EN fasting practices for airway procedures are variable, ranging from 0 to 34 h.
•There is a lack of high-quality evidence to guide EN fasting practices in the ICU.
•RCTs are needed to explore risks/benefits of reduced fasting for airway procedures.
AbstractBackgroundThere is limited understanding of fasting practices and reported safety concerns for airway procedures in critically ill adults.
ObjectiveTo describe fasting practices including safety concerns for airway procedures in critically ill adult patients in the reported literature.
Inclusion criteriaStudies conducted in adult critically ill patients receiving enteral nutrition (EN) and undergoing an airway procedure (endotracheal intubation, endotracheal extubation, and tracheostomy) were included if EN fasting practices and/or prespecified nutrition and clinical outcomes were reported.
MethodsA scoping review using the Joanna Briggs Institute methodology was conducted. MEDLINE, Embase, and CINAHL were searched from 2000 to January 19, 2022. Results are presented via narrative synthesis.
ResultsFourteen studies were included, with only one randomised control trial (RCT). Twelve studies reported on fasting practices with varied EN fasting durations (0–34 h) and two reported data on nutrition adequacy. Three studies investigated continued EN in one study arm and four studies minimised fasting duration by including gastric suctioning prior to the airway procedure. Safety concerns primarily related to aspiration events (61%) were reported in nine studies.
ConclusionIn the reported literature, there is wide variation in EN fasting practices for airway procedures in critically ill patients with limited evidence to inform practice.
KeywordsAirway procedures
Enteral nutrition
Extubation
Fasting
Feeding interruptions
Tracheostomy
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