Paediatric anaesthesia & critical care
Impact of liberal preoperative clear fluid fasting regimens on the risk of pulmonary aspiration in children (EUROFAST): an international prospective cohort study
Authors' conclusion
The study provides evidence for the safety of reducing preoperative fasting time for clear fluids in children aged <16 yr from 2 h to ≤1 h.
Study context
- Population
- Children aged <16 yr anaesthetised at centres with >1000 paediatric anaesthesia cases per yearanaesthetic procedures, 31 centres
- Participants
- 306,900 children
- Exposure
- Sip-til-send or ≥1 h vs ≥2 h clear fluid fasting
- Outcome
- Confirmed pulmonary aspiration
Methodological detailsmulticentre, international, non-inferiority
- Multicentre
- International
- Non-inferiority
Main finding
As reported in the abstract
Incidence of confirmed pulmonary aspiration
Sip-til-send
1.18:10 000
≥1 h
0.96:10 000
Control
1.83:10 000
Control vs ≥1 h: 95% CI −0.344 to 3.76 · control vs sip-til-send: 95% CI −1.48 to 3.63
Observational data: associations, not effects.
Further findings
Transient regurgitation; regurgitation leading to escalation of care or intensive care
- Both sip-til-send and ≥1 h statistically noninferior to ≥2 h
Mortality due to aspiration
- No mortality as a result of aspiration
Original publication
Impact of liberal preoperative clear fluid fasting regimens on the risk of pulmonary aspiration in children (EUROFAST): an international prospective cohort study. Br J Anaesth. Published 26 May 2025. doi:10.
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