SHM Converge Scientific Abstract ePoster Gallery-Central Line Placement on the Wards Versus Intensive Care Unit

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This study compared central venous line (CVL) placements done on medical-surgical wards versus the intensive care unit (ICU) by a hospitalist bedside procedure service at one institution from 2015 to 2023. The authors wanted to assess whether ICU patients had higher bleeding risk, more complications, or more failed procedures than non-ICU patients.<br /><br />Over time, most CVLs shifted from being placed in the ICU to being placed on the wards. In 2015–16, 89% were done in the ICU, but by 2022–23, 96% were done on non-ICU patients. ICU patients had a much higher bleeding-risk profile than ward patients, with 36.4% classified as high risk versus 8.0% on the wards.<br /><br />Despite this higher risk, outcomes were similar. Complication rates were low and not significantly different between ICU and non-ICU placements (1.2% in ICU vs 1.8% on wards). Failure rates were also nearly identical (4.7% vs 4.8%). The average number of needle passes was essentially the same in both settings (1.2 vs 1.15), suggesting the procedure was not more technically difficult in ICU patients.<br /><br />One notable difference was learner involvement: trainees assisted less often with ICU procedures than with ward procedures, suggesting staff may have been less comfortable involving learners in higher-risk ICU cases.<br /><br />Overall, the study found that a trained hospitalist procedure team could safely place CVLs in ICU patients despite their greater bleeding risk, with no meaningful increase in complications or unsuccessful attempts compared with ward patients.

Asset Subtitle

Sheila Swartz

Meta Tag

Author List Adrian Umpierrez, Devin Madenberg, Joseph Puetz, Lara Voigt, Leah Cotter, Ricardo Franco Sadud, Sheila Swartz

Category Research

Concept Central Venous Catheterization

Concept Complication Rate

Concept ICU

Concept Hospital Ward

Concept Procedure Failure

Distinguished Non-Finalist

Presenter Organization Medical College of Wisconsin

Presenting Author Sheila Swartz

Track Outcomes Research

Keywords

central venous line

CVL placement

intensive care unit

medical-surgical wards

hospitalist procedure service

bleeding risk

procedure complications

failed procedures

needle passes

learner involvement

Central Venous Catheterization

Complication Rate

ICU

Hospital Ward

Procedure Failure