Power injectable peripherally inserted central venous catheter lines frequently flip after power injection of contrast.
OBJECTIVE
To determine the frequency of power injectable peripherally inserted central venous catheter (PIPICC) displacement after contrast injection for computed tomography.


METHODS
We included all patients who had a computed tomographic examination with contrast administration via PIPICC over a 4-month period. Several variables including catheter location before and after the injection were documented. Descriptive statistics were used for continuous variables. The χ² test was used to compare groups. Continuous variables were analyzed using the Student t test.


RESULTS
Among 78 injections in 67 patients (34 men and 33 women; median age, 49 years), there were 12 catheter displacements (15.4%): 5 (62.5%) of 8 catheters initially located proximal to the tracheobronquial angle (TBA) and 7 (10.14%) of 69 catheters initially located distal to the TBA. The initial catheter position before the injection correlated with the frequency of displacement significantly (P < 0.006). Contrast injection rate and amount of contrast were no risk factors for position change. There were no complications.


CONCLUSIONS
Catheter displacement occurred in 62.5%, with PIPICCS cephalad to the TBA. A preliminary scout view should be checked before the contrast injection. In addition, a postinjection scan scout view is recommended to verify catheter position.
Department of Radiology, Froedtert Memorial Lutheran Hospital, Medical College of Wisconsin, Milwaukee, WI 53226, USA. lsosalozano@mcw.edu
Luis Antonio Sosa
LA
Lozano
Charles
C
Marn
Lawrence R
LR
Goodman
D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000295:instrumentation*; D002406:Catheterization, Peripheral / Q000009:adverse effects* / Q000295:instrumentation*; D016009:Chi-Square Distribution; D003287:Contrast Media / Q000008:administration & dosage*; D004868:Equipment Failure; D004869:Equipment Safety; D005260:Female; D006801:Humans; D007275:Injections, Intravenous / Q000009:adverse effects / Q000295:instrumentation; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media