Safety of oral intake prior to cardiac catheterization with minimal to moderate sedation: A systematic review and meta-analysis of randomized controlled trials
Authors' conclusion
In conclusion, this analysis shows no significant difference in most safety outcomes between a fasting and a nonfasting strategy with potential increase in nausea/vomiting and decrease in acute kidney injury with fasting.
Study context
- Population
- Patients undergoing percutaneous cardiac procedures (cardiac catheterisation) with minimal to moderate sedation
- Participants
- 3,382 patients8 RCTs
- Comparison
- Fasting vs nonfasting before cardiac catheterisation
- Outcome
- Safety outcomes: nausea, vomiting, aspiration, intubation, hypoglycaemia, hypotension, AKI
Pooled result
As reported in the abstract
Safety outcomes, fasting vs nonfasting
Fasting vs NonfastingOdds ratio (95% CI)
Nausea/vomiting; no significant difference
0.99(0.68–1.45)
Hypoglycaemia; no significant difference
1.28(0.75–2.18)
Aspiration; no significant difference
0.72(0.36–1.43)
AKI; no significant difference
0.69(0.38–1.23)
Hypotension; no significant difference
1.57(0.47–5.30)
Further pooled results
| Outcome | SMD (95% CI) | |
|---|---|---|
| Patient satisfaction score and length of hospital stayFastingvs NonfastingPatient satisfaction score; no difference | 0.23 (−0.62 to 1.07) | |
| Patient satisfaction score and length of hospital stayFastingvs NonfastingLength of hospital stay; no difference | 0.0 (−0.6 to 0.7) | |
| −1−0.500.511.5Difference (linear scale) |
| Outcome | OR (95% CI) | |
|---|---|---|
| Nausea/vomiting and AKI (subgroup analysis)Fastingvs NonfastingNausea/vomiting; increased odds with fasting | 1.20 (1.04–1.39) | |
| Nausea/vomiting and AKI (subgroup analysis)Fastingvs NonfastingAKI; decreased odds with fasting | 0.50 (0.28–0.89) | |
| 0.20.5125Odds ratio (log scale) |
Safety
Events
| Outcome | Fasting | Nonfasting |
|---|---|---|
| Endotracheal intubation | 0 | 0 |
Original publication
Safety of oral intake prior to cardiac catheterization with minimal to moderate sedation: A systematic review and meta-analysis of randomized controlled trials. Am Heart J. Published 1 July 2025. doi:10.
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