Fasting practices of enteral nutrition delivery for airway procedures in critically ill adult patients: A scoping review.

Background: There is limited understanding of fasting practices and reported safety concerns for airway procedures in critically ill adults. Objective: To describe fasting practices including safety concerns for airway procedures in critically ill adult patients in the reported literature.Inclusion criteria: Studies conducted in adult critically ill patients receiving enteral nutrition (EN) and undergoing an airway procedure (endotracheal intubation, endotracheal extubation, and tracheostomy) were included if EN fasting practices and/or prespecified nutrition and clinical outcomes were reported.Methods: A scoping review using the Joanna Briggs Institute methodology was conducted. MEDLINE, Embase, and CINAHL were searched from 2000 to January 19, 2022.Results are presented via narrative synthesis. Results: Fourteen studies were included, with only one randomised control trial (RCT). Twelve studies reported on fasting practices with varied EN fasting durations (0-34 h) and two reported data on nutrition adequacy. Three studies investigated continued EN in one study arm and four studies minimised fasting duration by includ-ing gastric suctioning prior to the airway procedure. Safety concerns primarily related to aspiration events (61%) were reported in nine studies.Conclusion: In the reported literature, there is wide variation in EN fasting practices for airway procedures in critically ill patients with limited evidence to inform practice.(c) 2022 Published by Elsevier Inc.