Kim Brunet-Wood1, Mariska Simons2, Amanda Evasiuk3, Vera Mazurak4, Bryan Dicken5, Denise Ridley6, Bodil Larsen7. 1. Nutrition Services, Alberta Health Services. Electronic address: kim.brunetwood@albertahealthservices.ca. 2. Department of Agricultural, Life, and Environmental Sciences, University of Alberta. Electronic address: Mariska.simons@albertahealthservices.ca. 3. Department of Agricultural, Life, and Environmental Sciences, University of Alberta. Electronic address: Amanda.evasiuk@albertahealthservices.ca. 4. Department of Agricultural, Life, and Environmental Sciences, University of Alberta. Electronic address: vmazurak@ualberta.ca. 5. Department of Pediatrics, University of Alberta. Electronic address: bryan.dicken@albertahealthservices.ca. 6. Nutrition Services, Alberta Health Services. Electronic address: denise.ridley@albertahealthservices.ca. 7. Nutrition Services, Alberta Health Services; Department of Agricultural, Life, and Environmental Sciences, University of Alberta; Department of Pediatrics, University of Alberta. Electronic address: bodil.larsen@albertahealthservices.ca.
Abstract
BACKGROUND: Patients are traditionally kept fasting (NPO) from midnight prior to surgery, to prevent aspiration during anesthesia. NPO time is continued postoperatively, out of concern for ileus. Prolonged periods of NPO place the pediatric population at risk for under-nutrition. Published guidelines for preoperative NPO times have been shown to be safe. The aim of this study was to investigate current pre- and postoperative feeding practices of children at a pediatric tertiary care hospital. METHODS: Medical charts were used to extract data prospectively from 53 patients undergoing general, neurosurgical, or urological procedures. Date and time of NPO periods were recorded as well as the physician's postoperative diet orders and diet progression. Surgical procedures were classified as complex or noncomplex by the surgeons. Data were summarized and compared to published recommendations. RESULTS: Preoperative NPO times were greater than recommended in 70% of patients studied (n=37). Median time spent NPO preoperatively was not significantly different between complex (11.5h) and noncomplex groups (10.8h). Postoperative NPO time was significantly greater for complex procedures than for noncomplex. Most patients received some postoperative NPO time, even when it was not included in the physician diet order. CONCLUSION: Observed preoperative NPO time exceeded current recommendations in this study.
BACKGROUND:Patients are traditionally kept fasting (NPO) from midnight prior to surgery, to prevent aspiration during anesthesia. NPO time is continued postoperatively, out of concern for ileus. Prolonged periods of NPO place the pediatric population at risk for under-nutrition. Published guidelines for preoperative NPO times have been shown to be safe. The aim of this study was to investigate current pre- and postoperative feeding practices of children at a pediatric tertiary care hospital. METHODS: Medical charts were used to extract data prospectively from 53 patients undergoing general, neurosurgical, or urological procedures. Date and time of NPO periods were recorded as well as the physician's postoperative diet orders and diet progression. Surgical procedures were classified as complex or noncomplex by the surgeons. Data were summarized and compared to published recommendations. RESULTS: Preoperative NPO times were greater than recommended in 70% of patients studied (n=37). Median time spent NPO preoperatively was not significantly different between complex (11.5h) and noncomplex groups (10.8h). Postoperative NPO time was significantly greater for complex procedures than for noncomplex. Most patients received some postoperative NPO time, even when it was not included in the physician diet order. CONCLUSION: Observed preoperative NPO time exceeded current recommendations in this study.
Authors: Carlos Augusto Leite de Barros Carvalho; Augusto Aurélio de Carvalho; Paulo Luiz Batista Nogueira; José Eduardo de Aguilar-Nascimento Journal: Arq Bras Cir Dig Date: 2017 Jan-Mar