Zaozhuang Traditional Chinese Medicine Hospital, Zaozhuang, Shandong, P.R. China.
PLoS One. 2020 Apr 7;15(4):e0231110. doi: 10.1371/journal.pone.0231110. eCollection 2020.
Infection is one of the most commonly described complications, and a major cause of morbidity and mortality in pediatric patients treated using central venous catheters (CVCs). Taurolidine lock solutions have been used to decrease catheter-related bloodstream infections (CRBSIs) in both adult and pediatric patients. The purpose of this study was to systematically search the literature and conduct a meta-analysis to determine the efficacy of taurolidine in reducing CRBSI in children. We conducted an electronic search of the PubMed, EMBASE, Cochrane Library, TRIP Database, CINAHL, and Google Scholar databases for articles published up to 1st November 2019. Eligible studies included randomized controlled trials (RCTs) comparing the effects of taurolidine with control for preventing CRBSI in pediatric patients. Four studies were included. Our results indicated a statistical significant reduction in the total number of CRBSI with taurolidine as compared to control (RR: 0.23; 95% CI:0.13, 0.40; I2 = 0%; P<0.00001). The pooled analysis also indicated a statistical significant reduction in the incidence of CRBSI (defined as the number of CRBSI events/1000 catheter days) in the taurolidine group (MD: -1.12; 95% CI:-1.54, -0.71; I2 = 1%; P<0.00001). The number of catheters removed due to infection or suspected infection was not significantly different between the two groups (RR: 0.68; 95% CI:0.22, 2.10; I2 = 56%; P = 0.50) (Fig 5). The quality of the included studies was not high. The use of taurolidine as a catheter locking solution may significantly reduce CRBSI in pediatric patients. However, the quality of current evidence is not high and further high-quality large scale RCTs are needed to corroborate our results.
感染是最常见的并发症之一，也是使用中心静脉导管 (CVC) 治疗的儿科患者发病率和死亡率的主要原因。牛磺罗定锁液已被用于减少成人和儿科患者的导管相关血流感染 (CRBSI)。本研究的目的是系统地搜索文献并进行荟萃分析，以确定牛磺罗定在降低儿童 CRBSI 中的疗效。我们对 PubMed、EMBASE、Cochrane 图书馆、TRIP 数据库、CINAHL 和 Google Scholar 数据库进行了电子检索，以查找截至 2019 年 11 月 1 日发表的文章。合格的研究包括比较牛磺罗定与对照预防儿科患者 CRBSI 效果的随机对照试验 (RCT)。共纳入 4 项研究。我们的结果表明，与对照组相比，牛磺罗定可显著减少 CRBSI 的总发生数（RR：0.23；95%CI：0.13，0.40；I2=0%；P<0.00001）。汇总分析还表明，牛磺罗定组 CRBSI 的发生率（定义为 CRBSI 事件/1000 导管日数）显著降低（MD：-1.12；95%CI：-1.54，-0.71；I2=1%；P<0.00001）。两组因感染或疑似感染而拔除的导管数量无显著差异（RR：0.68；95%CI：0.22，2.10；I2=56%；P=0.50）（图 5）。纳入研究的质量不高。使用牛磺罗定作为导管锁定溶液可能会显著降低儿科患者的 CRBSI。然而，当前证据的质量不高，需要进一步的高质量大规模 RCT 来证实我们的结果。
