前瞻性研究外周静脉入路自动对比注射在 MDCT 中的入路部位并发症。

Prospective study of access site complications of automated contrast injection with peripheral venous access in MDCT.

机构信息

Department of Clinical Radiology, University of Muenster, Muenster D-48149, Germany.

出版信息

AJR Am J Roentgenol. 2010 Oct;195(4):825-9. doi: 10.2214/AJR.09.3739.

DOI:10.2214/AJR.09.3739

PMID:20858804

Abstract

OBJECTIVE

The purpose of this article is to prospectively assess the frequency and type of IV injection site complications associated with high-flow power injection of nonionic contrast medium in MDCT.

SUBJECTS AND METHODS

Contrast-enhanced (300-370 mg iodine/mL) MDCT examinations with high flow rates (up to 8 mL/s) using automatic CT injectors were performed according to standardized MDCT protocols. The location, type, and size (16-24 gauge) of IV catheters and volumes, iodine concentration, and flow rates of contrast medium were documented. Patients were questioned about associated discomfort, IV catheter sites were checked, and adverse effects were recorded.

RESULTS

Prospectively, 4,457 patients were studied. The injection rate ranged from 1-2.9 mL/s (group 1; n = 1,140) to 3-4.9 mL/s (group 2; n = 2,536) to 5-8 mL/s (group 3; n = 781); 1.2% of the patients experienced extravasations (n = 52). Contrast medium iodine concentration, flow rates, and volumes were not related to the frequency of extravasation. The extravasation rate was highest with 22-gauge IV catheters (2.2%; p < 0.05) independently of the anatomic location. For 20-gauge IV catheters, extravasation rates were significantly higher in the dorsum of the hand than in the antecubital fossa (1.8% vs 0.8%; p = 0.018). Extravasation rates were higher in older patients (≥ 50 vs < 50 years, 0.6% vs 1.4%; p = 0.019). Different iodine concentrations did not trigger significant differences in contrast material reactions (p = 0.782).

CONCLUSION

Automated IV contrast injection applying high flow rates (i.e., up to 8 mL/s) is performed without increased risk of extravasation. The overall extravasation rate was 1.2% and showed no correlation with iodine concentration, flow rates, or contrast material reactions. Performing high flow rates with low-diameter IV catheters (e.g., 22-gauge catheters) and a location of IV catheter in the hand is associated with a higher extravasation rate.

摘要

目的

本文旨在前瞻性评估与 MDCT 中使用高流速（高达 8 毫升/秒）非离子型造影剂高压注射相关的 IV 注射部位并发症的频率和类型。

材料与方法

根据标准 MDCT 方案，使用自动 CT 注射器进行增强（300-370 毫克碘/毫升）MDCT 检查。记录 IV 导管的位置、类型和大小（16-24 号）、体积、碘浓度和造影剂流速。询问患者相关不适，检查 IV 导管部位，并记录不良反应。

结果

前瞻性研究了 4457 例患者。注射速度范围为 1-2.9 毫升/秒（组 1；n=1140）至 3-4.9 毫升/秒（组 2；n=2536）至 5-8 毫升/秒（组 3；n=781）；1.2%的患者发生外渗（n=52）。造影剂碘浓度、流速和体积与外渗频率无关。22 号 IV 导管的外渗率最高（2.2%；p<0.05），与解剖位置无关。对于 20 号 IV 导管，手部背侧的外渗率明显高于肘前窝（1.8%比 0.8%；p=0.018）。老年患者（≥50 岁与<50 岁，0.6%与 1.4%；p=0.019）的外渗率更高。不同的碘浓度并未导致造影剂反应的显著差异（p=0.782）。