Gastric emptying for liquids of different compositions in children

Area of Science:

• Gastroenterology
• Nutritional Science
• Clinical Medicine

Background:

• Pre-operative fasting is crucial for patient safety but can cause discomfort.
• Comparing gastric emptying of novel clear, high-protein drinks with traditional clear and non-clear fluids is important for optimizing fasting protocols.

Purpose of the Study:

• To compare the gastric emptying profiles of a novel clear, high-protein drink (Ensure Clear) against traditional clear (apple juice) and non-clear (2% milk) fluids.
• To evaluate the relevance of current pre-operative fasting guidelines based on liquid type.

Main Methods:

• A prospective cross-sectional study involving 48 healthy volunteers (8-14 years) with overnight fasting.
• Subjects were randomized to ingest 296ml of apple juice, 2% milk, or Ensure Clear.
• Gastric emptying was assessed using ultrasound measurements of gastric antral cross-sectional area every 30 minutes for up to 6 hours.

Main Results:

• Gastric emptying profiles differed significantly between the three drinks (P<0.0001), with faster emptying observed in males compared to females (P<0.01).
• However, the terminal phase of gastric emptying was similar across all three liquids.
• The stomach was essentially clear of all tested liquids by 3-3.5 hours post-ingestion.

Conclusions:

• Despite initial differences in gastric emptying rates, apple juice, 2% milk, and Ensure Clear demonstrate similar clearance from the stomach in the terminal phase.
• The findings suggest that current pre-operative fasting guidelines, which differentiate between liquid types, may not be fully supported by this study.
• The stomach is clear within 3-3.5 hours for all investigated beverages, indicating a potential window for updated fasting recommendations.