Rafiei Alavi Niloufar, Limfueco Julie, Yamamoto Randall, Shi James, Houshyar Roozbeh, Yaghmai Vahid
Department of Radiological Sciences, University of California Irvine, Orange, CA 92868.
Department of Radiological Sciences, University of California Irvine, Orange, CA 92868.
Acad Radiol. 2025 Apr;32(4):2111-2120. doi: 10.1016/j.acra.2024.12.013. Epub 2024 Dec 27.
Multidose iodinated contrast media (ICM) injectors have shown promise in reducing ICM waste. This study aims to evaluate the impact of patient volume on ICM waste reduction in multidose injectors.
CT studies performed over one-year period with a multidose injector at our emergency CT unit. We recorded the ICM volume, time, and date for each injection and calculated total annual ICM use, accounting for the 500 mL ICM containers' 8-hour window usage limit. We then calculated the ICM waste for the same patient cohort assuming single-dose vials used with single-dose injectors were used instead, without the 8-hour window for usage. To assess the impact of patient volume, we evaluated six subgroups based on daily injected patient counts: Group 1 (<10 patients/day), Group 2 (10-19 patients/day), Group 3 (20-29 patients/day), Group 4 (30-39 patients/day), Group 5 (40-49 patients/day), Group 6 (≥50 patients/day). Annual and mean per patient ICM waste was calculated for both injector types and compared among all subgroups.
In total, across 12,290 scans, multidose injectors reduced annual ICM waste by 86.1% compared to single-use injectors. Annual ICM waste was zero on days with 50 or more patients and was minimal (253 mL) for days with 40-49 patients. A significant negative correlation between patient volume and ICM waste was observed (r=-0.365, p<0.0001). Mean ICM waste per patient was 2.5 times higher in Group 1 and 71.4% higher in Group 2 with multidose injector compared to single-dose injector. Conversely, in groups with at least 20 patients per day, mean ICM waste per patient was lower with multidose injectors compared to single-dose injectors. Mean ICM waste per patient was reduced by 53.9% in Group 3, 88.9% in Group 4 and 100% in Group 6.
High patient throughput centers with over 40 patients per day can nearly eliminate ICM waste with multidose injectors. However, using multidose injectors in centers with lower patient volumes (<20 patients per day) may lead to increased ICM waste compared to single-dose injectors, underscoring the importance of aligning injector choice with patient volume to optimize resource utilization and minimize waste.
多剂量碘化造影剂（ICM）注射器在减少ICM浪费方面已显示出前景。本研究旨在评估患者数量对多剂量注射器减少ICM浪费的影响。
在我们的急诊CT科室，使用多剂量注射器进行了为期一年的CT研究。我们记录了每次注射的ICM体积、时间和日期，并计算了每年的ICM总用量，同时考虑了500mL ICM容器的8小时使用期限。然后，假设使用单剂量注射器搭配单剂量小瓶，且无8小时使用期限，计算同一患者队列的ICM浪费量。为评估患者数量的影响，我们根据每日注射患者数量将其分为六个亚组：第1组（<10名患者/天）、第2组（10 - 19名患者/天）、第3组（20 - 29名患者/天）、第4组（30 - 39名患者/天）、第5组（40 - 49名患者/天）、第6组（≥50名患者/天）。计算两种注射器类型的年度和每位患者的平均ICM浪费量，并在所有亚组之间进行比较。
在总共12290次扫描中，与一次性注射器相比，多剂量注射器使年度ICM浪费减少了86.1%。在有50名或更多患者的日子里，年度ICM浪费为零，在有40 - 49名患者的日子里，浪费量最少（253mL）。观察到患者数量与ICM浪费之间存在显著的负相关（r = -0.365，p < 0.0001）。与单剂量注射器相比，使用多剂量注射器时，第1组每位患者的平均ICM浪费高2.5倍，第2组高71.4%。相反，在每天至少有20名患者的组中，与单剂量注射器相比，多剂量注射器每位患者的平均ICM浪费更低。第3组每位患者的平均ICM浪费减少了53.9%，第4组减少了88.9%，第6组减少了100%。
每天有超过40名患者的高患者流量中心使用多剂量注射器几乎可以消除ICM浪费。然而，在患者数量较少（<20名患者/天）的中心使用多剂量注射器可能会导致ICM浪费比单剂量注射器增加，这凸显了使注射器选择与患者数量相匹配以优化资源利用和最小化浪费的重要性。
