Robyn Matthews , Nicole C. Gavin , Nicole Marsh , Louise Marquart-Wilson , Samantha Keogh
{"title":"减少装置故障的外周静脉导管材料和设计：系统综述和荟萃分析。","authors":"Robyn Matthews , Nicole C. Gavin , Nicole Marsh , Louise Marquart-Wilson , Samantha Keogh","doi":"10.1016/j.idh.2023.05.005","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Patients require vascular access for medical treatments, diagnostic procedures and symptom management. Current failure rates of peripheral intravascular catheters (PIVCs) are unacceptably high (40–50%). This systematic review aimed to determine the effect of different PIVC materials and designs on the incidence of PIVC failure.</p></div><div><h3>Methods</h3><p>A systematic search was conducted in November 2022 using CINAHL, PubMed, EMBASE and Cochrane Central Register of Controlled Trials databases. Randomised controlled trials that compared PIVC novel PIVC material/design and standard material/design were included. The primary outcome was all causes of PIVC failure, any reason for device removal due to cessation of device function; and secondary outcomes included individual PIVC complications and infection (local or systemic), and dwell times. Quality appraisal was conducted using the Cochrane risk of bias tool. A meta-analysis was performed using random effects model.</p></div><div><h3>Results</h3><p>Seven randomised controlled trials were eligible for inclusion. In meta-analysis, the impact of material and design on PIVC failure in the studies favoured the intervention arms (RR 0.71, 95% CI 0.57–0.89), however there was substantial heterogeneity (I<sup>2</sup> = 81%, 95% CI 61–91%). Through subgroup analyses, a significant difference on PIVC failure favoured the closed system over the open system (RR 0.85, 95% CI 0.73 to 0.99; I<sup>2</sup> = 23%, 95% CI 0–90%).</p></div><div><h3>Conclusion</h3><p>Catheter material and design can impact PIVC outcome. Conclusive recommendations are limited due to the small number of studies and inconsistent reporting of clinical outcomes. Further rigorous research of PIVC types is necessary to improve clinical practice and device selection pathways should reflect the resulting evidence.</p></div>","PeriodicalId":45006,"journal":{"name":"Infection Disease & Health","volume":null,"pages":null},"PeriodicalIF":2.7000,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Peripheral intravenous catheter material and design to reduce device failure: A systematic review and meta-analysis\",\"authors\":\"Robyn Matthews , Nicole C. Gavin , Nicole Marsh , Louise Marquart-Wilson , Samantha Keogh\",\"doi\":\"10.1016/j.idh.2023.05.005\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Patients require vascular access for medical treatments, diagnostic procedures and symptom management. Current failure rates of peripheral intravascular catheters (PIVCs) are unacceptably high (40–50%). This systematic review aimed to determine the effect of different PIVC materials and designs on the incidence of PIVC failure.</p></div><div><h3>Methods</h3><p>A systematic search was conducted in November 2022 using CINAHL, PubMed, EMBASE and Cochrane Central Register of Controlled Trials databases. Randomised controlled trials that compared PIVC novel PIVC material/design and standard material/design were included. The primary outcome was all causes of PIVC failure, any reason for device removal due to cessation of device function; and secondary outcomes included individual PIVC complications and infection (local or systemic), and dwell times. Quality appraisal was conducted using the Cochrane risk of bias tool. A meta-analysis was performed using random effects model.</p></div><div><h3>Results</h3><p>Seven randomised controlled trials were eligible for inclusion. In meta-analysis, the impact of material and design on PIVC failure in the studies favoured the intervention arms (RR 0.71, 95% CI 0.57–0.89), however there was substantial heterogeneity (I<sup>2</sup> = 81%, 95% CI 61–91%). Through subgroup analyses, a significant difference on PIVC failure favoured the closed system over the open system (RR 0.85, 95% CI 0.73 to 0.99; I<sup>2</sup> = 23%, 95% CI 0–90%).</p></div><div><h3>Conclusion</h3><p>Catheter material and design can impact PIVC outcome. Conclusive recommendations are limited due to the small number of studies and inconsistent reporting of clinical outcomes. Further rigorous research of PIVC types is necessary to improve clinical practice and device selection pathways should reflect the resulting evidence.</p></div>\",\"PeriodicalId\":45006,\"journal\":{\"name\":\"Infection Disease & Health\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2023-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Infection Disease & Health\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2468045123000366\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Infection Disease & Health","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2468045123000366","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
Peripheral intravenous catheter material and design to reduce device failure: A systematic review and meta-analysis
Background
Patients require vascular access for medical treatments, diagnostic procedures and symptom management. Current failure rates of peripheral intravascular catheters (PIVCs) are unacceptably high (40–50%). This systematic review aimed to determine the effect of different PIVC materials and designs on the incidence of PIVC failure.
Methods
A systematic search was conducted in November 2022 using CINAHL, PubMed, EMBASE and Cochrane Central Register of Controlled Trials databases. Randomised controlled trials that compared PIVC novel PIVC material/design and standard material/design were included. The primary outcome was all causes of PIVC failure, any reason for device removal due to cessation of device function; and secondary outcomes included individual PIVC complications and infection (local or systemic), and dwell times. Quality appraisal was conducted using the Cochrane risk of bias tool. A meta-analysis was performed using random effects model.
Results
Seven randomised controlled trials were eligible for inclusion. In meta-analysis, the impact of material and design on PIVC failure in the studies favoured the intervention arms (RR 0.71, 95% CI 0.57–0.89), however there was substantial heterogeneity (I2 = 81%, 95% CI 61–91%). Through subgroup analyses, a significant difference on PIVC failure favoured the closed system over the open system (RR 0.85, 95% CI 0.73 to 0.99; I2 = 23%, 95% CI 0–90%).
Conclusion
Catheter material and design can impact PIVC outcome. Conclusive recommendations are limited due to the small number of studies and inconsistent reporting of clinical outcomes. Further rigorous research of PIVC types is necessary to improve clinical practice and device selection pathways should reflect the resulting evidence.
期刊介绍：
The journal aims to be a platform for the publication and dissemination of knowledge in the area of infection and disease causing infection in humans. The journal is quarterly and publishes research, reviews, concise communications, commentary and other articles concerned with infection and disease affecting the health of an individual, organisation or population. The original and important articles in the journal investigate, report or discuss infection prevention and control; clinical, social, epidemiological or public health aspects of infectious disease; policy and planning for the control of infections; zoonoses; and vaccination related to disease in human health. Infection, Disease & Health provides a platform for the publication and dissemination of original knowledge at the nexus of the areas infection, Disease and health in a One Health context. One Health recognizes that the health of people is connected to the health of animals and the environment. One Health encourages and advances the collaborative efforts of multiple disciplines-working locally, nationally, and globally-to achieve the best health for people, animals, and our environment. This approach is fundamental because 6 out of every 10 infectious diseases in humans are zoonotic, or spread from animals. We would be expected to report or discuss infection prevention and control; clinical, social, epidemiological or public health aspects of infectious disease; policy and planning for the control of infections; zoonosis; and vaccination related to disease in human health. The Journal seeks to bring together knowledge from all specialties involved in infection research and clinical practice, and present the best work in this ever-changing field. The audience of the journal includes researchers, clinicians, health workers and public policy professionals concerned with infection, disease and health.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
