Forum topic

6 posts / 0 new
Last post
Wendy Erickson RN
CVP Monitoring via PICC Lines

Does anyone know of any articles out there that deal with the use of PICC lines for CVP monitoring?  We have a new medical director of our PICC service who is interested in the evidence for this.  Thanks in advance. 

smarison
Yes, please share if there
Yes, please share if there is any info out there.  I have a few articles but not much proof in them.  Our intensivist would love the info and he felt the articles I shared with him were not great.  Some of the staff here is considering doing our own study after the new year.
Wendy Erickson RN
Thanks! 
Thanks! 

Wendy Erickson RN
Eau Claire WI

Wendy Erickson RN
Here are a couple more that
Here are a couple more that I pulled from the bibliography of the first article.

Wendy Erickson RN
Eau Claire WI

DML RN
 Hi Wendy- A few more

 Hi Wendy-

A few more references for you. First,"Early use of open-ended PICC's are associated with decreased CR-BSI's". Patel,et al Critical Care Med. 31:A99. 2003. Talks about using PICC's for CVP readings--similar outcomes as CVC's with fewer complications.

"Can different types of central venous catheters be used to measure central venous pressure in an emergent situation?". Gilboy,N and Tanabe,P. Advanced Emergency Nursing Journal Vol 28,No.4,pages 269-274. Mostly about using preexisting central catheter on a patient that comes into the ER rather than placing a new one,especially for septic scenario.

Then there's also "Pulmonary-Artery catheters--Peace at last?" Shure,D NEJM 354;21 2006. Editorial with a review of PAC's vs CVC's--in many cases no difference in mortality outcomes for some patients managed with CVC vs Swan-Ganz. (The point here is that if a PICC is better than a CVC in general and if a CVC is the equal of a PAC,why not PICC? With a functional art line,the noninvasive monitors like Lidco or FloTrac can give you Cardiac Output/Index,SV and SVR.)

From a practical,bedside standpoint,I am not fussy about whether my CVP comes from a PICC or CVC or SG. Unfortunately,the situations in which CVP's are very high (tension pneumo,tamponnade,florid CHF) or very low (hemorrhage,hypovolemia,especially sepsis) can be prety dire emergencies that can't wait for a PICC.

David Longseth,RN

Trauma Life Support Center

University of Wisconsin Hospital

Wendy Erickson RN
Thanks, Dave!  This is
Thanks, Dave!  This is plenty for my purposes!  Happy Holidays!

Wendy Erickson RN
Eau Claire WI

Log in or register to post comments