Comparison of clinically indicated replacement and routine replacement of peripheral intravenous catheters: A systematic review and meta-analysis of randomized controlled trials
BackgroundIt is unknown whether clinically indicated replacement of peripheral intravenous catheters (PIVCs) increases the risks of PIVC-associated complications and infections compared to routine replacement of PIVCs.MethodsWe searched PubMed, the Web of Science, the Cochrane Library, Ovid MEDLINE,...
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Frontiers Media S.A.
2022-08-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2022.964096/full |
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| author | Ching-Yi Chen Wang-Chun Chen Wang-Chun Chen Jung-Yueh Chen Jung-Yueh Chen Chih-Cheng Lai Yu-Feng Wei Yu-Feng Wei Yu-Feng Wei |
| author_facet | Ching-Yi Chen Wang-Chun Chen Wang-Chun Chen Jung-Yueh Chen Jung-Yueh Chen Chih-Cheng Lai Yu-Feng Wei Yu-Feng Wei Yu-Feng Wei |
| author_sort | Ching-Yi Chen |
| collection | DOAJ |
| description | BackgroundIt is unknown whether clinically indicated replacement of peripheral intravenous catheters (PIVCs) increases the risks of PIVC-associated complications and infections compared to routine replacement of PIVCs.MethodsWe searched PubMed, the Web of Science, the Cochrane Library, Ovid MEDLINE, and Clinicaltrials.gov for randomized controlled trials (RCTs) that compare the safety outcomes of routine replacement and clinically indicated replacement of PIVCs were included for meta-analysis. The primary outcome was the incidence of phlebitis, and secondary outcomes included the risks of occlusion, local infection, infiltration, catheter-related bloodstream infection (CRBSI), and accidental removal of the PIVC.ResultsA total of 9 RCTs involving 10 973 patients were included in this meta-analysis, of whom 5,546 and 5,527 were assigned to the study group (clinically indicated replacement of PIVCs) and control group (routine replacement of PIVCs every 72–96 h), respectively. The incidence of phlebitis in the study group was significantly higher than that in the control group [risk ratio (RR), 1.20; 95% confidence interval (CI), 1.01–1.44, P = 0.04, I2 = 49%]. In addition, the study group was associated with a higher risk of occlusion (RR, 1.45; 95% CI, 1.08–1.95, P = 0.01, I2 = 82%) and infiltration (fluid leaks) (RR, 1.27; 95% CI, 1.06–1.53, P = 0.01, I2 = 72%) than the control group. However, no significant differences were observed in the risks of local infection (RR, 1.75; 95% CI, 0.38–8.16, P = 0.48, I2 = 0%) and CRBSI (RR, 0.61; 95% CI, 0.08–4.68, P = 0.64, I2 = 0%) between the study and control groups.ConclusionThe clinically indicated replacement of PIVCs may increase the risks of PIVC-associated phlebitis, infiltration, and occlusion compared to the routine replacement of PIVCs, but did not increase the risk of PIVC-associated infections. Based on these findings, routine replacement of PIVCs every 72–96 h maybe a preferred option than clinically indicated replacement of PIVCs.Systematic review registration[www.crd.york.ac.uk/prospero/], identifier [CRD42022302021]. |
| first_indexed | 2024-04-13T09:57:55Z |
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| id | doaj.art-dc66680392844f6c93446d62dd32b00e |
| institution | Directory Open Access Journal |
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| language | English |
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| publishDate | 2022-08-01 |
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| spelling | doaj.art-dc66680392844f6c93446d62dd32b00e2022-12-22T02:51:19ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2022-08-01910.3389/fmed.2022.964096964096Comparison of clinically indicated replacement and routine replacement of peripheral intravenous catheters: A systematic review and meta-analysis of randomized controlled trialsChing-Yi Chen0Wang-Chun Chen1Wang-Chun Chen2Jung-Yueh Chen3Jung-Yueh Chen4Chih-Cheng Lai5Yu-Feng Wei6Yu-Feng Wei7Yu-Feng Wei8Division of Pulmonary Medicine, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, TaiwanDepartment of Pharmacy, E-Da Hospital, I-Shou University, Kaohsiung, TaiwanInstitute of Biotechnology and Chemical Engineering, I-Shou University, Kaohsiung, TaiwanSchool of Medicine, College of Medicine, I-Shou University, Kaohsiung, TaiwanDepartment of Internal Medicine, E-Da Hospital, Kaohsiung, TaiwanDivision of Hospital Medicine, Department of Internal Medicine, Chi