ArticleThe ultrasound journal2025
WINFOCUS worldwide survey on central venous catheter insertion and position confirmation practices (CVC-ICON study).
Article in The ultrasound journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Central venous cannulation in critically ill patients: guidelines of the Polish Society of Anaesthesiology and Intensive Therapy.Anaesthesiology intensive therapy · 2026Guideline
- Rethinking routine chest radiography after central venous catheterisation: a rapid review of current evidence and alternatives.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Review
- Point-of-care ultrasonography for verification of central venous catheter placement in cats and dogs.Frontiers in veterinary science · 2026Article
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCentral 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.
methodsA 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.
resultsA 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%).
conclusionsDespite 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.
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