Proactive Air Management in CT Power Injections: A Comprehensive Approach to Reducing Air Embolization

Area of Science:

• Radiology
• Medical Imaging
• Patient Safety

Background:

• Venous air embolism (VAE) is a complication of contrast media administration during CT scans, occurring in 7%-55% of patients.
• VAE negatively impacts patient safety, diagnostic image quality, workflow efficiency, and patient/radiographer satisfaction.
• Current systems use reactive air management, posing challenges for effective air control.

Purpose of the Study:

• To review challenges of reactive air management in CT contrast injection systems.
• To propose a novel proactive air management approach.
• To compare the effectiveness of proactive versus reactive air management in reducing injected air volumes.

Main Methods:

• Three power injection systems were tested under simulated clinical conditions.
• Air volumes injected were measured using a custom air trap fixture.
• Two systems utilized reactive air management, while one employed the proposed proactive approach.

Main Results:

• The proactive system injected significantly less air (average 0.005 mL ± 0.006 mL) compared to reactive systems (averages 0.130 mL ± 0.082 mL and 0.106 mL ± 0.094 mL).
• Visible air bubbles (0.1 mL) were observed in CT images of a vascular phantom, causing artifacts similar to clinical observations.
• The proactive approach demonstrated a statistically significant reduction in injected air volumes (p < 0.05).

Conclusions:

• A proactive air management approach significantly reduces injected air volumes compared to reactive systems.
• This reduction in air embolism can improve patient safety and diagnostic accuracy in CT procedures.
• Implementing proactive air management is recommended to mitigate VAE complications.