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Non-tunelled CVC for CVP monitoring
Can all lumens of a non-tunelled CVC be used for CVP monitoring if the tip of the catheter is in optimal position (distal 1/3rd of the SVC to the SVC/RA junction)?  We have had some recent discussions regarding this issue because occasionally, anesthesia will use the distal port of a triple lumen CVC for volume replacement (the flow rate of the distal port is almost double of the other two ports) and use the proximal or medial port for CVP monitoring.  When the pt arrives in the unit, the RNs prefer to use the distal port for monitoring so they will switch the lines.  Some have argued that consistency is better so to continue using the ports the same as anesthesia had been using them.  Does anyone have any thoughts on this issue or any articles regarding this issue?      Vickie