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Pre-procedural fasting for coronary interventions: is it time to change practice?
Tahir Hamid1, Qaiser Aleem, Yeecheng Lau
1Royal Blackburn Hospital NHS Trust, , Blackburn, UK.
Heart (British Cardiac Society)
|February 14, 2014
Summary
Fasting before percutaneous coronary intervention (PCI) is not necessary. This study found no complications in patients who did not fast, suggesting current NPO/NBM guidelines may be outdated for PCI.
Area of Science:
- Cardiology
- Interventional Cardiology
- Clinical Practice Guidelines
Background:
- Traditional nil-per-os/nil-by-mouth (NPO/NBM) protocols before invasive cardiac procedures lack evidence.
- Current guidelines for fasting prior to percutaneous cardiac catheterisation are not clearly defined.
Purpose of the Study:
- To evaluate the safety and efficacy of foregoing pre-procedure fasting for patients undergoing percutaneous coronary intervention (PCI).
Main Methods:
- Retrospective analysis of a data registry of 1916 consecutive patients undergoing PCI for acute coronary syndrome or stable angina.
- Data collected from two UK district general hospitals without on-site cardiac surgery services.
Main Results:
- No patients were kept NPO/NBM prior to PCI.
- PCI was technically successful in 95% of patients.
- No aspiration pneumonia or need for emergency intubation occurred; 77% of elective PCI patients discharged within 6 hours.
Conclusions:
- Percutaneous coronary intervention can be safely performed without prior patient fasting.
- Observational data supports the discontinuation of routine NPO/NBM for PCI procedures.
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