在所有心脏 катетеризация之前的常规Nil Per Os:是时候重新考虑了吗?
Sammy Arab1, Karan Josan2, Jude Merzah3
1School of Medicine, Imperial College London, London, United Kingdom.
The Canadian journal of cardiology
|November 29, 2024
概括
在心脏导管 (NPO) 之前禁食可能是不必要的,对患者的健康构成风险,并增加成本. 目前的证据表明,不禁食是安全的,支持减少NPO周期和针对高风险患者的有针对性的方法.
科学领域:
- 心脏病学 心脏病学
- 医疗程序 医疗程序
- 患者安全 患者安全
背景情况:
- 在心脏导管注射之前,以防止吸入,Nil per os (NPO) 或禁食是标准.
- NPO与患者的不适,禁食并发症和更高的医疗保健费用有关.
- 现代麻醉和对比剂可能会减少长时间禁食的需要.
研究的目的:
- 在心脏导管注射之前,评估支持和反对常规NPO的证据.
- 探索一种风险分层的方法来进行手术前的禁食.
- 为了确定当前的NPO指南是否仍然相关.
主要方法:
- 对NPO和心脏导管治疗的现有文献进行系统审查.
- 在禁食患者和非禁食患者中分析并发症率,包括肺吸气.
- 评估与NPO相关的患者福利和医疗保健费用.
主要成果:
- 目前的证据表明,在心脏导管注射之前不禁食并不会显著增加吸入风险.
- 在非禁食患者中没有观察到其他程序并发症的实质性增加.
- 长时间的禁食与对患者体验的负面影响和医疗保健成本的增加有关.
结论:
- 对于大多数患者来说,心脏导管注射前的常规NPO可能已经过时了.
- 应该更新指导方针,以根据愿望风险对患者进行分层,为高风险个人保留NPO.
- 在等待进一步的大规模试验确认的同时,医院应该考虑减少NPO持续时间.
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