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

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Heng Liu ◽  
Yu Liu ◽  
Li Zhao ◽  
Xue Li ◽  
Weiguo Zhang
Keyword(s):  
Aspiration Pneumonia ◽  
Negative Effects ◽  
Iodinated Contrast ◽  
Contrast Enhanced Ct ◽  
Single Instance ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Clinical Benefits ◽  
Risk Of Aspiration ◽  
Operational Guidance

AbstractTraditional 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.

scholarly journals The effect of abolishing instructions to fast prior to contrast-enhanced CT on the incidence of acute adverse reactions

2020 ◽  
Vol 11 (1) ◽  
Author(s):  
Yoshito Tsushima ◽  
Yuko Seki ◽  
Takahito Nakajima ◽  
Hiromi Hirasawa ◽  
Ayako Taketomi-Takahashi ◽  
...  
Keyword(s):  
Food Intake ◽  
Policy Change ◽  
Aspiration Pneumonia ◽  
Medical Records ◽  
Adverse Reactions ◽  
Solid Food ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct

Abstract Objectives To evaluate the effect of abolishing instructions to fast prior to contrast-enhanced CT on acute adverse reactions (AARs). Methods In our institution, we instructed patients to fast one meal before contrast-enhanced CT examinations. However, we abolished these instructions at the end of March 2019, and solid food intake was not restricted before contrast-enhanced CT after this date. The differences in the incidence of AARs before (December 2015–November 2018, n = 43,927) and after (April 2019–March 2020, n = 14,676) abolishing instructions to fast were compared. We allowed 4 months (December 2018–March 2019) for this policy change to fully permeate the CT referrals. The medical records of patients who vomited were retrospectively reviewed by one of the authors for notations of aspiration or aspiration pneumonia attributable to vomiting. Results The overall incidence of AARs before (1.60%, n = 705) and after abolition (1.40%, n = 205) did not change significantly. As the chemotoxic reactions, the incidence of nausea decreased significantly (0.31 to 0.18%, p = 0.006). The incidence of vomiting did not change (0.12 to 0.16%), and there were no cases of aspiration pneumonia attributable to vomiting during the study period. The incidence of severe hypersensitivity/allergy-like reactions did not change (0.06 to 0.05%). Conclusions Abolishing instructions to fast decreased the incidence of nausea, but did not affect the incidence of vomiting. No cases of aspiration pneumonia attributable to vomiting were found. Our study confirmed that fasting is not required prior to contrast-enhanced CT.

Iso-Osmolality versus Low-Osmolality Iodinated Contrast Medium at Intravenous Contrast-enhanced CT: Effect on Kidney Function

Radiology ◽  
2008 ◽  
Vol 248 (1) ◽  
pp. 97-105 ◽  
Author(s):  
Shaun A. Nguyen ◽  
Pal Suranyi ◽  
James G. Ravenel ◽  
Patrick K. Randall ◽  
Peter B. Romano ◽  
...  
Keyword(s):  
Contrast Medium ◽  
Kidney Function ◽  
Intravenous Contrast ◽  
Iodinated Contrast Medium ◽  
Iodinated Contrast ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct

scholarly journals Intravenous iodinated contrast is not associated with acute kidney injury in adult patients with nephrotic syndrome

2019 ◽  
Vol 5 (2) ◽  
Author(s):  
Andrew Bacyinski
Keyword(s):  
Acute Kidney Injury ◽  
Nephrotic Syndrome ◽  
Retrospective Cohort ◽  
Critical Appraisal ◽  
Kidney Injury ◽  
European Radiology ◽  
Iodinated Contrast ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct

<p>A critical appraisal and clinical application of Tao SM, Kong X, Schoepf UJ, et al. Acute kidney injury in patients with nephrotic syndrome undergoing contrast-enhanced CT for suspected venous thromboembolism: a propensity score-matched retrospective cohort study. <em>European Radiology</em>. 2018;28(4):1585-1593. doi: <a href="https://doi.org/10.1007/s00330-017-5109-0">10.1007/s00330-017-5109-0</a></p>

Early diagnosis of poststernotomy mediastinitis: Are there typical findings in contrast-enhanced CT?

2009 ◽  
Vol 56 (S 01) ◽  
Author(s):  
C Schimmer ◽  
M Weininger ◽  
K Hamouda ◽  
C Ritter ◽  
SP Sommer ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct
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