Complications of upper extremity versus lower extremity placed peripherally inserted central catheters in neonatal intensive care units: A meta-analysis

Chen, Hongxiu; Zhang, Xiaoxia; Wang, Heng; Hu, Xiuying

doi:10.1016/j.iccn.2019.08.003

Cited by 23 publications

(29 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We found that PICC insertion from a leg had the highest odds of reaching central CTP, compared with insertion from an arm. This is in line with previous findings and a recent meta‐analysis from Chen et al, where a higher risk of malpositioning in the upper extremity group was reported 4 . Even though the lower extremity has been shown to be a preferable insertion site, the upper extremity veins are more commonly used.…”

Section: Figuresupporting

confidence: 91%

Peripherally inserted central catheters in extremely preterm infants: Placement success rates and complications

Gavelli

Wackernagel

2021

Acta Paediatrica

View full text Add to dashboard Cite

Section: Figuresupporting

confidence: 91%

Peripherally inserted central catheters in extremely preterm infants: Placement success rates and complications

Gavelli

Wackernagel

2021

Acta Paediatrica

View full text Add to dashboard Cite

“…125,127 In neonates and infants, PICC insertion at foot or ankle sites was significantly associated with an increased risk of phlebitis, thrombosis, and dysfunction. 47,125,136 Overall, there was no direct association between PICC insertion at brachial, cephalic, or saphenous insertion sites and thrombosis in pediatric patients 122 ; however, left-sided PICC insertion was associated with higher rates of PICC-related complications. 37 The majority of studies, with 2 exceptions, 18,78 found that rates of infection and complication varied significantly on the basis of CVAD insertion sites.…”

Section: Recommendations For Insertion Insertion Locationsmentioning

confidence: 99%

Selection and Insertion of Vascular Access Devices in Pediatrics: A Systematic Review

et al. 2020

View full text Add to dashboard Cite

OBJECTIVE: To critically review the evidence for the selection and insertion of pediatric vascular access devices (VADs). DATA SOURCES: Data were sourced from the US National Library of Medicine, Cumulative Index to Nursing and Allied Health, the Cochrane Library databases, Embase, and international clinical trial databases. STUDY SELECTION: Clinical practice guidelines, systematic reviews, cohort designs, randomized control trials (RCTs), quasi RCTs, before-after trials, or case-control studies that reported on complications and/or risk as well as reliability of VADs in patients aged 0 to 18 years were included. DATA EXTRACTION: Articles were independently reviewed to extract and summarize details on the number of patients and catheters, population, age of participants, VAD type, study method, indication, comparators, and the frequency of VAD failure or complications. RESULTS: VAD selection and insertion decision-making in general hospitalized and some specialized patient populations were well evidenced. The use of single-lumen devices and ultrasound-guided techniques was also broadly supported. There was a lack of RCTs, and for neonates, cardiac patients, patients with difficult venous access, midline catheters, catheter-tovein ratio, and near-infrared devices, the lack of evidence necessitated broadening the review scope. LIMITATIONS: Limitations include the lack of formal assessment of the quality of evidence and the lack of RCTs and systematic reviews. Consequently, clinical decision-making in certain pediatric populations is not guided by strong, evidence-based recommendations. CONCLUSIONS: This is the first synthesis of available evidence for the selection and insertion of VADs in pediatric patients and is important for determining the appropriateness of VADs in pediatric patients. WHAT'S KNOWN ON THIS SUBJECT: Individual studies, systematic reviews, and focused clinical practice guidelines that evaluate vascular access devices (VADs) in various pediatric populations are available. However, to date, no systematic review examining the appropriateness, and inappropriateness, of VADs across common pediatric clinical scenarios exists. WHAT THIS STUDY ADDS: There is strong evidence to support and facilitate appropriate clinical decision-making in some pediatric indications. However, certain populations, device types and characteristics, and insertion procedures are poorly evidenced, necessitating the application of clinical judgment for VAD decision-making.

show abstract

“…A previous meta-analysis revealed that PICC inserted in the lower limbs did not show worse results compared to the upper limb group in the NICU, apart from thrombosis [25]. A finding divergent from this was demonstrated by Pet et al, who reported the occurrence of complications more frequently with PICC inserted in the upper extremities than in the lower extremities [26].…”

Section: Plos Onementioning

confidence: 87%

Prevalence of complications associated with the use of a peripherally inserted central catheter in newborns: A systematic review protocol

et al. 2021

View full text Add to dashboard Cite

Background The improper handling of a peripherally inserted central catheter (PICC) in newborns (NBs) may result in mechanical and infectious complications. Aim The aim of this systematic review (SR) is to estimate the prevalence of complications associated with the use of PICC in NBs. Methods We will utilize PubMed, Embase, CENTRAL, Web of Science, Scopus, Cochrane Library, CINAHL, and Google Scholar for the databases search. There will be no restrictions on the search for languages, and observational studies will be selected wherein the prevalence rate of complications associated with the use of PICC in NBs has been presented or can be calculated. The systematic review will follow the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Two reviewers will independently select studies and assess their eligibility using predefined criteria. Using standardized forms, two other reviewers will independently extract data from each included study, and the random-effects pooled prevalence will be calculated in the meta-analysis with the respective 95% confidence intervals. The methodological quality of the studies will be assessed using the modified Newcastle-Ottawa Scale. Review Manager V.5.3.5 will be used for the qualitative and quantitative synthesis. A protocol was developed and published on PROSPERO (Registration number CRD42020211983). Expected results This SR will show the prevalence of complications caused by the inadequate management of PICC in NBs, which is information considered important for clinical practice improvement.

show abstract

Complications of upper extremity versus lower extremity placed peripherally inserted central catheters in neonatal intensive care units: A meta-analysis

Cited by 23 publications

References 39 publications

Peripherally inserted central catheters in extremely preterm infants: Placement success rates and complications

Peripherally inserted central catheters in extremely preterm infants: Placement success rates and complications

Selection and Insertion of Vascular Access Devices in Pediatrics: A Systematic Review

Prevalence of complications associated with the use of a peripherally inserted central catheter in newborns: A systematic review protocol

Contact Info

Product

Resources

About