TY - JOUR
T1 - Fasting habits over a 10-year period
T2 - An observational study on adherence to preoperative fasting and postoperative restoration of oral intake in 2 Dutch hospitals
AU - van Noort, Harm H.J.
AU - Eskes, Anne M.
AU - Vermeulen, Hester
AU - Besselink, Marc G.
AU - Moeling, Miranda
AU - Ubbink, Dirk T.
AU - Huisman–de Waal, Getty
AU - Witteman, Ben J.M.
N1 - Funding Information: We would like to thank Linda Koolen, RN, and Emma van der Voorden, RN, from the Faculty of Health and Social Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands, for their cooperation during the data collection. Publisher Copyright: © 2021 The Author(s)
PY - 2021/8
Y1 - 2021/8
N2 - Background: Since 1999, international guidelines recommend fasting from solid foods up to 6 hours and clear liquids up to 2 hours before surgery. Early recovery after surgery programs recommend restoration of oral intake as soon as possible. This study determines adherence to these guidelines up to 20 years after its introduction. Methods: A 2-center observational study with a 10-year interval was performed in the Netherlands. In period 1 (2009), preoperative fasting time was observed as primary outcome. In period 2 (2019), preoperative fasting and postoperative restoration of oral intake were observed. Fasting times were collected using an interview-assisted questionnaire. Results: During both periods, 311 patients were included from vascular, trauma, orthopedic, urological, oncological, gastrointestinal, and ear-nose-throat and maxillary surgical units. Duration of preoperative fasting was prolonged in 290 (90.3%) patients for solid foods and in 208 (67.8%) patients for clear liquids. Median duration of preoperative fasting from solid foods and clear liquids was respectively 2.5 and 3 times the recommended 6 and 2 hours, with no improvements from one period to another. Postoperative food intake was resumed within 4 hours in 30.7% of the patients. Median duration of perioperative fasting was 23:46 hours (interquartile range 20:00–30:30 hours) for solid foods and 11:00 hours (interquartile range 7:53–16:00 hours) for clear liquids. Conclusion: Old habits die hard. Despite 20 years of fasting guidelines, surgical patients are still exposed erroneously to prolonged fasting in 2 hospitals. Patients should be encouraged to eat and drink until 6 and 2 hours, respectively, before surgery and to restart eating after surgery.
AB - Background: Since 1999, international guidelines recommend fasting from solid foods up to 6 hours and clear liquids up to 2 hours before surgery. Early recovery after surgery programs recommend restoration of oral intake as soon as possible. This study determines adherence to these guidelines up to 20 years after its introduction. Methods: A 2-center observational study with a 10-year interval was performed in the Netherlands. In period 1 (2009), preoperative fasting time was observed as primary outcome. In period 2 (2019), preoperative fasting and postoperative restoration of oral intake were observed. Fasting times were collected using an interview-assisted questionnaire. Results: During both periods, 311 patients were included from vascular, trauma, orthopedic, urological, oncological, gastrointestinal, and ear-nose-throat and maxillary surgical units. Duration of preoperative fasting was prolonged in 290 (90.3%) patients for solid foods and in 208 (67.8%) patients for clear liquids. Median duration of preoperative fasting from solid foods and clear liquids was respectively 2.5 and 3 times the recommended 6 and 2 hours, with no improvements from one period to another. Postoperative food intake was resumed within 4 hours in 30.7% of the patients. Median duration of perioperative fasting was 23:46 hours (interquartile range 20:00–30:30 hours) for solid foods and 11:00 hours (interquartile range 7:53–16:00 hours) for clear liquids. Conclusion: Old habits die hard. Despite 20 years of fasting guidelines, surgical patients are still exposed erroneously to prolonged fasting in 2 hospitals. Patients should be encouraged to eat and drink until 6 and 2 hours, respectively, before surgery and to restart eating after surgery.
UR - http://www.scopus.com/inward/record.url?scp=85102281819&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.surg.2021.01.037
DO - https://doi.org/10.1016/j.surg.2021.01.037
M3 - Article
C2 - 33712307
SN - 0039-6060
VL - 170
SP - 532
EP - 540
JO - Surgery (United States)
JF - Surgery (United States)
IS - 2
ER -