Systematic Review: Outcomes by Duration of NPO Status prior to Colonoscopy
Background/Aims. Variation exists among anesthesia providers as to acceptable timing of NPO (“nothing by mouth”) for elective colonoscopy procedures. There is a need to balance optimal colonic preparation, patient convenience, and scheduling efficiency with anesthesia safety concerns. We reviewed th...
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| Format: | Article |
| Language: | English |
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Wiley
2017-01-01
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| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2017/3914942 |
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| author | Aasma Shaukat Ashish Malhotra Nancy Greer Roderick MacDonald Joseph Wels Timothy J. Wilt |
| author_facet | Aasma Shaukat Ashish Malhotra Nancy Greer Roderick MacDonald Joseph Wels Timothy J. Wilt |
| author_sort | Aasma Shaukat |
| collection | DOAJ |
| description | Background/Aims. Variation exists among anesthesia providers as to acceptable timing of NPO (“nothing by mouth”) for elective colonoscopy procedures. There is a need to balance optimal colonic preparation, patient convenience, and scheduling efficiency with anesthesia safety concerns. We reviewed the evidence for the relationship between NPO timing and aspiration incidence and colonoscopy rescheduling. Methods. We searched MEDLINE (1990–April 2015) for English language studies of any design and included them if at least one bowel preparation regimen was completed within 8 hours of colonoscopy. Study characteristics, patient characteristics, and outcomes were abstracted and verified by investigators. We determined risk of bias for each study and overall strength of evidence for primary and secondary outcomes. Results. We included 28 randomized controlled trials (RCTs), 2 controlled clinical trials, and 10 observational reports. Six studies reported on aspiration; none found that shorter NPO status prior to colonoscopy increased aspiration risk, though studies were not designed to assess this outcome (low strength of evidence). One RCT found fewer rescheduled procedures following split-dose preparation but NPO status was not well-documented (insufficient evidence). Conclusions. Aspiration incidence requiring hospitalization during colonoscopy with moderate or deep sedation is very low. No study found that shorter NPO status prior to colonoscopy increased aspiration risk. We did not find direct evidence of the effect of NPO status on colonoscopy rescheduling. |
| format | Article |
| id | doaj-art-deea4e98794b4afaa36d8a54dd67fa86 |
| institution | Kabale University |
| issn | 1687-6121 1687-630X |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Gastroenterology Research and Practice |
| spelling | doaj-art-deea4e98794b4afaa36d8a54dd67fa862025-08-20T03:26:15ZengWileyGastroenterology Research and Practice1687-61211687-630X2017-01-01201710.1155/2017/39149423914942Systematic Review: Outcomes by Duration of NPO Status prior to ColonoscopyAasma Shaukat0Ashish Malhotra1Nancy Greer2Roderick MacDonald3Joseph Wels4Timothy J. Wilt5Division of Gastroenterology, Veterans Affairs Medical Center, Minneapolis, MN, USADivision of Gastroenterology, Veterans Affairs Medical Center, Minneapolis, MN, USACenter for Chronic Disease Outcomes Research, Veterans Affairs Medical Center, Minneapolis, MN, USACenter for Chronic Disease Outcomes Research, Veterans Affairs Medical Center, Minneapolis, MN, USADivision of Anesthesiology, Veterans Affairs Medical Center, Minneapolis, MN, USADepartment of Medicine, University of Minnesota, Minneapolis, MN, USABackground/Aims. Variation exists among anesthesia providers as to acceptable timing of NPO (“nothing by mouth”) for elective colonoscopy procedures. There is a need to balance optimal colonic preparation, patient convenience, and scheduling efficiency with anesthesia safety concerns. We reviewed the evidence for the relationship between NPO timing and aspiration incidence and colonoscopy rescheduling. Methods. We searched MEDLINE (1990–April 2015) for English language studies of any design and included them if at least one bowel preparation regimen was completed within 8 hours of colonoscopy. Study characteristics, patient characteristics, and outcomes were abstracted and verified by investigators. We determined risk of bias for each study and overall strength of evidence for primary and secondary outcomes. Results. We included 28 randomized controlled trials (RCTs), 2 controlled clinical trials, and 10 observational reports. Six studies reported on aspiration; none found that shorter NPO status prior to colonoscopy increased aspiration risk, though studies were not designed to assess this outcome (low strength of evidence). One RCT found fewer rescheduled procedures following split-dose preparation but NPO status was not well-documented (insufficient evidence). Conclusions. Aspiration incidence requiring hospitalization during colonoscopy with moderate or deep sedation is very low. No study found that shorter NPO status prior to colonoscopy increased aspiration risk. We did not find direct evidence of the effect of NPO status on colonoscopy rescheduling.http://dx.doi.org/10.1155/2017/3914942 |
| spellingShingle | Aasma Shaukat Ashish Malhotra Nancy Greer Roderick MacDonald Joseph Wels Timothy J. Wilt Systematic Review: Outcomes by Duration of NPO Status prior to Colonoscopy Gastroenterology Research and Practice |
| title | Systematic Review: Outcomes by Duration of NPO Status prior to Colonoscopy |
| title_full | Systematic Review: Outcomes by Duration of NPO Status prior to Colonoscopy |
| title_fullStr | Systematic Review: Outcomes by Duration of NPO Status prior to Colonoscopy |
| title_full_unstemmed | Systematic Review: Outcomes by Duration of NPO Status prior to Colonoscopy |
| title_short | Systematic Review: Outcomes by Duration of NPO Status prior to Colonoscopy |
| title_sort | systematic review outcomes by duration of npo status prior to colonoscopy |
| url | http://dx.doi.org/10.1155/2017/3914942 |
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