A survey of the use of ultrasound during central venous catheterization

• Published in: Anesthesia and analgesia Vol. 104; no. 3; pp. 491 - 497
• Main Authors: BAILEY, Peter L, GLANCE, Laurent G, EATON, Michael P, PARSHALL, Bob, MCINTOSH, Scott
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott 01.03.2007
• Subjects: Anesthesia; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Catheterization, Central Venous - methods; Catheters, Indwelling; Data Collection; Female; Humans; Jugular Veins; Male; Medical sciences; Multivariate Analysis; Practice Patterns, Physicians; Prospective Studies; Safety; Ultrasonography - methods; United States; United States; Catheterization; Anesthesia
• ISSN: 0003-2999; 1526-7598
• DOI: 10.1213/01.ane.0000255289.78333.c2

Complications during central venous catheterization (CVC) are not rare and can be serious. The use of ultrasound (US) during CVC has been recommended to improve patient safety. We performed a survey to evaluate the frequency of, and factors influencing, US use. We conducted an electronic survey of all members of the Society of Cardiovascular Anesthesiologists. Univariate and multivariate logistic regressions were used to assess the association between the frequency of US use and hospital and physician factors. All tests were two-sided, and a P value <0.05 was considered statistically significant. Of the 4235 members, 1494 responded (response rate = 35.3%). Two-thirds of the respondents never, or almost never, use US, whereas only 15% always, or almost always, use US. Thirty-three percent of the respondents never, or almost never, have US available, whereas 41% stated that US is always, or almost always, available. Availability of US equipment was strongly associated with US use for CVC (adj OR = 18.9; P value <0.001). The most common reason cited for not using US was "no apparent need for the use of US" (46%). When US was used, rescue or screening approaches were more common (72%) than real-time use (26%). The use of US during CVC remains limited and is most strongly associated with the availability of equipment. Screening and rescue use of US are more common than real-time guidance. Our survey suggests that current use of US during CVC differs from existing evidence-based recommendations.