Adherence to Preoperative Fasting Guidelines in Elective Surgical Patients.

Autor:	Sidik AI; Surgery, Rossiiskii Universitet Druzhby Narodov (RUDN) University, Moscow, RUS., Lishchuk A; Cardiothoracic Surgery, A.A. Vishnevskiy Third Central Military Clinical Hospital, Moscow, RUS., Faybushevich AN; Cardiothoracic Surgery, Rossiiskii Universitet Druzhby Narodov (RUDN) University, Moscow, RUS., Moomin A; Nutrition and Health, Rowett Institute, University of Aberdeen, Aberdeen, GBR., Akambase J; Anatomy, Cairns Hospital, Cairns, AUS., Dontsov V; Cardiothoracic Surgery, Moscow Regional Research and Clinical Institute, Moscow, RUS., Sobolev D; Cardiology, European Medical Center, Moscow, RUS., Ilyas Mohammad Shafii A; Cardiovascular Medicine, Rossiiskii Universitet Druzhby Narodov (RUDN) University, Moscow, RUS., Najneen F; Cardiovascular Medicine, Rossiiskii Universitet Druzhby Narodov (RUDN) University, Moscow, RUS., Ak G; Cardiovascular Medicine, Rossiiskii Universitet Druzhby Narodov (RUDN) University, Moscow, RUS., Ahlam D; Cardiovascular Medicine, Rossiiskii Universitet Druzhby Narodov (RUDN) University, Moscow, RUS., Adam MK; Health Sciences, Robert Gordon University, Aberdeen, GBR., Baatiema L; Health Services, Ghana Health Service, Wa, GHA., Benneh C; Pharmacy and Pharmacy Practice, School of Pharmacy, Ulster University, Coleraine, GBR., Adu-Gyamfi PKT; Nursing and Midwifery, Pentecost University College, Accra, GHA., Agyapong F; Nursing and Midwifery, Pentecost University College, Accra, GHA., Mensah KB; Pharmacology, College of Health Science, Kwame Nkrumah University of Science and Technology, Kumasi, GHA.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Oct 15; Vol. 16 (10), pp. e71554. Date of Electronic Publication: 2024 Oct 15 (Print Publication: 2024).
DOI:	10.7759/cureus.71554
Abstrakt:	Introduction: Preoperative fasting is recommended by international guidelines as a means to minimize the risk of aspiration of gastric content during induction of anesthesia or surgery. Prolonged preoperative fasting is, however, discouraged due to the associated side effects such as dehydration and electrolyte imbalance, which can negatively impact recovery after surgery. An initial quality improvement study revealed poor implementation of the best practice guidelines on preoperative fasting in three departments of a hospital and an institutional action plan was devised to enforce adherence to these guidelines. This present study aimed to assess compliance with the action plan and for that matter, adherence to international consensus on preoperative fasting in three surgical departments. Methods: Adult patients undergoing elective cardiac, thoracic, and vascular surgery at a university teaching hospital were surveyed over four months (September October, November, and December of 2023). Data on the length of preoperative fasting was collected using a standardized questionnaire. A total of 306 patients who were scheduled for elective surgery were included in the study. Results: Of the 306 patients, 139 (45.4%) had vascular surgeries, 108 (35.4%) received cardiac surgeries, and 59 (19.3%) had thoracic surgeries. For clear fluids, the overall median fasting time (Q1, Q3) was 4.5 (2.7, 7.4) hours, and for solid food, 14.5 (12.1, 19.0) hours. Extended abstinence from clear fluids and solid food for more than 12 hours was observed in 43 (14.1%) and 231 (75.5%) instances, respectively, while abstinence from solid food for more than 24 hours was noticed in 40 (13.1%) cases. When compared to patients having operations in the morning, those scheduled for afternoon surgery had longer median fasting periods from clear fluids and solid food, p<0.001: 6.2 (4.0, 12.0) hours vs. 3.4 (2.0, 5.2) hours for clear fluids and 16.7 (12.6, 22.6) hours vs. 13.2 (9.6, 15.2) hours for solid food, respectively. Conclusion: Patients continue to abstain from clear fluids and solid food for extended periods of time, despite the fact that there is worldwide agreement regarding shorter periods of preoperative fasting. Compared to patients undergoing morning surgery, individuals hospitalized for afternoon procedures were more likely to fast for extended periods of time. Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Sidik et al.)
Databáze:	MEDLINE
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