Can we safely Have Our patients eat With cardiac catheterization – Nix Or allow: The CHOW NOW study (Preliminary analysis from inpatient population)

Background:
Currently, patients undergoing cardiac catheterization are kept nil per os (NPO) as no standard fasting protocol exists. We compared safety and clinical outcomes of a non-fasting (NF) strategy as compared to our current fasting protocol.

Methods:
A single center, prospective, randomized study which compared these strategies in patients (both in and outpatients) undergoing non-emergent cardiac catherization. Fasting group was instructed to be NPO after midnight for solids but could have clear liquids up to 2 hours of procedures. NF group had no restriction or oral intake irrespective of time of procedure.

Results:
A total of 253 inpatients enrolled till December 2018 were included in this prelim analysis. Both groups had similar baseline characteristics (table 1). As compared to the fasting group (n=131), NF group (n=122) had similar rates of CIN (3% vs 4%),peri-procedural hypotension (3% vs 0.8%),aspiration pneumonitis (none vs 0.8%),nausea/vomiting (4% vs 8%), hyperglycemia(7% vs 2%) and hypoglycemia(0.8% vs 2%) respectively [p=not significant (ns) for all]. Thirty-day mortality was comparable between these two groups. The fasting group had significantly lower patient satisfaction score (4.1±0.09 vs 4.3±0.08, p=0.039) and higher cost of index hospitalization (USD 13837±1470 vs 9693±878, p=0.016) as compared to NF group (table 2).

Conclusions:
No restriction of oral intake prior to cardiac catheterization is safe and is associated with better patient satisfaction as well as lower cost of care as compared to traditional NPO strategy.