在导管实验室程序之前禁食或不禁食:SCOFF试验
David Ferreira1,2,3, Jack Hardy1, William Meere4
1Cardiovascular Department, John Hunter Hospital, Lookout Road, New Lambton Heights, Newcastle, 2305, Australia.
European heart journal
|September 1, 2024
概括
在需要有意识镇静的心脏手术之前不禁禁食是安全有效的. 患者经历了较少的不良事件和更高的满意度,支持从传统的禁食指南转变.
科学领域:
- 心脏病学 心脏病学
- 麻醉学 麻醉学
- 胃肠病学 胃肠病学
背景情况:
- 目前的指导方针要求在有意识镇静的心脏手术之前长时间禁食 (6小时固体,2小时液体).
- 支持这些禁食建议的证据有限,促使人们研究替代策略.
- 之前的单中心研究表明,不遵守禁食要求是安全的.
研究的目的:
- 为了确定没有禁食的策略是否与心脏导管手术前的传统禁食相比不劣.
- 评估在接受有意识镇静心脏手术的患者中取消禁食限制的安全性和有效性.
主要方法:
- 在澳大利亚进行了一项多中心,随机,开放标签,盲目的终点试验.
- 716名接受冠状动脉血管造影,PCI或CIED手术的患者被随机分为1:1进行禁食或不禁食.
- 主要结局是吸入性肺炎,低血压,高血糖和低血糖的复合,使用贝叶斯方法进行评估.
主要成果:
- 没有禁食显著降低了初级复合结果 (12.0%对19.1%),表明非劣势和优势.
- 患者满意度得分在非禁食组显著更高 (平均差异为4.02分).
- 二次结果,包括不良事件和死亡率,在各组之间是相似的.
结论:
- 没有禁食的策略对于接受心脏导管和CIED手术的患者来说,与传统禁食相比,不逊色,更优越.
- 消除禁食要求可以提高患者的满意度,而不会影响安全.
- 这些发现支持修订当前的指导方针,以消除心脏干预中意识镇静的术前禁食.
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