WINFOCUS worldwide survey on central venous catheter insertion and position confirmation practices (CVC-ICON study)
Abstract Background Central venous catheters (CVC) are essential in medicine for monitoring, drug and fluid administration, and renal replacement therapy. Complications such as arrhythmias, endothelial damage, thrombosis, or hemothorax might arise from incorrect positioning. Despite evidence showing...
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SpringerOpen
2025-08-01
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| Series: | The Ultrasound Journal |
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| Online Access: | https://doi.org/10.1186/s13089-025-00429-1 |
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| author | Francesco Corradi Giada Cucciolini Guido Tavazzi Adrian Wong Cosmin Balan Lawrence A. Melniker Arif Hussain Julina Md Noor Jacob John Bailey Anselmo A. Abdo Cuza Alberto Goffi Gabriele Via |
| author_facet | Francesco Corradi Giada Cucciolini Guido Tavazzi Adrian Wong Cosmin Balan Lawrence A. Melniker Arif Hussain Julina Md Noor Jacob John Bailey Anselmo A. Abdo Cuza Alberto Goffi Gabriele Via |
| author_sort | Francesco Corradi |
| collection | DOAJ |
| description | Abstract Background Central venous catheters (CVC) are essential in medicine for monitoring, drug and fluid administration, and renal replacement therapy. Complications such as arrhythmias, endothelial damage, thrombosis, or hemothorax might arise from incorrect positioning. Despite evidence showing their reduction using ultrasound to guide insertion and correct tip positioning, and greater accuracy for tip position assessment vs. chest-X-ray (CXR), ultrasound adoption greatly varies worldwide. This study, conducted by the World Interactive Network Focused On Critical Ultrasound (WINFOCUS) aimed to assess global practices in CVC insertion and tip position confirmation. Methods A web-based survey was conducted (April–September 2023) among WINFOCUS members/affiliates across five continents. It assessed clinical backgrounds, CVC insertion and tip position check methods, and reasons for not using ultrasound. Developed by WINFOCUS Research sub-committee, the survey was emailed, with two reminders. Data were analyzed using SPSS 27.0. Results A total of 1,227 respondents (5.1% response rate) participated, mainly from Europe (33.5%), Asia (28.3%), and the Americas (30.9%), with 95.4% being physicians. Over half (51.3%) had over six years of experience and placed over 200 CVC, mostly using ultrasound guidance (70% of cases). The internal jugular vein (IJV) was the preferred insertion site (74%). Ultrasound was used for pre-insertion assessment (55%) and vessel puncture (57%) but less for guidewire confirmation (44%). CXR remained the primary method for tip position assessment (52%), while only 12% relied solely on bedside ultrasound. Barriers to exclusive ultrasound use included institutional guidelines (33.9%) and medico-legal concerns (13.8%). Conclusions Despite evidence favoring ultrasound for CVC insertion and tip position confirmation, its use remains inconsistent, with CXR still widely used. This survey underscores the need for standardized protocols and training to enhance US adoption, improve patient safety, and reduce CXR reliance. |
| format | Article |
| id | doaj-art-6bca3a35504d40e88d001978765bd1a7 |
| institution | DOAJ |
| issn | 2524-8987 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | SpringerOpen |
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| series | The Ultrasound Journal |
| spelling | doaj-art-6bca3a35504d40e88d001978765bd1a72025-08-20T03:04:31ZengSpringerOpenThe Ultrasound Journal2524-89872025-08-0117111410.1186/s13089-025-00429-1WINFOCUS worldwide survey on central venous catheter insertion and position confirmation practices (CVC-ICON study)Francesco Corradi0Giada Cucciolini1Guido Tavazzi2Adrian Wong3Cosmin Balan4Lawrence A. Melniker5Arif Hussain6Julina Md Noor7Jacob John Bailey8Anselmo A. Abdo Cuza9Alberto Goffi10Gabriele Via11Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, Azienda Ospedaliero Universitaria Pisana, University of PisaDepartment of Surgical, Medical, Molecular Pathology and Critical Care Medicine, Azienda Ospedaliero Universitaria Pisana, University of PisaDepartment of Clinical Surgical, Diagnostic and Pediatric