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

Comparison of the Central Venous Pressures Measured From the Peripherally Inserted Antecubital Central Catheters and the Internal Jugular Vein Central Catheters in Liver Transplantation Recipients

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.

Study Overview

• Status: Completed
• Conditions: Patients Cannulated With Both PICC and CICC.; The Rapidly Fluctuating Hemodynamics During LT.
• Intervention / Treatment: Device: PICC, CICC

Detailed Description

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.)

• Study Type: Observational
• Enrollment (Actual): 35

Contacts and Locations

Study Locations

• Korea, Republic of
  • Gyeonggi-do
    • 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, Korea, Republic of, 410-769
      • National Cancer Center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Adult patients who had been scheduled for elective liver transplant surgery, and placed with both PICC and CICC.

Description

Inclusion Criteria:

• Adult patients who had been scheduled for elective liver transplant surgery
• Patients who had been placed with both PICC and CICC at anesthetic induction

Exclusion Criteria:

• Failure to insert PICC

Study Plan

How is the study designed?

Design Details

• Observational Models: Case-Only
• Time Perspectives: Prospective

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Liver transplantation (LT) recipients; LT recipients who had both PICC and CICC at the same time according to the LT protocol of our hospital	Device: PICC, CICC; PICC insertion, CICC (advanced venous access with pulmonary artery catheter) insertion

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
PICCP: CVP measured from peripherally inserted antecubital central catheters in liver transplantation recipients	every 10 minutes during the liver transplantation
CICCP: CVP from IJV central catheters in liver transplantation recipients	every 10 minutes during the liver transplantation

Collaborators and Investigators

• Sponsor: National Cancer Center, Korea
• Investigators: Study Director: So-Hee Park, PhD, Department of cancer registration and biostatistics branch, Research institute and hospital, National cancer center, Republic of Korea; Study Director: Soon-Ae Lee, MD.PhD., Department of Anesthesiology and pain medicine, Research institute and hospital, National cancer center, Republic of Korea

Publications and helpful links

General Publications

• Black IH, Blosser SA, Murray WB. Central venous pressure measurements: peripherally inserted catheters versus centrally inserted catheters. Crit Care Med. 2000 Dec;28(12):3833-6. doi: 10.1097/00003246-200012000-00014.
• McLemore EC, Tessier DJ, Rady MY, Larson JS, Mueller JT, Stone WM, Fowl RJ, Patel BM. Intraoperative peripherally inserted central venous catheter central venous pressure monitoring in abdominal aortic aneurysm reconstruction. Ann Vasc Surg. 2006 Sep;20(5):577-81. doi: 10.1007/s10016-006-9108-x. Epub 2006 Jul 27.

Study record dates

Study Major Dates

• Study Start: August 1, 2008
• Primary Completion (Actual): June 1, 2009
• Study Completion (Actual): June 1, 2009

Study Registration Dates

• First Submitted: October 1, 2009
• First Submitted That Met QC Criteria: October 1, 2009
• First Posted (Estimate): October 2, 2009

Study Record Updates

• Last Update Posted (Estimate): October 2, 2009
• Last Update Submitted That Met QC Criteria: October 1, 2009
• Last Verified: October 1, 2009

More Information

Terms related to this study

• Keywords: PICC (peripherally inserted central venous catheter); CICC (centrally inserted central venous catheter; CVP (central venous pressure); LT (liver transplantation); agreement
• Other Study ID Numbers: PICC1342

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No