A Study to Demonstrate the Immediate Destination of an Embolus Formed in the Lumen of a Peripheral Venous Catheter
This study was designed to show the immediate destination of an embolus formed in the lumen of an intravenous catheter placed in a peripheral vessel. The hypothesis stated that clots injected into a peripheral vessel will lodge in the lungs. A subhypothesis was that the clot may lodge anywhere along the circulatory pathway. Indications of need for the study as shown by the review of literature were the following: (1) the complications resulting from the frequent use of intravenous polyethylene catheters, (2) experimental studies that showed that clots were formed around intravenous catheters, (3) the evidence that intravenous catheters predispose to venous thrombosis, and (4) probable relationship of multiple small emboli from catheter irrigation to fatal embolization. The experimental method of research was used to collect data on twenty-two rabbits. Each rabbit was injected with a clot tagged with 131 I-MAA in the foreleg and later scanned to determine the location of each clot. The lobes were homogenized separately, and the level of radioactivity of samples from each was determined by a Well Scintillation Counter. The data showed that 90.91 percent of the clots lodged in the lungs and 9.09 percent within the circulatory pathway between the injected site and the heart. In nineteen of the twenty-two experiments, where the lung was the destination of the clot, the lung tissue was homogenized. The statistical findings, using the Friedman Rank Test, did not show that a particular lobe received a greater number of clots than did any other lobe. T-tests comparing upper and lower lobes showed no statistical significance. But the frequency chart seemed to show that clots lodge more often in the lower lobes of both the right and left lungs than in the upper lobes. There was no significant difference between right and left lungs of the nineteen rabbits compared. But, when the sample was divided into two groups by injection sites, a significant number of clots (P < 0.01) lodged in the superior lung with the rabbit lying in a lateral decubitus position, Comparison of relationship between scan interpretation and counts per minute/milligram or percent values showed 78.99 percent agreement, indicating that the experimental procedure was reasonably reliable Conclusions drawn from the study are: (1) the majority of clots injected into a peripheral vessel will lodge in the lung, (2) some may lodge along the circulatory pathway between the injection site and the heart, and (3) clots did not go to a particular lobe but seemed to lodge in the lower lobes more often than the upper lobes.
Animal Experimentation and Research, Biostatistics, Circulatory and Respiratory Physiology, Equipment and Supplies, Laboratory and Basic Science Research, Nursing, Infusions; Parenteral.
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