A comparative study using gastric ultrasound to evaluate the safety of shortening the fasting time before pediatric echocardiography: a randomized controlled non-inferiority study.

Publisher: Springer International for the Japan Society of Anesthesiology Country of Publication: Japan NLM ID: 8905667 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1438-8359 (Electronic) Linking ISSN: 09138668 NLM ISO Abbreviation: J Anesth Subsets: MEDLINE

Publication: Tokyo : Springer International for the Japan Society of Anesthesiology
Original Publication: [Tokyo] : Japan Society of Anesthesiology, [1987-

Fasting* ; Echocardiography*/methods ; Stomach*/diagnostic imaging ; Ultrasonography*/methods; Humans ; Female ; Male ; Infant ; Child, Preschool ; Time Factors ; Pneumonia, Aspiration/prevention & control

Purpose: The objective of this study was to demonstrate that the gastric cross-sectional area (CSA) in the right lateral decubitus position (RLDP) during a 2-h fasting period is not larger than that during a conventional 4-h fasting period prior to pediatric echocardiography.
Methods: 93 patients aged under 3 years scheduled for echocardiography under sedation were enrolled and randomly allocated into two groups; 2-h fasting vs 4-h fasting. For group 4 h (n = 46), the patients were asked to be fasted for all types of liquid for more than 4 h, while group 2 h (n = 47) were asked to be fasted for all types of liquid for 2 h before echocardiography. Gastric ultrasound was performed before echocardiography, and CSA RLDP was measured. We compared CSA RLDP, incidence of at-risk stomach, fasting duration, and the incidence of major (pulmonary aspiration, aspiration pneumonia) and minor complications (nausea, retching, and vomiting, apnea, and bradycardia) between two groups.
Results: The mean difference of CSA RLDP (group 2 h-group 4 h) was 0.49 (- 0.18 to 1.17) cm ² , and it was within the non-inferiority margin (Δ = 2.1 cm ² ). There was no difference in the incidence of at-risk stomach (P = 0.514). There was no significant difference in the incidence of major and minor complications between the two groups.
Conclusion: Two-hour fasting in pediatric patients who need an echocardiography did not increase major and minor complications and CSA significantly.
(© 2024. The Author(s) under exclusive licence to Japanese Society of Anesthesiologists.)

Comment in: J Anesth. 2024 Aug 13. doi: 10.1007/s00540-024-03391-9. (PMID: 39136765)

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Keywords: Fasting guideline; Fasting time; Gastric ultrasound; Sedation

Date Created: 20240607 Date Completed: 20240728 Latest Revision: 20240813

20240813

10.1007/s00540-024-03360-2

38849566