Use of Ultrasound Guidance for Central Venous Catheterization (US-CVC): A National Survey of Intensivists & Hospitalists
Abstract Purpose Evaluate the frequency and barriers to use of ultrasound guidance for central venous catheter (CVC) insertion by physicians specializing in critical care and hospital medicine. Materials and methods A national cross-sectional electronic survey of intensivists and hospitalists was ad...
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| Veröffentlicht in: | Journal of critical care 2016-12, Vol.36, p.277-283 |
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| creator | Soni, Nilam J., MD Reyes, Luis F., MD Keyt, Holly, MD Arango, Alejandro, DDS Gelfond, Jonathan A., MD, PhD Peters, Jay I., MD Levine, Stephanie M., MD Adams, Sandra, MD MSc Restrepo, Marcos I., MD MSc |
| description | Abstract Purpose Evaluate the frequency and barriers to use of ultrasound guidance for central venous catheter (CVC) insertion by physicians specializing in critical care and hospital medicine. Materials and methods A national cross-sectional electronic survey of intensivists and hospitalists was administered from November 2014 to January 2015. Results The survey response rate was 5.9% (1013/17,233). Moderate to very frequent use of ultrasound guidance varied by site: internal jugular vein (80%), subclavian vein (31%), and femoral vein (45%). Nearly all physicians (99%) that insert internal jugular CVCs daily use ultrasound guidance, whereas only 46% of physicians that insert subclavian CVCs daily use ultrasound guidance. Use of real-time ultrasound guidance varied by insertion site: internal jugular vein (73%), subclavian vein (28%), and femoral vein (42%). The majority of physicians (59%) reported not being comfortable with real-time needle tracking at the subclavian site. The most frequently reported barriers to use of ultrasound guidance were (1) limited availability of ultrasound equipment (28%), (2) perception of increased total procedure time (22%), and (3) concern for loss of landmark skills (13%). Conclusions Most intensivists routinely use ultrasound guidance to insert internal jugular CVCs but not subclavian CVCs. The most commonly reported barrier to ultrasound use was limited access to an ultrasound machine. |
| doi_str_mv | 10.1016/j.jcrc.2016.07.014 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1836726230</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0883944116302192</els_id><sourcerecordid>4244358961</sourcerecordid><originalsourceid>FETCH-LOGICAL-c439t-c68f54ce4ef4e56c7f57399bc8a413b50ff7bd8d9ed05fef3a236c6f1748a3be3</originalsourceid><addsrcrecordid>eNp9kl-L1DAUxYso7rj6BXyQgCDrQ2vS_GtFhKXo7sKiD-Psa0jTG0ztNLNJOzh-etOdVWEffEpy87sHzj03y14SXBBMxLu-6E0wRZnuBZYFJuxRtiKcy7wShD_OVriqaF4zRk6yZzH2GBNJKX-anZSS1YQLusp-biIgb9FmmIKOfh47dDG7To8GkPUBNTCmjwHdwOjniBo9fYcJgvulJ-dHdLZZ581N8_Y9Okdf7kqJXc9hD4dF9WqcYIxu7-IU0Rt06ePOTXpYns-zJ1YPEV7cn6fZ5vOnb81lfv314qo5v84No_WUG1FZzgwwsAy4MNJySeu6NZVmhLYcWyvbrupq6DC3YKkuqTDCEskqTVugp9nZUXcX_O0McVJbFw0Mgx4hOVKkokKWoqQ4oa8foL2fQ3J0R0meplnxRJVHygQfYwCrdsFtdTgogtWSi-rVkotaclFYqpRLanp1Lz23W-j-tvwJIgEfjgCkWewdBBWNg5RC5wKYSXXe_V__44N2M7jRGT38gAPEfz5ULBVW62UzlsUgguKS1CX9DcMxs58</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1837588385</pqid></control><display><type>article</type><title>Use of Ultrasound Guidance for Central Venous Catheterization (US-CVC): A National Survey of Intensivists & Hospitalists</title><source>MEDLINE</source><source>ScienceDirect Journals (5 years ago - present)</source><source>ProQuest Central UK/Ireland</source><creator>Soni, Nilam J., MD ; Reyes, Luis F., MD ; Keyt, Holly, MD ; Arango, Alejandro, DDS ; Gelfond, Jonathan A., MD, PhD ; Peters, Jay I., MD ; Levine, Stephanie M., MD ; Adams, Sandra, MD MSc ; Restrepo, Marcos I., MD MSc</creator><creatorcontrib>Soni, Nilam J., MD ; Reyes, Luis F., MD ; Keyt, Holly, MD ; Arango, Alejandro, DDS ; Gelfond, Jonathan A., MD, PhD ; Peters, Jay I., MD ; Levine, Stephanie M., MD ; Adams, Sandra, MD MSc ; Restrepo, Marcos I., MD MSc</creatorcontrib><description>Abstract Purpose Evaluate the frequency and barriers to use of ultrasound guidance