Routine Nil-per-os Before All Cardiac Catheterizations: Time to Reconsider?

Author Department

Cardiology; Medicine

Document Type

Article, Peer-reviewed

Publication Date

11-2024

Abstract

Nil-per-os (NPO) is a common instruction before cardiac catheterization. NPO was originally adopted from general surgery to minimize gastric contents during procedures and reduce the risk of pulmonary aspiration in case of vomiting. However, NPO has since been associated with adverse effects on patient well-being, fasting-related complications, and increased healthcare costs. These burdens are multiplied by the large number of cardiac catheterizations performed. Advancements in anesthesia and contrast agents may have rendered pre-procedural fasting obsolete. Here, we examine the evidence for and against routine NPO practices, and consider the possible value of a more targeted approach. Current evidence strongly suggests that non-fasting before cardiac catheterization does not significantly increase the risk of pulmonary aspiration or other complications. Therefore, while further large-scale trials are on-going to confirm the safety of non-fasting, hospitals should begin to reduce fasting periods whenever possible. New guidelines should stratify patients by their risk of aspiration, reserving NPO only for those at high risk.

Keywords: ASA; Cardiac Catheterization; NPO.

PMID

39613292

Link to Full Text

Share

COinS