Document Detail


Risk of extravasation after power injection of contrast media via the proximal port of multilumen central venous catheters: case report and review of the literature.
MedLine Citation:
PMID:  19859861     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Multilumen central venous catheters (CVCs) are not commonly used for power injection. However, in critically ill patients, CVCs-- most of which do not have FDA approval for power injection--may be the only available venous access. MATERIALS AND METHODS: The pitfalls of multilumen CVCs are illustrated by a case report of a patient in whom extravasation of intravenously administered contrast medium occurred after power injection in a triple-lumen CVC using the lumen with the port furthest from the catheter tip. RESULTS: The underlying mechanisms for the displacement of the initially correctly placed right subclavian CVC could include elevation of both arms of the obese patient or the power injection itself. The distances between port openings and catheter tips of various commercially available multilumen CVCs are assessed. We examine the possible caveats of ECG-guided CVC placement for optimal tip position, discuss technical difficulties related to power injection via CVCs, and review commonly used drugs that may cause extravasation injury. CONCLUSION: Knowledge of the distances between CVC port openings and the catheter tip are essential for safe intravasal administration of fluids.
Authors:
C Schummer; Y Sakr; J Steenbeck; M Gugel; K Reinhart; W Schummer
Publication Detail:
Type:  Journal Article; Review     Date:  2009-10-26
Journal Detail:
Title:  R?Fo : Fortschritte auf dem Gebiete der R?ntgenstrahlen und der Nuklearmedizin     Volume:  182     ISSN:  1438-9010     ISO Abbreviation:  Rofo     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2009-12-31     Completed Date:  2010-01-19     Revised Date:  2010-06-04    
Medline Journal Info:
Nlm Unique ID:  7507497     Medline TA:  Rofo     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  14-9     Citation Subset:  IM    
Copyright Information:
(c) Georg Thieme Verlag KG Stuttgart-New York.
Affiliation:
Klinik f?r An?sthesiologie und Intensivtherapie, Friedrich-Schiller-Universit?t, Albert-Schweitzer-Strasse 2, Suhl. cwsm.schummer@gmx.de
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MeSH Terms
Descriptor/Qualifier:
Adult
Catheterization, Central Venous / instrumentation,  methods*
Contrast Media / administration & dosage*
Extravasation of Diagnostic and Therapeutic Materials / radiography*
Female
Humans
Injections, Intravenous / instrumentation
Intensive Care Units
Iohexol / adverse effects,  analogs & derivatives*,  diagnostic use
Liver Abscess / radiography*
Lung Diseases / radiography*
Mediastinum / radiography
Neck / radiography
Obesity / complications
Quality Assurance, Health Care
Shock, Septic / radiography*
Shoulder / radiography
Subclavian Vein
Tomography, Spiral Computed*
Vena Cava, Superior
Chemical
Reg. No./Substance:
0/Contrast Media; 66108-95-0/Iohexol; 73334-07-3/iopromide
Comments/Corrections
Comment In:
Rofo. 2010 Jun;182(6):536; author reply 536-7   [PMID:  20517796 ]

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


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