Brachial Tunneled Peripherally Inserted Central Catheters and the Risk of Catheter Complications: A Systematic Review and Meta-Analysis
Introduction: Situations involving increased workloads and stress (i.e., the COVID-19 pandemic) underline the need for healthcare professionals to minimize patient complications. In the field of vascular access, tunneling techniques are a possible solution. This systematic review and meta-analysis a...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-02-01
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| Series: | Nursing Reports |
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| Online Access: | https://www.mdpi.com/2039-4403/14/1/35 |
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| author | Davide Giustivi Mattia Donadoni Stefano Maria Elli Francesco Casella Massimiliano Quici Chiara Cogliati Silvia Cavalli Giulia Rizzi Leyla La Cava Arianna Bartoli Elena Martini Alba Taino Martina Perego Antonella Foschi Roberto Castelli Maria Calloni Antonio Gidaro |
| author_facet | Davide Giustivi Mattia Donadoni Stefano Maria Elli Francesco Casella Massimiliano Quici Chiara Cogliati Silvia Cavalli Giulia Rizzi Leyla La Cava Arianna Bartoli Elena Martini Alba Taino Martina Perego Antonella Foschi Roberto Castelli Maria Calloni Antonio Gidaro |
| author_sort | Davide Giustivi |
| collection | DOAJ |
| description | Introduction: Situations involving increased workloads and stress (i.e., the COVID-19 pandemic) underline the need for healthcare professionals to minimize patient complications. In the field of vascular access, tunneling techniques are a possible solution. This systematic review and meta-analysis aimed to compare the effectiveness of tunneled Peripherally Inserted Central Catheters (tPICCs) to conventional Peripherally Inserted Central Catheters (cPICCs) in terms of bleeding, overall success, procedural time, and late complications. Methods: Randomized controlled trials without language restrictions were searched using PUBMED<sup>®</sup>, EMBASE<sup>®</sup>, EBSCO<sup>®</sup>, CINAHL<sup>®</sup>, and the Cochrane Controlled Clinical Trials Register from August 2022 to August 2023. Five relevant papers (1238 patients) were included. Results: There were no significant differences in overall success and nerve or artery injuries between the two groups (<i>p</i> = 0.62 and <i>p</i> = 0.62, respectively), although cPICCs caused slightly less bleeding (0.23 mL) and had shorter procedural times (2.95 min). On the other hand, tPICCs had a significantly reduced risk of overall complications (<i>p</i> < 0.001; RR0.41 [0.31–0.54] CI 95%), catheter-related thrombosis (<i>p</i> < 0.001; RR0.35 [0.20–0.59] IC 95%), infection-triggering catheter removal (<i>p</i> < 0.001; RR0.33 [0.18–0.61] IC 95%), wound oozing (<i>p</i> < 0.001; RR0.49 [0.37–0.64] IC 95%), and dislodgement (<i>p</i> < 0.001; RR0.4 [0.31–0.54] CI 95%). Conclusions: The tunneling technique for brachial access appears to be safe concerning intra-procedural bleeding, overall success, and procedural time, and it is effective in reducing the risk of late complications associated with catheterization. |
| first_indexed | 2024-04-24T17:56:48Z |
| format | Article |
| id | doaj.art-092be311aa174c9d8465277e9d6798a5 |
| institution | Directory Open Access Journal |
| issn | 2039-439X 2039-4403 |
| language | English |
| last_indexed | 2024-04-24T17:56:48Z |
| publishDate | 2024-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Nursing Reports |
| spelling | doaj.art-092be311aa174c9d8465277e9d6798a52024-03-27T13:57:54ZengMDPI AGNursing Reports2039-439X2039-44032024-02-0114145546710.3390/nursrep14010035Brachial Tunneled Peripherally Inserted Central Catheters and the Risk of Catheter Complications: A Systematic Review and Meta-AnalysisDavide Giustivi0Mattia Donadoni1Stefano Maria Elli2Francesco Casella3Massimiliano Quici4Chiara Cogliati5Silvia Cavalli6Giulia Rizzi7Leyla La Cava8Arianna Bartoli9Elena Martini10Alba Taino11Martina Perego12Antonella Foschi13Roberto Castelli14Maria Calloni15Antonio Gidaro16Post-Anesthesia Care Unit ASST Lodi, 26900 Lodi, ItalyDepartment of Biomedical and Clinical Sciences “Luigi Sacco”, Luigi Sacco Hospital, University of Milan, 20122 Milan, ItalyHealthcare Profession Department—PICC Team, University of Milan Bicocca, IRCCS San Gerardo dei Tintori Foundation Hospital, 20126 Monza, ItalyDepartment of Biomedical and Clinical Sciences “Luigi Sacco”, Luigi Sacco Hospital, University of Milan, 20122 Milan, ItalyDepartment of Biomedical and Clinical Sciences “Luigi Sacco”, Luigi Sacco Hospital, University of Milan, 20122 Milan, ItalyDepartment of Biomedical and Clinical Sciences “Luigi Sacco”, Luigi Sacco Hospital, University of Milan, 20122 Milan, ItalyHealthcare Profession Department—PICC Team, University of Milan Bicocca, IRCCS San Gerardo