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Assessment of Preoperative Fasting Duration in Pediatric Patients at a Tertiary Care Hospital
Mayra Elvira Saucedo-Toledo1, Miroslava Iliana Carrasco-González1, Margarita Torres-García1
1Nursing Research Unit, Hospital Infantil de México Federico Gómez, Mexico City, Mexico.
Insights
Prolonged preoperative fasting in pediatric patients can lead to complications. This study found that actual fasting durations varied, with longer fasting times associated with negative outcomes and longer hospital stays.
Area of Science:
- Pediatric Anesthesiology
- Surgical Patient Care
- Clinical Research
Background:
- Preoperative fasting is standard practice to prevent aspiration.
- Prolonged fasting poses risks, especially in children.
- Optimizing fasting protocols is crucial for pediatric surgical outcomes.
Purpose of the Study:
- To determine actual preoperative fasting durations in a pediatric hospital.
- To identify factors associated with varying fasting times in pediatric surgical patients.
Main Methods:
- Cross-sectional study of 153 pediatric patients undergoing elective surgery.
- Analysis of clinical records to calculate actual preoperative fasting time.
- Statistical comparison of patient groups based on median fasting duration.
Main Results:
- Median actual preoperative fasting time was 440 minutes.
- Longer fasting times correlated with increased surgery length, delayed refeeding, and extended hospital stays.
- Significant differences observed in ASA score and hospitalization units between fasting groups.
Conclusions:
- Prolonged preoperative fasting in pediatric patients has detrimental effects.
- Interventions are needed to reduce fasting durations and associated complications.
- Targeted strategies are essential for complex pediatric surgical cases.
Purpose:
Preoperative fasting is a widely practiced method to prevent pulmonary aspiration events, but prolonged fasting can be as harmful as insufficient fasting, particularly in pediatric settings. The aim of this study was to identify the actual duration of preoperative fasting in a tertiary pediatric hospital and the associated factors.
Design:
A cross-sectional study was conducted, reviewing the clinical records of 153 pediatric patients undergoing elective surgery between May and June 2023.
Methods:
The actual preoperative fasting time was calculated and the sample was divided into two equivalent groups: participants below the median fasting time and those above the median fasting time. Sociodemographic and health information from the preoperative period until discharge was recorded. Statistical tests, including Pearson's χ2 and Mann-Whitney U, were performed for comparison.
Findings:
The study included a sample of participants comprising 46.4% females and 53.6% males, with a median age of 8.2 years. The median actual preoperative fasting time was 440 minutes, and significant differences were identified between participants below and above the median fasting time in several factors, including length of surgery, postoperative reingestion time, length of hospital stay, hospitalization unit, American Society of Anesthesiologists' score, and postoperative destination unit (all P < .05).
Conclusions:
These findings underscore the detrimental effects of prolonged fasting, and highlight the necessity for targeted interventions aimed at reducing fasting durations and associated complications, particularly within pediatric populations facing complex medical scenarios.
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