Mei Medical Center, Tainan, TaiwanInstitute of Biotechnology and Chemical Engineering, I-Shou University, Kaohsiung, TaiwanDepartment of Internal Medicine, E-Da Cancer Hospital, Kaohsiung, TaiwanSchool of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, TaiwanBackgroundIt is unknown whether clinically indicated replacement of peripheral intravenous catheters (PIVCs) increases the risks of PIVC-associated complications and infections compared to routine replacement of PIVCs.MethodsWe searched PubMed, the Web of Science, the Cochrane Library, Ovid MEDLINE, and Clinicaltrials.gov for randomized controlled trials (RCTs) that compare the safety outcomes of routine replacement and clinically indicated replacement of PIVCs were included for meta-analysis. The primary outcome was the incidence of phlebitis, and secondary outcomes included the risks of occlusion, local infection, infiltration, catheter-related bloodstream infection (CRBSI), and accidental removal of the PIVC.ResultsA total of 9 RCTs involving 10 973 patients were included in this meta-analysis, of whom 5,546 and 5,527 were assigned to the study group (clinically indicated replacement of PIVCs) and control group (routine replacement of PIVCs every 72–96 h), respectively. The incidence of phlebitis in the study group was significantly higher than that in the control group [risk ratio (RR), 1.20; 95% confidence interval (CI), 1.01–1.44, P = 0.04, I2 = 49%]. In addition, the study group was associated with a higher risk of occlusion (RR, 1.45; 95% CI, 1.08–1.95, P = 0.01, I2 = 82%) and infiltration (fluid leaks) (RR, 1.27; 95% CI, 1.06–1.53, P = 0.01, I2 = 72%) than the control group. However, no significant differences were observed in the risks of local infection (RR, 1.75; 95% CI, 0.38–8.16, P = 0.48, I2 = 0%) and CRBSI (RR, 0.61; 95% CI, 0.08–4.68, P = 0.64, I2 = 0%) between the study and control groups.ConclusionThe clinically indicated replacement of PIVCs may increase the risks of PIVC-associated phlebitis, infiltration, and occlusion compared to the routine replacement of PIVCs, but did not increase the risk of PIVC-associated infections. Based on these findings, routine replacement of PIVCs every 72–96 h maybe a preferred option than clinically indicated replacement of PIVCs.Systematic review registration[www.crd.york.ac.uk/prospero/], identifier [CRD42022302021].https://www.frontiersin.org/articles/10.3389/fmed.2022.964096/fullcatheter-related infectionperipheral intravenous catheterPIVCphlebitisroutine replacementclinically indicated replacement |
| spellingShingle | Ching-Yi Chen Wang-Chun Chen Wang-Chun Chen Jung-Yueh Chen Jung-Yueh Chen Chih-Cheng Lai Yu-Feng Wei Yu-Feng Wei Yu-Feng Wei Comparison of clinically indicated replacement and routine replacement of peripheral intravenous catheters: A systematic review and meta-analysis of randomized controlled trials Frontiers in Medicine catheter-related infection peripheral intravenous catheter PIVC phlebitis routine replacement clinically indicated replacement |
| title | Comparison of clinically indicated replacement and routine replacement of peripheral intravenous catheters: A systematic review and meta-analysis of randomized controlled trials |
| title_full | Comparison of clinically indicated replacement and routine replacement of peripheral intravenous catheters: A systematic review and meta-analysis of randomized controlled trials |
| title_fullStr | Comparison of clinically indicated replacement and routine replacement of peripheral intravenous catheters: A systematic review and meta-analysis of randomized controlled trials |
| title_full_unstemmed | Comparison of clinically indicated replacement and routine replacement of peripheral intravenous catheters: A systematic review and meta-analysis of randomized controlled trials |
| title_short | Comparison of clinically indicated replacement and routine replacement of peripheral intravenous catheters: A systematic review and meta-analysis of randomized controlled trials |
| title_sort | comparison of clinically indicated replacement and routine replacement of peripheral intravenous catheters a systematic review and meta analysis of randomized controlled trials |
| topic | catheter-related infection peripheral intravenous catheter PIVC phlebitis routine replacement clinically indicated replacement |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2022.964096/full |
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