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近红外光设备在小儿外周静脉置管中的应用:一项系统评价和荟萃分析。

Utility of near-infrared light devices for pediatric peripheral intravenous cannulation: a systematic review and meta-analysis.

作者信息

Park Joon Min, Kim Min Joung, Yim Hyeon Woo, Lee Won-Chul, Jeong Hyunsuk, Kim Na Jin

机构信息

Department of Emergency Medicine, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea.

Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.

出版信息

Eur J Pediatr. 2016 Dec;175(12):1975-1988. doi: 10.1007/s00431-016-2796-5. Epub 2016 Oct 26.

Abstract

UNLABELLED

We investigated the utility of near-infrared (NIR) light devices for peripheral intravenous cannulation (PIVC) in pediatric patients. We searched three databases, MEDLINE, EMBASE, and the Cochrane CENTRAL. Randomized controlled trials that compared PIVC using NIR light devices and the "traditional" method (with no assistive device) were included. The primary outcome was a failure rate at the first attempt, and the effect size was measured by the risk ratio for failure. Subgroup analysis was performed according to control group risk for failure at first attempt as an indicator of difficult procedure (low vs. high). Eleven studies were included in the meta-analysis. There was no significant difference in the primary outcome between the two methods (risk ratio 1.03, confidence interval 0.89-1.20, I  = 48 %). In a subgroup analysis, the subgroup difference between subsets of low and high control group risk was significant (I  = 83 %). In the subset of the high control group risk, using NIR light devices showed a lower risk for failure than the traditional method (risk ratio 0.81, confidence interval 0.64-1.01, I  = 0 %).

CONCLUSION

Using NIR light devices did not have an impact on overall failure rate at the first attempt at PIVC in pediatric patients. What is Known: • Near-infrared light devices have been used to help vascular access especially for the pediatric patients. But, their utilities reported in previous studies were conflicting. What is New: • From this study, we could not find out overall benefit of using near-infrared light devices for pediatric peripheral intravenous cannulation. But, this device might be useful for the patients in a difficult condition of successful cannulation.

摘要

未标注

我们研究了近红外(NIR)光设备在儿科患者外周静脉置管(PIVC)中的效用。我们检索了三个数据库,即MEDLINE、EMBASE和Cochrane CENTRAL。纳入了比较使用NIR光设备的PIVC和“传统”方法(不使用辅助设备)的随机对照试验。主要结局是首次尝试时的失败率,效应大小通过失败风险比来衡量。根据对照组首次尝试失败风险作为困难操作指标(低风险与高风险)进行亚组分析。荟萃分析纳入了11项研究。两种方法在主要结局上无显著差异(风险比1.03,置信区间0.89 - 1.20,I² = 48%)。在亚组分析中,低风险和高风险对照组子集之间的亚组差异显著(I² = 83%)。在高风险对照组子集中,使用NIR光设备显示出比传统方法更低的失败风险(风险比0.81,置信区间0.64 - 1.01,I² = 0%)。

结论

使用NIR光设备对儿科患者PIVC首次尝试的总体失败率没有影响。已知信息:• 近红外光设备已被用于帮助血管通路建立,尤其是儿科患者。但是,先前研究报告的其效用相互矛盾。新发现:• 从这项研究中,我们未能发现使用近红外光设备进行儿科外周静脉置管的总体益处。但是,这种设备可能对置管成功困难的患者有用。

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