Journal article

An international multidisciplinary consensus statement on fasting before procedural sedation in adults and children

SM Green, PL Leroy, MG Roback, MG Irwin, G Andolfatto, FE Babl, E Barbi, LR Costa, A Absalom, DW Carlson, BS Krauss, J Roelofse, VM Yuen, E Alcaino, PS Costa, KP Mason

Anaesthesia | WILEY | Published : 2019


The multidisciplinary International Committee for the Advancement of Procedural Sedation presents the first fasting and aspiration prevention recommendations specific to procedural sedation, based on an extensive review of the literature. These were developed using Delphi methodology and assessment of the robustness of the available evidence. The literature evidence is clear that fasting, as currently practiced, often substantially exceeds recommended time thresholds and has known adverse consequences, for example, irritability, dehydration and hypoglycaemia. Fasting does not guarantee an empty stomach, and there is no observed association between aspiration and compliance with common fastin..

View full abstract


Funding Acknowledgements

This manuscript had no outside funding or support. MI has received travel support from Fresenius Kabi and is an editor of Anaesthesia. FB has research grants from the National Health and Medical Research Council, Canberra, Australia and the Royal Children's Hospital Foundation, Melbourne, Australia. LC has research grants from Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq), Coordenacao de Aperfeicoamento de Pessoal deNivel Superior (CAPES) e Fundacao de Amparoa Pesquisa do Estado de Goias (FAPEG). AA has sponsored research and consultancy fees from The Medicines Company, Orion, and Johnson and Johnson, and unrestricted research grants from Carefusion and Drager. PC is supported by the Brazilian National Research Scientific Research Council. KM receives support from Hospira for investigator-initiated studies and unrestricted educational support for conferences. Upon project completion one committee member elected to not be included in the authorship list. He expressed that the development process was fair, that his views were heard and that he supported the quality of the literature summaries. His decision was based on his caution in making specific recommendations based upon the reported degree of incomplete evidence.