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Influence of Shortened Fasting Time on Perioperative Outcomes in Pediatric Patients: A Systematic Review
Amanda Michelly Braga da Mata1, Ane Gabriele do Carmo Tomaz1, Gabriella Cristina Andrade da Cunha1
1Instituto da Criança e do Adolescente do Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Enéas Carvalho de Aguiar, 647, Cerqueira César, São Paulo, 05403-000, Brazil.
Insights
Shortening preoperative fasting with carbohydrate drinks in children and adolescents is safe and improves outcomes. This practice leads to better blood glucose levels and fewer adverse effects like hypoglycemia and nausea.
Area of Science:
- Pediatric Anesthesiology
- Perioperative Medicine
- Evidence-Based Practice
Background:
- Prolonged preoperative fasting in children can lead to hypoglycemia, dehydration, hypotension, and irritability.
- Multimodal protocols like ERAS and ACERTO recommend reduced fasting times.
- This study evaluates the impact of shortened preoperative fasting on pediatric perioperative outcomes.
Approach:
- Systematic review of original studies published between January 2017 and November 2022.
- Inclusion of studies on patients aged 0-17 years using validated shortened preoperative fasting protocols.
- Literature search conducted across LILACS, PubMed, and Science Direct databases.
Key Points:
- Shortened preoperative fasting is safe for pediatric patients.
- Benefits include higher preoperative blood glucose levels.
- Reduced incidence of preoperative hypoglycemia, nausea, and crying were observed.
Conclusions:
- Administering high-carbohydrate drinks 1-2 hours before surgery is safe for children and adolescents.
- Shortened fasting is associated with improved metabolic and emotional responses during the perioperative period.
Background:
Prolonged preoperative fasting can cause hypoglycemia, dehydration, hypotension, and irritability, especially in children. Multimodal protocols such as the Enhanced Recovery After Operation (ERAS) and the Accelerated Full Postoperative Recovery (ACERTO, Aceleração da Recuperação Total Pós-Operatória) recommend a shortened fasting period. The aim of this study is to evaluate the association between shortened preoperative fasting and perioperative outcomes in pediatric patients.
Methods:
This study is a systematic review of the literature. The inclusion criteria were original studies published between January 2017-November 2022 that used shortened preoperative fasting protocols validated in patients aged 0-17 years and that evaluated the association of this practice with perioperative outcomes. The studies were obtained from the Latin American and Caribbean Literature on Health Sciences (LILACS), National Library of Medicine and National Institutes of Health (PubMed) and Science Direct databases.
Results:
A total of 6064 articles were obtained, of which eight were considered eligible. The results showed that shortened preoperative fast is safe in children and adolescents. The main benefits of this practice were higher preoperative blood glucose, no episodes of preoperative hypoglycemia, lower incidence of nausea, and minor complaints of crying.
Conclusions:
Shortening the fasting time with high-carbohydrate drinks between one and 2 h before operation is safe in children and adolescents, being associated with better metabolic and emotional responses in the perioperative period.
Levels Of Evidence:
Level II.
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