Incidence and Risk Factors of Nausea and Vomiting after Exposure to Low-Osmolality Iodinated Contrast Media in Children: A Focus on Preparative Fasting
Incidence and Risk Factors of Nausea and Vomiting after Exposure to Low-Osmolality Iodinated Contrast Media in Children: A Focus on Preparative Fasting
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DOI：
10.3348/kjr.2019.0835
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发表时间：
2020-10-01
影响因子：
4.8
通讯作者：
Kim, Woo Sun
中科院分区：
文献类型：
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作者：
Ha, Ji Young;Choi, Young Hun;Kim, Woo Sun
目的：探讨静脉注射低渗碘造影剂(ICM)在儿童CT检查中呕吐并发症的发生率及危险因素。材料和方法：选择2017年4月至2019年7月接受CT增强扫描的儿童。儿科患者在我们机构接受了准备饮食方案的指导。放射科有经验的护士在CT扫描期间监测儿童，并在他们的电子医疗记录中记录任何呕吐并发症。这些数据被用来计算呕吐并发症的发生率。通过单因素和多因素Logistic回归分析确定呕吐并发症的危险因素。结果：在864名儿童(平均年龄8.4±5.7岁)中，发生呕吐并发症18例(2.1%)，其中6例出现恶心，12例出现恶心呕吐。所有儿童均未患上吸入性肺炎。有呕吐者的平均禁食时间为7.9±5.7小时(3~21小时)，无恶心的患者平均禁食时间为8.7±5.7小时(0~24小时)。禁食时间与恶心和呕吐的发生无关(p=0.634)。多因素Logistic回归分析显示，持续化疗(OR=4.323；95%可信区间[CI]=1.430~13.064；p=0.009)、使用碘丙醇(OR=7.219；95%CI=1.442~36.146；p=0.016)、使用碘海醇(OR=5.241；95%CI=1.350~20.346；p=0.017)是呕吐并发症的独立危险因素。许多儿童经历了过度禁食；然而，禁食时间与恶心和呕吐无关。此外，正在进行的化疗和使用碘丙醇或碘海醇被确定为儿童呕吐并发症的潜在危险因素。
Objective: To evaluate the incidence and risk factors of emetic complications associated with the intravenous administration of low-osmolality iodinated contrast media (ICM) in children undergoing computed tomography (CT).Materials and Methods: All children who underwent contrast-enhanced CT between April 2017 and July 2019 were included. Pediatric patients were instructed on the preparative dietary protocol at our institution. Experienced nurses in the radiology department monitored the children during the CT scans and recorded any emetic complications in their electronic medical records. These data were used to calculate the incidence of emetic complications. Various patient factors and technical factors, including fasting duration, the type and volume of ICM, and ongoing chemotherapy, were evaluated to identify risk factors for emetic complications using univariate and multivariate logistic regression analyses.Results: Among the 864 children (mean age, 8.4 +/- 5.7 years) evaluated, 18 (2.1%) experienced emetic complications (6 experienced nausea only and 12 experienced nausea and vomiting). None of the children developed aspiration pneumonia. The mean fasting duration of patients with emesis was 7.9 +/- 5.7 hours (range, 3-21 hours), whereas that of patients without nausea was 8.7 +/- 5.7 hours (range, 0-24 hours). Fasting duration was not associated with the development of nausea and vomiting (p = 0.634). Multivariate logistic regression analysis revealed that ongoing chemotherapy (odds ratio [OR] = 4.323; 95% confidence interval [CI] = 1.430-13.064; p = 0.009), iomeprol use (OR = 7.219; 95% CI = 1.442-36.146; p = 0.016), and iohexol use (OR = 5.241; 95% CI = 1.350-20.346; p = 0.017) were independent risk factors for emetic complications.Conclusion: Only a small proportion (2.1%) of children experienced nausea or vomiting after exposure to low-osmolality ICM. Many children underwent excessive fasting; however, fasting duration was not associated with nausea and vomiting. Moreover, ongoing chemotherapy and the use of iomeprol or iohexol were identified as potential risk factors for emetic complications in children.