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Is fasting still necessary prior to contrast-enhanced computed tomography? A randomized clinical study
Ziv Neeman1,2, Mayasa Abu Ata3, Elia Touma3
1Department of Radiology, Emek Medical Center, Afula, Israel.
Fasting before contrast-enhanced computed tomography (CT) is not necessary. Withholding fasting orders did not increase the risk of aspiration pneumonitis or gastrointestinal symptoms in patients undergoing CT scans.
Area of Science:
- Radiology
- Gastroenterology
- Clinical Medicine
Background:
- The necessity of preparative fasting before contrast-enhanced computed tomography (CT) is widely practiced but lacks robust evidence.
- This study addresses the common clinical practice of pre-CT fasting.
Purpose of the Study:
- To evaluate the impact of withholding fasting orders on the incidence of aspiration pneumonitis.
- To assess the effect on adverse gastrointestinal symptoms, such as nausea and vomiting, following contrast-enhanced CT.
Main Methods:
- A randomized controlled trial involving hospitalized patients scheduled for non-emergency contrast-enhanced CT.
- Participants were assigned to either a fasting group (≥4 hours) or a non-fasting group with unrestricted intake.
- Primary outcome: aspiration pneumonitis; Secondary outcomes: nausea and vomiting.
Main Results:
- A total of 2091 participants (1080 fasting, 1011 non-fasting) were analyzed.
- No cases of aspiration pneumonitis were observed in either group.
- Rates of nausea and vomiting were not significantly different between the fasting and non-fasting groups.
Conclusions:
- Withholding preparative fasting prior to contrast-enhanced CT is safe.
- It does not increase the risk of aspiration pneumonitis or adverse gastrointestinal symptoms.
- Patients can be permitted to eat and drink before contrast-enhanced CT scans.
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