Pre-procedural fasting for coronary interventions: is it time to change practice?
Pre-procedural fasting for coronary interventions: is it time to change practice?
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DOI：
10.1136/heartjnl-2013-305289
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发表时间：
2014-04-15
期刊：
影响因子：
5.7
通讯作者：
Balachandran, Kanarath
中科院分区：
文献类型：
--
作者：
Hamid, Tahir;Aleem, Qaiser;Balachandran, Kanarath
简介 传统上，患者在进行侵入性心脏手术之前会保持零经口/零经口（NPO/NBM），但既没有证据也没有明确的指导来说明这种做法的好处。目的 证明经皮心导管插入术不需要事先禁食。方法数据来源是对在英国两所地区综合医院因急性冠状动脉综合征（ACS）和稳定型心绞痛接受经皮冠状动脉介入治疗（PCI）的连续患者的数据登记的回顾性分析，现场心脏手术服务。结果 3 年期间共进行了 1916 例 PCI 手术。没有患者在进行冠状动脉手术之前接受 NPO/NBM。平均年龄为6716岁。 1349 名（70%）为男性； 38.5% (738/1916) 患有慢性稳定性心绞痛，其余则患有 ACS。 21% (398/1916) 是糖尿病患者，53% (1017/1916) 是高血压患者。 PCI 在技术上对 95% (1821/1916) 的患者是成功的。 88.5% (1697/1916) 采用经桡动脉入路。 77% (570/738) 的择期 PCI 患者在术后 6 小时内出院。没有患者需要紧急气管插管，也没有发生术中或术后吸入性肺炎。结论我们的观察性研究表明，接受 PCI 的患者在手术前不需要禁食。
Introduction Traditionally, patients are kept nil-per-os/nil-by-mouth (NPO/NBM) prior to invasive cardiac procedures, yet there exists neither evidence nor clear guidance about the benefits of this practice.Objectives To demonstrate that percutaneous cardiac catheterisation does not require prior fasting.Methods The data source is a retrospective analysis of data registry of consecutive patients who underwent percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) and stable angina at two district general hospitals in the UK with no on-site cardiac surgery services.Results A total of 1916 PCI procedures were performed over a 3-year period. None of the patients were kept NPO/NBM prior to their coronary procedures. The mean age was 6716years. 1349 (70%) were men; 38.5% (738/1916) had chronic stable angina, while the rest had ACS. 21% (398/1916) were diabetics while 53% (1017/1916) were hypertensive. PCI was technically successful in 95% (1821/1916) patients. 88.5% (1697/1916) had transradial approach. 77% (570/738) of elective PCI patients were discharged within 6h postprocedure. No patients required emergency endotracheal intubation and there were no occurrences of intraprocedural or postprocedural aspiration pneumonia.Conclusions Our observational study demonstrates that patients undergoing PCI do not need to be fasted prior to their procedures.