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

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.