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A Descriptive Analysis on Effects of NPO Status on Intubated Patients Undergoing Surgery
Margaret Siu, MD1, Aixa Perez Coulter, MS, MPH1, Heather Grant, MD, MS1, Reginald Alouidor, MD1, Michael V. Tirabassi, MD1 1University of Massachusetts Chan Medical School-Baystate, Department of Surgery, Springfield, MA, USA

Background: Patient outcomes rely on nutritional support. Holding enteric feeds prior to surgical operations in critically ill patients is still a common practice in intensive critical units. Our objective is to describe the relationship between duration of nil per os (NPO) and respiratory outcomes in intubated, critically ill patients requiring operative intervention.

Methods: We conducted a retrospective analysis on intubated, critically ill patients who underwent operative intervention between 1/1/2016 and 12/31/2018 to investigate how the duration of NPO status may affect respiratory outcomes. We compared adverse respiratory events among patients kept NPO ≥6 hours (NPO group) vs. those who were NPO <6 hours (Non-NPO group) prior to surgery.

Results: 200 patients met inclusion criteria, 104 for NPO and 96 for Non-NPO. Aspiration event was found in 5.8% of NPO patients and 7.3% in Non-NPO patients, p=0.66. Desaturation event was found in 16.3% for NPO and 14.6% in Non-NPO, p=0.73. Pneumonia was found in 18.3% of NPO patients and 19.8% in Non-NPO patients, p=0.78. Reintubated rates were 13.5% for NPO and 16.7% for Non-NPO, p=0.57. Median (range) hours of NPO for Non-NPO was 1.0 hours (0 - 3.0), and 13.0 hours (6.0 - 20.0) for NPO, p<0.05.

Conclusion: For intubated, critically ill patients requiring surgery, there was no difference observed in adverse respiratory events between those kept NPO for 6 hours or greater compared to those kept NPO for less than 6 hours. Patients were commonly without enteric nutrition for periods of time much greater than the ASA recommended 6-hour period.
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