Comparison of Central Venous Pressures (CVPs) Measured From Peripherally Inserted Central Catheters (PICC) and CICC in Liver Transplantation Recipients

Overview

Background: Central venous pressure (CVP) monitoring from the peripherally inserted central venous catheter (PICC) has not often been used because of the higher inherent resistance of the PICC due to its longer length and narrower lumen. The objective of this study was to assess the reliability of the CVP measured from PICCs as a predictor of the CVP measured from CICCs in the setting of rapidly fluctuating hemodynamic conditions during liver transplantation.

According to the protocol of LT in our hospital, a PICC is concomitantly inserted with the pulmonary artery catheter (PAC) and 9-Fr advanced venous access (AVA) catheter for the LT recipient at anesthetic induction. PAC and AVA catheter are usually removed on the second postoperative day, and instead the PICC is used for the postoperative infusion of prostaglandin E1 which is very irritable to small peripheral vein. So we fortunately had chance to measure the CVPs from both CICC and PICC simultaneously in the same patients. Methods: We measured the CVPs from the CICC and the PICC simultaneously during each main surgical period of adult liver transplantation (preanhepatic, anhepatic, reperfusion, and neo-hepatic period). Data are presented as means ± standard deviation. Statistical analysis was performed using simple linear regression analysis to observe whether changes in the PICCP were paralleled by simultaneous changes in the CICCP. Bland-Altman analysis was used to determine the degree of agreement between the two devices. Analysis of variance was performed to study whether there were changes in the CVP agreement profiles in regard to the different time periods of LT. Differences were regarded as being statistically significant when p values were less than 0.05. (This observational study has been completed already.)

Conditions