Accuracy

[are-in]

Can anyone comment on the accuracy of a CVP through a PICC vs HD cath (like a quentin) vs a central line. All IJ or Subclavian of course.

Thanks,

Are-In

[versatile_kat]

From what I've seen, your readings should be pretty similar, no matter which invasive line you are transducing (as long as they're in the correct anatomical region via CXR and phlebostatic axis). The waveform I've transduced through a PICC looks almost identical to the one I've seen using a Swan. User error has a lot to do with aberrant numbers (is fluid running through the CVP port/PICC/cordis at the same time you're reading your CVP?).

[trakstar]

Technically you can transduce through a PICC line however the accuracy over time is questionable. Obtaining a consistent acceptable wave form with a,c and v waves is quiet difficult. You have a lot of extraneous variables that can effect this measurement over time (i.e. patient position, transducer position, position of PICC catheter tip. I work in a CCU/MICU. It is our policy that we can only report CVPs via PICCs to doc's but cannot record them ih\n the patients chart. the doc's are only allowed to treat a CVP via PICC when following the trends. If the trends warrant aggressive intervention the patient has just bought themselves a central line. I find it possible to obtain similar tracings. We do not rountinely transduce CVPs with regards to HD catheters enless emergently needed or just prior to HD due to the high incidence of clotting. Be cautious when ever measuring and evaluating CVPs.