Sensible Medicine This Fortnight in Medicine (Episode III)
Jul 2, 2025
Exploring the necessity of preprocedural fasting, the discussion challenges long-standing norms that could hinder patient care. It critically evaluates the validity of clinical studies and highlights the complexities of managing dietary restrictions for patients. New insights into fasting guidelines for cardiac procedures prompt a reevaluation of patient lifestyle changes. The episode also sheds light on the influence of social media on public perceptions of heart disease, emphasizing the importance of rigorous research interpretation.
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Fasting Dogma Lacks Evidence
- The long-standing fasting rule before procedures lacks strong evidence and is based on outdated animal studies.
- Modern meta-analysis shows no significant difference in aspiration risk between liberal and conservative fasting.
Advocate RCT on Fasting Duration
- A well-designed randomized control trial is needed to confirm fasting duration does not increase aspiration risk.
- Such a study could also show benefits of shorter fasting on glucose and blood pressure control.
Imaging Can Harm Patients
- John Mandrola shared his personal experience with incidental MRI findings worsening his perception of back pain.
- This illustrates how imaging can sometimes create harm by alarming patients unnecessarily.