A cross-sectional survey of Chinese anesthesiologists' understanding of fluid resuscitation recommendations in the 2021 surviving sepsis campaign guidelines.

backgroundThis study evaluated whether anesthesiologists from various backgrounds are familiar with the 2021 Surviving Sepsis Campaign (SSC) fluid resuscitation recommendations and identified areas for targeted education and practice improvements.

methodsThe internet-based survey was conducted from March 13 to April 13, 2024, using Tencent Questionnaire via WeChat. Data concerning respondents' demographics, self-reported familiarity with and adherence to SSC fluid resuscitation recommendations, and specific knowledge questions were collected. Comparisons were made between anesthesiologists from hospitals across different tiers to evaluate differences in understanding. Multivariable logistic regression was performed to adjust for potential confounders.

resultsIn total, 1,227 anesthesiologists completed the survey; after excluding non-anesthesiologists, 1,051 were included in the analysis. Among them, 7.2% reported being "very familiar" and 28.4% reported being "somewhat familiar" with fluid resuscitation strategies outlined in the SSC guidelines. Moreover, 72.2% of anesthesiologists reported following the SSC guidelines during perioperative management of septic patients. Although self-reported familiarity and adherence did not significantly differ across hospital tiers, differences emerged in specific areas of knowledge, including the choice of first-line fluid for resuscitation and the selection of first-line vasopressor. However, after adjusting for years of clinical experience, professional rank, academic degree, and annual sepsis case volume, hospital tier was no longer significantly associated with knowledge of either first-line fluid or first-line vasopressor selection.

conclusionsThis nationwide cross-sectional survey suggests that while more than half of Chinese anesthesiologists reported general familiarity with and adherence to the SSC guidelines, many lacked updated knowledge of specific 2021 recommendations. Individual-level factors were associated with guideline familiarity and knowledge, whereas institutional characteristics appeared to play a limited role after adjustment. These findings may help identify gaps and inform targeted educational interventions for junior anesthesiologists and those with lower academic qualifications, though causal inferences are precluded by the observational design.