Chen Xiuwen, Yue Liqing, Liao Peng, Li Bingyu
Teaching and Research Section of Clinical Nursing, Xiangya Hospital, Central South University, Changsha, China.
National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.
Nurs Crit Care. 2025 Mar;30(2):e13121. doi: 10.1111/nicc.13121. Epub 2024 Jul 14.
Catheter-related thrombosis is a common complication of the peripherally inserted central catheter (PICC) in neonates, leading to unintended tube removal and significantly affecting neonatal health and safety. Despite widespread reporting on the estimated occurrence and factors contributing to neonatal PICC-related thrombosis, these findings have not been synthesized.
The purpose of this study was to determine the incidence and risk factors of neonatal PICC-related thrombosis.
Systematic literature review and meta-analysis. Two independent researchers systematically explored multiple databases-such as PubMed, Medline, Embase and the Cochrane Library-from their inception until October 2023. Our study aggregates and scrutinizes studies specifically addressing the incidence and risk factors of neonatal PICC-related thrombosis. Employing the RevMan 5.3 software, a meta-analysis was executed to determine the incidence of both thrombosis and odds ratios (OR), accompanied by their respective 95% confidence intervals (CI) for the risk factors.
A total of 327 articles were screened, and data from 24 studies were used in synthesis. Neonatal PICC-related thrombosis incidence varied from 0.23% to 17.91%. The pooled incidence was 2% (95% CI: 1%-2%; I = 94%; p < .0001). The study identified 12 risk factors, including insertion sites in the lower extremities (OR = 0.22; 95% CI: 0.09-0.56; p = .001), gestational age <28 weeks, abdominal pathology, fresh frozen plasma by day 5 > 50 mL/kg, PICC tip location (proximal placement), two lumens, three lumens, prolonged hospital stay, infection, mothers' use of anticoagulants, patients with cardiac insufficiency and being twin-to-twin transfusion syndrome donor.
The analysis indicates an overall pooled incidence of neonatal PICC-related thrombosis of 2%. Twelve factors were identified as risks associated with neonatal PICC-related thrombosis. Understanding the risk factors can provide evidence-based recommendations for improving awareness, control and treatment and better nursing management.
This systematic review and meta-analysis illuminates the incidence and risk factors linked to neonatal PICC-related thrombosis, delivering essential insights pivotal for clinical decision-making and enhancing patient care within neonatal health care settings.
导管相关血栓形成是新生儿外周静脉穿刺中心静脉导管（PICC）常见的并发症，可导致意外拔管，并严重影响新生儿的健康和安全。尽管关于新生儿PICC相关血栓形成的估计发生率及相关因素已有广泛报道，但这些研究结果尚未得到综合分析。
本研究旨在确定新生儿PICC相关血栓形成的发生率及危险因素。
系统文献综述和荟萃分析。两名独立研究人员系统检索了多个数据库，如PubMed、Medline、Embase和Cochrane图书馆，检索时间从各数据库建库至2023年10月。本研究汇总并审查了专门针对新生儿PICC相关血栓形成的发生率及危险因素的研究。使用RevMan 5.3软件进行荟萃分析，以确定血栓形成的发生率及比值比（OR），并给出其危险因素各自的95%置信区间（CI）。
共筛选出327篇文章，24项研究的数据用于综合分析。新生儿PICC相关血栓形成的发生率在0.23%至17.91%之间。合并发生率为2%（95%CI：1%-2%；I² = 94%；p < 0.0001）。该研究确定了12个危险因素，包括下肢穿刺部位（OR = 0.22；95%CI：0.09-0.56；p = 0.001）、胎龄<28周、腹部病变、出生后5天内新鲜冰冻血浆用量>50 mL/kg、PICC尖端位置（近端放置）、双腔、三腔、住院时间延长、感染、母亲使用抗凝剂、心脏功能不全患者以及双胎输血综合征供体。
分析表明，新生儿PICC相关血栓形成的总体合并发生率为2%。确定了12个与新生儿PICC相关血栓形成相关的危险因素。了解这些危险因素可为提高认识、控制和治疗以及更好的护理管理提供循证建议。
本系统综述和荟萃分析阐明了新生儿PICC相关血栓形成的发生率及危险因素，为新生儿医疗保健环境中的临床决策和改善患者护理提供了至关重要的见解。
