Comparison of Fasting and Nonfasting Regimens Outcomes Before Catheterization Laboratory Procedures: A Systematic...

Area of Science:

• Cardiology
• Clinical Practice Guidelines
• Patient Safety

Background:

• Current guidelines recommend fasting before cardiac catheterization laboratory (cath lab) procedures.
• Emerging evidence suggests fasting may not offer substantial clinical benefits and could potentially be unnecessary.

Purpose of the Study:

• To evaluate the evidence comparing patient outcomes between fasting and non-fasting regimens before cath lab procedures.
• To determine if non-fasting protocols impact key safety outcomes.

Main Methods:

• A comprehensive literature search was conducted for randomized controlled trials (RCTs) comparing fasting versus non-fasting protocols.
• A random-effects meta-analysis was performed on data from 8 RCTs involving 3,068 participants.
• Key outcomes assessed included hypoglycemia, aspiration pneumonia, contrast nephropathy, and mortality.

Main Results:

• Non-fasting was not associated with statistically significant differences in hypoglycemia, aspiration pneumonia, contrast nephropathy, all-cause mortality, or cardiovascular mortality compared to fasting.
• Odds ratios and 95% confidence intervals indicated no increased risk for adverse events in the non-fasting group.

Conclusions:

• Non-fasting regimens appear to be as safe as fasting for patients undergoing cath lab procedures.
• Implementing non-fasting protocols could enhance patient experience without compromising safety.
• Further large-scale trials are recommended to definitively confirm the safety and efficacy of non-fasting regimens.