Ultrasound Guided Vascular Access in The Neonatal Intensive Care Unit: A Nationwide Survey

Ultrasound guided percutaneous vascular access (USG-PVA) is recommended by international practice guidelines but information regarding its use in the neonatal intensive care unit (NICU) is lacking. Our objective was to assess neonatologist’s perceptions and current implementation of USG-PVA in Spain. This was a nationwide online survey. The survey was composed of 37 questions divided in 4 domains: 1) neonatologist’s background, 2) NICU characteristics, 3) personal perspectives about USG-PVA and clinical experience in USG-PVA. One hundred and eighty survey responses from 59 NICUs (62% of Spanish NICUs) were analyzed. Most neonatologist (81%) perceive that competence in USG-PVA is indispensable or very useful in clinical practice. However, 64 (35.5%) have never used USG-PVA in real patients. Among neonatologists with some experience in USG-PVA most perform less than 5 procedures per year (59% in venous access and 80% in arterial access) and a 38% and 60% have never used USG for venous and arterial access respectively in very low birth weight infants (VLBWI). Spanish neonatologists report that residents/fellows training in USG-PVA is absent (52.2%) or unstructured (32%) in their units. The lack of adequate training is identified by a 60% of neonatologists as the most important barrier for implementation of USG-PVA and 87% would recommend that future neonatologists receive formal training. In conclusion, Spanish neonatologists perceive that USG-PVA is important in clinical practice but, currently these techniques are largely underused. Our results indicate that specific training in USG-PVA should be implemented in the NICU.