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Fasting and surgery timing (FaST) audit.

Ahmed M El-Sharkawy1, Prita Daliya1, Christopher Lewis-Lloyd1

  • 1East Midlands Surgical Academic Network, Queen's Medical Centre, Nottingham, NG7 2UH, UK; Gastrointestinal Surgery, Nottingham Digestive Diseases Centre and National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals and University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK.

Clinical Nutrition (Edinburgh, Scotland)
|September 16, 2020
PubMed
Summary
This summary is machine-generated.

Patients undergoing surgery in the UK East Midlands frequently experience prolonged preoperative fasting, exceeding recommended guidelines for both food and clear fluids. Emergency surgery patients face longer fasting durations than elective surgery patients.

Keywords:
Adherence to guidelinesClear liquidsElective surgeryEmergency surgeryFoodPreoperative fasting

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Area of Science:

  • Perioperative Medicine
  • Surgical Patient Care
  • Clinical Audit

Background:

  • International guidelines recommend minimizing preoperative fasting to prevent negative impacts on perioperative hydration.
  • Prolonged fasting poses risks to patient well-being and recovery.
  • Adherence to fasting guidelines is crucial for optimal surgical outcomes.

Purpose of the Study:

  • To evaluate adherence to international preoperative fasting guidelines.
  • To assess fasting durations for elective and emergency surgery patients in the UK East Midlands.
  • To identify potential disparities in fasting practices based on surgical urgency.

Main Methods:

  • A prospective audit was conducted over two months across five National Health Service (NHS) Trusts.
  • Data collected included patient demographics, surgical details, and preoperative fasting times.
  • Adult patients undergoing elective and emergency surgery were included in the study.

Main Results:

  • 73% of patients fasted from food longer than 12 hours, and 21% fasted from clear fluids longer than 12 hours.
  • Median fasting times for food and clear fluids were significantly longer for emergency surgery patients compared to elective surgery patients (p < 0.0001).
  • The study included 343 surgical patients, with 78% undergoing elective and 22% undergoing emergency procedures.

Conclusions:

  • Despite international recommendations, prolonged preoperative fasting remains prevalent in surgical care.
  • Patients undergoing emergency surgery experience longer fasting periods than those undergoing elective surgery.
  • Further interventions are needed to improve adherence to evidence-based fasting guidelines.