Effect of Three Side Hole Infusion Catheter on CT Image Quality Compared to a Standard Infusion Catheter

Not Applicable

Completed

Conditions: Contrast Enhanced Computed Tomography (CT) Scanning

Interventions: Device: Standard intravenous catheter
Device: Becton Dickinson Nexiva Diffusics System

Registration Number: NCT02943226

Lead Sponsor: The University of Texas Health Science Center, Houston

Brief Summary: The purpose of this research study is to compare two types of catheters used for infusing the contrast dye necessary for viewing internal organs during computed tomography (CT) scanning. The standard catheter, which has one hole from which contrast dye enters veins, will be compared to the Becton Dickinson Nexiva Diffusics System catheter, which has three holes for diffusing dye into veins. The purpose of this study is to determine which catheter type gives the best image.

Detailed Description: This will be a prospective, randomized, controlled trial. The catheter is already in use at our facilities. After informed consent, patients will be randomly given the standard or new catheter in our practice. Envelopes with the random assignment will be available to the individuals consenting patients. Randomization generally ensures that study groups are similar on average. As age, sex, and weight impact image quality, we will collect data on these factors in case randomization results in an imbalance. This will allow for control of these factors in analysis of the data. Data will be collected from CT abdomen pelvis examinations within a 6 month-1 year period in 2016 - 2017. Our primary outcome is image quality, measured as tissue density and distribution of contrast within the liver, spleen, aorta and IVC. Our secondary outcomes include Peak Contrast Infusion Pressure and Injection Flow Rate. Possible adverse events for use of any type of catheter include contrast infiltration into the subcutaneous tissues which is a minor limited event. All infiltrations will be recorded as part of the permanent medical record, documented in the chart, and the referring physician notified. The patient will be assessed by a physician immediately and referred to the ED if necessary for further evaluation. Current technology utilizes Power injector equipment which alerts the technologist to the pressure being achieved. If the injection pressure exceeds 325 psi the Power injector automatically shuts off.

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 61

Inclusion Criteria

Patients undergoing contrast enhanced CT abdomen pelvis examinations at Lyndon B. Johnson General Hospital in Texas
Patients whose access point is the antecubital fossa
Patients receiving 20 or 22 gauge catheters for their CT exam
Patients scanned on two 64 slice CT scanners at the same hospital

Exclusion Criteria

patients whose access point is other than antecubital fossa

Study & Design

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Standard intravenous catheter	Standard intravenous catheter	Standard catheter with one hole at the tip will be compared to novel 3 hole Becton Dickinson Nexiva Diffusics System to see which catheter provides the best image quality.
Becton Dickinson Nexiva Diffusics System	Becton Dickinson Nexiva Diffusics System	Intervention with the new Becton Dickinson Nexiva Diffusics System will be evaluated to see if it will improve image quality compared to the standard catheter.

Primary Outcome Measures

Name	Time	Method
Image Quality as Assessed by Ratio of Tissue Density of Main Portal Vein (MPV) to the Aorta	at the time of CT scanning	The ratio of tissue density measured in the main portal vein (MPV) to tissue density in the aorta on the CT images will be determined and will provide a measure of biodistribution, which is an important indicator of image quality. Dividing each Hounsfield unit measurement by the aorta density and determining these ratios will be done on a per patient basis to assess biodistribution as a measure of image quality.
Image Quality as Assessed by Ratio of Tissue Density of Inferior Vena Cava (IVC) to the Aorta	at the time of CT scanning	The ratio of tissue density measured in the inferior vena cava (IVC) to tissue density in the aorta on the CT images will be determined and will provide a measure of biodistribution, which is an important indicator of image quality. Dividing each Hounsfield unit measurement by the aorta density and determining these ratios will be done on a per patient basis to assess biodistribution as a measure of image quality.
Image Quality as Assessed by Ratio of Tissue Density of Spleen to the Aorta	at the time of CT scanning	The ratio of tissue density measured in the spleen to tissue density in the aorta on the CT images will be determined and will provide a measure of biodistribution, which is an important indicator of image quality. Dividing each Hounsfield unit measurement by the aorta density and determining these ratios will be done on a per patient basis to assess biodistribution as a measure of image quality.
Image Quality as Assessed by Rating Scale	at the time of CT scanning	Radiologists blinded to catheter type will review images and rate them on a scale of 1 to 10. 10 indicates a better outcome.

Secondary Outcome Measures

Name	Time	Method
Peak Contrast Infusion Pressure	at the time of CT scanning	The peak contrast infusion pressure is recorded in the electronic health record (EHR) during every CT examination preformed at the hospitals taking part in this study.
Injection Flow Rate	at the time of CT scanning	The injection flow rate is recorded in the electronic health record (EHR) during every CT examination preformed at the hospitals taking part in this study.