• Erika Dulay, Bronwyn Griffin, James Brannigan, Craig McBride, Adrienne Hudson, and Amanda Ullman.
• Children's Health Queensland Hospital and Health Service, South Brisbane, QLD, Australia; School of Nursing and Midwifery, Griffith University, Nathan, QLD, Australia; School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, QLD, Australia. Electronic address: erika.dulay@health.qld.gov.au.
• Br J Anaesth. 2024 Sep 19.

BackgroundPreoperative fasting is the standard of care for patients undergoing a procedure under general anaesthesia. Despite the increased leniency of fasting guideline recommendations, prolonged preoperative fasting periods continue to disproportionally affect paediatric patients. This review maps existing interventions optimising paediatric fasting practices, to explore strategies that can be best applied in clinical practice.MethodsA search strategy applied to PubMed, CINAHL, Embase, Scopus, and the Cochrane Database involved four key concepts: (1) fasting, (2) preoperative, (3) paediatric, and (4) quality improvement intervention. The Preferred Reporting Items of Systematic Reviews and Meta-analyses extension for Scoping Reviews was utilised in this review.ResultsThirteen heterogeneous studies, involving approximately 31 000 children across five continents, were included. Each intervention studied fell into at least one of the following six themes: (1) change in facility protocol, (2) technology-based intervention, (3) individualised fasting programs, (4) processes to improve communication between clinicians, (5) processes to improve communication to parents and families, and (6) staff education.ConclusionsA variety of interventions have been studied to optimise paediatric preoperative fasting duration. These interventions show potential in reducing preoperative fasting duration.Crown Copyright © 2024. Published by Elsevier Ltd. All rights reserved.

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