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Preparative fasting for contrast-enhanced CT: reconsideration.

Bae-Young Lee1, Jin-Ju Ok, Abdelrahman Adel Abdelaziz Elsayed

  • 1Department of Radiology, St. Paul's Hospital, The Catholic University of Korea, Seoul, Korea.

Radiology
|April 21, 2012
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Drinking clear fluids before a contrast-enhanced computed tomography (CT) scan appears safe, with no aspiration pneumonia observed in over 2000 patients. Hospital policies on pre-scan fasting vary widely globally, with many institutions having no restrictions on fluid intake.

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Area of Science:

  • Radiology and Imaging
  • Patient Safety
  • Medical Policy Evaluation

Background:

  • Pre-procedural fasting protocols for contrast-enhanced computed tomography (CT) are common.
  • Concerns exist regarding potential aspiration risks associated with fluid ingestion before CT scans.
  • Current institutional practices for pre-CT fasting lack standardization.

Purpose of the Study:

  • To assess the safety of fluid intake before contrast-enhanced CT.
  • To review existing literature on aspiration pneumonia linked to pre-CT fluid consumption.
  • To survey international institutional policies on pre-CT fasting for fluids and solids.

Main Methods:

  • Systematic literature search using Medline with 20 keyword combinations.
  • Meta-analysis of 13 studies involving 2001 patients to determine aspiration incidence.
  • Multinational survey of 80 leading institutions regarding their fasting protocols for elective CT.

Main Results:

  • No cases of aspiration pneumonia were reported in 2001 patients who ingested fluids before contrast-enhanced CT.
  • Data from 69 institutions revealed significant variability in fasting policies.
  • A majority of French and German hospitals, and a high percentage of Australian hospitals, had liberal fluid policies.

Conclusions:

  • Evidence suggests that consuming clear fluids before contrast-enhanced CT does not significantly increase aspiration pneumonia risk.
  • Pre-procedural fasting durations for fluids and solids differ substantially across hospitals and countries.
  • There is a need for evidence-based guidelines to standardize fasting protocols for contrast-enhanced CT.