Nicole Clare Gavin1,2,3, Elise Button3,4, Samantha Keogh1,2, David McMillan2,5, Claire Rickard1,2. 1. 1 National Health and Medical Research Council Centre of Research Excellence in Nursing, Menzies Health Institute Queensland, Nathan Campus, Griffith University, Nathan, QC, Australia. 2. 2 Alliance for Vascular Access Teaching and Research Group, Menzies Health Institute Queensland, Nathan Campus, Griffith University, Nathan, QC, Australia. 3. 3 Cancer Care Services, Royal Brisbane and Women's Hospital, Herston, QC, Australia. 4. 4 School of Nursing, Queensland University of Technology, Kelvin Grove Campus, Kelvin Grove, QC, Australia. 5. 5 Inflammation and Healing Research Cluster, University of the Sunshine Coast, Sippy Downs, QC, Australia.
Abstract
BACKGROUND: Central venous access devices (CVADs) are used for parenteral nutrition (PN) delivery. We systematically reviewed research-based publications that reported comparative rates of catheter-related bloodstream infection (CRBSI) in patients with CVADs who received PN vs those who did not receive PN therapy. MATERIALS AND METHODS: The literature search included the Cochrane Library, MEDLINE, CINAHL, and PubMed up to July 14, 2015, to identity studies that compared patients with a CVAD who did and did not have PN therapy. RESULTS: Eleven observational studies were identified, comprising 2854 participants with 6287 CVADs. Six studies produced significant results in favor of non-PN, 4 studies showed no evidence of a difference between PN and non-PN, and 1 study produced significant results in favor of PN when analyzed per patient with multiple CVADs. Incidence ranged from 0 to 6.6 CRBSIs per 1000 CVAD days in the PN patients and 0.39 to 3.6 CRBSIs per 1000 CVAD days in the non-PN patients. The Cochrane risk of bias assessment tool for nonrandomized studies of interventions was used. Eight studies were rated as moderate risk of bias, 2 as serious, and 1 as critical. CONCLUSION: The data presented in this systematic review are not sufficient to establish whether patients receiving PN are more at risk of developing CRBSI than those who do not. Future PN studies needs to adjust for baseline imbalances and improve quality and reporting.
BACKGROUND: Central venous access devices (CVADs) are used for parenteral nutrition (PN) delivery. We systematically reviewed research-based publications that reported comparative rates of catheter-related bloodstream infection (CRBSI) in patients with CVADs who received PN vs those who did not receive PN therapy. MATERIALS AND METHODS: The literature search included the Cochrane Library, MEDLINE, CINAHL, and PubMed up to July 14, 2015, to identity studies that compared patients with a CVAD who did and did not have PN therapy. RESULTS: Eleven observational studies were identified, comprising 2854 participants with 6287 CVADs. Six studies produced significant results in favor of non-PN, 4 studies showed no evidence of a difference between PN and non-PN, and 1 study produced significant results in favor of PN when analyzed per patient with multiple CVADs. Incidence ranged from 0 to 6.6 CRBSIs per 1000 CVAD days in the PN patients and 0.39 to 3.6 CRBSIs per 1000 CVAD days in the non-PN patients. The Cochrane risk of bias assessment tool for nonrandomized studies of interventions was used. Eight studies were rated as moderate risk of bias, 2 as serious, and 1 as critical. CONCLUSION: The data presented in this systematic review are not sufficient to establish whether patients receiving PN are more at risk of developing CRBSI than those who do not. Future PN studies needs to adjust for baseline imbalances and improve quality and reporting.
Entities:
Keywords:
catheter-related bloodstream infection; central venous access device; central venous catheterization; parenteral nutrition; systematic review
Authors: Simon Bessis; Nadim Cassir; Line Meddeb; Anne Bonnet Remacle; Jérôme Soussan; Vincent Vidal; Pierre-Edouard Fournier; Florence Fenollar; Didier Raoult; Philippe Brouqui Journal: Medicine (Baltimore) Date: 2020-01 Impact factor: 1.817