Revista Latino-Americana de Enfermagem (Jul 2024)

Prevention of complications related to peripherally inserted central catheter insertion techniques in newborns: systematic review and network meta-analysis

  • Ludmylla de Oliveira Beleza,
  • Guilherme da Costa Brasil,
  • Amanda Salles Margatho,
  • Christiane Inocêncio Vasques,
  • Renata Cristina de Campos Pereira Silveira,
  • Priscilla Roberta Silva Rocha,
  • Laiane Medeiros Ribeiro

DOI
https://doi.org/10.1590/1518-8345.6905.4161
Journal volume & issue
Vol. 32

Abstract

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Objective: to analyze the effectiveness of peripherally inserted central catheter insertion techniques in preventing the occurrence of complications related to this device in newborns. Method: a paired and network systematic literature review and meta-analysis, with its search carried out in seven databases and in the Grey Literature, including randomized and non-randomized clinical trials. The risk of bias was assessed using the Cochrane Risk of Bias 2 and Risk of Bias In Non-randomized Studies of Interventions tools. Certainty of the evidence was assessed by means of the Grading of Recommendations Assessment, Development and Evaluation. A meta-analysis was carried out with the aid of the R statistical program. Results: eight studies with 1,126 newborns were included and six insertion techniques were identified: intracavitary electrocardiogram; intracavitary electrocardiogram associated with ultrasound; ultrasound; formula; anatomical landmark; and modified anatomical landmark. Five techniques significantly decreased primary tip malpositioning when compared to the control ( p <0.05). Intracavitary electrocardiogram significantly and more effectively reduced arrhythmias, general complications and phlebitis; the technique that used a formula also reduced general complications. Infection, infiltration, secondary tip malpositioning, catheter rupture, thrombosis, occlusion and catheter-associated skin lesion were not significantly preventable events. Conclusion: intracavitary electrocardiogram and use of the formula were the most effective techniques in reducing complications.

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