- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04501393
Recommended Clear Fluid Intake Volume at 2 Hours Prior to Esophagogastroduodenoscopy for Adult Patients
Study Overview
Detailed Description
Research in developing patient NPO guidelines was developed years ago. On a physiological basis, patients with a longer fasting time may have less residual gastric content and lower risk of pulmonary aspiration. The recent Practice Guidelines for Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration of The American Society of Anesthesiologists (ASA) was published in March 2017. Current practice consists of 2-hour fasting period for clear oral 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. However, there are only few supportive (category A) and suggestive (category B) scientific evidences.
Since Maltby et al showed results of patient's safety in elective surgical patients who had clear oral fluid intake 2 hours before surgery in 1986, the published clinical evidence is still insufficient to address the relationship between pulmonary aspiration and fasting time . For breast milk, infant formula and solid food, the latest Practice Guidelines for Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration in 2011 also follow previous suggestion of fasting time because of inadequate updated supportive clinical trials.
The purpose of this study is to evaluate the current clinical practice guidelines for preoperative fasting to enhance the quality of pediatric anesthesia care and promote patient safety. Andersson et al. reviewed 10,015 pediatric anesthesia charts retrospectively and found an incidence of 3 cases of pulmonary aspiration in 10,000 pediatric anesthesia patients who were allowed to drink clear liquid fluids until called to operative rooms . This approach promotes patient safety by minimizing a patient's dehydration status and reduced intraoperative hypotensive events. Furthermore, shortened fasting times also decreases patient irritability and improves parental satisfaction in preoperative experiences.
The investigators plan to enroll adults ages 18-60 years old, who are scheduled for esophago-gastro-duodenoscopy (EGD) at Siriraj hospital. This observational study will be conducted in 2 stages; (1) preoperative period (2) intraoperative period. Patients' demographic information will be collected along with NPO history including times, volume and type of fluid/ food intake in the preoperative period. Intragastric volume and pH from each patient's stomach at the beginning of EGD procedure will be measured in the intraoperative period.
The investigators believe that the information from this study will help us understand the effects of NPO time and the actual intragastric volume which may help establish a comprehensive NPO guideline.
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Sirirat Rattanaarpa, MD
- Phone Number: 024197989
- Email: rattanaarpa.s@gmail.com
Study Contact Backup
- Name: Patcharee Sriswasdi, MD, MPH
- Phone Number: 024197989
- Email: pat.si.research@gmail.com
Study Locations
-
-
Bangkok
-
Bangkok Noi, Bangkok, Thailand, 10700
- Recruiting
- Faculty of Medicine, Siriraj Hospital
-
Contact:
- Sirirat Rattana-arpa, MD
- Phone Number: +66819099242
- Email: mednoonr@gmail.com
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients who are 18-60 years scheduled for EGD procedure
- Patient who willing to participate in this study
Exclusion Criteria:
- Patient who scheduled for emergent EGD procedures
- Patients with active upper GI bleeding
- Patients who received preoperative oral medication
- BMI > 30 kg/m2
- Patients with previous GI motility or acid-base pathology
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
No Intervention: 0 ml/kg
The participants will not be asked to drink anything at 2 hours prior to planned procedure.
|
|
Active Comparator: 3 ml/kg
The participants will be asked to drink 3ml/kg of clear liquid at 2 hours prior to planned procedure.
|
Clear oral fluid including water, pulp-free juice and tea or coffee without milk
|
Active Comparator: 7 ml/kg
The participants will be asked to drink 7 ml/kg of clear liquid at 2 hours prior to planned procedure.
|
Clear oral fluid including water, pulp-free juice and tea or coffee without milk
|
Active Comparator: 10 ml/kg
The participants will be asked to drink 10 ml/kg of clear liquid at 2 hours prior to planned procedure.
|
Clear oral fluid including water, pulp-free juice and tea or coffee without milk
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Residual gastric volume
Time Frame: at 2 hour after drinking, during endoscopic procedure
|
Collect actual intra-gastric content volume after drinking assigned amount of fluid at 2-hour fasting period of each patient.
|
at 2 hour after drinking, during endoscopic procedure
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Gastric acidity (pH)
Time Frame: at 2 hour after drinking, during endoscopic procedure
|
Collect actual intra-gastric content pH after drinking assigned amount of fluid at 2-hour fasting period of each patient.
|
at 2 hour after drinking, during endoscopic procedure
|
Hypotension
Time Frame: at 2 hour after drinking, during endoscopic procedure
|
Compare hypotension incidence of each group
|
at 2 hour after drinking, during endoscopic procedure
|
Post operative nausea and vomitting
Time Frame: pre-endoscopic procedure
|
Compare postoperative nausea and vomiting incidence of each group
|
pre-endoscopic procedure
|
Ready to discharge time
Time Frame: When the procedure finish until ready to discharge, approximately 1-2 hours after endoscopy
|
Compare ready to discharge time of each group
|
When the procedure finish until ready to discharge, approximately 1-2 hours after endoscopy
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
- 382/2563
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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