A Peripherally Inserted Central Catheter is as Useful as a Central Venous Catheter for Rapid Fluid Infusion

Abstract Background Peripherally inserted central catheters (PICCs) have been widely used because of their low risk of mechanical complications associated with insertion compared with central venous catheters (CVCs). However, PICCs are not widely used for anesthetic management due to concerns regarding the measurement of central venous pressure (CVP) and rapid fluid infusion. The CVP measured via PICCs are reportedly as accurate as that measured via CVC, but the findings concerning rapid infusion are unclear. We therefore investigated the usefulness of a PICC as a rapid infusion route compared with a CVC. Methods The in-line pressure was measured in similar-sized double-lumen catheters - 4-Fr PICC (55, 45 and 35 cm) and 17-G CVC (13 and 20 cm) - at flow rates of saline decided using a roller pump system. We also examined the flow rate at an in-line pressure of 300 mmHg, which is the critical pressure at which hemolysis is considered to occur during blood transfusion. Results In-line pressures increased in proportion to the flow rate and catheter length in both the PICC and CVC. On comparing the 45-cm PICC and 20-cm CVC, the in-line pressures were higher in the PICC than in the CVC at a flow rate of ≤30 mL/min, although the opposite was true at a flow rate of ≥90 mL/min. Flow rates at an intra-circuit pressure of 300 mmHg were not significantly different between the 45-cm PICC and 20-cm CVC. Conclusion A PICC can be used for rapid fluid infusion and blood transfusion, just like a CVC.