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The effect of catheter to vein ratio on blood flow rates in a simulated model of peripherally inserted central venous catheters.
MedLine Citation:
PMID:  21349931     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Abstract BACKGROUND: Catheter-related thrombosis is a common complication in all anatomical sites, especially when smaller veins of the upper extremity are considered. It is presumed that the presence of a catheter within the lumen of a vein will decrease flow and potentially create stasis, and clinical data suggests that the size of the catheter impacts thrombosis rates. We sought to determine, both mathematically and experimentally, the impact of catheters on fluid flow rates. METHODS: We used fluid mechanics to calculate relative flow rates as a function of the ratio of the catheter to vein diameters.We also measured the flow rate of a blood analyte solution in an annular flow model utilizing diameters that simulate the size of upper extremity veins and commonly used peripherally inserted central catheters (PICCs). RESULTS: We compared each of the derived relative flow rates to the experimentally determined ones for threecylinder sizes. The correlation is r(2) = 0.90.We also confirmed that the decrease in fluid flow rate with each successive catheter size is statistically significant (p < 0.0001). CONCLUSIONS: Our results demonstrate that fluid flow is dramatically decreased by the insertion of a centrally located obstruction. Assuming that blood flow in veins behaves in a similar manner to our models, PICCs in particular may substantially decrease venous flow rates by as much as 93%.
Authors:
Thomas P Nifong; Timothy J McDevitt
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-24
Journal Detail:
Title:  Chest     Volume:  -     ISSN:  1931-3543     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
* Metamark Genetics, Inc., Cambridge, MA, tnifong@metamarkgenetics.com.
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