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

OBJECTIVE, This study evaluates the feasibility, safety, and efficacy of po wer-injecting IV contrast media through central venous catheters for CT exa minations. SUBJECTS AND METHODS. Two hundred ninety-five CT examinations were per form ed during an 18-month period in 225 patients with indwelling central venous catheters, Patients were randomized to power injection either through peri pheral IV catheter or through central venous catheter. Feasibility was defi ned as the percentage of patients with contrast material injected successfu lly through the randomized access route. Safety was evaluated by comparing patients with complications. Efficacy was evaluated by comparing contrast e nhancement of the thoracic aorta, pulmonary artery, abdominal aorta, and li ver, RESULTS. Two hundred nine patients had randomization data recorded. One hun dred three (94%) of 109 patients were successfully injected through their i ndwelling catheter compared with 42 (42%) of 100 through a peripherally pla ced IV catheter (p < 0.001). After reassignment for unsuccessful access, 17 4 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 ca theter groups. Enhancement was greater in the thoracic aorta, pulmonary art ery, and liver for the peripheral IV catheter group (p < 0.03). CONCLUSION. Power injection of contrast media through central venous cathet ers for CT examinations is feasible and safe when set hospital guidelines a nd injection protocols are followed. This: technique provides an acceptable alternative in patients without adequate peripheral IV access when bolus c ontrast enhancement is desired.