Ultrasound evaluation of gastric emptying for two different quantities of milk in elementary school-aged children.

IF 2.6 3区医学 Q1 PEDIATRICS European Journal of Pediatrics Pub Date : 2025-01-30 DOI:10.1007/s00431-025-06001-2

Xiaofang Liu, Xianjun Li, Guohua Liu, Yuxi Yan, Haotian Fang, Bin Zhang

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Abstract

Current guidelines recommend 6-h milk fasting in periprocedural settings; however, recent evidence suggests potential overconservativeness and supports more liberal pediatric fasting protocols. This study assessed the gastric emptying of two different milk quantities in elementary school-age children using gastric ultrasonography. This prospective crossover trial involved 30 healthy children who fasted overnight on two separate occasions within one month, consuming either 5 or 10 mL/kg of milk. Gastric ultrasonography assessed the gastric antrum cross-section area in the right lateral decubitus position at intervals until milk emptying. The time for the gastric antrum to return to baseline and the gastric emptying time was recorded. After consuming 5 mL/kg of milk, the time for the gastric antrum to return to baseline varied from 1.5 to 3.5 h (mean: 2.35 ± 0.56 h; median: 2.50 (2.00-2.63) hours). The gastric emptying time ranged from 1.5 to 4.0 h, with the mean and median time of 2.63 ± 0.54 h and 2.50 (2.50-3.00) hours, respectively. With 10 mL/kg of milk, the time for the gastric antrum to return to baseline ranged from 2.0 to 5.0 h, with a mean of 3.35 ± 0.62 h and a median time of 3.50 (3.00-4.00) hours. The gastric emptying time ranged from 2.0 to 5.0 h with a mean and median time of 3.62 ± 0.61 h and 3.50 (3.38-4.00) hours. Subgroup analysis revealed no significant differences between children of different genders or body mass indexes.

Conclusion: The gastric return and emptying times are different for both milk quantities, both shorter than the 6-h fasting recommendation, supporting the liberal fasting protocols recommended by the European Society of Anaesthesiology and Intensive Care.

Clinical trials registration: This trial was registered in the Chinese Clinical Trial Registry (Registration number ChiCTR2300077790) on November 20, 2023.

What is known: • The ESAIC guidelines recommend a 4-h fasting period for milk products in periprocedural settings for children.

What is new: • Our research demonstrates that cow's milk is emptied from the stomach within 4 h, supporting the ESAIC recommendations.

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两种不同量牛奶对小学学龄儿童胃排空的超声评价。

目前的指南建议围手术期禁食6小时牛奶；然而，最近的证据表明潜在的过度保守，并支持更自由的儿科禁食方案。本研究利用胃超音波评估两种不同奶量的小学生胃排空情况。这项前瞻性交叉试验涉及30名健康儿童，他们在一个月内两次禁食过夜，摄入5或10毫升/公斤的牛奶。胃超声检查每隔一段时间对右侧侧卧位胃窦横切面面积进行评估，直至乳汁排空。记录胃窦恢复基线时间和胃排空时间。在摄入5 mL/kg牛奶后，胃窦恢复到基线的时间从1.5到3.5小时不等(平均：2.35±0.56小时；中位数：2.50（2.00-2.63）小时)。胃排空时间为1.5 ~ 4.0 h，平均为2.63±0.54 h，中位数为2.50 (2.50 ~ 3.00)h。当添加10 mL/kg牛奶时，胃窦恢复到基线的时间范围为2.0 ~ 5.0 h，平均为3.35±0.62 h，中位时间为3.50（3.00 ~ 4.00）小时。胃排空时间范围为2.0 ~ 5.0 h，平均为3.62±0.61 h，中位数为3.50 (3.38 ~ 4.00)h。亚组分析显示，不同性别和体重指数的儿童之间没有显著差异。结论：两种奶量的胃回流和排空时间不同，均短于6小时禁食推荐，支持欧洲麻醉与重症监护学会推荐的自由禁食方案。临床试验注册：本试验已于2023年11月20日在中国临床试验注册中心注册（注册号ChiCTR2300077790）。什么是已知的：•ESAIC指南建议在围手术期儿童牛奶产品禁食4小时。最新进展：•我们的研究表明，牛奶会在4小时内从胃中排出，这支持了ESAIC的建议。

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

European Journal of Pediatrics 医学-小儿科

CiteScore

5.90

自引率

2.80%

发文量

367

审稿时长

3-6 weeks

期刊介绍： The European Journal of Pediatrics (EJPE) is a leading peer-reviewed medical journal which covers the entire field of pediatrics. The editors encourage authors to submit original articles, reviews, short communications, and correspondence on all relevant themes and topics. EJPE is particularly committed to the publication of articles on important new clinical research that will have an immediate impact on clinical pediatric practice. The editorial office very much welcomes ideas for publications, whether individual articles or article series, that fit this goal and is always willing to address inquiries from authors regarding potential submissions. Invited review articles on clinical pediatrics that provide comprehensive coverage of a subject of importance are also regularly commissioned. The short publication time reflects both the commitment of the editors and publishers and their passion for new developments in the field of pediatrics. EJPE is active on social media (@EurJPediatrics) and we invite you to participate. EJPE is the official journal of the European Academy of Paediatrics (EAP) and publishes guidelines and statements in cooperation with the EAP.