Tuesday June 13, 2006
Can we measure CVP (central venous pressure) with PICCs (peripherally inserted central catheters) ?
YES: PICC lines can be used to measure CVP, if situation arise. CVP recorded via PICC lines are about 1 mm Hg higher than CVP from centrally inserted venous catheters. PICC lines need to be hooked to continuous infusion with heparinized saline at 3 mL/hr to overcome the resistance of longer length and narrower lumen of PICC line. Trend should be followed for better perception as first PICC measured CVP is reported higher, probably due to microthrombi which get flushed later on.
Dr. Black and coll. from Pennsylvania State University College of Medicine, Hershey, PA studied 77 data pairs from 12 patients with measurements recorded at end-expiration. 19-gauge dual-lumen PICCs were used and were zeroed/levelled at right atrium. To overcome the longer length, narrower lumen an so higher inherent resistance, continuous infusion device is used with heparinized saline at 3 mL/hr (like in arterial lines) 1.
Reference: Click to get article
1. Central venous pressure measurements: Peripherally inserted catheters versus centrally inserted catheters - Critical Care Medicine. 28(12):3833-3836, December 2000.