Abstract
ObjectivesTo analyze the relationship between the dietary preparation status prior to contrast-enhanced CT (CECT) and adverse drug reactions (ADR) and emetic complications.MethodsNon-emergency adult patients who underwent routine CECT in our hospital from January 2019 to December 2020 were retrospectively analyzed. Stratified dietary preparation regimens were implemented for different clinical scenarios. The relationship between actual dietary preparation status and ADR and emetic complications was analyzed.ResultsA total of 127,200 cases were enrolled, including 49,676 cases in the fasting group (57 years ± 13, 56.79% men) and 77,524 cases in the non-fasting group (60 years ± 13, 54.55% men). No statistical difference was found in the overall incidence of ADR (0.211% vs. 0.254%, p = 0.126) or emetic complications (0.030% vs. 0.046%, p = 0.158) between the two groups, and no aspiration pneumonia or death occurred. For patients with an ICM-ADR history, the ADR incidence in non-fasting group was significantly lower than fasting group (2.424% vs. 12.371%, p = 0.002). For patients with hypertension, injection dose ≥ 100 mL, injection rate ≥ 5 mL/s, and Iopromide 370 usage, non-fasting was associated with higher ADR incidence (p < 0.05). 36.67% of the patients experienced unnecessary excessive fasting in practice. Excessive fasting (≥ 10 h) and more water ingestion (≥ 500 mL) within 1 h prior to CECT were associated with higher ADR incidence (p < 0.05).ConclusionUnrestricted food ingestion would not increase the overall risk of ADR and emetic complications. For some special patient subgroups, non-fasting, excessive fasting, and more water ingestion were associated with higher ADR incidence.
Highlights
As a time-honored tradition, preprocedural fasting for 4–6 h is typically required prior to contrast-enhanced CT (CECT) in most medical institutions worldwide, to reduce the possibility of adverse consequences after injection of iodinated contrast media (ICM) [1–3]
*Correspondence: jingqin0405@163.com; lixue928136@163.com †Heng Liu and Li Zhao contributed to this work 1 Present Address: Department of Radiology, Daping Hospital, Army Medical University, No 10 Changjiang Road, Yuzhong District, Chongqing 400042, China Full list of author information is available at the end of the article rate ≥ 5 mL/s, and Iopromide 370 usage), non-fasting was associated with higher adverse drug reactions (ADR) incidence
Excessive fasting (≥ 10 h) and more water ingestion (≥ 500 mL) within 1 h prior to CECT were associated with higher ADR incidence
Summary
As a time-honored tradition, preprocedural fasting for 4–6 h is typically required prior to contrast-enhanced CT (CECT) in most medical institutions worldwide, to reduce the possibility of adverse consequences (e.g., emetic complications and aspiration) after injection of iodinated contrast media (ICM) [1–3]. This policy lacks methodologically acceptable evidence, and the fasting time durations and contents vary considerably in different medical institutions, preprocedural fasting is still a fairly common request worldwide [3]. Non-fasting would not increase the risk of aspiration pneumonia and the incidence of emetic complications [3]. It seems not prudent to fast without distinction for every patient without evidencebased considerations, and the existing fasting strategies can reasonably be less restrictive
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