Residual gastric contents volume does not differ following 4 or 6 h fasting after a light breakfast - a magnetic resonance imaging investigation in healthy non-anaesthetised school-age children

• Published in: Acta anaesthesiologica Scandinavica Vol. 56; no. 5; pp. 589 - 594
• Main Authors: SCHMITZ, A., KELLENBERGER, C. J., LIAMLAHI, R., FRUEHAUF, M., KLAGHOFER, R., WEISS, M.
• Format: Journal Article
• Language: English
• Published: Oxford Blackwell Publishing Ltd 01.05.2012; Blackwell
• Subjects: Anesthesia; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Child; Cross-Over Studies; Data Interpretation, Statistical; Drinking; Eating - physiology; Fasting - physiology; Female; Gastric Emptying - physiology; Gastrointestinal Contents; Half-Life; Humans; Magnetic Resonance Imaging; Male; Medical sciences; Software; Stomach - anatomy & histology; Human; Stomach; Anesthesia; School age; Fasting; Child
• ISSN: 0001-5172; 1399-6576
• DOI: 10.1111/j.1399-6576.2011.02601.x

Background While American Society of Anesthesiologists and European Society of Anaesthesiology guidelines recommend 6 h pre‐anaesthetic fasting for food and non‐clear fluids in children, some institutions allow shorter fasting times of 4 h. Aim of this pilot study was to compare weight‐indexed residual gastric contents volumes (GCVw) after 4 vs. 6 h after a light breakfast, using magnetic resonance imaging (MRI) in healthy volunteer children not scheduled for anaesthesia. Methods Four vs. 6 h (F4/F6) of food fasting were simulated in a crossover study. After overnight fasting (baseline), each child ingested a light breakfast (cereal flakes, milk products) on two separate days. Additional clear fluid (7 ml/kg raspberry syrup) was given either after 2 (F4) or 4 h (F6), followed by half‐hourly MRI acquisition for 2 h. MRI was obtained on a 1.5 Tesla scanner as 5 mm axial images (FIESTA) and volumes were traced manually by one blinded observer. Data are given as median (range) or mean ± standard deviation. Results Eighteen healthy volunteers aged 9.0 (6.8–12.2) years participated. GCVw for F4 and F6 at baseline was 0.50 ± 0.27 and 0.76 ± 0.48 ml/kg (P = 0.07), respectively, GCVw after 4 and 6 h was 0.72 ± 0.85 and 0.47 ± 0.25 ml/kg (P = 0.88). T1/2 after syrup intake was 30.8 ± 12.2 and 28.3 ± 5.7 min (P = 0.47) for F4 and F6, respectively. Conclusion Residual gastric contents volumes at a hypothetical anaesthesia start were similar for 4 and 6 h food fasting in healthy volunteer school‐age children.