No Link Found for Preprocedural Fasting and Witnessed Pulmonary Aspiration
WEDNESDAY, July 2, 2025 -- For patients undergoing surgical procedures, there is no association between liberal preprocedural fasting policies and witnessed aspiration, according to a systematic review and meta-analysis published in the August issue of Surgery.
Stephanie Lam, D.O., from the UCLA School of Medicine in Los Angeles, and colleagues reviewed randomized clinical trials comparing outcomes from preprocedural fasting regimens and observational studies of witnessed aspiration events. Clinical aspiration was the main primary outcome. Seventeen studies were included in the analyses, nine of which reported outcomes for aspiration events.
The researchers found that the various preprocedural fasting regimens did not affect clinical aspiration, with an odds ratio for aspiration events of 1.17 (95 percent confidence interval, 0.32 to 4.23). Aspiration occurred rarely (four of 801 patients in experimental groups and seven of 990 patients in control groups [incidence, 0.50 and 0.71 percent, respectively]). There was little likelihood of finding a significant effect of new fasting regimens on aspiration. The surrogate outcomes of gastric volume and/or pH for aspiration were not associated with human anesthesia-related aspiration.
"Fasting for long periods of time is extremely uncomfortable and patients really don't like to do it," senior author Edward H. Livingston, M.D., also from the UCLA School of Medicine, said in a statement. "Our research suggests that long periods of fasting may not be necessary."
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