Preoperative fasting in children: review of existing guidelines and recent developments

This paper provides a concise review of current literature on preoperative fasting in children, including the physiological rationale.

The key points presented are:

  • Pulmonary aspiration in adults is rare, but can be associated with devastating consequences
  • Pulmonary aspiration in children is rare, morbidity or mortality have NOT been reported
  • Rate of gastric emptying in children is quick, although highly variable
  • Current fasting recommendations are most commonly 6-4-2
  • Children are often fasted for longer than instructed
  • Prolonged fasting has negative metabolic consequences

The author concludes that the evidence supports a reduction in paediatric fasting times for clear fluids prior to elective surgery in paediatric hospitals. To what degree remains controversial.

Reviewed by: Bae Corlette