Central venous pressure monitoring via peripherally or centrally                     inserted central catheters: a systematic review and                     meta-analysis

Sanfilippo, Filippo; Noto, Alberto; Farbo, Marco; Burgio, Gaetano; Biasucci, Daniele Guerino

doi:10.5301/jva.5000749

Cited by 16 publications

(12 citation statements)

References 33 publications

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“…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].…”

Section: Discussionsupporting

confidence: 83%

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

D’Arrigo

Sandroni

Cacciola

et al. 2020

Ann. Intensive Care

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Background Single-lumen 4Fr or double-lumen 5Fr power injectable peripherally inserted central catheters (PICCs) are not accurate for trans-pulmonary thermodilution (TPTD), since they overestimate cardiac index and other TPTD-derived parameters when compared with centrally inserted central catheters (CICCs) because of the smaller size of their lumen. We hypothesize that PICCs with larger lumen size may be reliable for the cardiac index assessment using the TPTD. Methods This is a single-centre, prospective method–comparison study that included adult patients admitted in ICU who required a calibrated Pulse Contour hemodynamic monitoring system (VolumeView/EV1000™) for circulatory shock and had both PICC and CICC in place. We compared TPTD measurements via single-lumen 5Fr or triple-lumen 6Fr polyurethane power injectable PICCs with triple-lumen 7Fr CICC (reference standard). To rule out biases related to manual injection, measurements were repeated using an automated rapid injection system. We performed Bland–Altman analysis accounting for multiple observations per patient. Results A total of 320 measurements were performed in 15 patients. During the manual phase, the cardiac index measured with either single-lumen 5Fr or triple-lumen 6Fr PICCs were comparable with cardiac index measured with triple-lumen 7Fr CICC (3.2 ± 1.04 vs. 3.2 ± 1.06 L/min/m2, bias 2.2% and 3.3 ± 0.8 vs. 3.0 ± 0.7 L/min/m2, bias 8.5%, respectively). During the automated phase, triple-lumen 6Fr PICC slightly overestimated the cardiac index when compared to triple-lumen 7Fr CICC (CI 3.4 ± 0.7 vs. 3.0 ± 0.7 L/min/m2, bias 12.5%; p = 0.012). For both single-lumen 5Fr and triple-lumen 6Fr PICCs, percentage error vs. triple-lumen 7Fr CICC was below 20% (14.7% and 19% during the manual phase and 14.4% and 13.8% during the automated phase, respectively). Similar results were observed for TPTD-derived parameters. Conclusions During hemodynamic monitoring with TPTD, both single-lumen 5Fr PICCs and triple-lumen 6Fr PICCs can be used for cold fluid bolus injection as an alternative to CICC (ClinicalTrials.gov NCT04241926).

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Section: Discussionsupporting

confidence: 83%

“…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.…”

Section: Introductionmentioning

confidence: 99%

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

D’Arrigo

Sandroni

Cacciola

et al. 2020

Ann. Intensive Care

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“…We think that the ideal central VAD in this situation is a power injectable peripherally inserted central catheter (PICC), either 5Fr double lumen or 6Fr triple lumen. Recent literature has shown that power injectable polyurethane, non-valved PICCs perform as good as centrally inserted central catheters (CICCs) in intensive care unit; 3,4 in particular, they tolerate very high flow of infusion, they are appropriate for measurement of central venous pressure 5 and for measurement of the cardiac output by thermodilution. 6,7 The risk of thrombosis and infection is similar to CICCs and—for both devices—depends mainly on the insertion technique.…”

Section: Wise Choice Of the Central Vadmentioning

confidence: 99%

Vascular access in COVID-19 patients: Smart decisions for maximal safety

2020

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The 2020 COVID pandemic has forced everyone to update the usual medical procedures and adapt them to a new situation characterized by a high risk of contamination of the health operator. The placement of a venous access device is no exception. In the experience of the vascular access team of our hospital, hit by the COVID epidemic in March 2020, the safety of both the patient and the staff can be ensured by an insertion bundle of few smart strategies, which include choice of long dwelling peripheral catheters (midline catheters) rather than short venous cannulas; use of power injectable peripherally inserted central catheters in the COVID patients in intensive care unit requiring a central line; use of wireless probes-easy to carry, easy to clean-for ultrasound guided venipuncture; avoidance of x-rays, using alternative methods for tip location such as intracavitary electrocardiography or trans-thoracic echocardiography; strict adoption of the barrier precautions recommended by the international guidelines.

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“…8,9 The most reliable and broadly used method to assess the CVP is the direct catheterization of the IJV or subclavian veins. 10 However, this is an invasive maneuver with an associated risk of complications and thus is not considered feasible as a routine approach. 11 Recently, it has been shown that the JVP can be obtained using B-mode ultrasound (US) assessment of changes in the cross-sectional area (CSA) of the IJVs over the CC.…”

Section: Introductionmentioning

confidence: 99%

Spectral characteristics of the internal jugular vein and central venous pressure pulses: a proof of concept study

Beggs

Tavoni

Menegatti

et al. 2021

Veins and Lymphatics

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In this proof-of-concept study the impact of central venous pressure (CVP) on internal jugular veins cross-sectional area (CSA) and blood flow time-average velocity (TAV) was evaluated in eight subjects, with the aim of understanding the drivers of the jugular venous pulse. CVP was measured using a central venous catheter while CSA variation and TAV along a cardiac cycle were acquired using ultrasound. Analysis of CVP, CSA and TAV time-series signals revealed TAV and CSA to lag behind CVP by on average 0.129 s and 0.138 s, with an inverse correlation between CSA and TAV (r= –0.316). The respective autocorrelation signals were strongly correlated (mean r=0.729-0.764), with mean CSA periodicity being 1.062 Hz. Fourier analysis revealed the frequency spectrums of CVP, TAV and CSA signals to be dominated by frequencies at approximately 1 and 2 Hz, with those >1 Hz greatly attenuated in the CSA signal. Because the autocorrelograms and periodograms of the respective signals were aligned and dominated by the same underlying frequencies, this suggested that they are more easily interpreted in the frequency domain rather than the time domain.

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Central venous pressure monitoring via peripherally or centrally inserted central catheters: a systematic review and meta-analysis

Abstract: Available evidence supports that CVP monitoring with PICCs is accurate and reproduces similar values to those obtained from CICCs. The possibility to monitor CVP should not be used among clinical criteria for preferring a CICC over a PICC line.

Cited by 16 publications

References 33 publications

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

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

Vascular access in COVID-19 patients: Smart decisions for maximal safety

Spectral characteristics of the internal jugular vein and central venous pressure pulses: a proof of concept study

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