J Korean Med Assoc.  2014 May;57(5):429-434. 10.5124/jkma.2014.57.5.429.

Preoperative fasting in emergencies: choice for preventing aspiration pneumonitis

Affiliations
  • 1Department of Anesthesiology and Pain Medicine, Gachon University Gil Medical Center, Incheon, Korea. endless37@gilhospital.com

Abstract

Preoperative fasting is prescribed for a certain period before operations or procedures in which patients are not allowed oral intake to prevent aspiration of gastric content. Fasting recommendations prohibit the consumption of a heavy meal for 8 hours, a light meal or milk for 6 hours, and breast milk for 4 hours, and permit the consumption of clear liquid until 2 hours before an operation. However, sometimes, in an emergency situation such as increased intra-cranial or intraabdominal pressure and other trauma, the recommended fasting time might not be an absolute policy for preventing the aspiration of gastric content because the disease or trauma itself causes changes on the esophageal sphincter pressure, volume of the gastric content, and pH of the gastric fluid. Preparation of a safe anesthetic technique and appropriate preoperative medications can be helpful in preventing aspiration pneumonitis in an emergency situation.

Keyword

Fasting; Acid asprin syndrome; Emergencies

MeSH Terms

Emergencies*
Fasting*
Humans
Hydrogen-Ion Concentration
Meals
Milk
Milk, Human
Pneumonia*

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