Comparison of the central venous pressure from internal jugular vein and the pressure measured from the peripherally inserted antecubital central catheter (PICCP) in liver transplantation recipients

Abstract

BackgroundUnlike its use during stable conditions, central venous pressure (CVP) monitoring from a peripherally inserted central venous catheter (PICC) has not often been used in surgeries with significant hemodynamic alterations. The aim of this study was to evaluate the feasibility of measuring PICC pressure (PICCP) as an alternative to measuring centrally inserted central catheter pressure (CICCP) in adult liver transplantation (LT) patients.MethodsWe measured PICCP and CICCP simultaneously during each main surgical period in adult LT. Statistical analysis was performed using simple linear regression analysis to observe whether changes in PICCP paralleled by simultaneous changes in CICCP. Correlation analysis and Bland-Altman analysis were used to determine the degree of agreement between the two devices. Differences were considered statistically significant when P values were less than 0.05.ResultsA total of 1342 data pairs were collected from 35 patients. The PICCPs and CICCPs were highly correlated overall (r = 0.970, P < 0.001) as well as at each period measured. The differences among each period were not clinically significant (0.33 mmHg for pre-anhepatic, 0.32 mmHg for anhepatic, -0.15 mmHg for reperfusion, and -0.10 mmHg for neohepatic periods). The overall mean difference was 0.14 mmHg (95% confidence interval: 0.09-0.19) and PICCP tended to give a higher reading by between 0.09 and 0.19 mmHg overall. The limit of agreement was -1.74 to 2.02 overall.ConclusionsThese findings suggest that PICCP can be a reasonable alternative to CICCP in situations of dynamic systemic compliance and preload, as well as under stable hemodynamic conditions.

Comparative Assessment of the Central Vein Pressure by Two Techniques: Centrally and Peripherally Inserted Central Catheter

“…This is in line with Yun's performance, in 2011, in South Korea, which was tried among liver transplantation candidates (6). In contrast to Black (9), who realized that the two factors of narrow lumen and long size made the CVP measures higher by PICC, we found similar measures to what Latham and colleagues reported, in 2012, in the SA (7).…”

Are single-lumen 5Fr and triple-lumen 6Fr PICCs suitable for hemodynamic assessment by trans-pulmonary thermodilution? A pilot study

“…The dependence of the bias we measured on the dynamic characteristics of the catheter used (i.e., resistance to bolus injection) is indirectly supported by the fact that in our study the CVP, which is a static pressure measured in no-flow conditions, was unaffected by the type of catheter used, as shown previously [1][2][3][4][5][6]8].…”

“…Several studies demonstrated that PICCs are equivalent to centrally inserted catheters (CICCs) for central venous pressure (CVP) measurement [1][2][3][4][5][6] but there is no evidence they can replace CICCs for cardiac output measurement using TPTD.…”

Pulmonary Artery/Central Venous Pressure Monitoring in Adults

“…The PICC should be referenced at the phlebostatic axis. [87][88][89][90][91] A shallow slope following a fast flush suggests PICC occlusion. 88 The CVP obtained from PICCs that support high-pressure infusions such as infusions of radiographic contrast media is also accurate.…”