健康儿童标准清淡早餐后胃排空时间的超声评估：一项前瞻性观察研究。
Ultrasound assessment of gastric emptying time after a standardised light breakfast in healthy children: A prospective observational study.
出版信息
Eur J Anaesthesiol. 2018 Dec;35(12):937-941. doi: 10.1097/EJA.0000000000000874.
OBJECTIVES
Current guidelines recommend 6 h of fasting for solids before anaesthesia. However, prolonged fasting may lead to discomfort, hunger, thirst, misbehaviour and lipolysis. To prevent this, a more liberal fasting regimen has been empirically implemented in our children's hospital, allowing a shorter fasting time of 4 h for a standardised light breakfast.
AIM
The aim of this study was to determine the gastric emptying time after a standardised light breakfast in healthy children.
DESIGN
A prospective observational noninterventional study.
METHODS
After fasting overnight, the children had a standardised light breakfast. Before and afterwards, ultrasound examinations of the gastric antrum were performed hourly to determine the gastric antral area (GAA), which is a surrogate parameter for gastric volume in children in the right lateral position (RLP). Demographic data and fasting times are presented as mean ± SD (range) and GAA as median (interquartile range).
RESULTS
Twenty-two children aged 7.8 (2.5 to 13.6) years volunteered for this study. After fasting overnight [735 ± 120 (467 to 930) min], the initial GAA was 3.06 (2.35 to 4.03) cm in RLP. After the light breakfast, GAA in RLP initially increased and decreased subsequently. After 4 h, GAA in RLP was lower than the initial value (median of differences -0.54, 95% confidence interval -1.00 to -0.07, P < 0.05). Correlation between GAA in RLP and fasting time was significant (r = -0.62, P < 0.0001). Using a linear regression model, the calculated mean gastric emptying time after the standardised light breakfast was 211 min for GAA = 3.06 cm.
CONCLUSION
The study showed a mean gastric emptying time of less than 4 h after a standardised light breakfast in children. These results encourage our current clinical practice and support the efforts towards a more liberal fasting regimen for light meals in paediatric anaesthesia.
TRIAL REGISTRATION
German Registry of Clinical Studies (DRKS-ID: DRKS 00013893).
目的
目前的指南建议麻醉前固体食物禁食 6 小时。然而，长时间禁食可能会导致不适、饥饿、口渴、行为不当和脂肪分解。为了预防这种情况，我们的儿童医院已经凭经验实施了更宽松的禁食方案，允许标准化的清淡早餐禁食时间更短，为 4 小时。
目的
本研究旨在确定健康儿童在标准化清淡早餐后的胃排空时间。
设计
前瞻性观察性非干预性研究。
方法
儿童隔夜禁食后，给予标准化清淡早餐。在禁食前后，每小时进行一次胃窦超声检查，以确定胃窦面积（GAA），这是右侧卧位（RLP）儿童胃容量的替代参数。人口统计学数据和禁食时间以平均值±标准差（范围）表示，GAA 以中位数（四分位数范围）表示。
结果
22 名年龄为 7.8（2.5 至 13.6）岁的儿童自愿参加了这项研究。在隔夜禁食[735±120（467 至 930）min]后，RLP 中的初始 GAA 为 3.06（2.35 至 4.03）cm。在清淡早餐后，RLP 中的 GAA 最初增加，随后减少。4 小时后，RLP 中的 GAA 低于初始值（中位数差值 -0.54，95%置信区间 -1.00 至 -0.07，P<0.05）。RLP 中的 GAA 与禁食时间之间存在显著相关性（r=-0.62，P<0.0001）。使用线性回归模型，标准化清淡早餐后 GAA 为 3.06 cm 时，计算出的平均胃排空时间为 211 min。
结论
本研究显示，儿童在标准化清淡早餐后平均胃排空时间不到 4 小时。这些结果支持我们目前的临床实践，并支持在小儿麻醉中为清淡餐制定更宽松的禁食方案的努力。
试验注册
德国临床研究注册处（DRKS-ID：DRKS 00013893）。
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