The Effects of Fasting Status on the Relative Risk of Pulmonary Aspiration in Acute Care Surgery Patients
Background Acute care surgery patients are often unfasted at the time of surgery, presenting a unique opportunity to study the effects of fasting on the risk of pulmonary aspiration. We aimed to determine the relative risk of aspiration in patients who were fasted at the time of surgery according to...
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| Veröffentlicht in: | The American surgeon 2020-07, Vol.86 (7), p.837-840 |
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| creator | Reed LaSala, V. Morgan, Madison E. Bradburn, Eric H. Vernon, Tawnya M. Maish, George O. |
| description | Background
Acute care surgery patients are often unfasted at the time of surgery, presenting a unique opportunity to study the effects of fasting on the risk of pulmonary aspiration. We aimed to determine the relative risk of aspiration in patients who were fasted at the time of surgery according to guidelines versus those in an unfasted state.
Methods
A retrospective chart review of 100 patients who underwent appendectomy (n = 76) or exploratory laparotomy (n = 24) was conducted at a single institution in 2016-2017. Using the American Society of Anesthesiologists (ASA) Practice Guidelines for Preoperative Fasting, patients were stratified into study and control groups according to whether they were unfasted (nothing by mouth for 8 hours prior to surgery). Data controlled for patients’ age, sex, body mass index (BMI), most recent hemoglobin A1c, presence of gastroesophageal reflux disease (GERD), and presence of hiatal hernia.
Results
Of the 76 patients who underwent appendectomy, 15% were unfasted with a total of 0 aspiration events (P < .001). Of the 24 patients who underwent exploratory laparotomy, 42% were unfasted with a total of 0 aspiration events (P < .001). This yields a relative risk of pulmonary aspiration of 1.0 (absolute risk of 0) in both the study and control groups.
Discussion
In an acute care surgery population including patients who were not fasted according to guidelines, there was no increase in the risk of pulmonary aspiration.
Level of Evidence
Epidemiological study; Level III. |
| doi_str_mv | 10.1177/0003134820940257 |
| format | Article |
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Acute care surgery patients are often unfasted at the time of surgery, presenting a unique opportunity to study the effects of fasting on the risk of pulmonary aspiration. We aimed to determine the relative risk of aspiration in patients who were fasted at the time of surgery according to guidelines versus those in an unfasted state.
Methods
A retrospective chart review of 100 patients who underwent appendectomy (n = 76) or exploratory laparotomy (n = 24) was conducted at a single institution in 2016-2017. Using the American Society of Anesthesiologists (ASA) Practice Guidelines for Preoperative Fasting, patients were stratified into study and control groups according to whether they were unfasted (nothing by mouth for <8 hours prior to surgery) or fasted (nothing by mouth for >8 hours prior to surgery). Data controlled for patients’ age, sex, body mass index (BMI), most recent hemoglobin A1c, presence of gastroesophageal reflux disease (GERD), and presence of hiatal hernia.
Results
Of the 76 patients who underwent appendectomy, 15% were unfasted with a total of 0 aspiration events (P < .001). Of the 24 patients who underwent exploratory laparotomy, 42% were unfasted with a total of 0 aspiration events (P < .001). This yields a relative risk of pulmonary aspiration of 1.0 (absolute risk of 0) in both the study and control groups.
Discussion
In an acute care surgery population including patients who were not fasted according to guidelines, there was no increase in the risk of pulmonary aspiration.
Level of Evidence
Epidemiological study; Level III.</description><identifier>ISSN: 0003-1348</identifier><identifier>EISSN: 1555-9823</identifier><identifier>DOI: 10.1177/0003134820940257</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Anesthesia ; Appendectomy ; Body mass ; Body mass index ; Body size ; Dogmatism ; Epidemiology ; Fasting ; Gastroesophageal reflux ; Guidelines ; Hemoglobin ; Hernia ; Hiatal hernias ; Hospitals ; Insulin resistance ; Intubation ; Laparotomy ; Ostomy ; Pulmonary aspiration ; Risk ; Surgery ; Surgical outcomes</subject><ispartof>The American surgeon, 2020-07, Vol.86 (7), p.837-840</ispartof><rights>The Author(s) 2020</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c295t-3b586b04a90abce14f3e653c800e48c149b038f0abeb69a5b33c4b43195c65623</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/0003134820940257$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/0003134820940257$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,776,780,21798,27901,27902,43597,43598</link.rule.ids></links><search><creatorcontrib>Reed LaSala, V.</creatorcontrib><creatorcontrib>Morgan, Madison E.</creatorcontrib><creatorcontrib>Bradburn, Eric H.</creatorcontrib><creatorcontrib>Vernon, Tawnya M.</creatorcontrib><creatorcontrib>Maish, George O.</creatorcontrib><title>The Effects of Fasting Status on the Relative Risk of Pulmonary Aspiration in Acute Care Surgery Patients</title><title>The American surgeon</title><description>Background
Acute care surgery patients are often unfasted at the time of surgery, presenting a unique opportunity to study the effects of fasting on the risk of pulmonary aspiration. We aimed to determine the relative risk of aspiration in patients who were fasted at the time of surgery according to guidelines versus those in an unfasted state.