Sciences, University of PaviaDepartment of Critical Care, King’s College Hospital1st Department of Cardiovascular Anesthesia and Intensive Care Medicine, Prof. Dr. C.C. Iliescu Institute for Emergency Cardiovascular DiseasesDepartment of Emergency Medicine NewYork-Presbyterian Brooklyn Methodist Hospital Weill College of Medicine, Cornell UniversityKing Abdulaziz Medical City, King Abdullah International Medical Research CenterDept of Emergency Medicine, Universiti Teknologi MARADepartment of Medicine, Temerty Faculty of Medicine, University of TorontoMedical-Surgical Research Center (CIMEQ)Interdepartmental Division of Critical Care Medicine, University of TorontoIstituto Cardiocentro Ticino – Ente Ospedaliero Cantonale (EOC), Università Della Svizzera Italiana (USI)Abstract Background Central venous catheters (CVC) are essential in medicine for monitoring, drug and fluid administration, and renal replacement therapy. Complications such as arrhythmias, endothelial damage, thrombosis, or hemothorax might arise from incorrect positioning. Despite evidence showing their reduction using ultrasound to guide insertion and correct tip positioning, and greater accuracy for tip position assessment vs. chest-X-ray (CXR), ultrasound adoption greatly varies worldwide. This study, conducted by the World Interactive Network Focused On Critical Ultrasound (WINFOCUS) aimed to assess global practices in CVC insertion and tip position confirmation. Methods A web-based survey was conducted (April–September 2023) among WINFOCUS members/affiliates across five continents. It assessed clinical backgrounds, CVC insertion and tip position check methods, and reasons for not using ultrasound. Developed by WINFOCUS Research sub-committee, the survey was emailed, with two reminders. Data were analyzed using SPSS 27.0. Results A total of 1,227 respondents (5.1% response rate) participated, mainly from Europe (33.5%), Asia (28.3%), and the Americas (30.9%), with 95.4% being physicians. Over half (51.3%) had over six years of experience and placed over 200 CVC, mostly using ultrasound guidance (70% of cases). The internal jugular vein (IJV) was the preferred insertion site (74%). Ultrasound was used for pre-insertion assessment (55%) and vessel puncture (57%) but less for guidewire confirmation (44%). CXR remained the primary method for tip position assessment (52%), while only 12% relied solely on bedside ultrasound. Barriers to exclusive ultrasound use included institutional guidelines (33.9%) and medico-legal concerns (13.8%). Conclusions Despite evidence favoring ultrasound for CVC insertion and tip position confirmation, its use remains inconsistent, with CXR still widely used. This survey underscores the need for standardized protocols and training to enhance US adoption, improve patient safety, and reduce CXR reliance.https://doi.org/10.1186/s13089-025-00429-1Patient safetyHospital resourcesRadiation exposureLow-resource settings |
| spellingShingle | Francesco Corradi Giada Cucciolini Guido Tavazzi Adrian Wong Cosmin Balan Lawrence A. Melniker Arif Hussain Julina Md Noor Jacob John Bailey Anselmo A. Abdo Cuza Alberto Goffi Gabriele Via WINFOCUS worldwide survey on central venous catheter insertion and position confirmation practices (CVC-ICON study) The Ultrasound Journal Patient safety Hospital resources Radiation exposure Low-resource settings |
| title | WINFOCUS worldwide survey on central venous catheter insertion and position confirmation practices (CVC-ICON study) |
| title_full | WINFOCUS worldwide survey on central venous catheter insertion and position confirmation practices (CVC-ICON study) |
| title_fullStr | WINFOCUS worldwide survey on central venous catheter insertion and position confirmation practices (CVC-ICON study) |
| title_full_unstemmed | WINFOCUS worldwide survey on central venous catheter insertion and position confirmation practices (CVC-ICON study) |
| title_short | WINFOCUS worldwide survey on central venous catheter insertion and position confirmation practices (CVC-ICON study) |
| title_sort | winfocus worldwide survey on central venous catheter insertion and position confirmation practices cvc icon study |
| topic | Patient safety Hospital resources Radiation exposure Low-resource settings |
| url | https://doi.org/10.1186/s13089-025-00429-1 |
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