ArticleJournal of anesthesia, analgesia and critical care2024
Preoperative clear fluids fasting times in children: retrospective analysis of actual times and complications after the implementation of 1-h clear fasting.
Article in Journal of anesthesia, analgesia and critical care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.
- The current state and implications of pre-operative fasting time in children: a systematic review and meta-analysis.Pediatric surgery international · 2025Pooled it
- Implementation of the 'Countdown to Theatre' Approach to Bridge the Evidence-Practice Gap in Paediatric Preoperative Fasting: A Quality Improvement Initiative.Journal of advanced nursing · 2026Article
- Preoperative Clear Fluid Fasting Duration and Arterial Hypotension During Anesthesia Induction: A Narrative Review.Journal of clinical medicine · 2025Review
- Impact of liberal preoperative clear fluid fasting regimens on the risk of pulmonary aspiration in children (EUROFAST): an international prospective cohort study.British journal of anaesthesia · 2025Article
- Preoperative fasting in noncardiac surgery in a tertiary pediatric center applying European guidelines: the difficulty of giving drink to the thirsty.Journal of anesthesia, analgesia and critical care · 2025Article
- Actual Preoperative Fasting Duration and its Impact on Hunger, Thirst, Blood Glucose, and Parental Satisfaction in Pediatric Patients: A Prospective Observational Study.Journal of Indian Association of Pediatric SurgeonsArticle
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPreoperative fasting before elective pediatric surgery is a matter of ongoing debate. The objectives of this study were to evaluate the compliance to a recently implemented preoperative fasting protocol (clear fluids until 1 hour from the induction of anesthesia), to identify predictors of prolonged preoperative fasting time, and to determine whether duration of preoperative fasting was associated with adverse outcomes.
methodsRetrospective single-center study in an operating theater of a tertiary pediatric hospital.
resultsIn a 6-month period, 1820 consecutive patients were analyzed. The data collected in the questionnaire reporting the time of last food, milk and/or liquid intake, and eventual reasons for nonadherence was analyzed. Median (interquartile range) preoperative fasting time was 186 (110-345) min. In 502 patients (27.6%), duration of preoperative fasting to clear fluid ranged from 60 to 119 min, whereas in 616 (34%) it was 120-240 min. The reasons for not respecting fasting time rules are mostly related to communication issues or unwillingness by the patients. A significant difference in fasting times was evident between infants and children older than 10 years (188, 105-290 vs. 198, 115-362; p = 0.02). Fasting times were significantly shorter in the inpatient group and in the first scheduled patients of the morning. Clear fluids fasting times were significantly longer in patients with hypovolemia complications than in those without, 373 (185-685) vs. 180 (110-330) min (p < 0.0001). Longer fasting times to clear fluids, younger age, and scheduled surgery time were independently associated with the odds of experiencing complications.
conclusionsIn this single pediatric center study, median clear fluids fasting time was three times higher (180 min) than those recommended by the preoperative fasting protocol. Compliance to the protocol was observed in approximately 1 out of 4 patients (27.6%). Longer fasting times were associated with an increased risk of complications, which might be due to dehydration and/or hypovolemia.
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