• Peter Frykholm, Nicola Disma, Hanna Andersson, Christiane Beck, Lionel Bouvet, Eloise Cercueil, Elizabeth Elliott, Jan Hofmann, Rebecca Isserman, Anna Klaucane, Fabian Kuhn, Mathilde de Queiroz Siqueira, David Rosen, Diana Rudolph, Alexander R Schmidt, Achim Schmitz, Daniel Stocki, Robert Sümpelmann, Paul A Stricker, Mark Thomas, Francis Veyckemans, and Arash Afshari.
• From the Department of Surgical Sciences, Section of Anaesthesiology and Intensive Care Medicine, Uppsala University, Uppsala, Sweden (PF, HA, AK), the Unit for Research & Innovation, Department of Paediatric Anaesthesia, Istituto Giannina Gaslini, Genova, Italy (ND), the Clinic of Anesthesiology and Intensive Care Medicine, Hannover Medical School, Hannover, Germany (CB, RS), the Department of Anaesthesiology and Intensive Care, Hospices Civils de Lyon, Femme Mère Enfant Hospital, Lyon, France (LB, EC, MDQS), the Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA (EE, RI, PAS), the Department of Anesthesia, University Children's Hospital, Zurich, Switzerland (JH, FK, ASc), the Children's Hospital of Eastern Ontario, University of Ottawa (DRo), the University of Ottawa, Ottawa, Ontario, Canada (DRo), the Department of Anesthesia, Pediatric Intensive Care and Emergency Medicine, Auf der Bult Children's Hospital, Hannover, Germany (DRu), Stanford University - School of Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Palo Alto, California, USA (ARS), the Sackler Faculty of Medicine, Tel Aviv University, Israel - Division of Anesthesia, Pain and Intensive Care, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel (DS), Great Ormond St. Hospital, London, United Kingdom (MT), the Clinique d'Anesthésie Pédiatrique, Hôpital Jeanne de Flandre, CHRU de Lille, France (FV), the Department of Paediatric and Obstetric Anaesthesia, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark (AA).
• Eur J Anaesthesiol. 2022 Jan 1; 39 (1): 4254-25.

AbstractCurrent paediatric anaesthetic fasting guidelines have recommended conservative fasting regimes for many years and have not altered much in the last decades. Recent publications have employed more liberal fasting regimes with no evidence of increased aspiration or regurgitation rates. In this first solely paediatric European Society of Anaesthesiology and Intensive Care (ESAIC) pre-operative fasting guideline, we aim to present aggregated and evidence-based summary recommendations to assist clinicians, healthcare providers, patients and parents. We identified six main topics for the literature search: studies comparing liberal with conservative regimens; impact of food composition; impact of comorbidity; the use of gastric ultrasound as a clinical tool; validation of gastric ultrasound for gastric content and gastric emptying studies; and early postoperative feeding. The literature search was performed by a professional librarian in collaboration with the ESAIC task force. Recommendations for reducing clear fluid fasting to 1 h, reducing breast milk fasting to 3 h, and allowing early postoperative feeding were the main results, with GRADE 1C or 1B evidence. The available evidence suggests that gastric ultrasound may be useful for clinical decision-making, and that allowing a 'light breakfast' may be well tolerated if the intake is well controlled. More research is needed in these areas as well as evaluation of how specific patient or treatment-related factors influence gastric emptying.Copyright © 2021 European Society of Anaesthesiology and Intensive Care. Unauthorized reproduction of this article is prohibited.

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