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Pre-procedural fasting for coronary interventions: is it time to change practice?
  1. Tahir Hamid1,2,
  2. Qaiser Aleem1,
  3. Yeecheng Lau1,
  4. Ravi Singh1,
  5. John McDonald1,
  6. John E Macdonald3,
  7. Sanjay Sastry2,
  8. Sanjay Arya2,
  9. Anthony Bainbridge2,
  10. Telal Mudawi2,
  11. Kanarath Balachandran1
  1. 1Royal Blackburn Hospital NHS Trust, Blackburn, UK
  2. 2Royal Albert Edward Infirmary, NHS Trust, Wigan, UK
  3. 3Salford Royal NHS Foundation Trust, Salford, UK
  1. Correspondence to Dr Tahir Hamid, Department of Cardiology, Royal Albert Edward Infirmary, NHS Trust, Wigan lane, WN12 NN, Wigan, UK; tahirhamid76{at}yahoo.co.uk

Abstract

Introduction Traditionally, patients are kept nil-per-os/nil-by-mouth (NPO/NBM) prior to invasive cardiac procedures, yet there exists neither evidence nor clear guidance about the benefits of this practice.

Objectives To demonstrate that percutaneous cardiac catheterisation does not require prior fasting.

Methods The data source is a retrospective analysis of data registry of consecutive patients who underwent percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) and stable angina at two district general hospitals in the UK with no on-site cardiac surgery services.

Results A total of 1916 PCI procedures were performed over a 3-year period. None of the patients were kept NPO/NBM prior to their coronary procedures. The mean age was 67±16 years. 1349 (70%) were men; 38.5% (738/1916) had chronic stable angina, while the rest had ACS. 21% (398/1916) were diabetics while 53% (1017/1916) were hypertensive. PCI was technically successful in 95% (1821/1916) patients. 88.5% (1697/1916) had transradial approach. 77% (570/738) of elective PCI patients were discharged within 6 h postprocedure. No patients required emergency endotracheal intubation and there were no occurrences of intraprocedural or postprocedural aspiration pneumonia.

Conclusions Our observational study demonstrates that patients undergoing PCI do not need to be fasted prior to their procedures.

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