Evaluate psychological effects of prolonged fasting in patients undergoing cardiac surgery

Abstract

Introduction: Comprehensive care of the cardiosurgical patient is essential to optimize clinical results. In this context, preoperative strategies play a key role, with accelerated recovery programs (ERAS) being a promising alternative. Objective: To evaluate the psychological and metabolic effects of prolonged fasting (>8 h) in patients undergoing elective cardiac surgery, comparing them with a group receiving carbohydrate supplementation. Methodology: Quasi-experimental, prospective and randomized study. Patients were assigned to two groups: (1) Carbohydrate supplementation and (2) Prolonged fasting. Clinical variables, capillary blood glucose, anxiety (Hamilton Scale), feeling of hunger and thirst, perceived satisfaction and postoperative complications were measured. Results: 58 patients were included. The intervention group presented a lower sensation of hunger and thirst (p < 0.001), as well as a significant reduction in pre-surgical anxiety (p = 0.003) compared to the control group. Perceived satisfaction was also higher in the intervention group (p = 0.047). No significant differences were detected in capillary blood glucose levels between the groups. Neither was a greater need for insulin administration observed in either group. Regarding postoperative complications, no significant differences were observed, nor were there any cases of mortality attributable to the procedure. Conclusions: Preoperative supplementation with carbohydrate-rich fluids improves the patient experience in terms of anxiety and comfort, without compromising metabolic stability or increasing the incidence of postoperative complications. The findings found throughout the research support the incorporation of this strategy into cardiac surgery protocols, with the potential to optimize patient experience and outcomes.