Find a customizable feed of newly released articles from the leading pediatric surgery journals right at your fingertips. Explore the articles our editors and your colleagues are talking about. Discover podcasts with expert discussions on hot topics in the field. Search our vast multimedia library to find articles, reviews, lectures, technique videos, infographics, guidelines, and podcasts. CME credit is available for select content. Presented by Cincinnati Children's Hospital and Children's Mercy Hospital, in partnership with Journal of Pediatric Surgery.
Available on the AppStore Get it on Google PlayPatients 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.
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.
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 (11.5 h) and noncomplex groups (10.8 h). 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.
Observed preoperative NPO time exceeded current recommendations in this study.