165 - The Peripherally Inserted Central Catheter is a Reliable Tool to Obtain Venous Oxygen Saturation in Patients with Heart Failure

Abstract

Background: For heart failure (HF) patients in the intensive care unit (ICU), venous oxygen saturations, which are used to calculate Fick cardiac output, are routinely measured from the distal port of the pulmonary artery catheter (PAC), which is typically in place to deliver inotropes. However, the PAC is not meant for long-term use and many patients require inotropes outside the ICU. The peripherally inserted central catheter (PICC) offers increased mobility, is intended for long-term use, and is used to deliver inotropes to patients outside of the ICU; yet, venous oxygen saturations are not currently measured via the PICC line. Objective: To determine if patients' oxygen saturation values differ between the PICC line and the distal Pulmonary artery (PA) and the proximal central venous pressure (CVP) ports on the PAC line. Methods: HF patients in the ICU were prospectively enrolled at the Baylor University Medical Center, Dallas, Texas. A total of 3 blood samples were taken per person (one sample at each PICC, CVP, and distal location). We performed repeated measures analysis of variance, as well as correlation and reliability analyses to assess the venous oxygen saturations. Results: There were 31 subjects included in the analysis; 77.4% were male, 71.0% were Caucasian, their mean (±standard deviation) age was 60.2 ± 8.46 years, and 80.0% received inotropes. The average oxygen saturation was 62.3 ± 10.7, 62.4 ± 11.7, and 61.4 ± 9.3 for the PICC line, CVP port, and distal port, respectively (PHuynh-Feldt = 0.66). The values from the PICC line had a strong, positive, linear correlation with those from the CVP and distal ports (r = 0.89, 0.76, respectively). Similarly, the correlation between the CVP and distal port was 0.72. The reliability of the values obtained across the 3 locations was excellent (Shrout-Fleiss reliability = 0.79). Conclusions: The venous oxygen saturation did not differ significantly between the PICC line, CVP port, or distal port, on average. Further, the majority (61.3%) of the patients' saturations differed by 5 or less percentage points between the PICC line and distal port of the PAC. This work indicates that reliable values of venous oxygen saturation may be obtained via the PICC line, after initial evaluation from the PAC. In turn, this may provide long-term hemodynamic assessment out of the ICU while improving patient comfort and mobility