Central venous pressure monitoring via peripherally or centrally inserted central catheters

A systematic review and meta-analysis

Filippo Sanfilippo, Alberto Noto, Gennaro Martucci, Marco Farbo, Gaetano Burgio, Daniele G. Biasucci

Research output: Contribution to journalReview article

Abstract

Introduction: The central venous pressure (CVP) is the most commonly used static marker of preload for guiding fluid therapy in critically ill patients, though its usefulness remains controversial. Centrally inserted central catheters (CICCs) are the gold-standard devices for CVP monitoring but peripherally inserted central catheters (PICCs) may represent a valid alternative. We undertook a systematic review and meta-analysis with the aim to investigate whether the difference between PICC- and CICC-measured CVP is not significant. Methods: We searched for clinical studies published in PubMed and EMBASE databases from inception until December 21st 2016. We included studies providing data on paired and simultaneous CVP measurement from PICCs and CICCs. We conducted two analyses on the values of CVP, the first one according to the total number of CVP assessments, the second one considering the number of patients recruited. Results: Four studies matched the inclusion criteria, but only three of them provided data for the meta-analyses. Both analyses showed non-significant differences between PICC-measured and CICC-measured CVP: 1489 paired simultaneous CVP assessments (MD 0.16, 95%CI -0.14, 0.45, p = 0.30) on a total of 57 patients (MD 0.22, 95%CI -1.46, 1.91, p = 0.80). Both analyses showed no heterogeneity (I2 = 0%). Conclusions: Available evidence supports that CVP monitoring with PICCs is accurate and reproduces similar values to those obtained from CICCs. The possibility to monitor CVP should not be used among clinical criteria for preferring a CICC over a PICC line.

Original languageEnglish
Pages (from-to)273-278
Number of pages6
JournalJournal of Vascular Access
Volume18
Issue number4
DOIs
Publication statusPublished - Jul 14 2017

Fingerprint

Central Venous Pressure
Meta-Analysis
Catheters
Fluid Therapy
PubMed
Critical Illness
Gold

Keywords

  • Central line
  • Critical care
  • Intensive care
  • PICC insertion

ASJC Scopus subject areas

  • Surgery
  • Nephrology

Cite this

Central venous pressure monitoring via peripherally or centrally inserted central catheters : A systematic review and meta-analysis. / Sanfilippo, Filippo; Noto, Alberto; Martucci, Gennaro; Farbo, Marco; Burgio, Gaetano; Biasucci, Daniele G.

In: Journal of Vascular Access, Vol. 18, No. 4, 14.07.2017, p. 273-278.

Research output: Contribution to journalReview article

@article{ca1f4a1a39af441f95c5879562efc293,
title = "Central venous pressure monitoring via peripherally or centrally inserted central catheters: A systematic review and meta-analysis",
abstract = "Introduction: The central venous pressure (CVP) is the most commonly used static marker of preload for guiding fluid therapy in critically ill patients, though its usefulness remains controversial. Centrally inserted central catheters (CICCs) are the gold-standard devices for CVP monitoring but peripherally inserted central catheters (PICCs) may represent a valid alternative. We undertook a systematic review and meta-analysis with the aim to investigate whether the difference between PICC- and CICC-measured CVP is not significant. Methods: We searched for clinical studies published in PubMed and EMBASE databases from inception until December 21st 2016. We included studies providing data on paired and simultaneous CVP measurement from PICCs and CICCs. We conducted two analyses on the values of CVP, the first one according to the total number of CVP assessments, the second one considering the number of patients recruited. Results: Four studies matched the inclusion criteria, but only three of them provided data for the meta-analyses. Both analyses showed non-significant differences between PICC-measured and CICC-measured CVP: 1489 paired simultaneous CVP assessments (MD 0.16, 95{\%}CI -0.14, 0.45, p = 0.30) on a total of 57 patients (MD 0.22, 95{\%}CI -1.46, 1.91, p = 0.80). Both analyses showed no heterogeneity (I2 = 0{\%}). Conclusions: Available evidence supports that CVP monitoring with PICCs is accurate and reproduces similar values to those obtained from CICCs. The possibility to monitor CVP should not be used among clinical criteria for preferring a CICC over a PICC line.",
keywords = "Central line, Critical care, Intensive care, PICC insertion",
author = "Filippo Sanfilippo and Alberto Noto and Gennaro Martucci and Marco Farbo and Gaetano Burgio and Biasucci, {Daniele G.}",
year = "2017",
month = "7",
day = "14",
doi = "10.5301/jva.5000749",
language = "English",
volume = "18",
pages = "273--278",
journal = "Journal of Vascular Access",
issn = "1129-7298",
publisher = "Wichtig Publishing",
number = "4",