Methods
A retrospective chart review of 100 patients who underwent appendectomy (n = 76) or exploratory laparotomy (n = 24) was conducted at a single institution in 2016-2017. Using the American Society of Anesthesiologists (ASA) Practice Guidelines for Preoperative Fasting, patients were stratified into study and control groups according to whether they were unfasted (nothing by mouth for <8 hours prior to surgery) or fasted (nothing by mouth for >8 hours prior to surgery). Data controlled for patients’ age, sex, body mass index (BMI), most recent hemoglobin A1c, presence of gastroesophageal reflux disease (GERD), and presence of hiatal hernia.
Results
Of the 76 patients who underwent appendectomy, 15% were unfasted with a total of 0 aspiration events (P < .001). Of the 24 patients who underwent exploratory laparotomy, 42% were unfasted with a total of 0 aspiration events (P < .001). This yields a relative risk of pulmonary aspiration of 1.0 (absolute risk of 0) in both the study and control groups.
Discussion
In an acute care surgery population including patients who were not fasted according to guidelines, there was no increase in the risk of pulmonary aspiration.
Level of Evidence
Epidemiological study; Level III.</description><subject>Anesthesia</subject><subject>Appendectomy</subject><subject>Body mass</subject><subject>Body mass index</subject><subject>Body size</subject><subject>Dogmatism</subject><subject>Epidemiology</subject><subject>Fasting</subject><subject>Gastroesophageal reflux</subject><subject>Guidelines</subject><subject>Hemoglobin</subject><subject>Hernia</subject><subject>Hiatal hernias</subject><subject>Hospitals</subject><subject>Insulin resistance</subject><subject>Intubation</subject><subject>Laparotomy</subject><subject>Ostomy</subject><subject>Pulmonary aspiration</subject><subject>Risk</subject><subject>Surgery</subject><subject>Surgical outcomes</subject><issn>0003-1348</issn><issn>1555-9823</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp10M9LwzAUB_AgCs7p3WPAi5fqS5N0yXGMTYWBw81zScPrzOzamaSC_70pEwTBU358P--RPEKuGdwxNpncAwBnXKgctIBcTk7IiEkpM61yfkpGQ5wN-Tm5CGGXjqKQbETc5g3pvK7RxkC7mi5MiK7d0nU0sU83LY0JvGBjovtMGxfeB7bqm33XGv9Fp-HgfAqTdC2d2j4inRmPdN37LSawSiG2MVySs9o0Aa9-1jF5Xcw3s8ds-fzwNJsuM5trGTNeSVVUIIwGU1lkouZYSG4VAAplmdAVcFWnEKtCG1lxbkUlONPSFrLI-ZjcHvsefPfRY4jl3gWLTWNa7PpQ5iKfcBBM60Rv_tBd1_s2vS4pKUApzSApOCrruxA81uXBu336e8mgHGZf_p19KsmOJcFs8bfpv_4b11WB9g</recordid><startdate>202007</startdate><enddate>202007</enddate><creator>Reed LaSala, V.</creator><creator>Morgan, Madison E.</creator><creator>Bradburn, Eric H.</creator><creator>Vernon, Tawnya M.</creator><creator>Maish, George O.</creator><general>SAGE Publications</general><general>SAGE PUBLICATIONS, INC</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>4T-</scope><scope>4U-</scope><scope>7QL</scope><scope>7RV</scope><scope>7T7</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M2P</scope><scope>M7N</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope></search><sort><creationdate>202007</creationdate><title>The Effects of Fasting Status on the Relative Risk of Pulmonary Aspiration in Acute Care Surgery Patients</title><author>Reed LaSala, V. ; Morgan, Madison E. ; Bradburn, Eric H. ; Vernon, Tawnya M. ; Maish, George O.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c295t-3b586b04a90abce14f3e653c800e48c149b038f0abeb69a5b33c4b43195c65623</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Anesthesia</topic><topic>Appendectomy</topic><topic>Body mass</topic><topic>Body mass index</topic><topic>Body size</topic><topic>Dogmatism</topic><topic>Epidemiology</topic><topic>Fasting</topic><topic>Gastroesophageal reflux</topic><topic>Guidelines</topic><topic>Hemoglobin</topic><topic>Hernia</topic><topic>Hiatal hernias</topic><topic>Hospitals</topic><topic>Insulin resistance</topic><topic>Intubation</topic><topic>Laparotomy</topic><topic>Ostomy</topic><topic>Pulmonary aspiration</topic><topic>Risk</topic><topic>Surgery</topic><topic>Surgical outcomes</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Reed LaSala, V.