title: Injection of gadolinium contrast through pediatric central venous catheters: a safety study.
abstract: BACKGROUND
  Catheter rupture during CT angiography has prompted policies prohibiting the use of electronic injectors with peripherally inserted central venous catheters (PICCs) not only for CT but also for MRI. Consequently, many institutions mandate hand injection for MR angiography, limiting precision of infusion rates and durations of delivery.
  
  
  OBJECTIVE
  To determine whether electronic injection of gadolinium-based contrast media through a range of small-caliber, single-lumen PICCs would be safe without risk of catheter rupture over the range of clinical protocols and determine whether programmed flow rates and volumes were realized when using PICCs for contrast delivery.
  
  
  METHODS
  Experiments were performed and recorded using the Medrad Spectris Solaris EP MR Injection System. PICC sizes, contrast media and flow rates were based on common institutional protocols.
  
  
  RESULTS
  No catheters were damaged during any experiments. Mean difference between programmed and delivered volume was 0.07 ± 0.10 mL for all experiments. Reduced flow rates and prolonged injection durations were observed when the injector's pressure-limiting algorithm was triggered, only in protocols outside the clinical range.
  
  
  CONCLUSIONS
  PICCs commonly used in children can withstand in vitro power injection of gadolinium-based contrast media at protocols significantly above clinical levels.
authors.affiliation: Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA 90095-7206, USA. jmoriarty@mednet.ucla.edu
authors.forename: John M
authors.initials: JM
authors.lastname: Moriarty
authors.forename: Geoffrey L
authors.initials: GL
authors.lastname: Kung
authors.forename: Yanerys
authors.initials: Y
authors.lastname: Ramos
authors.forename: Abbas N
authors.initials: AN
authors.lastname: Moghaddam
authors.forename: Daniel B
authors.initials: DB
authors.lastname: Ennis
authors.forename: J Paul
authors.initials: JP
authors.lastname: Finn
mesh_terms: D062905:Central Venous Catheters; D003287:Contrast Media / Q000008:administration & dosage*; D004868:Equipment Failure; D019544:Equipment Failure Analysis; D004869:Equipment Safety; D007275:Injections, Intravenous; D008536:Meglumine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D009942:Organometallic Compounds / Q000008:administration & dosage*
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C064572:gadobenic acid; D008536:Meglumine