829 Fasting Prior to Coronary Procedures: A Retrospective Audit

Abstract

Traditionally, patients are kept nil-by-mouth for 4-6 hours prior to coronary angiogram or percutaneous coronary intervention (PCI) because of concern for airway complications. There are no guidelines or evidence to inform this practice. From the 1st September 2014, practice at one tertiary hospital changed from patients being nil-by-mouth, to patients consuming free fluids up to the procedure and fasting from solid food 4 hours pre-procedure. To evaluate the safety of a modified fasting protocol in patients undergoing coronary procedures. Consecutive patients undergoing coronary angiogram and PCI at one hospital from 1st January 2015 to 31st December 2019 were included. All patients were able to consume free fluids up to the procedure but fasted from food for 4 hours pre-procedure. Any documented adverse respiratory events were identified, with these defined as pneumonia or aspiration pneumonitis A total of 14,741 coronary procedures were identified. The mean age was 69±13 years and 68% were male. There were 12,191 diagnostic coronary angiograms and 2,550 PCI. 2,009 coronary procedures were for suspected STEMI patients. Nine patients were intubated during their coronary procedure due to cardiac arrest or acute pulmonary oedema, and three patients were transferred for urgent cardiothoracic surgery. There were no adverse respiratory events observed for all procedures. The modified fasting protocol, involving consumption of free fluids until the time of coronary procedure, is safe. There were no adverse respiratory events observed in all procedures.