Abstract Body (Do not enter title and authors here): Introduction: Current guidelines recommend preprocedural fasting for at least 6 hours for solid food and 2 hours for clear liquids before cardiac transcatheter procedures. However, the supporting data are limited.
Research question: Does non-fasting impact (NF) patient safety and comfort compared to fasting (F) in transcatheter cardiac procedures?
Aims: To compare the effects of fasting vs. non-fasting on patient outcomes in cardiac transcatheter procedures.
Methods: We searched the Cochrane, Embase, and Medline databases for RCTs comparing fasting versus non-fasting states for cardiac transcatheter procedures. Risk ratios (RRs) and standardized mean difference (SMD) with 95% confidence intervals (CIs) were pooled for binary and continuous outcomes, respectively, using a random-effects model. Endpoints were hunger, thirst, incidence of aspiration, nausea/vomiting, acute kidney injury (AKI), length of stay, and patient satisfaction.
Results: Our meta-analysis included 8 studies with 2,930 patients. Hunger sensation was significantly lower in the NF group (SMD -0.91; 95% CI: -1.71 to -0.11; P = 0.026; I2 = 96%; Figure 1A), with no difference in thirst. The incidence of aspiration (RR 2.20; 95% CI 0.29–17.02; P = 0.449; I2 = 0%; Figure 1B), nausea/vomiting (RR 1.09; 95% CI 0.67-1.78; P = 0.723; I2 = 0%), and AKI (RR 1.90; 95% CI 0.84–4.31; P = 0.126; I2 = 0%) were not significantly different between groups. Similarly, length of stay (MD -0.01 days; 95% CI -0.39 to 0.36; P = 0.940; I2 = 3%; Figure 2A), and patient satisfaction (SMD -0.74; 95% CI: -1.54 to -0.07; P = 0.073; I2 = 98%; Figure 2B) were also similar in both groups.
Conclusions: Our study suggests a non-fasting strategy is a safe option before transcatheter cardiac procedures.