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外周静脉穿刺中心静脉导管与中心静脉导管用于静脉通路的比较:一项系统评价与荟萃分析方案

Peripherally inserted central catheter versus central venous catheter for intravenous access: A protocol for systematic review and meta-analysis.

作者信息

Santos Felipe Kenzo Yadoya, Flumignan Ronald Luiz Gomes, Areias Libnah Leal, Sarpe Anna Karina Paiva, Amaral Fabio Cabral Freitas, Ávila Rafael Bernardes de, Vasconcelos Vladimir Tonello de, Guedes Neto Henrique Jorge, Amorim Jorge Eduardo de, Nakano Luis Carlos Uta

机构信息

Undergraduate student of medicine.

Division of Vascular and Endovascular Surgery, Department of Surgery, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo-SP, Brazil.

出版信息

Medicine (Baltimore). 2020 Jul 24;99(30):e20352. doi: 10.1097/MD.0000000000020352.

Abstract

BACKGROUND

Since the first description of the central venous catheter (CVC) in 1952, it has been used for the rapid administration of drugs, chemotherapy, as a route for nutritional support, blood components, monitoring patients, or combinations of these. When CVC is used in the traditional routes (eg, subclavian, jugular, and femoral veins), the complication rates range up to 15% and are mainly due to mechanical dysfunction, infection, and thrombosis. The peripherally inserted central catheter (PICC) is an alternative option for CVC access. However, the clinical evidence for PICC compared to CVC is still under discussion. In this setting, this systematic review (SR) aims to assess the effects of PICC compared to CVC for intravenous access.

METHODS

We will perform a comprehensive search for randomised controlled trials (RCTs), which compare PICC and traditional CVC for intravenous access. The search strategy will consider free text terms and controlled vocabulary (eg, MeSH and Entree) related to "peripherally inserted central venous catheter," "central venous access," "central venous catheter," "catheterisation, peripheral," "vascular access devices," "infusions, intravenous," "administration, intravenous," and "injections, intravenous." Searches will be carried out in these databases: MEDLINE (via PubMed), EMBASE (via Elsevier), Cochrane CENTRAL (via Wiley), IBECS, and LILACS (both via Virtual Health Library). We will consider catheter-related deep venous thrombosis and overall successful insertion rates as primary outcomes and haematoma, venous thromboembolism, reintervention derived from catheter dysfunction, catheter-related infections, and quality of life as secondary outcomes. Where results are not appropriate for a meta-analysis using RevMan 5 software (eg, if the data have considerable heterogeneity and are drawn from different comparisons), a descriptive analysis will be performed.

RESULTS

Our SR will be conducted according to the Cochrane Handbook of Systematic Reviews of Interventions and the findings will be reported in compliance with PRISMA.

CONCLUSION

Our study will provide evidence for the effects of PICC versus CVC for venous access.

ETHICS AND DISSEMINATION

This SR has obtained formal ethical approval and was prospectively registered in Open Science Framework. The findings of this SR will be disseminated through peer-reviewed publications or conference presentations. REGISTRATION:: osf.io/xvhzf.

ETHICAL APPROVAL

69003717.2.0000.5505.

摘要

背景

自1952年首次描述中心静脉导管(CVC)以来,它一直被用于快速给药、化疗、作为营养支持途径、输注血液成分、监测患者或这些用途的组合。当CVC用于传统途径(如锁骨下静脉、颈静脉和股静脉)时,并发症发生率高达15%,主要原因是机械功能障碍、感染和血栓形成。经外周静脉穿刺中心静脉导管(PICC)是CVC置管的另一种选择。然而,与CVC相比,PICC的临床证据仍在讨论中。在此背景下,本系统评价(SR)旨在评估PICC与CVC用于静脉通路的效果。

方法

我们将全面检索随机对照试验(RCT),比较PICC和传统CVC用于静脉通路的情况。检索策略将考虑与“经外周静脉穿刺中心静脉导管”、“中心静脉通路”、“中心静脉导管”、“外周置管”、“血管通路装置”、“静脉输注”、“静脉给药”和“静脉注射”相关的自由文本词和受控词汇(如医学主题词和入口词)。检索将在以下数据库中进行:MEDLINE(通过PubMed)、EMBASE(通过Elsevier)、Cochrane CENTRAL(通过Wiley)、IBECS和LILACS(均通过虚拟健康图书馆)。我们将把导管相关的深静脉血栓形成和总体成功置入率作为主要结局,将血肿、静脉血栓栓塞、因导管功能障碍进行的再次干预、导管相关感染和生活质量作为次要结局。如果结果不适合使用RevMan 5软件进行Meta分析(例如,如果数据具有相当大的异质性且来自不同的比较),将进行描述性分析。

结果

我们的SR将根据《Cochrane系统评价干预措施手册》进行,并将按照PRISMA报告研究结果。

结论

我们的研究将为PICC与CVC用于静脉通路的效果提供证据。

伦理与传播

本SR已获得正式伦理批准,并在开放科学框架中进行了前瞻性注册。本SR的研究结果将通过同行评审出版物或会议报告进行传播。注册:osf.io/xvhzf。

伦理批准

69003717.2.0000.5505。

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