From the Guidelines
No, you do not need to be NPO for ultrasound-guided paracentesis. You can eat and drink normally before this procedure. Unlike some other medical procedures that require fasting to prevent aspiration during sedation or to improve visualization, paracentesis involves draining fluid from the peritoneal cavity in the abdomen and does not typically require sedation that would impair your protective airway reflexes. The ultrasound guidance, as recommended by the European Society of Paediatric and Neonatal Intensive Care (ESPNIc) in their 2020 guidelines 1, is used to visualize the fluid pocket and surrounding structures to ensure safe needle placement, regardless of recent food or fluid intake. Some key points to consider about this procedure include:
- The use of ultrasound guidance decreases bleeding complications and overall cost of care for patients undergoing in-hospital paracentesis, as noted in adult studies referenced by the ESPNIC guidelines 1.
- The procedure is typically performed using local anesthesia at the insertion site, and patients remain awake and alert throughout.
- You should always follow specific instructions from your healthcare provider, as individual circumstances may vary. Some providers might recommend limiting food intake shortly before the procedure simply for comfort, as having a full stomach while lying flat during the procedure might cause discomfort.
From the Research
NPO Status for Ultrasound-Guided Paracentesis
- There is no direct evidence in the provided studies that specifically addresses the need for NPO (nothing by mouth) status for ultrasound-guided paracentesis 2, 3, 4, 5, 6.
- The studies focus on the technical, diagnostic, and therapeutic aspects of paracentesis, including the use of ultrasound guidance, patient selection, and complication rates.
- None of the studies mention NPO status as a requirement or recommendation for patients undergoing ultrasound-guided paracentesis.
Relevant Findings
- Ultrasound-guided paracentesis is recommended to reduce the risk of serious complications, such as bleeding, and to improve the success rates of the procedure 2.
- The use of ultrasound guidance allows for the identification of a safe needle insertion site and the avoidance of abdominal wall blood vessels and underlying organs 2, 5.
- Paracentesis can be performed safely and effectively by trained healthcare professionals, including gastrointestinal endoscopy assistants and nephrologists 3, 5.
Procedure-Related Considerations
- The procedure can be performed on an inpatient or outpatient basis, depending on the patient's condition and the volume of ascitic fluid to be removed 3, 6.
- The use of intravenous albumin infusion may be necessary to avoid renal and electrolyte complications in patients with cirrhosis undergoing large-volume paracentesis 4.