensive Care. 1990;18:522–526
  34. Splinter WM, Schaefer JD, Zunder IH. Clear fluids three hours before surgery do not affect the gastric fluid contents of children. Canadian Journal of Anaesthesia. 1990;37:498–501
  35. Sandhar BK, Goresky GV, Maltby JR, Shaffer EA. Effect of oral liquids and ranitidine on gastric fulid volume and pH in children undergoing outpatient surgery. Anesthesiology. 1989;71:327–330
  36. Litman RS, Wu CL, Quinlivan JK. Gastric volume and pH in infants fed clear liquids and breast milk prior to surgery. Anesthesia and Analgesia. 1994;79:482–485
  37. Cook-Sather SD, Liacouras CA, Previte JP, et al. Gastric fluid measurement by blind aspiration in paediatric patients: a gastroscopic evaluation. Canadian Journal of Anaesthesia. 1997;44:168–172
  38. Cook-Sather S, Tulloch HV, Liacouras CA, Schreiner MS. Gastric fluid volume in infants for pyloromyotomy. Canadian Journal of Anaesthesia. 1997;44:278–283
  39. O'Hare B, Lerman J, Endo J, Cutz E. Acute lung injury after instillation of human breast milk or infant formula into rabbits' lungs. Anesthesiology. 1996;84:1386–1391
  40. Billeaud C, Guillet J, Sandler B. Gastric emptying in infants with or without gastro-oesophageal reflux according to the type of milk. European Journal of Clinical Nutrition. 1990;44:577–583
  41. Sethi AK, Chatterji C, Bhargava SK, et al. Safe pre-operative fasting times after milk or clear fluid in children. A preliminary study using real-time ultrasound. Anaesthesia. 1999;54:51–59
  42. McClure RJ, Newell SJ. Effect of fortifying breast milk on gastric emptying. Archives of Disease in Childhood. Fetal and Neonatal Edition. 1996;74:F60–F62
  43. Kawabata T, Tokumine J, Nakamura S, Sugahara K. Unanticipated vomiting and pulmonary aspiration at anesthesia induction in a formula-fed 4-month-old infant. Anesthesiology. 2004;100:1330–1331
  44. Cook-Sather SD, Nicolson SC, Schreiner MS, et al. Proponents of liberalized fasting guidelines. Anesthesiology. 2005;102:236–237
  45. Hanley JA, Lippman-Hand A. If nothing goes wrong, is everything all right? interpreting zero numerators. Journal of the American Medical Association. 1983;249:1743–1745
  46. Christensen S, Farrow-Gillespie A, Lerman J. Effects of ranitidine and metoclopramide on gastric fluid pH and volume in children. British Journal of Anaesthesia. 1990;65:456–460
  47. Chin C, Lerman J, Endo J. Acute lung injury after tracheal instillation of acidified soya-based or Enfalac formula or human breast milk in rabbits. Canadian Journal of Anaesthesia. 1999;46:282–286
  48. Meakin G, Dingwall AE, Addison GM. Effects of fasting and oral premedication on the pH and volume of gastric aspirate in children. British Journal of Anaesthesia. 1987;59:678–682
  49. Soreide E, Hausken T, Soreide JA, Steen PA. Gastric emptying of a light hospital breakfast. A study using real time ultrasonography. Acta Anaesthesiologica Scandinavica. 1996;40:549–553
  50. Fasting S, Soreide E, Raeder JC. Changing preoperative fasting policies. Impact of a national consensus. Acta Anaesthesiologica Scandinavica. 1998;42:1188–1191
  51. Soreide E, Holst-Larsen H, Veel T, Steen PA. The effects of chewing gum on gastric content prior to induction of general anesthesia. Anesthesia and Analgesia. 1995;80:985–989
  52. Dubin SA, Jense HG, McCranie JM, Zubar V. Sugarless gum chewing before surgery does not increase gastric fluid volume or acidity. Canadian Journal of Anaesthesia. 1994;41:603–606
  53. Nicolson SC, Dorsey AT, Schreiner MS. Shortened preanesthetic fasting interval in pediatric cardiac surgical patients. Anesthesia and Analgesia. 1992;74:694–697
  54. Olsson GL, Hallen B. Pharmacological evacuation of the stomach with metoclopramide. Acta Anaesthesiologica Scandinavica. 1982;26:417–420
  55. Schurizek BA, Rybro L, Boggild-Madsen NB, Juhl B. Gastric volume and pH in children for emergency surgery. Acta Anaesthesiologica Scandinavica. 1986;30:404–408
  56. Bricker SR, McLuckie A, Nightingale DA. Gastric aspirates after trauma in children. Anaesthesia. 1989;44:721–724
  57. Schwartz DA, Connelly NR, Theroux CA, et al. Gastric contents in children presenting for upper endoscopy. Anesthesia and Analgesia. 1998;87:757–760
  58. Crawford M, Lerman J, Christensen S, Farrow-Gillespie A. Effects of duration of fasting on gastric fluid pH and volume in healthy children. Anesthesia and Analgesia. 1990;71:400–403
  59. Miller BR, Tharp JA, Issacs WB. Gastric residual volume in infants and children following a 3-hour fast. Journal of Clinical Anesthesia. 1990;2:301–305
  60. Shoenfelder RC, Ponnamma CM, Freyle D, et al. Residual gastric fluid volume and chewing gum before surgery. Anesthesia and Analgesia. 2006;102:415–417

PII: S1521-6896(06)00020-6

doi: 10.1016/j.bpa.2006.02.003

Best Practice & Research Clinical Anaesthesiology
Volume 20, Issue 3 , Pages 471-481 , September 2006