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Surgical fasting guidelines in children: Are we putting them into practice?
Kim Brunet-Wood1, Mariska Simons2, Amanda Evasiuk2
1Nutrition Services, Alberta Health Services.
Journal of Pediatric Surgery
|May 12, 2016
Summary
Pediatric patients often experience prolonged fasting before and after surgery, exceeding recommended guidelines. This study highlights the need to reassess current NPO (nothing by mouth) practices in children to prevent under-nutrition.
Area of Science:
- Pediatric Surgery
- Anesthesiology
- Clinical Nutrition
Background:
- Traditional surgical protocols mandate prolonged fasting (nothing by mouth - NPO) to prevent aspiration and postoperative ileus.
- Extended NPO periods in pediatric patients pose a significant risk of under-nutrition.
- Established guidelines for preoperative fasting have demonstrated safety.
Purpose of the Study:
- To evaluate current preoperative and postoperative feeding practices for children undergoing surgery.
- To compare these practices against established clinical guidelines.
Main Methods:
- Prospective data extraction from medical charts of 53 pediatric patients.
- Recording of NPO durations and physician diet orders post-surgery.
- Classification of surgical procedures as complex or noncomplex.
Main Results:
- 70% of patients experienced preoperative NPO times exceeding recommendations.
- Median preoperative fasting duration was similar for complex and noncomplex procedures.
- Postoperative NPO duration was significantly longer for complex procedures, with many patients receiving NPO orders not explicitly documented.
Conclusions:
- Preoperative fasting durations in the studied pediatric population frequently surpassed current evidence-based recommendations.
- Postoperative feeding practices warrant closer examination, particularly for complex surgical cases.
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