Effect of NPO Time and Type of Food Intake on Preoperative Residual Gastric Content and pH

January 15, 2021 updated by: Patcharee Sriswasdi, Boston Children's Hospital

According to normal physiology, the longer fasting period allows food particles to pass stomach through small intestines to minimize intragastric content. The practice guidelines recommend 2-hour fasting period for clear fluid (including water, pulp-free juice and tea or coffee without milk), 4- hour fasting period for breast milk and 6-hour fasting period for non-human milk and solid food to reduce risks of pulmonary aspiration. As a result of longer fasting period, patients tend to experience preoperative dehydrated states and intraoperative hypotension. Patients' demographic data will be obtained from charts. Parents will be asked for type, volume of fluid/food intake and NPO time.

This study will be done at BCH's Gastroenterology Procedure Unit (GPU) theaters to measure actual intragastric volume and pH at the beginning esopagogastroduodenoscopy procedures. We hope to demonstrate the relationship between NPO time and actual intragastric volume which provide sufficient data of NPO time to ensure patient's safety.

Study Overview

Status

Completed

Conditions

Detailed Description

This study is a prospective observational cohort study which will be conducted in 2 parts including preoperative and intraoperative periods.

  • Preoperative period, patients' demographic information will be collected along with NPO history including times, type ,amount of preoperative fluid/ food intake and patients' anxiety score.
  • Intraoperatively, at the beginning of EGD procedure, total volume of intragastric content(ml) and gastric acidity will be measured.

We plan to offer participation to all patients or parents of patients' ages 0-17 years who are scheduled for EGD at GPU, BCH Longwood campus and are fluent in English. A brochure describing our study in English will be given to patients or their families on the day of surgery. If the patient or family agrees to participate in this study, the study will be provided in the GPU theaters.

Study Type

Observational

Enrollment (Actual)

150

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • Massachusetts
      • Boston, Massachusetts, United States, 02115
        • Boston Children Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

No older than 17 years (Child)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

The study will include all patients who aged 0-17 years scheduled for EGD procedure at GPU, Boston Children's Hospital, Longwood.

Description

Inclusion Criteria:

- All patients who aged 0-17 years scheduled for EGD procedure.

Exclusion Criteria:

- Patients who required emergency EGD procedures and patients with active upper GI bleeding.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Observational Models: Cohort
  • Time Perspectives: Prospective

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Actual intragastric content volume (ml)
Time Frame: 1 day
Actual intragastric content volume (ml) which is suctioned from each pediatric patient is measured
1 day

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Correlation between NPO time(hr) and intraoperative intragastric content volume(ml).
Time Frame: 1 day
Correlation between NPO time(hr) and intraoperative intragastric content volume(ml).
1 day
Correlation between NPO time(hr) and intraoperative intragastric content acidity (pH).
Time Frame: 1 day
Correlation between NPO time(hr) and intraoperative intragastric content acidity (pH).
1 day
Incidence of perioperative hypotension
Time Frame: 1 day
Hypotension is defined as 20% reduction of normal systolic blood pressure for any age groups
1 day
Incidence of pulmonary aspiration risk.
Time Frame: 1 day
Pulmonary aspiration is defined by the regurgitation of gastric contents into the larynx and the respiratory tract and cause a syndrome of progressive dyspnea, hypoxia, bronchial wheeze and patchy collapse, consolidation on chest X-ray or all.
1 day
Correlation between preoperative patient's anxiety score and actual intragastric content volume (ml)
Time Frame: 1 day
Correlation between preoperative patient's anxiety score and actual intragastric content volume (ml)
1 day
Incidence of surgery delay or cancellation due to NPO guideline violation
Time Frame: 1 day
Surgery delay is defined when the patient's queue is postponed in order to wait for proper NPO time
1 day
Actual pH of intragastric content
Time Frame: 1 day
Actual pH of intragastric content which is suctioned from each pediatric patient is measured
1 day

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Boston Children's Hospital

Investigators

  • Principal Investigator: Patcharee Sriswasdi, MD., Boston Children's Hospital

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

August 24, 2018

Primary Completion (Actual)

December 11, 2019

Study Completion (Actual)

December 11, 2019

Study Registration Dates

First Submitted

February 20, 2018

First Submitted That Met QC Criteria

February 27, 2018

First Posted (Actual)

February 28, 2018

Study Record Updates

Last Update Posted (Actual)

January 19, 2021

Last Update Submitted That Met QC Criteria

January 15, 2021

Last Verified

January 1, 2021

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • IRB-P00027981

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

No

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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