Comparison of 18-gauge and 20-gauge catheters for IV contrast infusion

0

“A 20-gauge fenestrated catheter performs similarly to an 18-gauge nonfenestrated catheter with respect to IV contrast infusion rates and aortic enhancement levels and can be placed in most subjects whose veins are deemed insufficient for an 18-gauge catheter.” Johnson et al (2014).

Reference:

Johnson, P.T., Christensen, G.M. and Fishman, E.K. (2014) IV Contrast Administration With Dual Source 128-MDCT: A Randomized Controlled Study Comparing 18-Gauge Nonfenestrated and 20-Gauge Fenestrated Catheters for Catheter Placement Success, Infusion Rate, Image Quality, and Complications. AJR American Journal of Roentgenology. 202(6), p.1166-70.

Abstract:

OBJECTIVE: The purpose of this study was to compare the performance of a 20-gauge fenestrated catheter with an 18-gauge nonfenestrated catheter for IV contrast infusion during MDCT.

SUBJECTS AND METHODS. Two hundred five adult outpatients imaged on a dual-source 128-MDCT scanner with arterial phase body CT (flow rates, 5.0-7.5 mL/s) were randomized to either an 18-gauge nonfenestrated or 20-gauge fenestrated catheter. After randomization, any 18-gauge nonfenestrated subjects whose veins were deemed insufficient for that catheter gauge were assigned to a third cohort for placement of a 20-gauge fenestrated catheter. Catheter placement success, infusion rate, contrast volume, maximum pressure, complications, and aortic enhancement levels were recorded.

RESULTS. Catheters were placed on the first attempt in 97% (100/103) for 18-gauge nonfenestrated and 94% (96/102) for 20-gauge fenestrated placements and in two or fewer attempts in 99% of both groups. Mean infusion rates (5.74 mL/s for 18-gauge nonfenestrated and 5.58 mL/s for 20-gauge fenestrated placements) and aortic enhancement levels were not significantly different. Maximum pressure was higher with 20-gauge fenestrated catheters (mean ± SD, 230.5 ± 27.6 pounds per square inch [psi]) than 18-gauge nonfenestrated catheters (mean ± SD 215.6 ± 32.8 psi) (p = 0.002). One subject with an 18-gauge nonfenestrated catheter had a high-pressure alarm. In the third cohort, a 20-gauge fenestrated catheter was successfully placed in two or fewer attempts in 85% (28/33), with one minor extravasation attributed to vein insufficiency.

CONCLUSION. A 20-gauge fenestrated catheter performs similarly to an 18-gauge nonfenestrated catheter with respect to IV contrast infusion rates and aortic enhancement levels and can be placed in most subjects whose veins are deemed insufficient for an 18-gauge catheter.

Other intravenous and vascular access resources that may be of interest (External links – IVTEAM has no responsibility for content).

Main page

Share.

Comments are closed.

Free Email Updates
Join 5.5K IVTEAM members. Subscribe now and be the first to receive all the latest free updates from IVTEAM!
100% Privacy. We don't spam.