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Sedation for pediatric echocardiography: evaluation of preprocedure fasting guidelines
Sadia Ghaffar1, Cherie Haverland, Claudio Ramaciotti
1Department of Pediatrics, University of Texas, Southwestern Medical Center at Dallas, 5323 Harry Hines Boulevard, Dallas, TX 75390-9018, USA.
Insights
Longer fasting times before sedated echocardiograms are less effective for children under 6 months and do not improve safety. Optimal fasting protocols are needed for pediatric procedural sedation.
Area of Science:
- Pediatric Cardiology
- Anesthesiology
- Patient Safety
Background:
- Increasing preprocedure fasting times is a trend to enhance safety during sedated procedures.
- Optimal fasting durations for sedated echocardiograms are not well-established.
- Fasting guidelines vary, impacting pediatric patient care and procedural outcomes.
Purpose of the Study:
- To evaluate the efficacy and safety of different preprocedure fasting times for sedated echocardiograms in pediatric patients.
- To determine if extended fasting periods improve outcomes or increase risks in this population.
- To identify optimal fasting durations, particularly for infants.
Main Methods:
- Retrospective analysis of 334 pediatric patients undergoing sedated echocardiograms.
- Patients were divided into two groups: Group 1 (fasting < 2 hours) and Group 2 (fasting > 2 hours).
- Comparison of procedural efficacy and complication rates between the two fasting groups.
Main Results:
- No significant difference in overall efficacy between fasting groups (P = .08).
- Significantly decreased efficacy in Group 2 (fasting > 2 hours) for patients younger than 6 months (P = .03).
- No difference in major or minor complication rates between the groups.
Conclusions:
- Extended fasting times (> 2 hours) are less efficacious in children under 6 months undergoing sedated echocardiograms.
- Longer fasting periods do not enhance the safety of sedated echocardiograms in pediatric patients.
- Current fasting practices may need adjustment for younger infants to optimize procedural success.
Abstract:
In an effort to increase the safety of sedated procedures, there is a recent trend to increase preprocedure fasting times. However, optimal fasting times have never been established for a sedated echocardiogram. We retrospectively analyzed 334 patients divided into 2 groups. Group 1 (140 patients) had fasting times less than 2 hours, whereas group 2 (184 patients) had fasting times more than 2 hours. When the entire population was considered, there was no difference in efficacy between the 2 groups (P =.08). However, in patients younger than 6 months, group 2 had decreased efficacy compared with group 1 (P =.03). There were no major complications in either group. There was no difference in the rate of minor complications between the 2 groups. Our study concludes that longer fasting times are less efficacious in children younger than 6 months, and do not improve safety.