Nausea, vomiting, and aspiration pneumonia in “non-fasting” patients undergoing non-emergent contrast-enhanced computed tomography scan and relation to food intake

Objectives Traditionally, fasting before a contrast-enhanced computed tomography (CECT) scan was considered necessary due to the concerns of nausea, vomiting, and aspiration pneumonia. As per the recent international guidelines, fasting is not recommended prior to routine CECT; and with the use of non-ionic iodinated contrast media (ICM), the frequency of adverse reactions has decreased significantly. Our aim is to prospectively evaluate the effect of non-fasting on the occurrence of nausea, vomiting, aspiration pneumonia, and other acute adverse reactions (AARs) in patients undergoing non-emergent CECT and correlating these complications with the time of food ingestion, type (solid/liquid), and the quantity of food ingested. Material and Methods A 100 adult non-fasting patients who underwent a non-emergent CECT scan after intravenous injection of non-ionic ICM (iohexol-350 mg I/ml), were observed for 1 hour for the occurrence of AARs. The time, type, and quantity of food ingested prior to CECT were recorded. Results Four patients out of 100 (4%) developed mild emetic complications with spontaneous resolution within 1 hour. No aspiration pneumonia, urticaria, bronchospasm, or any severe AARs were seen. No statistically significant correlation was found between the time of food ingestion, type and quantity of food ingested, and the occurrence of AARs. (p = 0.61, 0.388, and 0.255, respectively). Conclusion No significant AARs or aspiration pneumonia were seen in non-fasting patients undergoing non-emergent CECT with non-ionic ICM, irrespective of the time of food ingestion, type, or quantity of food ingested.