Fasting before cardiac catheterization: Is it necessary?

• Despite a lack of scientific evidence, fasting has been a longstanding practice before cardiac catheterization. • Modern contrast agents like low- and iso-osmolality non-ionic iodinated contrast media have much lower rates of nausea and vomiting and the reduced risk of aspiration. In parallel, the need for urgent surgery has decreased significantly. • This mini review shows that fasting before cardiac catheterization may not be necessary, and a no-fasting strategy may be safe and cost-effective as compared to traditional fasting practice in patients undergoing cardiac catheterization. • If the procedure is to be delayed, which is common due to busy catheterization lab, this could result in low patient satisfaction and hypoglycemia. Occasionally, cancellation occur because patients are found to be non-fasting. • Healthcare professionals should carefully individualized each patient's risk factors and medical history on deciding whether to fast or not before cardiac catheterization. • Due to the gap in knowledge that exists regarding this topic, there is need for large scale studies in this field comparing non-fasting group i.e. clear fluids and food and up to the time of the procedure to a fasting group (current practice) - clear fluids up to the time of the procedure and no food for at least 2 hours before the procedure.