Han Leyao, Wang Yingqiao, Zhong Juanping, Zhang Meishan, Li Weiping, Zhou Yihan, Yao Nan, Zhang Liping, Dou Xinman, Wang Xinglei
School of Nursing, Lanzhou University, Lanzhou, China.
Department of Nursing, Lanzhou University Second Hospital, Lanzhou, China.
Pediatr Surg Int. 2025 Apr 9;41(1):108. doi: 10.1007/s00383-025-06004-y.
Previous clinical practice suggests that prolonged fasting could negatively impact their hemodynamic stability and lead to children's dissatisfaction with the perioperative experience. Fasting guidelines for children are frequently updated. This study aims to explore the status of pre-operative fasting time in children and observe the practice of guidelines in clinical practice. A comprehensive search was conducted until 27 March 2024 in English. We used Stata14.0 for meta-analysis. We used the JBI cross-sectional study quality assessment tool to evaluate the quality. We applied a random effects model to conduct a separate meta-regression analysis on the age and the sample size. Our meta-analysis included 10 studies, with 1694 and 3527 children respectively included in solid and liquid fasting time. The effect magnitude of pre-operative solids fasting time was 12.694 [95% confidence interval (CI), 11.962-13.426, I: 94.2%, p = 0.001], and the liquid fasting time was 8.379 (95% CI, 6.031-10.727, I: 99.7%, p < 0.001), both exceedingly greater than twice the recommended time in the guidelines. The duration of preoperative fasting in children differs significantly from international guidelines, and evidence-based improvements are needed in clinical practice. Future research should focus on existing obstacles and how to address them.
以往的临床实践表明，长时间禁食可能会对患儿的血流动力学稳定性产生负面影响，并导致患儿对围手术期体验不满意。儿童禁食指南经常更新。本研究旨在探讨儿童术前禁食时间的现状，并观察临床实践中指南的执行情况。截至2024年3月27日进行了全面的英文文献检索。我们使用Stata14.0进行荟萃分析。我们使用JBI横断面研究质量评估工具来评估质量。我们应用随机效应模型对年龄和样本量进行单独的荟萃回归分析。我们的荟萃分析纳入了10项研究，固体食物禁食时间和液体食物禁食时间分别纳入了1694名和3527名儿童。术前固体食物禁食时间的效应量为12.694[95%置信区间（CI），11.962 - 13.426，I²：94.2%，p = 0.001]，液体食物禁食时间为8.379（95%CI，6.031 - 10.727，I²：99.7%，p < 0.001），两者均远超指南推荐时间的两倍。儿童术前禁食时间与国际指南有显著差异，临床实践中需要基于证据进行改进。未来的研究应关注现有障碍以及如何解决这些障碍。
