Fasting guidance for children with Congenital Heart Disease
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Objectives
To standardise fasting instructions for all children with congenital heart disease, requiring a general anaesthetic within Royal Hospital for Children (RHC) Glasgow.
To maintain hydration status of children with congenital heart disease during the fasting period.
This guideline supplements RHC's standard pre-operative fasting guideline and can be used in conjunction with PICU fasting guidance.
Scope
This guideline applies to all paediatric cardiac patients with a pre procedure fasting requirement
Audience
This guideline is intended for all healthcare professionals involved in the care of paediatric cardiac patients with a pre procedure fasting requirement.
Children with congenital heart disease may be cyanotic, this causes an increase in erythropoietin thereby raising haematocrit, haemoglobin and blood viscosity.
Hyperviscosity is associated with stroke especially in young children in the presence of dehydration and so all children with cyanosis should have fasting kept to a minimum.
Children with congenital heart disease may be cyanotic, this causes an increase in erythropoietin thereby raising haematocrit, haemoglobin and blood viscosity.
Hyperviscosity is associated with stroke especially in young children in the presence of dehydration and so all children with cyanosis should have fasting kept to a minimum.
This policy was drawn up from best available evidence including consultation with local cardiologists, cardiac surgeons, anaesthetists, nursing staff, local practice and existing guidelines.
Intravenous fluid calculation:
100% fluid requirement =
- 100mls/kg/day for 1st 10kgs of weight
- 50mls/kg/day for 2nd 10kgs of weight
- 20mls/kg/day for weight over 20kg
Be aware that over a 24-hour period, males rarely need more than 2500 ml and females rarely need more than 2000 ml.
This guideline will be reviewed every 2 years with reference to clinical governance including review of associated guidelines, clinical incidents and audit.
Starship Children's Hospital, NZ. Cardiac Surgery – Admission Process
RHCG, Fasting guidance for procedures on PICU patients in PICU or theatre
NICE NG29 Algorithms for IV fluid therapy in children and young people in hospital
RHCG, Intravenous Fluid Guidance in Previously Well Children Aged 7 days to 16 Years
RHCG, Preoperative fasting of Elective Patients, Royal Hospital for Children
Last reviewed: 03 March 2022
Next review: 31 March 2025
Author(s): Alison Buller
Version: 1
Approved By: Paediatric Cardiology Department