{"id":5575,"date":"2023-09-18T11:00:27","date_gmt":"2023-09-18T09:00:27","guid":{"rendered":"https:\/\/eu.bd.com\/iv-news\/?p=5575"},"modified":"2023-09-28T16:10:26","modified_gmt":"2023-09-28T14:10:26","slug":"ct-scan-contrast-how-to-help-prevent-extravasation","status":"publish","type":"post","link":"https:\/\/eu.bd.com\/iv-news\/news-innovation\/ct-scan-contrast-how-to-help-prevent-extravasation\/","title":{"rendered":"CT scan contrast: How to help prevent extravasation"},"content":{"rendered":"

Intravenous (IV) injection of contrast media is frequently used for computerised tomography (CT) scans. CT scans may help clinicians detect tumours or evaluate vasculature before surgery.1<\/sup><\/p>\n

However, there is a risk of extravasation when injecting contrast media, especially in patients who have received chemotherapy.2<\/sup><\/p>\n

Extravasation from contrast media may occur when injecting large volumes or at fast rates through the infusion pump.2<\/sup><\/p>\n

More on this topic: <\/strong>Extravasation injury claims cost NHS \u00a315.6 million<\/a><\/p>\n

CT scan contrast and image quality<\/h2>\n

Good image quality depends on:3<\/sup><\/h3>\n
    \n
  • Intravascular contrast enhancement<\/li>\n
  • High-vessel attenuation<\/li>\n
  • Specific infusion flow rates<\/li>\n<\/ul>\n

    Total amount of iodine and iodine delivery rate determine contrast enhancement.3<\/sup> Iodine delivery rate increases with higher concentrations of the contrast medium along with increasing injection flow rates.3<\/sup><\/p>\n

    Higher flow rates have traditionally necessitated the use of large-gauge (i.e., 18 or 20 G) peripheral IV catheters (PIVCs).1,3<\/sup> However, not all patients have the vasculature to support a large-gauge PIVC, especially older patients, obese patients and those with cancer.1,3<\/sup><\/p>\n

    When a smaller gauge (i.e., 22 or 24 G) PIVC is placed, slower flow rates and reduced image quality may result.3<\/sup> Another concern with smaller gauge PIVCs is that they may increase the risk of extravasation when injecting the contrast medium.4<\/sup><\/p>\n

    More on this topic:<\/strong> Difficult IV access: Is ultrasound-guided cannulation the answer?<\/a><\/p>\n

    The use power injectors to infuse CT scan contrast<\/h2>\n

    Power injectors may offer the following advantages when injecting contrast media intravenously:3<\/sup><\/h3>\n
      \n
    • Steady flow rate<\/li>\n
    • Automatic pressure adaptation<\/li>\n
    • Improved uniformity of contrast medium<\/li>\n
    • Consistent pressure<\/li>\n<\/ul>\n

      The choice of an appropriate PIVC<\/h2>\n

      The selected PIVC should:<\/h3>\n
        \n
      • Contain a diffusion catheter tip that enables the use of a smaller gauge for high-flow protocols (22 G up to 6.5 mL\/sec), while still delivering the desired image quality.5<\/sup><\/li>\n
      • Allow for a reduction in force to stabilise the catheter in the vein and prevent whipping, movement and backing out of the vein, which may reduce the motion effects that can lead to extravasation.6<\/sup><\/li>\n
      • Be power injectable up to 325 psi.3<\/sup><\/li>\n<\/ul>\n

        To find out more about an IV catheter that meets the criteria above, discover the BD Nexiva\u2122 Diffusics\u2122 Closed IV Catheter System<\/a> and watch the video below.<\/p>\n