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Nausea and vomiting after exposure to non-ionic contrast media: incidence and risk factors focusing on preparatory fasting.

ABSTRACT: OBJECTIVE:To prospectively evaluate the incidence of nausea and vomiting after exposure to non-ionic iodinated contrast media (ICM), and to identify potential risk factors, with a focus on fasting duration for solid food and fluids, separately. METHODS:From January to March 2017, 1175 patients (605 males, 570 females; median age, 60 years; range, 20-91 years) undergoing ICM-enhanced CT were included in this study. Patients received instructions for a 6?h preparatory fast from solid food. Nausea and vomiting after ICM exposure were assessed on a 3-point scale (mild, moderate, severe). Patients' characteristics and the fasting duration were evaluated to identify risk factors using logistic regression analysis. RESULTS:Of the 1175 patients, 34 [2.9%; 95%?confidence interval (CI) (2.0-4.0)] experienced mild nausea. No patients experienced vomiting [95%?CI (0.0000-0.0005)]. 1173 (99.8%) carried out a 6?h fast, and the median fasting durations were 14?h for solid food (interquartile range, 12.5-15.5?h) and 11?h for fluid (interquartile range, 0-13.5?h), respectively. Fasting durations for solid food and fluids were not associated with nausea on univariate regression analyses (p = 0.282-1.000?and 0.146-1.000, respectively). Multivariate regression analysis revealed that a history of drug hypersensitivity [odds ratio = 4.33; 95%?CI (1.85-17.52); p = 0.039] was independent risk factors for nausea, whereas iobitridol was less nauseous [odds ratio = 0.32; 95%?CI (0.11-0.90); p = 0.032]. CONCLUSION:Mild nausea occurred in 2.9% of patients and none vomited in our study population with a 6?h preparatory fast from solid food. Many patients underwent excessive fasting for fluids as well as solid food and their fasting durations were not associated with nausea. Advances in knowledge: We firstly evaluated fasting durations for solid food and fluids, and their impacts on vomiting or nausea after ICM exposure with an instruction of 6?h preparatory fast for solid food: many patients underwent excessive fasting for fluids and the fasting duration was unrelated to nausea.

SUBMITTER: Kim YS

PROVIDER: S-EPMC6221763 | biostudies-literature | 2018 Jul

REPOSITORIES: biostudies-literature

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Nausea and vomiting after exposure to non-ionic contrast media: incidence and risk factors focusing on preparatory fasting.

Kim Yeon Soo YS Yoon Soon Ho SH Choi Young Hun YH Park Chang Min CM Lee Whal W Goo Jin Mo JM

The British journal of radiology 20180517 1087

<h4>Objective</h4>To prospectively evaluate the incidence of nausea and vomiting after exposure to non-ionic iodinated contrast media (ICM), and to identify potential risk factors, with a focus on fasting duration for solid food and fluids, separately.<h4>Methods</h4>From January to March 2017, 1175 patients (605 males, 570 females; median age, 60 years; range, 20-91 years) undergoing ICM-enhanced CT were included in this study. Patients received instructions for a 6 h preparatory fast from soli ...[more]

PMID: 29694239

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Project description:BackgroundHyperemesis gravidarum (HG), a severe form of nausea and vomiting in pregnancy (NVP), is a leading indication for hospitalization in the first trimester. NVP and HG are associated with Helicobacter pylori (HP) infection in non-United States cohorts. How HP exposure and NVP interact to affect metabolic disturbance and pregnancy outcomes is not known.Materials and methodsWe designed a retrospective cohort study relating HP and NVP to serum electrolyte laboratory results, preterm delivery, and infant birth weight. Single academic institution discovery and independent multi-institutional validation cohorts included pregnant subjects with an HP test result. Associations of HP, NVP, and pregnancy outcomes were assessed with odds ratio calculations, Student's t-tests, and multivariate logistic regression.ResultsAmong subjects with positive HP test results, the prevalence of hyperemesis gravidarum (HG) was 0.025 (66 of 2671) and NVP was 0.27 (710 of 2671). Subjects with negative HP had prevalence of HG 0.015 (165 of 10,960) and NVP 0.22 (2392 of 10,960). History of HP exposure increased risk of NVP, including HG (odds ratio 1.3, 95% CI 1.1-1.4). Patients with HP exposure had lower serum potassium (mean difference 0.1 mEq/L) and bicarbonate (mean difference 0.3 mEq/L) during pregnancy than HP-negative patients (p < 0.01). Serum potassium was lowest in subjects with both NVP and HP exposure (mean 3.5 mEq/L [3.4-3.6], p < 0.0001). HP exposure alone carried increased risk for preterm delivery (OR 1.3 [1.1-1.4]). NVP alone increased risk of preterm delivery (OR 2.8 [2.5-3.1]) including second trimester delivery (OR 2.2 [1.7-2.8]). In multivariate analysis, HP exposure in the setting of NVP further increased risk of preterm delivery (adjusted OR 1.4 [1.0-1.9], p = 0.03).ConclusionsH. pylori exposure and diagnosis of NVP are individually associated with metabolic disturbances and adverse pregnancy outcomes such as preterm labor and delivery, and their combination further increases risk in US populations.

Dataset Information

Nausea and vomiting after exposure to non-ionic contrast media: incidence and risk factors focusing on preparatory fasting.

Publications

Nausea and vomiting after exposure to non-ionic contrast media: incidence and risk factors focusing on preparatory fasting.

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