for central venous catheter (CVC) insertion by physicians specializing in critical care and hospital medicine. Materials and methods A national cross-sectional electronic survey of intensivists and hospitalists was administered from November 2014 to January 2015. Results The survey response rate was 5.9% (1013/17,233). Moderate to very frequent use of ultrasound guidance varied by site: internal jugular vein (80%), subclavian vein (31%), and femoral vein (45%). Nearly all physicians (99%) that insert internal jugular CVCs daily use ultrasound guidance, whereas only 46% of physicians that insert subclavian CVCs daily use ultrasound guidance. Use of real-time ultrasound guidance varied by insertion site: internal jugular vein (73%), subclavian vein (28%), and femoral vein (42%). The majority of physicians (59%) reported not being comfortable with real-time needle tracking at the subclavian site. The most frequently reported barriers to use of ultrasound guidance were (1) limited availability of ultrasound equipment (28%), (2) perception of increased total procedure time (22%), and (3) concern for loss of landmark skills (13%). Conclusions Most intensivists routinely use ultrasound guidance to insert internal jugular CVCs but not subclavian CVCs. The most commonly reported barrier to ultrasound use was limited access to an ultrasound machine.</description><identifier>ISSN: 0883-9441</identifier><identifier>ISSN: 1557-8615</identifier><identifier>EISSN: 1557-8615</identifier><identifier>DOI: 10.1016/j.jcrc.2016.07.014</identifier><identifier>PMID: 27491563</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Catheterization, Central Venous - methods ; Catheters ; Central venous catheterization ; Central Venous Catheters ; Critical Care ; Cross-Sectional Studies ; Emergency medical care ; Female ; Femoral vein ; Femoral Vein - diagnostic imaging ; Hospitalists ; Humans ; Jugular vein ; Jugular Veins - diagnostic imaging ; Male ; Middle Aged ; Physicians ; Practice Patterns, Physicians ; Subclavian vein ; Subclavian Vein - diagnostic imaging ; Surveys and Questionnaires ; Ultrasonic imaging ; Ultrasonography - statistics & numerical data ; Ultrasound ; United States</subject><ispartof>Journal of critical care, 2016-12, Vol.36, p.277-283</ispartof><rights>2016</rights><rights>Published by Elsevier Inc.</rights><rights>Copyright Elsevier Limited Dec 01, 2016</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c439t-c68f54ce4ef4e56c7f57399bc8a413b50ff7bd8d9ed05fef3a236c6f1748a3be3</citedby><cites>FETCH-LOGICAL-c439t-c68f54ce4ef4e56c7f57399bc8a413b50ff7bd8d9ed05fef3a236c6f1748a3be3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1837588385?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3548,27923,27924,45994,64384,64386,64388,72240</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27491563$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Soni, Nilam J., MD</creatorcontrib><creatorcontrib>Reyes, Luis F., MD</creatorcontrib><creatorcontrib>Keyt, Holly, MD</creatorcontrib><creatorcontrib>Arango, Alejandro, DDS</creatorcontrib><creatorcontrib>Gelfond, Jonathan A., MD, PhD</creatorcontrib><creatorcontrib>Peters, Jay I., MD</creatorcontrib><creatorcontrib>Levine, Stephanie M., MD</creatorcontrib><creatorcontrib>Adams, Sandra, MD MSc</creatorcontrib><creatorcontrib>Restrepo, Marcos I., MD MSc</creatorcontrib><title>Use of Ultrasound Guidance for Central Venous Catheterization (US-CVC): A National Survey of Intensivists & Hospitalists</title><title>Journal of critical care</title><addtitle>J Crit Care</addtitle><description>Abstract Purpose Evaluate the frequency and barriers to use of ultrasound guidance for central venous catheter (CVC) insertion by physicians specializing in critical care and hospital medicine. Materials and methods A national cross-sectional electronic survey of intensivists and hospitalists was administered from November 2014 to January 2015. Results The survey response rate was 5.9% (1013/17,233). Moderate to very frequent use of ultrasound guidance varied by site: internal jugular vein (80%), subclavian vein (31%), and femoral vein (45%). Nearly all physicians (99%) that insert internal jugular CVCs daily use ultrasound guidance, whereas only 46% of physicians that insert subclavian CVCs daily use ultrasound guidance. Use of real-time ultrasound guidance varied by insertion site: internal jugular vein (73%), subclavian vein (28%), and femoral vein (42%). The majority of physicians (59%) reported not being comfortable with real-time needle tracking at the subclavian site. The most frequently reported barriers to use of ultrasound guidance were (1) limited availability of ultrasound equipment (28%), (2) perception of increased total procedure time (22%), and (3) concern for loss of landmark skills (13%). Conclusions Most intensivists routinely use ultrasound guidance to insert internal jugular CVCs but not subclavian CVCs. The most commonly reported barrier to ultrasound use was limited access to an ultrasound machine.</description><subject>Adult</subject><subject>Catheterization, Central Venous - methods</subject><subject>Catheters</subject><subject>Central venous catheterization</subject><subject>Central Venous Catheters</subject><subject>Critical Care</subject><subject>Cross-Sectional Studies</subject><subject>Emergency medical care</subject><subject>Female</subject><subject>Femoral vein</subject><subject>Femoral Vein - diagnostic imaging</subject><subject>Hospitalists</subject><subject>Humans</subject><subject>Jugular vein</subject><subject>Jugular Veins - diagnostic imaging</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Physicians</subject><subject>Practice Patterns, Physicians</subject><subject>Subclavian vein</subject><subject>Subclavian Vein - diagnostic imaging</subject><subject>Surveys and Questionnaires</subject><subject>Ultrasonic imaging</subject><subject>Ultrasonography - statistics & numerical data</subject><subject>Ultrasound</subject><subject>United States</subject><issn>0883-9441</issn><issn>1557-8615</issn><issn>1557-8615</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kl-L1DAUxYso7rj6BXyQgCDrQ2vS_GtFhKXo7sKiD-Psa0jTG0ztNLNJOzh-etOdVWEffEpy87sHzj03y14SXBBMxLu-6E0wRZnuBZYFJuxRtiKcy7wShD_OVriqaF4zRk6yZzH2GBNJKX-anZSS1YQLusp-biIgb9FmmIKOfh47dDG7To8GkPUBNTCmjwHdwOjniBo9fYcJgvulJ-dHdLZZ581N8_Y9Okdf7kqJXc9hD4dF9WqcYIxu7-IU0Rt06ePOTXpYns-zJ1YPEV7cn6fZ5vOnb81lfv314qo5v84No_WUG1FZzgwwsAy4MNJySeu6NZVmhLYcWyvbrupq6DC3YKkuqTDCEskqTVugp9nZUXcX_O0McVJbFw0Mgx4hOVKkokKWoqQ4oa8foL2fQ3J0R0meplnxRJVHygQfYwCrdsFtdTgogtWSi-rVkotaclFYqpRLanp1Lz23W-j-tvwJIgEfjgCkWewdBBWNg5RC5wKYSXXe_V__44N2M7jRGT38gAPEfz5ULBVW62UzlsUgguKS1CX9DcMxs58</recordid><startdate>20161201</startdate><enddate>20161201</enddate><creator>Soni, Nilam J., MD</creator><creator>Reyes, Luis F., MD</creator><creator>Keyt, Holly, MD</creator><creator>Arango, Alejandro, DDS</creator><creator>Gelfond, Jonathan A., MD, PhD</creator><creator>Peters, Jay I., MD</creator><creator>Levine, Stephanie M., MD</creator><creator>Adams, Sandra, MD MSc</creator><creator>Restrepo, Marcos I., MD MSc</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>ASE</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K6X</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20161201</creationdate><title>Use of Ultrasound Guidance for Central Venous Catheterization (US-CVC): A National Survey of Intensivists & Hospitalists</title><author>Soni, Nilam J., MD ; Reyes, Luis F., MD ; Keyt, Holly, MD ; Arango, Alejandro, DDS ; Gelfond, Jonathan A., MD, PhD ; Peters, Jay I., MD ; Levine, Stephanie M., MD ; Adams, Sandra, MD MSc ; Restrepo, Marcos I., MD MSc</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c439t-c68f54ce4ef4e56c7f57399bc8a413b50ff7bd8d9ed05fef3a236c6f1748a3be3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Catheterization, Central Venous - methods</topic><topic>Catheters</topic><topic>Central venous catheterization</topic><topic>Central Venous Catheters</topic><topic>Critical Care</topic><topic>Cross-Sectional Studies</topic><topic>Emergency medical care</topic><topic>Female</topic><topic>Femoral vein</topic><topic>Femoral Vein - diagnostic imaging</topic><topic>Hospitalists</topic><topic>Humans</topic><topic>Jugular vein</topic><topic>Jugular Veins - diagnostic