Central venous catheters versus peripheral veins for sampling blood levels of commonly used drugs.
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.
Shulman
R J
RJ
US Department of Agriculture/Agriculture Research Service Children's Nutrition Research Center, Department of Pediatrics; Houston, TX, USA.
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Reed
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Gardner
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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
D000617:Aminoglycosides; D014640:Vancomycin; D016572:Cyclosporine