Document Detail


Central venous catheter integrity during mechanical power injection of iodinated contrast medium.
MedLine Citation:
PMID:  19789224     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To evaluate a widely used nontunneled triple-lumen central venous catheter in order to determine whether the largest of the three lumina (16 gauge) can tolerate high flow rates, such as those required for computed tomographic angiography. MATERIALS AND METHODS: Forty-two catheters were tested in vitro, including 10 new and 32 used catheters (median indwelling time, 5 days). Injection pressures were continuously monitored at the site of the 16-gauge central venous catheter hub. Catheters were injected with 300 and 370 mg of iodine per milliliter of iopamidol by using a mechanical injector at increasing flow rates until the catheter failed. The infusion rate, hub pressure, and location were documented for each failure event. The catheter pressures generated during hand injection by five operators were also analyzed. Mean flow rates and pressures at failure were compared by means of two-tailed Student t test, with differences considered significant at P < .05. RESULTS: Injections of iopamidol with 370 mg of iodine per milliliter generate more pressure than injections of iopamidol with 300 mg of iodine per milliliter at the same injection rate. All catheters failed in the tubing external to the patient. The lowest flow rate at which catheter failure occurred was 9 mL/sec. The lowest hub pressure at failure was 262 pounds per square inch gauge (psig) for new and 213 psig for used catheters. Hand injection of iopamidol with 300 mg of iodine per milliliter generated peak hub pressures ranging from 35 to 72 psig, corresponding to flow rates ranging from 2.5 to 5.0 mL/sec. CONCLUSION: Indwelling use has an effect on catheter material property, but even for used catheters there is a substantial safety margin for power injection with the particular triple-lumen central venous catheter tested in this study, as the manufacturer's recommendation for maximum pressure is 15 psig.
Authors:
Douglas B Macha; Rendon C Nelson; Laurens E Howle; John W Hollingsworth; Sebastian T Schindera
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Publication Detail:
Type:  Journal Article     Date:  2009-09-29
Journal Detail:
Title:  Radiology     Volume:  253     ISSN:  1527-1315     ISO Abbreviation:  Radiology     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-12-02     Completed Date:  2010-01-07     Revised Date:  2010-04-23    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  870-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Radiology, Center for Nonlinear and Complex Systems, Duke University Medical Center, Box 3808, Erwin St, Durham, NC 27710, USA.
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MeSH Terms
Descriptor/Qualifier:
Catheterization, Central Venous / adverse effects*,  instrumentation*
Catheters, Indwelling
Contrast Media / administration & dosage*
Equipment Failure
Equipment Safety
Humans
Injections, Intravenous / adverse effects,  instrumentation
Pressure
Rheology
Rupture
Statistics, Nonparametric
Tomography, X-Ray Computed
Chemical
Reg. No./Substance:
0/Contrast Media
Comments/Corrections
Comment In:
Radiology. 2010 May;255(2):662; author reply 662   [PMID:  20413780 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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