Hongxiu Chen1, Xiaoxia Zhang2, Heng Wang3, Xiuying Hu4. 1. West China School of Nursing, West China Hospital, Sichuan University, PO Box 610041, No. 37 Guo Xue Street, Chengdu, Sichuan Province, PR China. Electronic address: chenhongxiu@stu.scu.edu.cn. 2. Department of Breast Surgery/Tumor Center, West China Hospital, Sichuan University, PO Box 610041, No. 37 Guo Xue Street, Chengdu, Sichuan Province, PR China. Electronic address: zhangxiaoxia@scu.edu.cn. 3. Department of Anesthesia, West China Hospital, Sichuan University, PO Box 610041, No. 37 Guo Xue Street, Chengdu, Sichuan Province, PR China. 4. West China School of Medicine/West China Hospital, Sichuan University, PO Box 610041, No. 37 Guo Xue Street, Chengdu, Sichuan Province, PR China. Electronic address: huxiuying@scu.edu.cn.
Abstract
OBJECTIVE: To compare the risks of catheter-related complications between peripherally inserted central catheters placed via the upper and lower extremities in neonatal intensive care units. RESEARCH METHODOLOGY: PUBMED, EMBASE, SCOPUS, and the Cochrane Library databases were searched from inception to 3 January 2019. All studies were of patients in neonatal intensive care units who underwent insertion of peripherally inserted central catheters and were published in English. RESULTS: Eight studies covering 4405 peripherally inserted central catheters were included. The upper extremity group was associated with a higher risk of non-elective removal (OR = 1.41; 95% 1.16-1.72; p = 0.0007) and malposition (OR = 4.52, 95% CI 2.16-9.47; p < 0.0001) and a lower risk of thrombosis (OR = 0.23, 95% CI 0.07-0.77; p = 0.02) compared with the lower extremity group. There was no significant difference in mechanical complications, catheter-related infection, or phlebitis. CONCLUSION: This meta-analysis showed that the lower extremity group was not associated with worse outcomes compared with the upper extremity group in the neonatal intensive care unit, with the exception of thrombosis. However, further prospective randomised controlled studies are needed to ensure the quality of the results.
OBJECTIVE: To compare the risks of catheter-related complications between peripherally inserted central catheters placed via the upper and lower extremities in neonatal intensive care units. RESEARCH METHODOLOGY: PUBMED, EMBASE, SCOPUS, and the Cochrane Library databases were searched from inception to 3 January 2019. All studies were of patients in neonatal intensive care units who underwent insertion of peripherally inserted central catheters and were published in English. RESULTS: Eight studies covering 4405 peripherally inserted central catheters were included. The upper extremity group was associated with a higher risk of non-elective removal (OR = 1.41; 95% 1.16-1.72; p = 0.0007) and malposition (OR = 4.52, 95% CI 2.16-9.47; p < 0.0001) and a lower risk of thrombosis (OR = 0.23, 95% CI 0.07-0.77; p = 0.02) compared with the lower extremity group. There was no significant difference in mechanical complications, catheter-related infection, or phlebitis. CONCLUSION: This meta-analysis showed that the lower extremity group was not associated with worse outcomes compared with the upper extremity group in the neonatal intensive care unit, with the exception of thrombosis. However, further prospective randomised controlled studies are needed to ensure the quality of the results.