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Review
. 2021 Dec 4;12(1):180.
doi: 10.1186/s13244-021-01131-1.

Preprocedural fasting for contrast-enhanced CT: when experience meets evidence

Heng Liu #  1   2 , Yu Liu #  3 , Li Zhao  2 , Xue Li  4 , Weiguo Zhang  5   6
Affiliations
Review

Preprocedural fasting for contrast-enhanced CT: when experience meets evidence

Heng Liu et al. Insights Imaging. .

Abstract

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.

Keywords: Aspiration pneumonia; Contrast-enhanced CT; Nausea; Preparatory fasting; Vomiting.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
The negative effects of excessive preprocedural fasting and the benefits of non-fasting prior to CECT
See this image and copyright information in PMC

References

    1. Chinese Society of Imaging Technology, China Society for Radiology CT examination technology expert consensus. Chin J Radiol. 2016;50:916–928.
    1. Lee BY, Ok JJ, Abdelaziz Elsayed AA, Kim Y, Han DH. Preparative fasting for contrast-enhanced CT: reconsideration. Radiology. 2012;263:444–450. - PubMed
    1. American Society of Anesthesiologists Committee Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: application to healthy patients undergoing elective procedures: an updated report by the American Society of Anesthesiologists Committee on Standards and Practice Parameters. Anesthesiology. 2011;114:495–511. - PubMed
    1. Mendelson CL. Aspiration of stomach contents into lungs during obstetric anesthesia. Am J Obstet Gynecol. 1946;52:191–205. - PubMed
    1. O'Sullivan G, Scrutton M. NPO during labor. Is there any scientific validation? Anesthesiol Clin North Am. 2003;21:87–98. - PubMed

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