</creatorcontrib><creatorcontrib>Morgan, Madison E.</creatorcontrib><creatorcontrib>Bradburn, Eric H.</creatorcontrib><creatorcontrib>Vernon, Tawnya M.</creatorcontrib><creatorcontrib>Maish, George O.</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Docstoc</collection><collection>University Readers</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Nursing & Allied Health Database</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Science Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><jtitle>The American surgeon</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Reed LaSala, V.</au><au>Morgan, Madison E.</au><au>Bradburn, Eric H.</au><au>Vernon, Tawnya M.</au><au>Maish, George O.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Effects of Fasting Status on the Relative Risk of Pulmonary Aspiration in Acute Care Surgery Patients</atitle><jtitle>The American surgeon</jtitle><date>2020-07</date><risdate>2020</risdate><volume>86</volume><issue>7</issue><spage>837</spage><epage>840</epage><pages>837-840</pages><issn>0003-1348</issn><eissn>1555-9823</eissn><abstract>Background
Acute care surgery patients are often unfasted at the time of surgery, presenting a unique opportunity to study the effects of fasting on the risk of pulmonary aspiration. We aimed to determine the relative risk of aspiration in patients who were fasted at the time of surgery according to guidelines versus those in an unfasted state.
Methods
A retrospective chart review of 100 patients who underwent appendectomy (n = 76) or exploratory laparotomy (n = 24) was conducted at a single institution in 2016-2017. Using the American Society of Anesthesiologists (ASA) Practice Guidelines for Preoperative Fasting, patients were stratified into study and control groups according to whether they were unfasted (nothing by mouth for <8 hours prior to surgery) or fasted (nothing by mouth for >8 hours prior to surgery). Data controlled for patients’ age, sex, body mass index (BMI), most recent hemoglobin A1c, presence of gastroesophageal reflux disease (GERD), and presence of hiatal hernia.
Results
Of the 76 patients who underwent appendectomy, 15% were unfasted with a total of 0 aspiration events (P < .001). Of the 24 patients who underwent exploratory laparotomy, 42% were unfasted with a total of 0 aspiration events (P < .001). This yields a relative risk of pulmonary aspiration of 1.0 (absolute risk of 0) in both the study and control groups.
Discussion
In an acute care surgery population including patients who were not fasted according to guidelines, there was no increase in the risk of pulmonary aspiration.
Level of Evidence
Epidemiological study; Level III.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><doi>10.1177/0003134820940257</doi><tpages>4</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0003-1348 |
| ispartof | The American surgeon, 2020-07, Vol.86 (7), p.837-840 |
| issn | 0003-1348 1555-9823 |
| language | eng |
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| source | SAGE Complete |
| subjects | Anesthesia Appendectomy Body mass Body mass index Body size Dogmatism Epidemiology Fasting Gastroesophageal reflux Guidelines Hemoglobin Hernia Hiatal hernias Hospitals Insulin resistance Intubation Laparotomy Ostomy Pulmonary aspiration Risk Surgery Surgical outcomes |
| title | The Effects of Fasting Status on the Relative Risk of Pulmonary Aspiration in Acute Care Surgery Patients |
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