To investigate the application of critical care blood purification (CCBP) in Intensive care units (ICUs) in Shaanxi province.

From August 31^st to September 10^th, 2021, a comprehensive Network Survey with simple sampling was released to ICU staffs in the hospitals of various levels aimed to collect data about the current application and underlying influence factors of CCBP in the ICUs in Shaanxi province.

A total of 146 questionnaires were collected in this cross-sectional study. Ten questionnaires with obvious logical errors were excluded and finally 136 questionnaires were included in this analysis. This study covers 11 different cities or regions in Southern, Central and Northern Shaanxi. The survey showed that CCBP was mainly carried out in the department of critical medicine of tertiary hospitals, 50.70% in class A tertiary hospitals, 11.27% in class B tertiary hospitals and 38.03% in class A secondary hospitals. A Spearman Correlation coefficient analysis of grades of hospital, years of applying purification, numbers of beds and machines and case numbers by month in these ICUs showed correlations between these factors and the application of blood purification (P＜0.05). 50% of ICUs use self-made dialysis fluid. Multiple organ dysfunction syndrome (MODS), acute kidney injury (AKI) and septic shock were the top three diseases treated by CCBP (18.20%, 17.38%, 16.56%). The most commonly used modes were continuous veno-venous hemofiltration (CVVH), continuous veno-venous hemodiafiltration (CVVHD) and plasma exchange (PE) (28.18%, 21.95%, 15.96%). The catheterization mostly was performed with anatomical positioning, and the right femoral vein was the first choice of catheterization (41.91%). Systemic heparin anticoagulation and regional citrate anticoagulation were commonly used. Bleeding and pipeline coagulation were the main complications in the process of CCBP.

This study illustrates an imbalanced development of CCBP in Shaanxi province. Application of CCBP in low-level hospitals needs to be improved. This study provides some valuable information to the local health administration for developing relevant policies and training system and improving CCBP in Shaanxi province.