Power injection of contrast media using central venous catheters: feasibility, safety, and efficacy.

Abstract

This study evaluates the feasibility, safety, and efficacy of power-injecting IV contrast media through central venous catheters for CT examinations. Two hundred ninety-five CT examinations were performed during an 18-month period in 225 patients with indwelling central venous catheters. Patients were randomized to power injection either through peripheral IV catheter or through central venous catheter. Feasibility was defined as the percentage of patients with contrast material injected successfully through the randomized access route. Safety was evaluated by comparing patients with complications. Efficacy was evaluated by comparing contrast enhancement of the thoracic aorta, pulmonary artery, abdominal aorta, and liver. Two hundred nine patients had randomization data recorded. One hundred three (94%) of 109 patients were successfully injected through their indwelling catheter compared with 42 (42%) of 100 through a peripherally placed IV catheter (p < 0.001). After reassignment for unsuccessful access, 174 patients underwent central venous catheter injection, and 51, peripheral IV catheter injection. No statistically significant difference was noted in the complications between the central venous catheter and peripheral IV catheter groups. Enhancement was greater in the thoracic aorta, pulmonary artery, and liver for the peripheral IV catheter group (p < 0.03). Power injection of contrast media through central venous catheters for CT examinations is feasible and safe when set hospital guidelines and injection protocols are followed. This technique provides an acceptable alternative in patients without adequate peripheral IV access when bolus contrast enhancement is desired.