SAFE USE OF POWER INJECTORS WITH CENTRAL AND PERIPHERAL VENOUS ACCESSDEVICES FOR PEDIATRIC CT

Purpose. We report our experience in the safe use of power injectors w ith central and small-gauge peripheral venous access devices for intra venous administration of contrast agent to children undergoing compute d tomography (CT) examinations. Materials and methods. We reviewed the medical records of 500 patients randomly selected from the 3121 child ren who underwent intravenous contrast-enhanced CT examinations at our institution from November 1993 through July 1995. Results. The group of 500 patients, all younger than 18 years of age, accounts for 16% of the contrast-enhanced CT examinations performed during the study peri od. Medrad MCT 311 Mark V or Medrad MCT Plus 311 power injectors were used to intravenously administer Omnipaque 300 (2 ml/kg, maximum dose = 150 ml) through venous access devices. These devices comprised Hickm an or Broviac lines (n = 228), subcutaneous Port-A-Caths (n = 55), sma ll-gauge butterfly needles (n = 215), and percutaneous intravenous cen tral lines (n = 2), Two complications, one involving a Hickman line an d the other a subcutaneous Port-A-Cath, occurred in the study populati on. These complications correspond to a frequency of 0.4%. Six cases o f contrast extravasation, all of them with the use of 23- (n = 1) and 25-gauge (n = 5) butterfly catheters (frequency = 0.2%), occurred amon g the remaining 2621 cases. Conclusion. In light of the low frequency of complications, power injectors and central venous access devices or small-gauge butterfly catheters are safe systems for delivery of intr avenous contrast material to pediatric patients. We feel that our stri ct adherence to manufacturers' guidelines and previously reported tech niques partially accounts for our success with these modes of delivery .