Related Experiment Video
Updated: May 10, 2025
A Clinical Trial Assessing the Safety, Efficacy, and Delivery of Olive-Oil-Based Three-Chamber Bags for Parenteral Nutrition
Published on: September 20, 2019
Optimizing pediatric preoperative fasting management: a survey of practices and real durations in Chinese hospitals
Bin Zhang1, Shoudong Pan2, Jijian Zheng3
1Department of Anesthesiology, Children's Hospital Affiliated to Shandong University & Jinan Children's Hospital, Jinan, 250012, China.
Insights
Pediatric preoperative fasting in China shows significant gaps between guidelines and practice, with actual fasting times exceeding recommendations. Anesthesiologists need improved understanding and gastric ultrasound skills to optimize patient safety.
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Patient Safety
Background:
- Rational preoperative fasting is crucial for reducing risks like regurgitation and aspiration during anesthesia in pediatric patients.
- Current practices in Chinese pediatric preoperative fasting management and actual fasting durations require investigation.
Purpose of the Study:
- To investigate current preoperative fasting practices for pediatric patients in China.
- To explore the real-world durations of preoperative fasting in this population.
Main Methods:
- A cross-sectional study utilizing online surveys distributed to anesthesiologists across China.
- Data collection included adherence to fasting protocols, anesthesiologists' knowledge, gastric ultrasound application, and actual preoperative fasting durations.
Main Results:
- Significant variations in hospital fasting protocols were observed, with traditional durations for milk and solids largely maintained.
- Actual preoperative fasting durations for children were substantially longer than guideline recommendations.
- Limited use of gastric ultrasound and varied anesthesiologist awareness regarding aspiration risks were noted.
Conclusions:
- A considerable discrepancy exists between established guidelines and actual clinical practices for pediatric preoperative fasting in China.
- Anesthesiologists require enhanced training in preoperative fasting management and gastric ultrasound techniques.
- Addressing inefficiencies in pediatric preoperative fasting is essential for improving patient outcomes.
Background:
Rational preoperative fasting can reduce the risk of regurgitation and aspiration, enhance anesthesia safety and efficiency, and mitigate the adverse effects of prolonged fasting. This study investigates the existing practices of preoperative fasting management in Chinese pediatric patients and explores the real duration of preoperative fasting.
Methods:
This is a cross-sectional study. A questionnaire on fasting management in children was developed and an online survey was conducted among anesthesiologists. The survey mainly included the real implementation of pediatric fasting protocols, anesthesiologists' understanding of pediatric fasting management, and the application of gastric ultrasound. Moreover, data on pediatric preoperative fasting durations were collected from different hospitals across China.
Results:
A total of 770 questionnaires and 1285 records of preoperative fasting cases were obtained. The survey indicated variations in preoperative fasting protocols among hospitals. Most hospitals recommended fasting for clear fluids for 2 h, while the new 1-h regimen and the liberal regimen were less implemented due to concerns regarding regurgitation and aspiration risks. Fasting for breast milk, formula milk, and solid food was mainly based on traditional protocols, with fasting durations of 4 h, 6 h, and 8 h, respectively. Most anesthesiologists have experienced regurgitation and aspiration, but there were significant differences in their awareness of the prevention and prognosis of regurgitation and aspiration. Utilization of gastric ultrasound was limited, with a lack of equipment and familiarity among anesthesiologists. Real preoperative fasting durations for children were significantly longer than those recommended in the guidelines. Factors contributing to prolonged fasting were identified.
Conclusions:
There is a big gap between preoperative fasting practices and the guidelines, and the real fasting durations of children before surgery are significantly longer than the guideline recommendations. Anesthesiologists should strengthen their understanding of preoperative fasting management in pediatric patients, master the skills of gastric ultrasound assessment, and timely address inefficiencies in pediatric preoperative fasting management.
Related Concept Videos
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
01:15Hypoglycemia and Glucagon
01:27Parentral Nutrition: Centeral and Peripheral Parental Nutrition
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...