Department of Catheterization Center, Henan Provincial People's Hospital, Henan Provincial Key Medicine Laboratory of Nursing, People's Hospital of zhengzhou University, Zhengzhou, China.
Henan Evidence-based Nursing Centre: A JBI Affiliated Group, The University of Adelaide, Zhengzhou, China.
Int Wound J. 2024 Mar;21(3):e14468. doi: 10.1111/iwj.14468. Epub 2023 Dec 4.
Studies showed that integrating coating or valve into Peripherally Inserted Central (PICC) can prevent related complications. However, data regarding efficiency were controversial. Therefore, a systematic review was needed to analyse the effect of PICC materials and designs on reduction of PICC-related complications. We searched PubMed, Cochrane library, EMbase, grey literature and referent literature from inception to 5 August 2022. Randomized controlled trials (RCTs) and case-control study were included. Two authors extracted data independently, using a predesigned Excel form, and assessed the quality of included RCTs according to the Cochrane Handbook for Systematic Reviews (V5.1.0), case-control study was assessed by the Newcastle-Ottawa Scale. Data were analysed using Review Manager (v5.3.0). A total of 10 RCTs and one case-control study were included. Meta-analysis results showed that PICC designs reduce the incidence of obstruction, and at the critical value of PICC-associated bloodstream infection, but may have no effects on other complications. Based on the literature reviewed, we can only say PICC new materials did not reflect significant reduction on complications, what's more, the result needs more multicentre, large RCTs to support. We suggested clinicians combine descriptive research and cost-effect analysis to select appropriate PICC materials and designs for patients.
研究表明,在经外周静脉穿刺中心静脉置管(PICC)中加入涂层或瓣膜可以预防相关并发症。然而,关于其效率的数据存在争议。因此,需要进行系统评价来分析 PICC 材料和设计对减少 PICC 相关并发症的影响。我们检索了 PubMed、Cochrane 图书馆、EMbase、灰色文献和参考文献,检索时间从建库至 2022 年 8 月 5 日。纳入随机对照试验(RCT)和病例对照研究。两位作者独立提取数据,使用预先设计的 Excel 表格,并根据 Cochrane 系统评价手册(V5.1.0)评估 RCT 的质量,病例对照研究采用纽卡斯尔-渥太华量表进行评估。使用 Review Manager(v5.3.0)进行数据分析。共纳入 10 项 RCT 和 1 项病例对照研究。Meta 分析结果表明,PICC 设计可降低阻塞和 PICC 相关性血流感染的发生率,但对其他并发症可能没有影响。基于我们回顾的文献,我们只能说 PICC 新材料并没有显著降低并发症的发生率,而且,这一结果需要更多的多中心、大样本 RCT 来支持。我们建议临床医生结合描述性研究和成本效益分析,为患者选择合适的 PICC 材料和设计。