Courtney Ann Coursey MD, Presenter: Research funded, Becton Dickinson and Company

Daniella Ferraro Fernandes Costa Pinho MD, Abstract Co-Author: Nothing to Disclose

Rendon C. Nelson MD, Abstract Co-Author: Consultant, General Electric Company Research support, Bracco Group Research support, Becton, Dickinson and Company Speakers Bureau, Siemens AG Royalties, Lippincott, Williams & Wilkins

Dushyant V. Sahani MD, Abstract Co-Author: Grant, General Electric Company Consultant, Bracco Group

Melissa Jenkins, Abstract Co-Author: Research funded, Becton, Dickinson and Company

MaryAnne Zabrycki, Abstract Co-Author: Research funded, Becton, Dickinson and Company

Humaira Chaudry, Abstract Co-Author: Research funded, Becton, Dickinson and Company

Zhengjia Chen PhD, Abstract Co-Author: Nothing to Disclose

To determine the impact of catheter dwell time and gauge, rate of contrast material administration, and patient age and gender on volume of extravasate at intravenous contrast enhanced MDCT. 

118,970 intravenous contrast material injections were performed in adult patients (> 18 years) for MDCT examinations from two institutions between March 2006 and December 2009. Nursing notes and radiology reports were reviewed for all extravasation events. Patient age and gender, peripheral intravenous catheter dwell time and gauge, rate of contrast material administration, and estimated volume of extravasated contrast material were recorded. Mean estimated volumes of extravasated contrast material were compared for catheters newly placed in the radiology department versus existing catheters. Mean estimated volumes of extravasate also were compared based on rate of contrast material injection (2mL/sec, 3, 4, and 5), patient age (18-39 years, 40-59, 60-79, 80-93), patient gender, and catheter gauge (18, 20, 22 and 24).  

330 extravasation events were recorded for the 118,970 contrast material administrations (0.3%). Mean volumes of extravasated contrast material were statistically significantly less for catheters newly-placed in the radiology department (mean 41 mL (SD 38 mL)) as compared to existing catheters (63 mL (45)) ( p = .0005). Mean volumes of extravasated contrast material were statistically significantly different for varying rates of contrast material administration [2 mL/sec: mean 53 mL (33mL); 3 mL/sec: 62 mL (48); 4 mL/sec: 49 mL (39); 5 mL/sec: 25 mL (13)] (p = .0076). There was a statistically significant trend towards decreasing mean volume of extravasate with increasing rates of contrast material administration from 2 to 5 mL/sec (p = .04).  Mean volume of extravasated contrast material did not vary significantly based on patient age (p = .83), gender (p = .81), or catheter gauge (p = .14).  

When an extravasation event occurred, the volume of extravasated contrast material was less for newly placed catheters and for higher rates of contrast material administration. Volume of extravasate did not vary based on patient age, gender, or catheter gauge.

Consideration should be given to placing new peripheral intravenous catheters in the radiology department prior to administration of intravenous contrast material for MDCT examinations.

Coursey, C, Pinho, D, Nelson, R, Sahani, D, Jenkins, M, Zabrycki, M, Chaudry, H, Chen, Z, Lessons Learned from 118,970 Multidetector CT (MDCT) Intravenous Contrast Material Administrations: Impact of Catheter Dwell Time and Gauge, Rate of Contrast Material Administration, and Patient Age and Gender on Volume of Extravasate.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11004277.html