Effect of a liberal fluid fasting policy before surgery on the incidence of aspiration: a single centre retrospective observational study
Authors' conclusion
A liberal fasting policy for clear fluids before elective and urgent surgery in adults had a higher associated incidence of aspiration compared with the previously reported incidence using a standard 2-h fasting policy.
Study context
- Population
- Adults undergoing elective and urgent procedures under anaesthesia, Dutch tertiary referral hospital, June 2019–February 2025
- Participants
- 56,995 adults
- Outcome
- Pulmonary aspiration (documented visualisation of gastric content in the tracheobronchial tree below the vocal cords by laryngoscopy, bronchoscopy, after tracheal suctioning, with or without respiratory distress)
Methodological detailsobservational, single-centre, tertiary referral hospital
- Observational
- Single-centre
- Tertiary referral hospital
Main finding
As reported in the abstract
Recognised pulmonary aspiration incidence
Aspiration incidence per 10 000 patients
3.7
95% CI 2.4–5.6
Observational data: associations, not effects.
Secondary outcomes
Regurgitation incidence
- Regurgitation incidence per 10 000
- 25 (95% CI 21-29)
Fasting duration for clear fluids
- Median fasting duration for clear fluids, min (IQR 24-116 min)
- 63
Safety
Aspiration pneumonia incidence
- Aspiration pneumonia per 10 000
- 2.1 (95% CI 1.2-3.7)
Original publication
Effect of a liberal fluid fasting policy before surgery on the incidence of aspiration: a single centre retrospective observational study. BJA Open. Published 1 July 2026. doi:10.
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