Evaluation of insertion methods and the anatomic region preference by the intensivists in central venous catheterization during COVID-19 pandemic: a survey-based study from Turkey

Abstract

Background & Objective: COVID-19 pandemic caused several clinicopathological conditions. The majority of the patients required intensive care. Even in the intensive care unit (ICU) setting, invasive procedures were challenging for healthcare workers due to the highly infectious nature of the disease and the need to work in cumbersome personal protective equipment. Peripheral and central venous catheterisation (CVC) were the most performed invasive procedures. We evaluated the preferred anatomical region and the preferred insertion method of CVC by the intensive care physicians.

Methodology: The study was conducted between July 2020 and October 2020, after obtaining institutional ethics committee approval. Physicians working in ICUs across Turkey were included in the survey. A specialy prepared questionnaire was delivered online to the study sample via email invitation or social media applications. A total of 314 people received the questionnaire, 4 of the respondents did not allow the use of the survey data and 53 did not complete the questionnaire, so 57 records were excluded from the study and statistical data analysis was performed on 247 responses.

Results: Participants were aged between 25 and 60 y. Regarding academic status, 97 of the participants were assistants, 112 were specialists, 25 were assistant professors, 5 were associate professors and 8 were professors. The number of catheters inserted by the physicians participating in the study showed statistically significant decrease during the pandemic period but controversially total number of catheters inserted in the ICUs showed no difference. Femoral vein was the most preferred anatomic region during pandemic period in both intubated patients, and patients using other ventilation support devices. Physician’s preferred method of catheter insertion remains the same.

Conclusion: Central venous catheterisation is one of the vital invasive procedures performed on patients admitted to intensive care. The vital nature of the procedure, the proximity of the insertion site to the airway and the cumbersome personal protective equipment worn by healthcare workers made it a challenging intervention. we concluded that intensive care physicians in our country are reluctant to use central venous catheters because of concerns about contracting infection, and as a result of these concerns, they increase the use of personal protective equipment and protect themselves by changing anatomical site for catheterization.

Key words: COVID-19; Central Venous Access; Central Venous Cannulation; Ultrasound-Guided; ICU

Citation: Civraz AZT. Evaluation of insertion methods and the anatomic region preference by the intensivists in central venous catheterization during COVID-19 pandemic: a survey-based study from Turkey. Anaesth. pain intensive care 2023;27(5):619−624; DOI: 10.35975/apic.v27i5.2294

Received: August 29, 2023; Reviewed: September 12, 2023; Accepted: September 19, 2023