Practice of ultrasound-guided CVC catheterization by Chinese anesthesiologists: a comparison of two national cross-sectional surveys

Abstract

Abstract Background CVC catheterization is widely used in the anesthesiology department, critical care department, emergency department, and other departments, which is especially important for clinical treatment. Ultrasound-guided CVC catheterization is recommended by many guidelines, and the use of ultrasound is the key to improving the success rate of puncture and reducing subsequent complications. Existing studies have not yet conducted a survey on the clinical implementation status of ultrasound-guided CVC catheterization. This paper aims to further understand the use of ultrasound-guided CVC catheterization in China's medical environment through cross-sectional study comparison. It also provides a reference for promoting the wide application of this technique in clinical practice and guiding teaching. Methods A cross-sectional survey method was used to compare the current situation of ultrasound-guided deep vein puncture in the Chinese Mainland through two electronic questionnaires from April 2017 to May 2017 and April 2023 to May 2023. IBMSPSS Statistics 26 is used for statistical analysis, and the differences between different positions are analyzed and compared from the title level, and the related influencing factors are analyzed. Result In 2017, 1347 people were included in the survey, mainly young residents and attending physicians. 45% of respondents said they did not use ultrasound to implement CVC placement, for that ultrasound instruction was not considered necessary (34%) or could not be used immediately (19%), and only 20.2% indicated a preference for using ultrasound (US) to guide CVC placement. With the increase of professional titles, the frequency of ultrasonic use decreases. In 2023, 1019 people were included in the survey, including residents, attending physicians, associate chief physicians, and chief physicians accounting for 23.1%, 29.7%, 26.4%, and 20.8% respectively. 42.8% said they prefer to use ultrasound (US) to guide CVC placement. 8.4% indicated that they did not use ultrasound, and the main reason is similar to the previous survey. Through the comparison of two questionnaire surveys, the survey results in 2023 showed that the frequency of ultrasound use has increased significantly compared with that in 2017, and the difference is reduced from the level of professional titles. In both surveys, 98% recommended that body surface localization techniques be taught to younger physicians. Conclusion In recent years, using ultrasound-guided CVC catheterization has greatly reduced iatrogenic damage due to its non-invasive and visual advantages. The visualization operation of CVC catheterization has also been paid attention to in clinical and teaching, the utilization rate is on the rise, the differences at all levels are gradually reduced, and the overall development trend is good. However, there is still a large space for technological improvement, and the national implementation rate needs further improvement, which may face the challenge of unbalanced regional teaching development.