Preprocedural fasting for contrast-enhanced CT: when experience meets evidence.
Preprocedural fasting for contrast-enhanced CT: when experience meets evidence.
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对比增强 CT 术前禁食：当经验与证据相遇时
DOI：
10.1186/s13244-021-01131-1
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发表时间：
2021-12-04
影响因子：
4.7
通讯作者：
Zhang W
中科院分区：
文献类型：
--
作者：
Liu H;Liu Y;Zhao L;Li X;Zhang W
传统的在碘化造影剂(ICM)辅助增强CT(CECT)检查前的准备禁食政策缺乏方法学上可接受的证据。考虑到术前禁食可能产生的负面影响，最新的欧洲泌尿生殖系统放射学会指南V10.0和美国放射委员会2021指南明确指出，在常规静脉注射ICM之前，不建议术前禁食。这篇全面而详细的综述介绍了当前的全球膳食制备政策，过度禁食的潜在危害，以及对膳食制备实践进展的系统和深入的描述。证据显示，目前尚无单一的呕吐相关吸入性肺炎病例，这是由于在CECT前并未严格执行预备禁食。非禁食不会增加呕吐症状的发生率和吸入性肺炎的风险。并不是每个患者都应该在不禁食的情况下接受所有CECT检查。在准备禁食政策方面，仍有更多需要完善的地方。传统预备禁食政策的改变将对临床实践产生积极而重要的影响。本审查旨在为从业者和政策制定者提供操作指导和建议，促进有效、合理、安全和规范的ICM使用，并实现最佳的患者临床利益和高质量的放射治疗实践。
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.
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影响因子：
5.9
作者：
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通讯作者：
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影响因子：
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DOI：
10.31744/einstein_journal/2019ao4418
发表时间：
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期刊：
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