Key result
Non-fasting prior to contrast-enhanced CT does not increase the risk of aspiration pneumonia or the incidence of emetic complications compared to traditional fasting.
Why the study?
Traditional preparatory fasting prior to contrast-enhanced CT lacks methodologically acceptable evidence, and guidelines do not recommend routine fasting.
Does non-fasting prevent emetic symptoms and aspiration pneumonia in patients undergoing contrast-enhanced CT?
Does non-fasting prevent emetic symptoms and aspiration pneumonia in patients undergoing contrast-enhanced CT?
Non-fasting prior to routine intravenous iodinated contrast media administration is safe and does not increase the risk of emetic symptoms or aspiration pneumonia, supporting the abolition of traditional fasting dogmas.
Supports reevaluation of fasting for contrast CT; leaves open prospective trials before practice change.
Traditional preparatory fasting policy prior to iodinated contrast media (ICM) assisted contrast-enhanced CT (CECT) examinations lacks methodologically acceptable evidence. Considering the possible negative effects of preprocedural fasting, the latest European Society of Urogenital Radiology guidelines V10.0 and American Committee of Radiology 2021 guidelines clearly state that preprocedural fasting is not recommended prior to routine intravenous ICM administration. This comprehensive and detailed Review presents the current global dietary preparation policies, potential harm of excessive fasting, and a systematical and well-bedded description of practice advancements of dietary preparation. The evidences revealed that there has been no single instance of vomiting-associated aspiration pneumonia due to the undemanding implementation of preparatory fasting prior to CECT yet. Non-fasting would not increase the incidence of emetic symptoms and the risk of aspiration pneumonia. Not every patient should undergo all CECT examinations without preparatory fasting. There is still much more refinement to be done on the preparatory fasting policy. Changes in traditional preparatory fasting policy will make positive and significant implications on clinical practice. This Review aims to provide operational guidance and suggestions for practitioners and policymakers, motivate efficient, reasonable, safe and normative ICM usage, and achieve optimal patient clinical benefits and high-quality radiological care practices.
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Liu et al. (2021) conducted a review in Patients undergoing contrast-enhanced CT (CECT). Non-fasting (unrestricted consumption of liquids and solids) vs. Traditional preparatory fasting was evaluated on Incidence of emetic symptoms and risk of aspiration pneumonia. Non-fasting prior to contrast-enhanced CT does not increase the risk of aspiration pneumonia or the incidence of emetic complications compared to traditional fasting.
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