Central venous pressure measurements: peripherally inserted catheters versus centrally inserted catheters

Area of Science:

• Cardiovascular Medicine
• Critical Care Medicine
• Medical Devices

Background:

• Central venous pressure (CVP) monitoring is crucial in intensive care.
• Traditionally, CVP is measured using centrally inserted central catheters (CICCs).
• Peripherally inserted central catheters (PICCs) offer a less invasive alternative but their utility for CVP measurement requires validation.

Purpose of the Study:

• To evaluate the correlation between CVP measurements obtained from PICCs and CICCs.
• To determine the clinical applicability of PICCs for CVP monitoring.

Main Methods:

• A pilot bench study assessed catheter resistance.
• A prospective, non-blinded clinical study compared CVP measurements from concomitant PICCs and CICCs in 12 ICU patients.
• Measurements were taken using digital systems with continuous pressure infusion devices.

Main Results:

• Bench study indicated PICCs have higher resistance, manageable with infusion devices.
• Clinical study yielded 77 paired CVP measurements (mean CVP: CICC 11±7 mm Hg, PICC 12±7 mm Hg).
• A strong correlation (r=0.99) was observed between PICC and CICC CVP readings; PICC CVP was slightly higher (1.0±3.2 mm Hg, p=0.02).

Conclusions:

• PICCs are suitable for CVP measurement and trend monitoring in clinical settings.
• Utilizing a pressure infusion device is essential to overcome PICC's inherent resistance.
• The slight increase in CVP measured by PICCs is clinically insignificant, validating their use.