Interventions to optimise preoperative fasting in paediatrics: a scoping review

Area of Science:

• Anesthesiology
• Pediatric Surgery
• Healthcare Quality Improvement

Background:

• Preoperative fasting is standard for general anesthesia but often prolonged in pediatric patients.
• Current guidelines offer more leniency, yet children still experience extended fasting periods.
• Optimizing pediatric preoperative fasting is crucial for patient well-being.

Purpose of the Study:

• To review interventions aimed at optimizing pediatric preoperative fasting practices.
• To identify strategies applicable for clinical implementation in pediatric settings.

Main Methods:

• Systematic literature search across major databases (PubMed, CINAHL, Embase, Scopus, Cochrane).
• Keywords included: fasting, preoperative, pediatric, and quality improvement intervention.
• Scoping review methodology guided by PRISMA-S guidelines.

Main Results:

• Thirteen studies involving ~31,000 children globally were analyzed.
• Interventions focused on six key themes: protocol changes, technology, individualized programs, clinician communication, parent communication, and staff education.
• Diverse approaches were identified to address prolonged fasting.

Conclusions:

• Multiple interventions have been investigated to shorten pediatric preoperative fasting.
• These strategies demonstrate potential for reducing fasting duration in children.