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08-06-2024 | Original Article

A comparative study using gastric ultrasound to evaluate the safety of shortening the fasting time before pediatric echocardiography: a randomized controlled non-inferiority study

Authors: Eunah Cho, Ji Hee Kwak, June Huh, I-Seok Kang, Kyoung-Ho Ryu, Sung Hyun Lee, Jin Hee Ahn, Hyeong-Kyeong Choi, Jinyoung Song

Published in: Journal of Anesthesia

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Abstract

Purpose

The objective of this study was to demonstrate that the gastric cross-sectional area (CSA) in the right lateral decubitus position (RLDP) during a 2-h fasting period is not larger than that during a conventional 4-h fasting period prior to pediatric echocardiography.

Methods

93 patients aged under 3 years scheduled for echocardiography under sedation were enrolled and randomly allocated into two groups; 2-h fasting vs 4-h fasting. For group 4 h (n = 46), the patients were asked to be fasted for all types of liquid for more than 4 h, while group 2 h (n = 47) were asked to be fasted for all types of liquid for 2 h before echocardiography. Gastric ultrasound was performed before echocardiography, and CSARLDP was measured. We compared CSARLDP, incidence of at-risk stomach, fasting duration, and the incidence of major (pulmonary aspiration, aspiration pneumonia) and minor complications (nausea, retching, and vomiting, apnea, and bradycardia) between two groups.

Results

The mean difference of CSARLDP (group 2 h–group 4 h) was 0.49 (– 0.18 to 1.17) cm2, and it was within the non-inferiority margin (Δ = 2.1 cm2). There was no difference in the incidence of at-risk stomach (P = 0.514). There was no significant difference in the incidence of major and minor complications between the two groups.

Conclusion

Two-hour fasting in pediatric patients who need an echocardiography did not increase major and minor complications and CSA significantly.
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Metadata
Title
A comparative study using gastric ultrasound to evaluate the safety of shortening the fasting time before pediatric echocardiography: a randomized controlled non-inferiority study
Authors
Eunah Cho
Ji Hee Kwak
June Huh
I-Seok Kang
Kyoung-Ho Ryu
Sung Hyun Lee
Jin Hee Ahn
Hyeong-Kyeong Choi
Jinyoung Song
Publication date
08-06-2024
Publisher
Springer Nature Singapore
Published in
Journal of Anesthesia
Print ISSN: 0913-8668
Electronic ISSN: 1438-8359
DOI
https://doi.org/10.1007/s00540-024-03360-2