Selection of peripheral intravenous catheters with 24-gauge side-holes versus those with 22-gauge end-hole for MDCT: A prospective randomized study. Issue 87 (February 2017)

• Record Type: Journal Article
• Authors: Tamura, Akio; Kato, Kenichi; Kamata, Masayoshi; Suzuki, Tomohiro; Suzuki, Michiko; Nakayama, Manabu; Tomabechi, Makiko; Nakasato, Tatsuhiko; Ehara, Shigeru
• Is Part Of: European journal of radiology. Issue 87(2017)
• Page Start: 8
• Page End: 12
• Publication Date: 2017-02
• Subjects: Access site complication -- Contrast media -- Extravasation -- Multi-detector computed tomography; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2016.12.005
• Languages: English
• ISSNs: 0720-048X

Abstract

Highlights: We compared 24-gauge side-hole and conventional 22-gauge end-hole catheters in MDCT. The 24-gauge side-hole catheter is noninferior to the 22-gauge end-hole catheter. The 24-gauge side-hole catheter is safe and facilitates optimal enhancement quality. The 24-gauge side-hole catheter is suitable for patients with narrow or fragile veins. Abstract: Purpose: To compare the 24-gauge side-holes catheter and conventional 22-gauge end-hole catheter in terms of safety, injection pressure, and contrast enhancement on multi-detector computed tomography (MDCT). Materials & methods: In a randomized single-center study, 180 patients were randomized to either the 24-gauge side-holes catheter or the 22-gauge end-hole catheter groups. The primary endpoint was safety during intravenous administration of contrast material for MDCT, using a non-inferiority analysis (lower limit 95% CI greater than −10% non-inferiority margin for the group difference). The secondary endpoints were injection pressure and contrast enhancement. Results: A total of 174 patients were analyzed for safety during intravenous contrast material administration for MDCT. The overall extravasation rate was 1.1% (2/174 patients); 1 (1.2%) minor episode occurred in the 24-gauge side-holes catheter group and 1 (1.1%) in the 22-gauge end-hole catheter group (difference: 0.1%, 95% CI: −3.17% to 3.28%, non-inferiority P = 1). The mean maximum pressure was higher with the 24-gauge side-holes catheter than with the 22-gauge end-hole catheter (8.16 ± 0.95 kg/cm 2 vs. 4.79 ± 0.63 kg/cm 2, P < 0.001). The mean contrast enhancement of the abdominal aorta, celiac artery, superior mesenteric artery, and pancreatic parenchyma in the two groups were not significantly different. Conclusion: In conclusion, our study showed that the 24-gauge side-holes catheter is safe and suitable for delivering iodine with a concentration of 300 mg/mL at a flow-rate of 3 mL/s, and it may contribute to the care of some patients, such as patients who have fragile and small veins. (Trial registration: UMIN000023727)