Nils Dennhardt1, Christiane Beck1, Dirk Huber1, Bjoern Sander1, Martin Boehne2, Dietmar Boethig3, Andreas Leffler1, Robert Sümpelmann1. 1. Clinic for Anesthesiology and Intensive Care Medicine, Hanover Medical School, Hanover, Germany. 2. Clinic for Pediatric Cardiology and Pediatric Intensive Care Medicine, Hanover Medical School, Hanover, Germany. 3. Clinic for Cardiac, Thoracic, Transplant and Vascular Surgery, Hanover Medical School, Hanover, Germany.
Abstract
BACKGROUND: In pediatric anesthesia, preoperative fasting guidelines are still often exceeded. OBJECTIVE: The objective of this noninterventional clinical observational cohort study was to evaluate the effect of an optimized preoperative fasting management (OPT) on glucose concentration, ketone bodies, acid-base balance, and change in mean arterial blood pressure (MAP) during induction of anesthesia in children. METHODS: Children aged 0-36 months scheduled for elective surgery with OPT (n = 50) were compared with peers studied before optimizing preoperative fasting time (OLD) (n = 50) who were matched for weight, age, and height. RESULTS: In children with OPT (n = 50), mean fasting time (6.0 ± 1.9 h vs 8.5 ± 3.5 h, P < 0.001), deviation from guideline (ΔGL) (1.2 ± 1.4 h vs 3.7 ± 3.1 h, P < 0.001, ΔGL>2 h 8% vs 70%), ketone bodies (0.2 ± 0.2 mmol·l(-1) vs 0.6 ± 0.6 mmol·l(-1) , P < 0.001), and incidence of hypotension (MAP <40 mmHg, 0 vs 5, P = 0.022) were statistically significantly lower and MAP after induction was statistically significantly higher (55.2 ± 9.5 mmHg vs 50.3 ± 9.8 mmHg, P = 0.015) as compared to children in the OLD (n = 50) group. Glucose, lactate, bicarbonate, base excess, and anion gap did not significantly differ. CONCLUSION: Optimized fasting times improve the metabolic and hemodynamic condition during induction of anesthesia in children younger than 36 months of age.
BACKGROUND: In pediatric anesthesia, preoperative fasting guidelines are still often exceeded. OBJECTIVE: The objective of this noninterventional clinical observational cohort study was to evaluate the effect of an optimized preoperative fasting management (OPT) on glucose concentration, ketone bodies, acid-base balance, and change in mean arterial blood pressure (MAP) during induction of anesthesia in children. METHODS:Children aged 0-36 months scheduled for elective surgery with OPT (n = 50) were compared with peers studied before optimizing preoperative fasting time (OLD) (n = 50) who were matched for weight, age, and height. RESULTS: In children with OPT (n = 50), mean fasting time (6.0 ± 1.9 h vs 8.5 ± 3.5 h, P < 0.001), deviation from guideline (ΔGL) (1.2 ± 1.4 h vs 3.7 ± 3.1 h, P < 0.001, ΔGL>2 h 8% vs 70%), ketone bodies (0.2 ± 0.2 mmol·l(-1) vs 0.6 ± 0.6 mmol·l(-1) , P < 0.001), and incidence of hypotension (MAP <40 mmHg, 0 vs 5, P = 0.022) were statistically significantly lower and MAP after induction was statistically significantly higher (55.2 ± 9.5 mmHg vs 50.3 ± 9.8 mmHg, P = 0.015) as compared to children in the OLD (n = 50) group. Glucose, lactate, bicarbonate, base excess, and anion gap did not significantly differ. CONCLUSION: Optimized fasting times improve the metabolic and hemodynamic condition during induction of anesthesia in children younger than 36 months of age.
Authors: Alison R Carroll; Allison B McCoy; Katharina Modes; Marni Krehnbrink; Lauren S Starnes; Patricia A Frost; David P Johnson Journal: J Hosp Med Date: 2022-02-14 Impact factor: 2.899
Authors: A S Szostek; P Boucher; F Subtil; O Zerzaihi; C Saunier; M de Queiroz Siqueira; F Merquiol; P Martin; M Granier; A Gerst; A Lambert; T Storme; D Chassard; P Nony; B Kassai; S Gaillard Journal: Trials Date: 2021-03-12 Impact factor: 2.279
Authors: Wietze Pasma; Linda M Peelen; Stefanie van den Broek; Stef van Buuren; Wilton A van Klei; Jurgen C de Graaff Journal: Acta Anaesthesiol Scand Date: 2019-12-22 Impact factor: 2.105
Authors: Ji Young Ha; Young Hun Choi; Yeon Jin Cho; Seunghyun Lee; Seul Bi Lee; Gayoung Choi; Jung Eun Cheon; Woo Sun Kim Journal: Korean J Radiol Date: 2020-08-04 Impact factor: 3.500