Objective. Because cardiovascular perforation by a central venouscatheter (CVC) is a serious complication of catheterization in pediatricpatients, we conducted an in vitro study of the relative potential forperforation of a standard material by the tips of multilumen pediatriccatheters. Since we could not simulate vessel tissue, we hypothesized thattesting catheters on a standard material would show whether catheters variedin tendency to perforate such a material and thus indicate a “relativepotential for perforation.” Methods. Each CVC protruding from asupport tube was suspended in a water-filled Plexiglas chamber at a 90°incident angle to a polyethylene film, which was made to bulge 6 mm into theCVC tip 120 times per minute by hydropressure. Perforation of the polyethylenefilm was documented on a time-based, strip-chart recording of pressure changeon the opposite side of the film. We recorded the number of pulsationsrequired for the following catheters to perforate the polyethylene: Arrow flextip, Cook polyurethane, Viggo hydrocath polyurethane, and Cook silicone CVCsof 4- and 5-Fr size with 2 or 3 lumens (n = 5 catheters of each type, eachcatheter being tested 5 times). Results. The number of pulsations toperforation ranged from 1 ± 0.4 SD to > 7000.Conclusions. This in vitro study of the worst-case condition(90° incident angle between CVC tip and polyethylene film) indicates thatpediatric multilumen CVCs vary significantly in their relative potential toperforate a standard material. We suggest that, when central venouscatheterization is contemplated in children, in addition to insertion site,catheter length, and depth of insertion, the type of catheter is anothervariable to consider in order to minimize the chance of cardiovascularperforation by the CVC tip.