Volume gástrico residual e risco de aspiração pulmonar em crianças com refluxo gastroesofágico: estudo comparativo

Cruvinel, Marcos Guilherme Cunha; Bittencourt, Paulo Fernando Souto; Costa, José Roberto de Rezende; Barbosa, Paulo Roberto

doi:10.1590/s0034-70942004000100005

Cited by 5 publications

(4 citation statements)

References 6 publications

(8 reference statements)

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“…For this reason, those patients were excluded from the abbreviation of preoperative fasting protocol. However, at least in children who ingested clear liquids two hours before surgery, residual gastric volume was not increased in patients with gastroesophageal reflux 13 . Recent studies indicate that the use of a carbohydrate-rich liquid solution increases patient satisfaction, decreases irritability and the incidence of vomiting, increases the pH, improves gastric emptying, and reduces the organic response to surgical stress [14][15][16] .…”

Section: Discussionmentioning

confidence: 89%

“…This was probably due to the time necessary for the combined anesthetic technique. Studies have demonstrated that prolonged fasting results in greater residual gastric volume with more acid pH, while ingestion of clear fluids up to two hours before the procedure decreases the residual volume and increases the pH [12][13][14] . Besides, prolonged preoperative fasting is not only uncomfortable and unnecessary, but it can also be harmful by potentiating or perpetuating the organic response to trauma 1,12 .…”

Section: Discussionmentioning

confidence: 99%

“…Currently, anesthesia societies recommend more liberal rules regarding preoperative fasting, allowing the ingestion of clear liquids up to two hours before surgery 10,12 . Among patients at risk for pulmonary aspiration of gastric contents, those with gastroesophageal reflux deserve additional care 13 . For this reason, those patients were excluded from the abbreviation of preoperative fasting protocol.…”

Section: Discussionmentioning

confidence: 99%

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A abreviação do jejum pré-operatório para duas horas com carboidratos aumenta o risco anestésico?

Oliveira¹,

Balsan²,

Oliveira³

et al. 2009

Rev. Bras. Anestesiol.

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BACKGROUND AND OBJECTIVES:The objective of the present study was to evaluate the incidence of possible anesthetic complications related with the abbreviation of preoperative fasting to two hours with a solution of 12.5% dextrinomaltose within the ACERTO (from the Portuguese for Acceleration of Total Postoperative Recovery) project. METHODS:All patients undergoing different types of digestive tract and abdominal wall surgeries within a new protocol of perioperative conducts, established by the ACERTO project, between August 2005 and December 2007 were evaluated. All patients received oral nutritional supplementation (12.5% dextrinomaltose) six and two hours before the procedure. Data were collected prospectively without the knowledge of the professionals in the department. The length of preoperative fasting and anesthetic complications related with the short fasting time (pulmonary aspiration) were recorded. RESULTS:Three hundred and seventy five patients, 174 male (46.4%) and 201 female (53.6%), ages 18 to 90 years, were evaluated. The mean preoperative fasting time was four hours, ranging from two to 20 hours. Pulmonary aspiration was not observed during the procedures. The length of fasting was longer (p < 0.01) when combined anesthesia (blockade + general) was used. CONCLUSIONS:Adopting the multidisciplinary preoperative measures of the ACERTO project was not associated with any preoperative fasting-associated complications. Dextrinomaltose is a useful and safe nutritional supplement for the patient.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A abreviação do jejum pré-operatório para duas horas com carboidratos aumenta o risco anestésico?

Oliveira¹,

Balsan²,

Oliveira³

et al. 2009

Rev. Bras. Anestesiol.

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“…Evidence Summary: There were eight retrospective/observational studies, and one RCT (Table 13). 49–57 The studies were generally small, with a sample size range of 6 to 108. There was significant heterogeneity in the ages of the studied participants, and many studies recruited patients from a wide age range.…”

Section: Comorbidity Medications and Prematuritymentioning

confidence: 99%

Pre-operative fasting in children

Frykholm

Disma

Andersson

et al. 2022

European Journal of Anaesthesiology

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Current paediatric anaesthetic fasting guidelines have recommended conservative fasting regimes for many years and have not altered much in the last decades. Recent publications have employed more liberal fasting regimes with no evidence of increased aspiration or regurgitation rates. In this first solely paediatric European Society of Anaesthesiology and Intensive Care (ESAIC) pre-operative fasting guideline, we aim to present aggregated and evidence-based summary recommendations to assist clinicians, healthcare providers, patients and parents. We identified six main topics for the literature search: studies comparing liberal with conservative regimens; impact of food composition; impact of comorbidity; the use of gastric ultrasound as a clinical tool; validation of gastric ultrasound for gastric content and gastric emptying studies; and early postoperative feeding. The literature search was performed by a professional librarian in collaboration with the ESAIC task force. Recommendations for reducing clear fluid fasting to 1 h, reducing breast milk fasting to 3 h, and allowing early postoperative feeding were the main results, with GRADE 1C or 1B evidence. The available evidence suggests that gastric ultrasound may be useful for clinical decision-making, and that allowing a ‘light breakfast’ may be well tolerated if the intake is well controlled. More research is needed in these areas as well as evaluation of how specific patient or treatment-related factors influence gastric emptying.

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Perioperative Care of Children with Cerebral Palsy and Behavioral Problems

Jöhr

Berger²

2016

Anesthesia, Intensive Care and Pain in Neonates and Children

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Volume gástrico residual e risco de aspiração pulmonar em crianças com refluxo gastroesofágico: estudo comparativo

Abstract: Children with gastroesophageal reflux were not at increased risk for pulmonary aspiration, as compared to children without reflux. Therefore, its prophylaxis would not be necessary.

Cited by 5 publications

References 6 publications

A abreviação do jejum pré-operatório para duas horas com carboidratos aumenta o risco anestésico?

A abreviação do jejum pré-operatório para duas horas com carboidratos aumenta o risco anestésico?

Pre-operative fasting in children

Perioperative Care of Children with Cerebral Palsy and Behavioral Problems

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