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Meta-Analysis
. 2023 Apr;20(4):1130-1138.
doi: 10.1111/iwj.13971. Epub 2022 Oct 11.

Impact of peripherally inserted central venous catheter-associated phlebitis in neonate guided by intracavitary electrocardiogram: A systematic review and meta-analysis of randomised controlled trials

Wenyi Gan  1 , Lin Hu  1 , Yulan Luo  1 , Menglin Tang  1
Affiliations
Meta-Analysis

Impact of peripherally inserted central venous catheter-associated phlebitis in neonate guided by intracavitary electrocardiogram: A systematic review and meta-analysis of randomised controlled trials

Wenyi Gan et al. Int Wound J. 2023 Apr.

Abstract

Because the application of intracavitary electrocardiogram (IC-ECG)-guided peripherally inserted central catheter (PICC) in the treatment of neonates is controversial in terms of phlebitis reduction compared with traditional X-ray positioning technique, a systematical evaluation is needed on the impact of IC-ECG on this common complication following PICC. Literature retrieval was conducted on large databases including PubMed, Google Scholar, Cochrane library, and CNKI. Randomised controlled trials (RTCs) of intracavitary electrocardiogram-guided peripherally inserted central catheter tip placement in the treatment of neonates up to July 7, 2022, were collected. Then indicators of included studies were compared and analysed by two researchers. Meta-analysis was performed on the STATA 17.0 software. After excluding invalid trials, 11 out of 316 randomised controlled trials were included for further analysis. Meta-analysis results showed that compared with the control group, IC-ECG-guided PICC could decrease the incidence of phlebitis (I2 = 0.00%, P = 0.76, OR = 0.33, 95% CI 0.19-0.56) and that no significant difference was observed between preterm neonates and term neonates (P = 0.74). Meanwhile, total complications were decreased in neonates (I2 = 0.00%, P = 0.00 OR = 0.23, 95% CI 0.16-0.33). IC-ECG-guided PICC could also improve the accuracy of optimal tip location (I2 = 0.00%, P = 0.53, OR = 5.37, 95% CI 3.80-7.59). IC-ECG-guided PICC could achieve reduced phlebitis incidence and total complications in the treatment of neonates, as well as increased accuracy of optimal tip location, no matter if those neonates were preterm or not. This study was registered in inplasy.com with No. INPLASY202280012 (DOI: 10.37766/inplasy2022.8.0012).

Keywords: PICC; intracavitary electrocardiogram; meta-analysis; neonate; phlebitis.

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Figures

FIGURE 1
FIGURE 1
PRISMA flow diagram
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FIGURE 2
Risk of bias summary
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FIGURE 3
Forest plots of phlebitis with neonates
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FIGURE 4
Forest plots of phlebitis with preterm neonates and term neonates
FIGURE 5
FIGURE 5
Forest plots of optimal tip location
FIGURE 6
FIGURE 6
Funnel plot of included studies
See this image and copyright information in PMC

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