Power injectable peripherally inserted central venous catheter lines frequently flip after power injection of contrast

J Comput Assist Tomogr. 2012 Jul-Aug;36(4):427-30. doi: 10.1097/RCT.0b013e3182575b88.

Abstract

Objective: To determine the frequency of power injectable peripherally inserted central venous catheter (PIPICC) displacement after contrast injection for computed tomography.

Materials and 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.

Conclusion: 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.

MeSH terms

  • Catheterization, Central Venous / adverse effects*
  • Catheterization, Central Venous / instrumentation*
  • Catheterization, Peripheral / adverse effects*
  • Catheterization, Peripheral / instrumentation*
  • Chi-Square Distribution
  • Contrast Media / administration & dosage*
  • Equipment Failure
  • Equipment Safety
  • Female
  • Humans
  • Injections, Intravenous / adverse effects
  • Injections, Intravenous / instrumentation
  • Male
  • Middle Aged
  • Prospective Studies
  • Tomography, X-Ray Computed / methods*

Substances

  • Contrast Media