Abstract:
Patients are often kept nil by mouth before a cardiac catheterisation. However, there is no published evidence to support this practice. This study aimed to measure current practice with regards to fasting at one centre and to quantify the rate of fasting-related complications. Methods: A single-centre prospective observational study was conducted at Auckland City Hospital, New Zealand. Consecutive patients undergoing elective cardiac catheterisation (coronary angiography and angioplasty) were included and complications associated with procedural fasting recorded. Results: A total of 1030 patients were included over 6 months. The mean age was 66 (SD 12) years, 67% were male, 26% had diabetes, and 72% had hypertension. All patients were kept nil by mouth prior to the procedure. The mean length of fasting was 11.6 (SD 4.9) hours. The highest complication was hunger (47%), with nausea (3.9%), vomiting (0.8%) and no aspiration episode. Patients experienced headache at 11.6%, hypotension (6%), hypertension (4.1%), arrhythmia (1.3%), vasovagal (0.8% and hypoglycaemia (0.7%). Conclusion: Within a single institution, there was wide variation in fasting practices related to cardiac catheterisation. In this real-world study, the duration of fasting was much longer than anticipated. Despite this, pre-hydration was used only in a minority of patients. Patient discomfort due to hunger and headache were common. There was a low rate of vomiting and no episodes of aspiration. Hunger was the most frequent complication. These data support the need for further research into the use of routine fasting prior to cardiac catheterisation.