PRÁTICAS SEGURAS NO JEJUM PRÉ-OPERATÓRIO DE CRIANÇAS E ADOLESCENTES: REVISÃO INTEGRATIVA

Abstract

Objective: To identify the most current evidence on the safe practice of reducing pediatric fasting based on preoperative gastric volume. Method: This is an integrative literature review on safe practices for reducing preoperative fasting in children and adolescents based on residual gastric volume, following the steps adapted from Galvão, 2008. The guiding question for selecting the articles was: "Can pediatric preoperative fasting be safely reduced based on gastric volume?". The PICO strategy was used to develop the health descriptors. The descriptors "Fasting", "Child", "Preoperative Care" "preoperative care" "fasting" were combined using the Boolean operator AND, through five databases: Pubmed, EMBASE, Web of Science, Virtual Health Library and SCOPUS. The inclusion criteria were complete articles available in full in the databases and articles that addressed preoperative fasting in children and adolescents and studies in any language and without a time frame. The exclusion criteria were unfinished articles, publications resulting from letters to the editor, reviews, editorials, expert opinions and reviews. Duplicate articles were considered only once. We tried to categorize the articles based on the levels of evidence, according to the methodological design recommended by the Joanna Briggs Institute (JBI), described in KARINO et.al (2012). Results: The sample obtained from the extraction of articles was 1,036. After using the Rayyan.ai platform to remove duplicates, 477 articles were obtained. After reading the titles, abstracts and keywords, 352 articles were excluded because they did not address the theme and/or population. After reading all 125 articles and taking into account the inclusion and exclusion criteria, 16 articles were chosen for critical analysis in this study. In order to facilitate visualization, a table was drawn up with data on the abbreviation of preoperative fasting based on gastric volume, such as the characteristics of the texts (title of the article, database, journal and year), the test used for gastric measurement and the main results of the sixteen articles included in the sample. Conclusion: Preoperative fasting in children and adolescents can be safely reduced by up to 2 hours, based on gastric volume. However, there is a tendency to reduce the preoperative fasting regime for clear liquids by up to 1 hour and fasting for light solids by up to 4 hours. Prolonged preoperative fasting in pediatric surgery can be detrimental to the patient. On the other hand, reducing preoperative fasting brings benefits such as shorter hospital stays. More studies are needed to endorse the trend and effectiveness of reducing preoperative fasting in children and adolescents by up to 1 hour for clear liquids and up to 4 hours for light solids. In addition, more studies are needed to define the ideal diets and volume to be implemented, thus providing more security for professionals to create and implement protocols that are in line with the current recommendations of anesthesiology societies.