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. 2024 May 3;10(9):e30582.
doi: 10.1016/j.heliyon.2024.e30582. eCollection 2024 May 15.

The ultrasound-guided versus standard technique for peripheral intravenous catheter placement by nurses: A systematic review and meta-analysis

Yishu Tian  1 , Zixing Zhong  2 , Djouhayna Dougarem  3 , Litao Sun  1
Affiliations

The ultrasound-guided versus standard technique for peripheral intravenous catheter placement by nurses: A systematic review and meta-analysis

Yishu Tian et al. Heliyon. .

Abstract

Aim: To comprehensively evaluate the efficacy of Ultrasound-guided technique for peripheral intravenous catheter placement by nurses in their daily practice.

Background: Peripheral intravenous catheter insertion is a common clinical procedure in healthcare settings. Ultrasound-guided peripheral intravenous placement has emerged in recent decades and was recognized as particularly useful in some specific patient groups.

Methods: Studies that had compared the ultrasound-guided and traditional approaches were eligible for inclusion and further analysis. The primary outcome was the success rate on the first intravenous insertion attempt. The secondary outcomes included the time needed for successful insertion, and the average number of attempts to establish the IV access. We systematically assess all studies using Cochrane Collaboration's Risk of Bias tool and the Newcastle-Ottawa Scale. We calculated the odds ratio and standardized mean difference with 95 % confidence intervals for the outcomes. Data were analyzed and visualized on Review Manager 5.3.4 and Stata 16.0.

Results: 23 studies were included (17 randomized controlled trials and six cohort studies) with a population of 2051 patients offered ultrasound-assisted technique and 2479 treated with the conventional approach for comparison. The former approach was associated with a higher success rate on the first attempt in comparison (OR = 2.95, 95 % CI: 1.86, 4.69). This technique also took less time and less acupuncture to patients' skin (SMD = -0.62, 95 % CI: 1.01, -0.23; SMD = -0.55, 95 % CI: 0.92, -0.18). In the sub-group analyses, children were more likely to benefit from ultrasound guided technique. Ultrasound guided technique demonstrated consistent and significant benefits in emergency clinical settings. Hospitals from different geographical locations exhibited similar trends in the three outcomes. Year of publication and study design revealed inconsistent and insignificant outcomes.

Conclusions: Ultrasound-guided technique can be a safer, faster, and more effective alternative to the traditional approach for nurses to establish intravenous access across different clinical settings and age groups.

Keywords: Intravenous access (IVA); Meta-analysis; Nurse; Systematic review; Ultrasound-guided peripheral intravenous catheter (USGPIVC).

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Conflict of interest statement

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Litao Sun reports financial support was provided by 10.13039/501100001809National Natural Science Foundation of China. Zixing Zhong reports financial support was provided by Zhejiang Provincial Project for Education. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Flowing diagram of included studies selection process.
Fig. 2
Fig. 2
Forest plot and Risk of Bias. The forest plot shows odds ratio between adults and children on ultrasound-guided peripheral intravenous catheter and conventional approach. Risk of Bias Summary for the Randomized controlled trials. Green color indicates low risk, yellow indicates unknown risk and red color indicates high risk. (For interpretation of the references to color in this figure legend, the reader is referred to the Web version of this article.)
Fig. 3
Fig. 3
The funnel plot to assess publication bias.
See this image and copyright information in PMC

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