Xuetang Zhao BSN, Yingfei Liu BSN, Xiaoyan Li BSN, Li Wei BSN, Lanzheng Bian BSN, Mingqi Peng BSN
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We aimed to evaluate the effects and safety of PICC placement through upper versus lower limb vein in neonates, to provide insights into the clinical PICC nursing care.</p>\n </section>\n \n <section>\n \n <h3> Design</h3>\n \n <p>A meta-analysis.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>We searched the Cochrane Library, Web of Science, PubMed, Science Direct, China national knowledge infrastructure, Wanfang Data Knowledge Service Platform, China Weipu Database, China Biomedical Literature Database for published randomized controlled trials (RCTs) on the placement of PICC via upper limb and lower limb venipuncture. Two reviewers independently evaluated and cross-checked the quality of the included studies in accordance with the quality standards of the Cochrane Manual. We used RevMan 5.3 software for statistical processing.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A total of 12 RCTs were included in this meta-analysis. Meta-analysis indicated that compared with upper limb veins, PICC insertion through lower limb veins is beneficial to increase the one-time puncture success rate (relative risk [RR] = 0.73, 95% confidence interval [CI]: 0.68–0.79) and the indwelling time (mean difference [MD] = −3.60, 95% CI: −5.35 to −1.86), reduce the operation time (MD = 10.37, 95% CI: 7.48–13.26), estimated bleeding volume (MD = 0.55, 95% CI: 0.34–0.75), incidence of catheter ectopia (RR = 2.46, 95% CI: 1.81–3.35), PICC-associated infection (RR = 2.82, 95% CI: 1.65–4.83), exosmosis (RR = 2.45, 95% CI: 1.49–4.04, <i>p</i> < .001) and phlebitis (RR = 1.40, 95% CI: 1.03–1.90). No significant difference in the Incidence of catheter obstruction between the upper and lower limb veins (RR = 1.20, 95% CI: 0.73–1.97, <i>p</i> = .48) was found.</p>\n </section>\n \n <section>\n \n <h3> Public Contribution</h3>\n \n <p>There are certain advantages in neonatal PICC puncture through the lower limb vein. The lower limb vein may be the preferred choice for neonatal PICC puncture.</p>\n </section>\n </div>","PeriodicalId":54900,"journal":{"name":"Journal for Specialists in Pediatric Nursing","volume":null,"pages":null},"PeriodicalIF":1.2000,"publicationDate":"2023-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Placement of peripherally inserted central catheter through upper versus lower limb vein in neonates: A meta-analysis of randomized controlled trials\",\"authors\":\"Xuetang Zhao BSN, Yingfei Liu BSN, Xiaoyan Li BSN, Li Wei BSN, Lanzheng Bian BSN, Mingqi Peng BSN\",\"doi\":\"10.1111/jspn.12417\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Aim</h3>\\n \\n <p>Peripherally inserted central catheter (PICC) is an important treatment for the drug and nutrition administration in neonates. We aimed to evaluate the effects and safety of PICC placement through upper versus lower limb vein in neonates, to provide insights into the clinical PICC nursing care.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Design</h3>\\n \\n <p>A meta-analysis.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>We searched the Cochrane Library, Web of Science, PubMed, Science Direct, China national knowledge infrastructure, Wanfang Data Knowledge Service Platform, China Weipu Database, China Biomedical Literature Database for published randomized controlled trials (RCTs) on the placement of PICC via upper limb and lower limb venipuncture. Two reviewers independently evaluated and cross-checked the quality of the included studies in accordance with the quality standards of the Cochrane Manual. We used RevMan 5.3 software for statistical processing.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>A total of 12 RCTs were included in this meta-analysis. Meta-analysis indicated that compared with upper limb veins, PICC insertion through lower limb veins is beneficial to increase the one-time puncture success rate (relative risk [RR] = 0.73, 95% confidence interval [CI]: 0.68–0.79) and the indwelling time (mean difference [MD] = −3.60, 95% CI: −5.35 to −1.86), reduce the operation time (MD = 10.37, 95% CI: 7.48–13.26), estimated bleeding volume (MD = 0.55, 95% CI: 0.34–0.75), incidence of catheter ectopia (RR = 2.46, 95% CI: 1.81–3.35), PICC-associated infection (RR = 2.82, 95% CI: 1.65–4.83), exosmosis (RR = 2.45, 95% CI: 1.49–4.04, <i>p</i> < .001) and phlebitis (RR = 1.40, 95% CI: 1.03–1.90). No significant difference in the Incidence of catheter obstruction between the upper and lower limb veins (RR = 1.20, 95% CI: 0.73–1.97, <i>p</i> = .48) was found.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Public Contribution</h3>\\n \\n <p>There are certain advantages in neonatal PICC puncture through the lower limb vein. 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Placement of peripherally inserted central catheter through upper versus lower limb vein in neonates: A meta-analysis of randomized controlled trials
Aim
Peripherally inserted central catheter (PICC) is an important treatment for the drug and nutrition administration in neonates. We aimed to evaluate the effects and safety of PICC placement through upper versus lower limb vein in neonates, to provide insights into the clinical PICC nursing care.
Design
A meta-analysis.
Methods
We searched the Cochrane Library, Web of Science, PubMed, Science Direct, China national knowledge infrastructure, Wanfang Data Knowledge Service Platform, China Weipu Database, China Biomedical Literature Database for published randomized controlled trials (RCTs) on the placement of PICC via upper limb and lower limb venipuncture. Two reviewers independently evaluated and cross-checked the quality of the included studies in accordance with the quality standards of the Cochrane Manual. We used RevMan 5.3 software for statistical processing.
Results
A total of 12 RCTs were included in this meta-analysis. Meta-analysis indicated that compared with upper limb veins, PICC insertion through lower limb veins is beneficial to increase the one-time puncture success rate (relative risk [RR] = 0.73, 95% confidence interval [CI]: 0.68–0.79) and the indwelling time (mean difference [MD] = −3.60, 95% CI: −5.35 to −1.86), reduce the operation time (MD = 10.37, 95% CI: 7.48–13.26), estimated bleeding volume (MD = 0.55, 95% CI: 0.34–0.75), incidence of catheter ectopia (RR = 2.46, 95% CI: 1.81–3.35), PICC-associated infection (RR = 2.82, 95% CI: 1.65–4.83), exosmosis (RR = 2.45, 95% CI: 1.49–4.04, p < .001) and phlebitis (RR = 1.40, 95% CI: 1.03–1.90). No significant difference in the Incidence of catheter obstruction between the upper and lower limb veins (RR = 1.20, 95% CI: 0.73–1.97, p = .48) was found.
Public Contribution
There are certain advantages in neonatal PICC puncture through the lower limb vein. The lower limb vein may be the preferred choice for neonatal PICC puncture.
期刊介绍：
Linking science and practice by publishing evidence-based information on pediatric nursing and answering the question, ''How might this information affect nursing practice?''
The Journal for Specialists in Pediatric Nursing (JSPN) is the international evidence-based practice journal for nurses who specialize in the care of children and families. JSPN bridges the gap between research and practice by publishing peer-reviewed reliable, clinically relevant, and readily applicable evidence. The journal integrates the best evidence with pediatric nurses'' passion for achieving the best outcomes. The journal values interdisciplinary perspectives and publishes a wide variety of peer-reviewed papers on clinically relevant topics.
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