Articles  |   May 2019
SEE Question
Article Information
Gastrointestinal and Hepatic Systems / Pediatric Anesthesia / Radiological and Other Imaging / Respiratory System / Articles
Articles   |   May 2019
SEE Question
ASA Monitor 5 2019, Vol.83, 54-55.
ASA Monitor 5 2019, Vol.83, 54-55.
A recent study used gastric ultrasound to assess gastric emptying times for three liquids (apple juice, 2 percent milk and Ensure® Clear, an optically clear, high-protein, high-carbohydrate drink) in healthy pediatric volunteers. Safe time was defined as the time at which the probability of the stomach returning to empty baseline exceeded 95 percent. Based on the study results, safe time was reached fastest for which of the liquids?
Preoperative fasting guidelines for elective surgery are designed to optimize patient safety by minimizing the risk of aspiration while also attempting to minimize patient discomfort associated with fasting for prolonged periods of time. Although the risk of aspiration under anesthesia is low, the complications resulting from aspiration can be devastating. The current fasting guidelines are considered standard of care; however, there is a notable gray area regarding various types of liquids, particularly those that contain protein. Ultrasound scanning of the gastric antrum noninvasively assesses gastric volume and can be practically applied even in pediatric patients. The goal of a recent study was to compare gastric emptying of three different types of liquids: clear liquid (apple juice); nonclear liquid (2 percent milk); and a new, clear, high-carbohydrate, high-protein drink that is similar in nutritional content to yogurt (Ensure® Clear [Abbott Nutrition]). ASA fasting recommendations categorize milk as a solid and thus, after ingestion, six hours should pass before anesthesia administration. This is in contrast to the two hours of fasting recommended for apple juice. The high-carbohydrate, high-protein drink falls into a gray area and is not specifically addressed in the 2017 ASA fasting guidelines.
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