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Original Research: CRITICAL CARE |

The Effect of Catheter to Vein Ratio on Blood Flow Rates in a Simulated Model of Peripherally Inserted Central Venous CathetersEffect of Catheter: Vein Ratio on Blood Flow Rates

Thomas P. Nifong, MD; Timothy J. McDevitt, PhD
Author and Funding Information

From Metamark Genetics, Inc (Dr Nifong), Cambridge, MA; and the Department of Mathematical Sciences (Dr McDevitt), Elizabethtown College, Elizabethtown, PA.

Correspondence to: Thomas P. Nifong, MD, Metamark Genetics, Inc, 245 First St, Ste 150, Cambridge, MA 02142; e-mail: tnifong@metamarkgenetics.com


For editorial comment see page 6

Funding/Support: The authors have reported to CHEST that no funding was received for this study.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2011 American College of Chest Physicians


Chest. 2011;140(1):48-53. doi:10.1378/chest.10-2637
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Background:  Catheter-related thrombosis is a common complication in all anatomic sites, especially when smaller veins of the upper extremity are considered. It is presumed that the presence of a catheter within the lumen of a vein will decrease flow and potentially create stasis, and clinical data suggest that the size of the catheter impacts thrombosis rates. We sought to determine, both mathematically and experimentally, the impact of catheters on fluid flow rates.

Methods:  We used fluid mechanics to calculate relative flow rates as a function of the ratio of the catheter to vein diameters. We also measured the flow rate of a blood analyte solution in an annular flow model using diameters that simulate the size of upper extremity veins and commonly used peripherally inserted central catheters (PICCs).

Results:  We compared each of the derived relative flow rates to the experimentally determined ones for three cylinder sizes and found a correlation of r2 = 0.90. We also confirmed that the decrease in fluid flow rate with each successive catheter size is statistically significant (P < .0001).

Conclusions:  Our results demonstrate that fluid flow is dramatically decreased by the insertion of a centrally located obstruction. Assuming that blood flow in veins behaves in a similar manner to our models, PICCs, in particular, may substantially decrease venous flow rates by as much as 93%.

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