Thursday, October 12, 2006















Thursday October 12, 2006
Why that PICC is purple ?

Power PICC


The use of multidetector CT scanners requires rapid injection of radiographic contrast media. Injecting contrast via regular PICC may cause rupture of catheter (rupture is recently reported with central venous catheter also 2) as well as it compromise clarity of images as target organ receives a bolus of the contrast media in a less concentrated dose. Power PICC is a new version of PICC line, identified by purple color and especially designed to inject radiological contrast media.

The maximum flow rate that can be used for power injection of contrast media through a PowerPICC is 5ml/sec but upto 2ml/sec is said to be satisfactory for imaging purposes 1. The maximum pressure the power injector should be set at 300 psi.

Again, you can recognize the PICC as a power injectable PICC, by its purple color port. The picture below is from
www.bardaccess.com (makers of PICC lines). You can have more information from website also.

Bonus Pearl: Remember, central lines (TLC or PICC lines) are technically not ideal for IVF boluses due to longer length and smaller radius. 2 Large bore (say 18 gauge) peripheral IVs or one large bore central IV (cordis / introducer use for swan placement) are real placements for aggressive resuscitation (due to bigger radius and shorter length). [As per Hagen-Poiseuille equation just 2 fold increase in radius increase flow by 16 fold but 2 fold increase in length decrease flow by 50%].



Reference: click to get article

1.
Power Injection of Contrast Media via Peripherally Inserted Central Catheters for CT - Journal of Vascular and Interventional Radiology 15:809-814 (2004)
2.
Central line pump infusion and large volume mediastinal contrast extravasation in CT - British Journal of Radiology (2006) 79, e75-e77