Hospital Universitario Marqués de Valdecilla - IDIVAL, Santander, Spain; Clínica Mompía School of Nursing, Universidad Católica de Ávila, Mompía, Spain.
Department of Nursing and Physiotherapy, Universitat de les Illes Balears, Palma, Spain; Care, Chronicity and Evidence in Health Research Group (CurES), Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain; Implementation, Research and Innovation Unit, Hospital de Manacor, Manacor, Spain.
J Infect Public Health. 2023 Jul;16(7):1023-1032. doi: 10.1016/j.jiph.2023.04.012. Epub 2023 Apr 23.
The use of central venous catheters (CVC) is associated with higher morbidity and mortality, related to infectious complications, contributing to poorer clinical outcomes and increased healthcare costs. According to the literature, the incidence of local infections related to CVC for hemodialysis is highly variable. This variability is related to differences in definitions of catheter-related infections.
To identify signs and symptoms for determining local infections (exit site and tunnel tract infections) used in the literature in tunnelled and nontunnelled CVC for hemodialysis.
Systematic review METHODS: Structured electronic searches were conducted in five electronic databases, from 1 January 2000-31 August 2022, using key words and specific vocabulary, as well as manual searches in several journals. Additionally, vascular access clinical guidelines and infection control clinical guidelines were reviewed.
After validity analysis, we selected 40 studies and seven clinical guidelines. The definitions of exit site infection and tunnel infection used in the different studies were heterogeneous. Among the studies, seven (17,5 %) used the definitions of exit site and tunnel infection based on a clinical practice guideline. Three of the studies (7.5 %) used the Twardowski scale definition of exit site infection or a modification. The remaining 30 studies (75 %) used different combinations of signs and symptoms.
Definitions of local CVC infections are highly heterogeneous in the revised literature. It is necessary to establish a consensus regarding the definitions of hemodialysis CVC exit site and tunnel infections.
PROSPERO (CRD42022351097).
中心静脉导管（CVC）的使用与更高的发病率和死亡率相关，这与感染并发症有关，导致更差的临床结果和增加医疗保健成本。根据文献，与血液透析用 CVC 相关的局部感染发生率差异很大。这种变异性与导管相关感染的定义差异有关。
确定文献中用于确定隧道和非隧道血液透析用 CVC 的局部感染（出口部位和隧道部位感染）的体征和症状。
系统评价
从 2000 年 1 月 1 日至 2022 年 8 月 31 日，在五个电子数据库中进行了结构化电子检索，使用关键词和特定词汇，并在多个期刊中进行了手动检索。此外，还审查了血管通路临床指南和感染控制临床指南。
经过有效性分析，我们选择了 40 项研究和 7 项临床指南。不同研究中使用的出口部位感染和隧道感染的定义是异构的。在这些研究中，有七项（17.5%）研究使用基于临床实践指南的出口部位和隧道感染的定义。三项（7.5%）研究使用了出口部位感染的 Twardowski 量表定义或其修改版。其余 30 项研究（75%）使用了不同的体征和症状组合。
在修订后的文献中，局部 CVC 感染的定义差异很大。有必要就血液透析 CVC 出口部位和隧道感染的定义达成共识。
PROSPERO（CRD42022351097）。
