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Fasting prior to cardiac catheterisation: a single-centre observational study

Sheila Badana Bacus1, John Parsons2, Jocelyne Benatar3

  • 1CIU/ CVRU, Auckland District Health Board, Auckland.

The New Zealand Medical Journal
|February 21, 2020
PubMed

Insights

Patients fasted significantly longer than recommended before cardiac catheterisation, experiencing hunger but no aspiration. Modern contrast agents appear safe without prolonged fasting, suggesting guideline reassessment.

Area of Science:

  • Cardiology
  • Medical Procedures
  • Patient Safety

Background:

  • Older contrast agents necessitated fasting due to nausea, vomiting, and aspiration risks.
  • Current guidelines recommend 4-6 hours of fasting before cardiac catheterisation, despite limited evidence for modern agents.
  • Modern contrast agents have a low risk of aspiration and are generally well-tolerated.

Purpose of the Study:

  • To assess the actual duration and effects of pre-procedure fasting in patients undergoing cardiac catheterisation.
  • To evaluate adherence to current fasting guidelines in elective cardiac catheterisation.
  • To determine the incidence of fasting-related symptoms and complications.

Main Methods:

  • A prospective observational study was conducted at a single centre over six months.
  • 1030 patients undergoing elective cardiac catheterisation were included.
  • Data collected included fasting duration, symptoms, pre-hydration status, and aspiration events.

Main Results:

  • The mean fasting duration was 11.6 hours, with 80% fasting longer than recommended.
  • 48% of patients with chronic kidney disease did not receive recommended pre-hydration.
  • The most common fasting-related symptoms were hunger (47%), nausea (3.9%), and vomiting (0.8%). No aspirations were reported.

Conclusions:

  • Patients frequently fast longer than recommended before cardiac catheterisation.
  • Pre-hydration was underused in high-risk patients, potentially increasing contrast-induced nephropathy risk.
  • The absence of aspiration events with modern contrast agents questions the necessity of prolonged fasting for elective procedures.
Abstract

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