}

TY - JOUR

T1 - Central venous pressure monitoring via peripherally or centrally inserted central catheters

T2 - A systematic review and meta-analysis

AU - Sanfilippo, Filippo

AU - Noto, Alberto

AU - Martucci, Gennaro

AU - Farbo, Marco

AU - Burgio, Gaetano

AU - Biasucci, Daniele G.

PY - 2017/7/14

Y1 - 2017/7/14

N2 - Introduction: The central venous pressure (CVP) is the most commonly used static marker of preload for guiding fluid therapy in critically ill patients, though its usefulness remains controversial. Centrally inserted central catheters (CICCs) are the gold-standard devices for CVP monitoring but peripherally inserted central catheters (PICCs) may represent a valid alternative. We undertook a systematic review and meta-analysis with the aim to investigate whether the difference between PICC- and CICC-measured CVP is not significant. Methods: We searched for clinical studies published in PubMed and EMBASE databases from inception until December 21st 2016. We included studies providing data on paired and simultaneous CVP measurement from PICCs and CICCs. We conducted two analyses on the values of CVP, the first one according to the total number of CVP assessments, the second one considering the number of patients recruited. Results: Four studies matched the inclusion criteria, but only three of them provided data for the meta-analyses. Both analyses showed non-significant differences between PICC-measured and CICC-measured CVP: 1489 paired simultaneous CVP assessments (MD 0.16, 95%CI -0.14, 0.45, p = 0.30) on a total of 57 patients (MD 0.22, 95%CI -1.46, 1.91, p = 0.80). Both analyses showed no heterogeneity (I2 = 0%). Conclusions: Available evidence supports that CVP monitoring with PICCs is accurate and reproduces similar values to those obtained from CICCs. The possibility to monitor CVP should not be used among clinical criteria for preferring a CICC over a PICC line.

AB - Introduction: The central venous pressure (CVP) is the most commonly used static marker of preload for guiding fluid therapy in critically ill patients, though its usefulness remains controversial. Centrally inserted central catheters (CICCs) are the gold-standard devices for CVP monitoring but peripherally inserted central catheters (PICCs) may represent a valid alternative. We undertook a systematic review and meta-analysis with the aim to investigate whether the difference between PICC- and CICC-measured CVP is not significant. Methods: We searched for clinical studies published in PubMed and EMBASE databases from inception until December 21st 2016. We included studies providing data on paired and simultaneous CVP measurement from PICCs and CICCs. We conducted two analyses on the values of CVP, the first one according to the total number of CVP assessments, the second one considering the number of patients recruited. Results: Four studies matched the inclusion criteria, but only three of them provided data for the meta-analyses. Both analyses showed non-significant differences between PICC-measured and CICC-measured CVP: 1489 paired simultaneous CVP assessments (MD 0.16, 95%CI -0.14, 0.45, p = 0.30) on a total of 57 patients (MD 0.22, 95%CI -1.46, 1.91, p = 0.80). Both analyses showed no heterogeneity (I2 = 0%). Conclusions: Available evidence supports that CVP monitoring with PICCs is accurate and reproduces similar values to those obtained from CICCs. The possibility to monitor CVP should not be used among clinical criteria for preferring a CICC over a PICC line.

KW - Central line

KW - Critical care

KW - Intensive care

KW - PICC insertion

UR - http://www.scopus.com/inward/record.url?scp=85024490598&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85024490598&partnerID=8YFLogxK

U2 - 10.5301/jva.5000749

DO - 10.5301/jva.5000749

M3 - Review article

VL - 18

SP - 273

EP - 278

JO - Journal of Vascular Access

JF - Journal of Vascular Access

SN - 1129-7298

IS - 4

ER -