Background Overnight preoperative fasting is routine in burn treatment centers. It helps systemic changes that exacerbate the hypermetabolic state in burned patients. Anesthesiology societies around the world preconize the ingestion of clear fluids up to two hours prior to surgical procedures. This article aims to investigate whether preoperative fasting should be reduced in moderately to severely burned patients. Methods In a systematic review of databases, 67 articles and guidelines were selected and analyzed. Results Few studies were found regarding preoperative fasting in burned patients. The studies on non-burned patients demonstrate that ingesting a solution with carbohydrate and glutamine two hours prior to surgery lowers insulin resistance, increases patient satisfaction, and reduces irritability, anxiety, thirst and hunger sensations, catabolic responses, postoperative nausea and vomiting. It also stimulates a proliferation response in enterocytes and colonocytes, enhances nutrient transport and decreases the length of hospital stays. Regurgitation and aspiration risks are low when following the protocols. Gastric emptying time and residual gastric volume return to normal within 120?min in most patients. Conclusion The benefits of reducing preoperative fasting in non-burned patients outweigh the risks and is recommended. Clinical research must be done on burned patients.
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