Interventions to optimise preoperative fasting in paediatrics: a scoping review

IF 9.1 1区医学 Q1 ANESTHESIOLOGY British journal of anaesthesia Pub Date : 2024-09-20 DOI:10.1016/j.bja.2024.08.010

Erika Dulay , Bronwyn Griffin , James Brannigan , Craig McBride , Adrienne Hudson , Amanda Ullman

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Abstract

Background

Preoperative fasting is the standard of care for patients undergoing a procedure under general anaesthesia. Despite the increased leniency of fasting guideline recommendations, prolonged preoperative fasting periods continue to disproportionally affect paediatric patients. This review maps existing interventions optimising paediatric fasting practices, to explore strategies that can be best applied in clinical practice.

Methods

A search strategy applied to PubMed, CINAHL, Embase, Scopus, and the Cochrane Database involved four key concepts: (1) fasting, (2) preoperative, (3) paediatric, and (4) quality improvement intervention. The Preferred Reporting Items of Systematic Reviews and Meta-analyses extension for Scoping Reviews was utilised in this review.

Results

Thirteen heterogeneous studies, involving approximately 31 000 children across five continents, were included. Each intervention studied fell into at least one of the following six themes: (1) change in facility protocol, (2) technology-based intervention, (3) individualised fasting programs, (4) processes to improve communication between clinicians, (5) processes to improve communication to parents and families, and (6) staff education.

Conclusions

A variety of interventions have been studied to optimise paediatric preoperative fasting duration. These interventions show potential in reducing preoperative fasting duration.

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优化儿科术前禁食的干预措施：范围界定综述。

背景术前禁食是对接受全身麻醉手术的患者进行护理的标准。尽管禁食指南的建议越来越宽松，但术前禁食时间过长对儿科患者的影响仍然不成比例。本综述对优化儿科禁食实践的现有干预措施进行了梳理，以探索可在临床实践中应用的最佳策略。方法在 PubMed、CINAHL、Embase、Scopus 和 Cochrane 数据库中采用的检索策略涉及四个关键概念：（1）禁食；（2）术前；（3）儿科；（4）质量改进干预措施。本综述采用了 "系统综述和荟萃分析的首选报告项目"（Preferred Reporting Items of Systematic Reviews and Meta-analyses extension for Scoping Reviews）。所研究的每项干预措施至少属于以下六个主题中的一个：（1）改变设施协议；（2）基于技术的干预措施；（3）个性化禁食计划；（4）改善临床医生之间沟通的流程；（5）改善与父母和家人沟通的流程；以及（6）员工教育。这些干预措施显示出缩短术前禁食时间的潜力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

British journal of anaesthesia 医学-麻醉学

CiteScore

13.50

自引率

7.10%

发文量

488

审稿时长

27 days

期刊介绍： The British Journal of Anaesthesia (BJA) is a prestigious publication that covers a wide range of topics in anaesthesia, critical care medicine, pain medicine, and perioperative medicine. It aims to disseminate high-impact original research, spanning fundamental, translational, and clinical sciences, as well as clinical practice, technology, education, and training. Additionally, the journal features review articles, notable case reports, correspondence, and special articles that appeal to a broader audience. The BJA is proudly associated with The Royal College of Anaesthetists, The College of Anaesthesiologists of Ireland, and The Hong Kong College of Anaesthesiologists. This partnership provides members of these esteemed institutions with access to not only the BJA but also its sister publication, BJA Education. It is essential to note that both journals maintain their editorial independence. Overall, the BJA offers a diverse and comprehensive platform for anaesthetists, critical care physicians, pain specialists, and perioperative medicine practitioners to contribute and stay updated with the latest advancements in their respective fields.