• Sushant Govindan, Amanda Jobe, Megan E O'Malley, Scott A Flanders, and Vineet Chopra.
• Pulmonary and Critical Care Medicine Service Line, Kansas City Veterans Affairs Hospital, Kansas City, MO, United States of America; Division of Pulmonary and Critical Care, Department of Medicine, University of Kansas Medical Center, Kansas City, KS, United States of America. Electronic address: Sushant.govindan@va.gov.
• J Crit Care. 2021 Jun 1; 63: 98-103.

PurposeVascular access patterns in the intensive care unit (ICU) have shifted from non-tunneled central venous catheters (CVCs) towards peripherally inserted central catheters (PICCs). We evaluated perceptions of critical care practitioners regarding these devices and variation in evidence-based practice.MaterialsA 35-question survey on ICU vascular access was deployed in 13 Michigan hospitals. Descriptive statistics summarized responses. Differences in utilization, perceptions and evidence-based practices between PICCs and CVCs, by participant and site-level characteristics, were assessed.Results314 of 621 eligible providers responded to the survey (response rate 51%). 15% of providers reported not routinely using ultrasound when placing CVCs. Respondents whom were trainees, from larger hospitals, and from closed ICUs were more likely to use ultrasound (p < 0.001). Additionally, 21% of respondents stated they did not specify number of CVC lumens, while 46% did not specify number of PICC lumens (p < 0.001). The likelihood of specifying PICC lumens increased when vascular access protocols were in place (p = 0.001). 2/3 of respondents (n = 173, 66%) stated more research on ICU vascular access was needed.ConclusionVariation in guideline-based vascular access practices exists in the ICU. Defined local protocols may improve guideline adherence. Studies evaluating vascular access decisions and patient safety in the ICU appear necessary.Published by Elsevier Inc.

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