• Posted January 2, 2024

Do You Really Need to Fast Before a Common Cardiac Test?

Prolonged fasting before an internal heart exam done under sedation may be unnecessary, new research suggests.

Typically, patients undergoing coronary artery catherization are told to take nothing by mouth after midnight before the procedure, but a randomized controlled trial at a Midwest heart hospital found no need for it.

"Requiring all patients to fast for six hours or longer has remained an anesthesia guideline for procedures requiring conscious sedation for decades," said study co-author Carri Woods, a manager of nursing at Parkview Heart Institute in Fort Wayne, Ind.

In cardiac catherization, a thin tube called a catheter is threaded through a blood vessel to the heart. It lets the doctor test pressures in the heart, remove tissue for biopsy, check for clots or open a narrowed artery.

The new study included 197 adult patients having elective cardiac catherization at Parkview Heart Institute.

One hundred were allowed to eat a specified diet of solid food low in fat, cholesterol, sodium and acid until the procedure. Ninety-seven were allowed nothing by mouth, except for sips of water with medication, starting at midnight before the procedure.

No one in either group had problems such as pneumonia, low blood sugar or aspiration after the procedure. Blood sugar levels, gastrointestinal issues and fatigue levels were similar.

"Our findings demonstrate that fasting isn't necessary for every patient, and patient satisfaction and comfort can safely be put at the forefront of care," Woods said in a heart institute news release.

As a result of the study, the hospital has updated its protocols for cardiology procedures to let patients eat before sedation.

The findings were published Jan. 1 in the American Journal of Critical Care.

More information

The Mayo Clinic has more about cardiac catherization.

SOURCE: American Association of Critical-Care Nurses, news release, Jan. 1, 2024