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. 2018 Jul;91(1087):20180107.
doi: 10.1259/bjr.20180107. Epub 2018 May 17.

Nausea and vomiting after exposure to non-ionic contrast media: incidence and risk factors focusing on preparatory fasting

Yeon Soo Kim  1 , Soon Ho Yoon  1   2 , Young Hun Choi  1   2 , Chang Min Park  1   2 , Whal Lee  1   2 , Jin Mo Goo  1   2   3
Affiliations

Nausea and vomiting after exposure to non-ionic contrast media: incidence and risk factors focusing on preparatory fasting

Yeon Soo Kim et al. Br J Radiol. 2018 Jul.

Abstract

Objective: To prospectively evaluate the incidence of nausea and vomiting after exposure to non-ionic iodinated contrast media (ICM), and to identify potential risk factors, with a focus on fasting duration for solid food and fluids, separately.

Methods: From January to March 2017, 1175 patients (605 males, 570 females; median age, 60 years; range, 20-91 years) undergoing ICM-enhanced CT were included in this study. Patients received instructions for a 6 h preparatory fast from solid food. Nausea and vomiting after ICM exposure were assessed on a 3-point scale (mild, moderate, severe). Patients' characteristics and the fasting duration were evaluated to identify risk factors using logistic regression analysis.

Results: Of the 1175 patients, 34 [2.9%; 95% confidence interval (CI) (2.0-4.0)] experienced mild nausea. No patients experienced vomiting [95% CI (0.0000-0.0005)]. 1173 (99.8%) carried out a 6 h fast, and the median fasting durations were 14 h for solid food (interquartile range, 12.5-15.5 h) and 11 h for fluid (interquartile range, 0-13.5 h), respectively. Fasting durations for solid food and fluids were not associated with nausea on univariate regression analyses (p = 0.282-1.000 and 0.146-1.000, respectively). Multivariate regression analysis revealed that a history of drug hypersensitivity [odds ratio = 4.33; 95% CI (1.85-17.52); p = 0.039] was independent risk factors for nausea, whereas iobitridol was less nauseous [odds ratio = 0.32; 95% CI (0.11-0.90); p = 0.032].

Conclusion: Mild nausea occurred in 2.9% of patients and none vomited in our study population with a 6 h preparatory fast from solid food. Many patients underwent excessive fasting for fluids as well as solid food and their fasting durations were not associated with nausea. Advances in knowledge: We firstly evaluated fasting durations for solid food and fluids, and their impacts on vomiting or nausea after ICM exposure with an instruction of 6 h preparatory fast for solid food: many patients underwent excessive fasting for fluids and the fasting duration was unrelated to nausea.

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Figures

Figure 1.
Figure 1.
Flowchart for selecting the study population. ICM, iodinated contrast media.
Figure 2.
Figure 2.
Histogram of fasting duration for solid food and fluids.
See this image and copyright information in PMC

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