Lowering Stomach Acidity and Increasing Patient Safety with Fluid Fasting
In recent years, an increasing number of clinical studies point to the fact that medical professionals should transition away from the traditional NPO fasting policy and instead encourage proper fluid fasting with an enhanced recovery drink. Today, we’ll cover:
- The benefits of fluid fasting with carbohydrate-rich clear liquids like ClearFast as it relates to reducing gastric acidity
- How ClearFast works to raise the pH in a patient’s stomach, leading to lower gastric acids and, ultimately, a reduced risk of aspiration under anesthesia
- Increasing patient safety with ClearFast in place of traditional NPO fasting
- Pre Op Carb Loading for enhanced recovery and reduced PONV
Now, let’s dig in…
Traditional NPO Fasting Versus Fluid Fasting: Debunking Common Misconceptions
Findings from a Cochrane Collaboration review of preoperative fasting states, “Fasting before general anaesthesia aims to reduce the volume and acidity of stomach contents during surgery, thus reducing the risk of regurgitation/aspiration.” Per this statement, we know that the goal of traditional NPO fasting is to reduce gastric contents, ultimately reducing the risk of aspiration. A misconception surrounding fluid fasting is the belief that a fluid fast increases these risks; however, findings from the Cochrane Collaboration Review debunk this common misconception. An analysis of 38 randomized controlled comparisons found “no evidence that the volume or pH of participants’ gastric contents differed significantly depending on whether the groups were permitted a shortened preoperative fluid fast or continued a standard fast.” In short, fluid fasting with traditional liquids (like coffee, water, fruit juice, etc.) prior to anesthesia, in no way, posed a risk to a patient’s safety.
Increased pH, Lower Gastric Acidity with ClearFast
Not only have recent studies shown that fluid fasting does not pose a threat to patient safety, but we’ve also learned that preparing patients for anesthesia with the right carbohydrate beverage can actually increase patient safety as compared to traditional “nothing after midnight” fasting.
Patients entering surgery after a two-bottle protocol of ClearFast have higher pH levels (and, thus, lower acidity) of stomach contents. Traditional NPO fasting caused a build up of gastric acids, with an average patient pH level of approximately 2.0. With a pH level of 4.2, ClearFast works to raise the pH in a patient’s stomach, leading to lower gastric acids and, ultimately, a reduced risk of aspiration under anesthesia.
Pre Op Carb Loading for Enhanced Recovery After Surgery
In addition to ClearFast better preparing patients for anesthesia and increasing safety during surgery, we also know that taking ClearFast as directed can lead to enhanced recovery after surgery, as well as a reduction in post op complications like PONV. In 2011, the American Society of Anesthesiologists® updated its fasting guidelines, ultimately advocating not only for pre-surgical hydration, but also nutrition (excluding fats and proteins as known retardants of normal gastric emptying), noting that patients should not be allowed to come to surgery in a hypoglycemic state. ClearFast helps patients maintain metabolic order by both hydrating and nourishing.
In addition to the AMA’s guidelines, we can look at Enhanced Recovery After Surgery or ERAS (an evidence-based program, borrowed from Europe and the UK), which lists “true pre-op carb loading” as one of the 17 key elements for perioperative patient management. The key to the pre-op carb loading element, however, is preparing patients with complex carbohydrate-rich beverages that contain primarily maltodextrins, rather than simple sugars like the fructose found in Gatorade. To these ends, ClearFast is the only domestically produced beverage of this kind (rich in maltodextrins, clear and colorless, free of simple sugars and colored dyes) used in Enhanced Recovery Protocols in luminary hospitals across the USA.
Interested in learning more about the benefits ClearFast can bring to your patients and your practice? Reach out to the ClearFast team today at firstname.lastname@example.org, or order ClearFast here.