Comparison between no fasting vs. fasting in patients undergoing cardiac catheterization laboratory procedures: a...

Fasting prior to procedures in the cardiac catheterization laboratory is an established indication in clinical practice. However, the evidence supporting this recommendation is uncertain.

The aim of this systematic review and meta-analysis was to evaluate the impact of non-fasting vs. fasting before cardiac catheterization.

PubMed, Embase, Scopus, and Web of Science databases were searched until September 2024. Randomized controlled trials comparing both strategies were included. Outcomes were hypoglycaemia, aspiration pneumonia, contrast-induced acute kidney injury (AKI), nausea/vomiting, hypotension, and patient satisfaction. Risk of bias was assessed using the RoB 2.0 tool. All meta-analyses were performed using a random-effects model. Six studies were included (n = 2736). The mean age ranged from 62 to 70 years, and 31% were female. There was no significant difference in the risk of hypoglycaemia [risk ratio (RR) 0.82, 95% confidence interval (CI) 0.49-1.38], aspiration pneumonia (RR 1.31, 95% CI 0.28-6.05), nausea/vomiting (RR 0.95, 95% CI 0.58-1.55), contrast-induced AKI (RR 1.87, 95% CI 0.94-3.72) between the non-fasting and fasting groups. In contrast, patients in the non-fasting group had a lower risk of hypotension (RR 0.57, 95% CI 0.38-0.86) and higher satisfaction scores (standardized mean difference -1.53, 95% CI -2.11 to -0.96) compared with the fasting group. The risk of bias was judged as some concerns in three of four studies.

Our results suggest that in patients who underwent cardiac catheterization procedures, non-fasting was a safe strategy and provoked higher satisfaction compared to fasting.