经皮心脏手术前非空腹与空腹状态的比较：随机对照试验的系统评价和荟萃分析

Non-fasting versus fasting before percutaneous cardiac procedures: a systematic review and meta-analysis of randomized controlled trials.

作者信息

Balbaa Elsayed, Ibrahim Ahmed A, Bazzazeh Mohammad, Tabassum Shehroze, Ramadan Shrouk, Gadelmawla Ahmed Farid, Elshimy Abdelrahman, Altobaishat Obieda, Abuelazm Mohamed

机构信息

Faculty of Medicine, Alexandria University, Alexandria, Egypt.

Faculty of Medicine, Menoufia University, Menoufia, Egypt.

出版信息

Perioper Med (Lond). 2025 Feb 28;14(1):24. doi: 10.1186/s13741-024-00485-6.

DOI:10.1186/s13741-024-00485-6

PMID:40022233

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11869692/

Abstract

BACKGROUND AND OBJECTIVE

Despite the absence of scientific evidence, fasting before percutaneous cardiac catheterization is still recommended to minimize complications. This systematic review and meta-analysis aimed to compare the outcomes of non-fasting protocols in patients undergoing percutaneous cardiac procedures.

MATERIALS AND METHODS

A systematic search of PubMed, Scopus, WOS, Embase, and Cochrane was conducted until September 2024. Dichotomous outcomes were pooled using risk ratio (RR), while continuous outcomes were pooled using standardized mean difference (SMD).

PROSPERO ID

CRD42024586147.

RESULTS

Five RCTs with 2034 patients were included. There was no significant difference between both groups regarding patient satisfaction score [SMD - 0.65, 95% CI (- 1.39, 0.09), P = 0.08], intra/postoperative aspiration (RR 1.00, 95% CI [0.20, 4.96], P = 1.00), postprocedural pneumonia (RR 0.60, 95% CI [0.14, 2.51], P = 0.49), emergency endotracheal intubation (RR 0.99, 95% CI [0.10, 9.51], P = 1.00), nausea/vomiting (RR 0.89, 95% CI [0.46, 1.76], P = 0.75), anti-emetic use (RR 0.49, 95% CI [0.24, 1.03], P = 0.06), hypoglycemia (RR 0.74, 95% CI [0.43, 1.28], P = 0.28), and the need for inotrope/vasopressor therapy (RR 1.03, 95% CI [0.81, 1.30], P = 0.82). However, the non-fasting approach significantly decreased the sensation of tiredness/fatigue (SMD - 0.31 with 95% CI [- 0.51, - 0.11], P < 0.001).

CONCLUSION

The non-fasting protocol demonstrated comparable efficacy, safety, and overall satisfaction to the conventional fasting approach. REVIEW REGISTRATION : PROSPERO CRD42024586147.

摘要

背景与目的

尽管缺乏科学证据，但经皮心脏导管插入术前禁食仍被推荐以尽量减少并发症。本系统评价和荟萃分析旨在比较接受经皮心脏手术患者的非禁食方案的结果。

材料与方法

对PubMed、Scopus、WOS、Embase和Cochrane进行系统检索，直至2024年9月。二分法结局采用风险比（RR）合并，连续结局采用标准化均数差（SMD）合并。

PROSPERO注册号：CRD42024586147。

结果

纳入了5项随机对照试验，共2034例患者。两组在患者满意度评分[SMD -0.65，95%CI（-1.39，0.09），P = 0.08]、术中和/或术后误吸（RR 1.00，95%CI[0.20，4.96]，P = 1.00）、术后肺炎（RR 0.60，95%CI[0.14，2.51]，P = 0.49）、紧急气管插管（RR 0.99，95%CI[0.10，9.51]，P = 1.00）、恶心/呕吐（RR 0.89，95%CI[0.46，1.76]，P = 0.75）、使用止吐药（RR 0.49，95%CI[0.24，1.03]，P = 0.06）、低血糖（RR 0.74，95%CI[0.43，1.28]，P = 0.28）以及使用血管活性药物治疗的必要性（RR 1.03，95%CI[0.81，1.30]，P = 0.82）方面无显著差异。然而，非禁食方法显著降低了疲倦/疲劳感（SMD -0.31，95%CI[-0.51，-0.11]，P < 0.001）。