title: Central venous catheters versus peripheral veins for sampling blood levels of commonly used drugs.
abstract: BACKGROUND
  Our objective was to compare the accuracy of drug levels in blood samples obtained from central venous catheters with those from peripheral blood samples taken to monitor various drug levels.
  
  
  METHODS
  Pediatric patients with central venous catheters receiving aminoglycosides, vancomycin, or cyclosporine had central and peripheral blood samples obtained within 5 minutes of each other and analyzed simultaneously. We ascertained how well blood levels from central venous catheters compared with those from peripheral blood (the criterion standard).
  
  
  RESULTS
  There were no clinically significant differences between central and peripheral values for amikacin, gentamicin, tobramycin, and vancomycin (both peaks and troughs). Preliminary data indicated that oral cyclosporine can be monitored via central venous catheter. In contrast, there was poor agreement between peripheral and central values when cyclosporine was administered by IV.
  
  
  CONCLUSIONS
  Amikacin, gentamicin, tobramycin, vancomycin, and probably oral cyclosporine can be monitored accurately via central venous catheter. In contrast, IV cyclosporine should be monitored via peripheral blood.
authors.affiliation: US Department of Agriculture/Agriculture Research Service Children's Nutrition Research Center, Department of Pediatrics; Houston, TX, USA.
authors.forename: R J
authors.initials: RJ
authors.lastname: Shulman
authors.forename: C
authors.initials: C
authors.lastname: Ou
authors.forename: T
authors.initials: T
authors.lastname: Reed
authors.forename: P
authors.initials: P
authors.lastname: Gardner
mesh_terms: D000293:Adolescent; D000617:Aminoglycosides / Q000008:administration & dosage / Q000097:blood*; D001800:Blood Specimen Collection / Q000379:methods*; D002405:Catheterization, Central Venous; D002648:Child; D016572:Cyclosporine / Q000008:administration & dosage / Q000097:blood*; D016903:Drug Monitoring; D006801:Humans; D014640:Vancomycin / Q000008:administration & dosage / Q000097:blood*; D014680:Veins
chemical_list: D000617:Aminoglycosides; D014640:Vancomycin; D016572:Cyclosporine