Comparison of complications and indwelling time in midline catheters versus central venous catheters: A systematic review and meta-analysis

IF 1.9 4区医学 Q2 NURSING International Journal of Nursing Practice Pub Date : 2024-09-03 DOI:10.1111/ijn.13301

Xin Li SD, Huixin Zhang MD, Hong Li SD, Weige Sun MD

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Abstract

Background

Central venous catheters and midline catheters are commonly used as medium- to long-term intravenous infusion tools in clinical nursing. However, there is currently no reliable conclusion on whether there are differences in complications and indwelling time between these two types of catheters.

Aim

To investigate whether there are differences in the incidence of complications and indwelling time between the use of midline catheters and central venous catheters as intravenous infusion tools.

Methods

A systematic search was conducted across various databases including Web of Science, PubMed, Embase, Cochrane Library, CINAHL, Wanfang and China National Knowledge Infrastructure. The selection of studies and assessment of their quality was carried out independently by two reviewers. Meta-analysis was conducted using the RevMan 5.3 software. Heterogeneity was evaluated, one of the pooled analyses was performed using the random-effect model, while the others used the fixed-effect model. Mean differences or odds ratios with corresponding 95% confidence intervals were calculated.

Results

Ten studies (1,554 participants) met the inclusion criteria. Meta-analysis showed that there was a statistically significant difference in the complication rates [OR = 0.36, 95% CI (0.18, 0.70), p = 0.003], incidence of catheter-related thrombosis [OR = 0.28, 95% CI (0.11, 0.71), I² = 0%,p = 0.007], catheter-related infection[OR = 0.36, 95% CI (0.16, 0.78), I² = 27%, p = 0.007] and catheter blockage [OR = 0.21, 95% CI (0.09, 0.51), I² = 18%, p = 0.0005] between midline catheters group and central venous catheters group. There was a statistically significant difference in the catheter indwelling time between the two groups [MD = 0.9, 95% CI (0.33, 1.46), I² = 0%, p = 0.002]. There was no significant difference in other complications such as phlebitis, catheter dislodgement and leakage between the two groups.

Linking Evidence to Action

Midline catheter was superior to central venous catheter in terms of the overall complication rates and incidence of catheter-related thrombosis, catheter blockage, catheter-related infection and indwelling time.

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中线导管与中心静脉导管并发症和留置时间的比较：系统回顾和荟萃分析。

背景：中心静脉导管和中线导管是临床护理中常用的中长期静脉输液工具。目的：研究使用中线导管和中心静脉导管作为静脉输液工具时，并发症的发生率和留置时间是否存在差异：在各种数据库中进行了系统检索，包括 Web of Science、PubMed、Embase、Cochrane Library、CINAHL、万方和中国国家知识基础设施。研究的筛选和质量评估由两名审稿人独立完成。荟萃分析使用 RevMan 5.3 软件进行。对异质性进行了评估，其中一项汇总分析采用随机效应模型，其他分析采用固定效应模型。计算了平均差异或几率比率及相应的 95% 置信区间：十项研究（1 554 名参与者）符合纳入标准。Meta 分析表明，并发症发生率[OR = 0.36, 95% CI (0.18, 0.70), p = 0.003]、导管相关血栓发生率[OR = 0.28, 95% CI (0.11, 0.71), I2 = 0%,p = 0.007]、导管相关感染[OR = 0.36，95% CI (0.16，0.78)，I2 = 27%，P = 0.007]和导管堵塞[OR = 0.21，95% CI (0.09，0.51)，I2 = 18%，P = 0.0005]在中线导管组和中心静脉导管组之间存在差异。两组导管留置时间差异有统计学意义[MD = 0.9，95% CI (0.33，1.46)，I2 = 0%，P = 0.002]。两组在静脉炎、导管脱落和渗漏等其他并发症方面没有明显差异：证据与行动的联系：就总体并发症发生率以及导管相关血栓形成、导管堵塞、导管相关感染和留置时间而言，中线导管优于中心静脉导管。

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来源期刊

International Journal of Nursing Practice NURSING-

CiteScore

4.10

自引率

0.00%

发文量

审稿时长

3 months

期刊介绍： International Journal of Nursing Practice is a fully refereed journal that publishes original scholarly work that advances the international understanding and development of nursing, both as a profession and as an academic discipline. The Journal focuses on research papers and professional discussion papers that have a sound scientific, theoretical or philosophical base. Preference is given to high-quality papers written in a way that renders them accessible to a wide audience without compromising quality. The primary criteria for acceptance are excellence, relevance and clarity. All articles are peer-reviewed by at least two researchers expert in the field of the submitted paper.