title: Safety and feasibility of using a central venous catheter for rapid contrast injection rates.
abstract: OBJECTIVE
  Our aim was to determine the safety and feasibility of using a central venous catheter for rapid contrast injections during CT.
  
  
  METHODS
  An in vitro experiment was performed using a 7-French Arrow-Howes multilumen central venous catheter. Each catheter port was tested by varying contrast agent flow rates delivered by a power injector. Contrast media specifications were kept similar to routine clinical practice. The in vivo experiment included 104 cases in which rapid contrast injections, 3.0-5.0 mL/sec, were delivered through a central venous catheter for dynamic CT examinations. Patient monitoring for early complications of contrast extravasation, cardiac arrhythmia, and allergic reactions was performed. Contrast injections were monitored for pressure limitation, automatic flow-rate adjustment, and catheter injury. Chart review was performed for delayed complications of mediastinal hematoma, infection, or catheter malfunction.
  
  
  RESULTS
  During the in vitro experiment, all desired flow rates, 3.0-9.9 mL/sec, could be delivered through the central venous catheter with no catheter injury. No immediate or early patient or catheter complications were observed during the in vivo experiment. Follow-up evaluation revealed that 18 blood cultures and one catheter culture were positive for bacterial growth. In a subgroup of 43 patients, five contrast injections were pressure-limited by the power injector, and only one had the flow rate automatically adjusted to 3.6 mL/sec from 4.0 mL/sec.
  
  
  CONCLUSIONS
  Rapid contrast injection rates, at 3.0-5.0 mL/sec, through the Arrow-Howes multilumen central venous catheter are feasible and safe in the clinical setting. However, a strict protocol should be followed to avoid possible serious complications.
authors.affiliation: Department of Radiology, New York Presbyterian Hospital, Weill Medical College of Cornell University, 520 E 70th St., Starr Pavilion-630, New York, NY 10021, USA. pcs9001@med.cornell.edu
authors.forename: Pina C
authors.initials: PC
authors.lastname: Sanelli
authors.forename: Monica
authors.initials: M
authors.lastname: Deshmukh
authors.forename: Igor
authors.initials: I
authors.lastname: Ougorets
authors.forename: Rachael
authors.initials: R
authors.lastname: Caiati
authors.forename: Linda A
authors.initials: LA
authors.lastname: Heier
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002405:Catheterization, Central Venous / Q000295:instrumentation*; D003287:Contrast Media / Q000008:administration & dosage*; D004869:Equipment Safety; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D066298:In Vitro Techniques; D007275:Injections, Intravenous / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media