Safety of Power Injector Use in Children as Measured by Incidence of Extravasation

• Published in: American journal of roentgenology (1976) Vol. 187; no. 2; pp. 580 - 583
• Main Authors: Amaral, Joao Guilherme, Traubici, Jeffrey, BenDavid, Guila, Reintamm, Gail, Daneman, Alan
• Format: Journal Article
• Language: English
• Published: Leesburg, VA Am Roentgen Ray Soc 01.08.2006; American Roentgen Ray Society
• Subjects: Adolescent; Adult; Biological and medical sciences; Child; Child, Preschool; Extravasation of Diagnostic and Therapeutic Materials - epidemiology; Extravasation of Diagnostic and Therapeutic Materials - etiology; Female; Humans; Infant; Infant, Newborn; Injections, Intravenous - adverse effects; Injections, Intravenous - instrumentation; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Prospective Studies; Safety; Human; Immunopathology; Allergy; Nuclear medicine; Radiodiagnosis; Epidemiology; Hand; Incidence; Treatment; Radiology; Medical imagery; Computerized axial tomography; Vein; Child
• ISSN: 0361-803X; 1546-3141
• DOI: 10.2214/AJR.05.0667

The purpose of this study was to assess the safety of power injector use in peripheral IV injections for CT examinations of children by measuring the incidence of contrast extravasation and to review the management of extravasation as reported in the literature. At a tertiary pediatric center, we prospectively collected data on 557 children undergoing CT with IV contrast injection by power injector through a peripheral venous line. Data collected included age, weight, angiocatheter size, location of venous access, flow rate, total contrast volume, maximum injector pressure, and incidence of extravasation. Adverse effects such as emesis, sensation of warmth, hives, and allergies and anaphylaxis also were recorded. The patients' ages ranged from 13 days to 20 years (mean, 9.8 years). The size of angiocatheter most commonly used was 22 gauge (n = 443). The dorsum of the hand was the most common site of venous access (n = 373). The mean flow rate was 1.48 mL/s. When the patients were divided into groups on the basis of reaction or no reaction, statistical differences between the groups were found with respect to flow rate (p = 0.016) and pressure (p = 0.017) needed for injection. There were two episode of extravasation (0.3%), which were treated conservatively. The use of power injectors through 18- to 24-gauge angiocatheters in children is safe when meticulous technique is used and personnel are appropriately trained. Our study showed a similar rate of extravasation as has been reported in other studies.