imaging</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Physicians</topic><topic>Practice Patterns, Physicians</topic><topic>Subclavian vein</topic><topic>Subclavian Vein - diagnostic imaging</topic><topic>Surveys and Questionnaires</topic><topic>Ultrasonic imaging</topic><topic>Ultrasonography - statistics & numerical data</topic><topic>Ultrasound</topic><topic>United States</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Soni, Nilam J., MD</creatorcontrib><creatorcontrib>Reyes, Luis F., MD</creatorcontrib><creatorcontrib>Keyt, Holly, MD</creatorcontrib><creatorcontrib>Arango, Alejandro, DDS</creatorcontrib><creatorcontrib>Gelfond, Jonathan A., MD, PhD</creatorcontrib><creatorcontrib>Peters, Jay I., MD</creatorcontrib><creatorcontrib>Levine, Stephanie M., MD</creatorcontrib><creatorcontrib>Adams, Sandra, MD MSc</creatorcontrib><creatorcontrib>Restrepo, Marcos I., MD MSc</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>British Nursing Index</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of critical care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Soni, Nilam J., MD</au><au>Reyes, Luis F., MD</au><au>Keyt, Holly, MD</au><au>Arango, Alejandro, DDS</au><au>Gelfond, Jonathan A., MD, PhD</au><au>Peters, Jay I., MD</au><au>Levine, Stephanie M., MD</au><au>Adams, Sandra, MD MSc</au><au>Restrepo, Marcos I., MD MSc</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Use of Ultrasound Guidance for Central Venous Catheterization (US-CVC): A National Survey of Intensivists & Hospitalists</atitle><jtitle>Journal of critical care</jtitle><addtitle>J Crit Care</addtitle><date>2016-12-01</date><risdate>2016</risdate><volume>36</volume><spage>277</spage><epage>283</epage><pages>277-283</pages><issn>0883-9441</issn><issn>1557-8615</issn><eissn>1557-8615</eissn><abstract>Abstract Purpose Evaluate the frequency and barriers to use of ultrasound guidance for central venous catheter (CVC) insertion by physicians specializing in critical care and hospital medicine. Materials and methods A national cross-sectional electronic survey of intensivists and hospitalists was administered from November 2014 to January 2015. Results The survey response rate was 5.9% (1013/17,233). Moderate to very frequent use of ultrasound guidance varied by site: internal jugular vein (80%), subclavian vein (31%), and femoral vein (45%). Nearly all physicians (99%) that insert internal jugular CVCs daily use ultrasound guidance, whereas only 46% of physicians that insert subclavian CVCs daily use ultrasound guidance. Use of real-time ultrasound guidance varied by insertion site: internal jugular vein (73%), subclavian vein (28%), and femoral vein (42%). The majority of physicians (59%) reported not being comfortable with real-time needle tracking at the subclavian site. The most frequently reported barriers to use of ultrasound guidance were (1) limited availability of ultrasound equipment (28%), (2) perception of increased total procedure time (22%), and (3) concern for loss of landmark skills (13%). Conclusions Most intensivists routinely use ultrasound guidance to insert internal jugular CVCs but not subclavian CVCs. The most commonly reported barrier to ultrasound use was limited access to an ultrasound machine.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>27491563</pmid><doi>10.1016/j.jcrc.2016.07.014</doi><tpages>7</tpages></addata></record> |
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| subjects | Adult Catheterization, Central Venous - methods Catheters Central venous catheterization Central Venous Catheters Critical Care Cross-Sectional Studies Emergency medical care Female Femoral vein Femoral Vein - diagnostic imaging Hospitalists Humans Jugular vein Jugular Veins - diagnostic imaging Male Middle Aged Physicians Practice Patterns, Physicians Subclavian vein Subclavian Vein - diagnostic imaging Surveys and Questionnaires Ultrasonic imaging Ultrasonography - statistics & numerical data Ultrasound United States |
| title | Use of Ultrasound Guidance for Central Venous Catheterization (US-CVC): A National Survey of Intensivists & Hospitalists |
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