Fasting and cardiac catheterisation - should we be following the evidence?


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Dr Charles Knight trained at Cambridge and Oxford Universities and is currently a consultant cardiologist at the London Chest Hospital. Dr Knight has a particular interest in chest pain, acute coronary syndromes and hypertrophic cardiomyopathy. He specialises in coronary angioplasty and stenting and has considerable experience in interventional cardiology and in the renal complications of coronary artery disease and its treatment. Dr Knight is Head of Cardiology at Barts and the London NHS trust. He is Honorary Secretary Elect of the British Cardiovascular Society and serves as a specialist advisor to NICE.

Fasting and cardiac catheterisation - should we be following the evidence?

James Rosengarten,
Muhiddin Ozkor, Charles Knight
Department of Cardiology, Barts and The London
NHS Trust, London, UK
Address for correspondence:
Dr Charles Knight
Department of Cardiology,
London Chest Hospital,
Bonner Road, London E2 9JX, UK
Tel: +44-(0)20-8983-2248 Fax: +44-(0)20-8983-2278
Email: charles.knight@bartsandthelondon.nhs.uk

Abstract
It is usual for food and fluids to be withheld for variable periods before cardiac catheterisation. Fasting is considered necessary to reduce the risk of aspiration in the case of emergency surgery or cardiac arrest. The risks involved are low compared with the greater risk of complications associated with dehydration, hypoglycaemia and omission of medication. Existing guidelines do not give clear direction and are not evidence based. We propose a less stringent approach with unlimited clear fluids allowed until the time of the procedure.