dei Tintori Foundation Hospital, 20126 Monza, ItalyDepartment of Biomedical and Clinical Sciences “Luigi Sacco”, Luigi Sacco Hospital, University of Milan, 20122 Milan, ItalyDepartment of Biomedical and Clinical Sciences “Luigi Sacco”, Luigi Sacco Hospital, University of Milan, 20122 Milan, ItalyDepartment of Biomedical and Clinical Sciences “Luigi Sacco”, Luigi Sacco Hospital, University of Milan, 20122 Milan, ItalyDepartment of Biomedical and Clinical Sciences “Luigi Sacco”, Luigi Sacco Hospital, University of Milan, 20122 Milan, ItalyDepartment of Biomedical and Clinical Sciences “Luigi Sacco”, Luigi Sacco Hospital, University of Milan, 20122 Milan, ItalyDepartment of Biomedical and Clinical Sciences “Luigi Sacco”, Luigi Sacco Hospital, University of Milan, 20122 Milan, ItalyDepartment of Infectious Diseases, Luigi Sacco Hospital, 20157 Milan, ItalyDepartment of Medicine, Surgery and Pharmacy, University of Sassari, Viale San Pietro N° 8, 07100 Sassari, ItalyDepartment of Biomedical and Clinical Sciences “Luigi Sacco”, Luigi Sacco Hospital, University of Milan, 20122 Milan, ItalyDepartment of Biomedical and Clinical Sciences “Luigi Sacco”, Luigi Sacco Hospital, University of Milan, 20122 Milan, ItalyIntroduction: Situations involving increased workloads and stress (i.e., the COVID-19 pandemic) underline the need for healthcare professionals to minimize patient complications. In the field of vascular access, tunneling techniques are a possible solution. This systematic review and meta-analysis aimed to compare the effectiveness of tunneled Peripherally Inserted Central Catheters (tPICCs) to conventional Peripherally Inserted Central Catheters (cPICCs) in terms of bleeding, overall success, procedural time, and late complications. Methods: Randomized controlled trials without language restrictions were searched using PUBMED<sup>®</sup>, EMBASE<sup>®</sup>, EBSCO<sup>®</sup>, CINAHL<sup>®</sup>, and the Cochrane Controlled Clinical Trials Register from August 2022 to August 2023. Five relevant papers (1238 patients) were included. Results: There were no significant differences in overall success and nerve or artery injuries between the two groups (<i>p</i> = 0.62 and <i>p</i> = 0.62, respectively), although cPICCs caused slightly less bleeding (0.23 mL) and had shorter procedural times (2.95 min). On the other hand, tPICCs had a significantly reduced risk of overall complications (<i>p</i> < 0.001; RR0.41 [0.31–0.54] CI 95%), catheter-related thrombosis (<i>p</i> < 0.001; RR0.35 [0.20–0.59] IC 95%), infection-triggering catheter removal (<i>p</i> < 0.001; RR0.33 [0.18–0.61] IC 95%), wound oozing (<i>p</i> < 0.001; RR0.49 [0.37–0.64] IC 95%), and dislodgement (<i>p</i> < 0.001; RR0.4 [0.31–0.54] CI 95%). Conclusions: The tunneling technique for brachial access appears to be safe concerning intra-procedural bleeding, overall success, and procedural time, and it is effective in reducing the risk of late complications associated with catheterization.https://www.mdpi.com/2039-4403/14/1/35Peripherally Inserted Central Catheter (PICC)tunnelinfectioncatheter-related thrombosis (CRT)bleedingwound oozing |
| spellingShingle | Davide Giustivi Mattia Donadoni Stefano Maria Elli Francesco Casella Massimiliano Quici Chiara Cogliati Silvia Cavalli Giulia Rizzi Leyla La Cava Arianna Bartoli Elena Martini Alba Taino Martina Perego Antonella Foschi Roberto Castelli Maria Calloni Antonio Gidaro Brachial Tunneled Peripherally Inserted Central Catheters and the Risk of Catheter Complications: A Systematic Review and Meta-Analysis Nursing Reports Peripherally Inserted Central Catheter (PICC) tunnel infection catheter-related thrombosis (CRT) bleeding wound oozing |
| title | Brachial Tunneled Peripherally Inserted Central Catheters and the Risk of Catheter Complications: A Systematic Review and Meta-Analysis |
| title_full | Brachial Tunneled Peripherally Inserted Central Catheters and the Risk of Catheter Complications: A Systematic Review and Meta-Analysis |
| title_fullStr | Brachial Tunneled Peripherally Inserted Central Catheters and the Risk of Catheter Complications: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Brachial Tunneled Peripherally Inserted Central Catheters and the Risk of Catheter Complications: A Systematic Review and Meta-Analysis |
| title_short | Brachial Tunneled Peripherally Inserted Central Catheters and the Risk of Catheter Complications: A Systematic Review and Meta-Analysis |
| title_sort | brachial tunneled peripherally inserted central catheters and the risk of catheter complications a systematic review and meta analysis |
| topic | Peripherally Inserted Central Catheter (PICC) tunnel infection catheter-related thrombosis (CRT) bleeding wound oozing |
| url | https://www.mdpi.com/2039-4403/14/1/35 |
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