Читать книгу Practical Pediatric Gastrointestinal Endoscopy - Группа авторов - Страница 38

Historically, the issue of fasting intervals before an elective procedure has generally followed those for elective anesthesia set forth by the ASA, yet recently these have come into question. Current ASA NPO guidelines state six hours is sufficient time for most foods, including infant formula, eight hours for a full meal and 4–6 hours for breast milk and clear liquids.

In 2016 the PRSC examined the effect NPO status had on aspiration, as well as major complications such as cardiac arrest or unplanned hospital admission. A total of 139 142 procedural sedations were reviewed. NPO status was known in 107 947 cases; 25 401 (23.5%) were not NPO. Aspiration occurred in eight of 82 546 (0.97 events per 10 000) who were made NPO per ASA guidelines versus two of 25 401 (0.79 events per 10 000) who were not NPO (OR 0.81, 95% CI 0.08–4.08; p = 0.79). Major complications occurred in 46 of 82 546 (5.57 events per 10 000) versus 15 of 25 401 (5.91 events per 10 000) (OR 1.06, 95% CI 0.55–1.93; p = 0.88). Overall, there were 0 deaths, 10 aspirations, and 75 major complications. Multivariate analysis revealed NPO status is not a predictor of either aspiration or experiencing a major complication.