Incidence of catheter-related bloodstream infections following ultrasound-guided central venous catheterization: a systematic review and meta-analysis.
Incidence of catheter-related bloodstream infections following ultrasound-guided central venous catheterization: a systematic review and meta-analysis.
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DOI：
10.1186/s12879-022-07760-1
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发表时间：
2022-10-04
影响因子：
3.7
通讯作者：
Shime, Nobuaki
中科院分区：
文献类型：
--
作者：
Takeshita, Jun;Tachibana, Kazuya;Nakajima, Yasufumi;Shime, Nobuaki
超声引导广泛应用于中心静脉置管。几项研究表明，与解剖标志引导插入技术相比，超声引导中心静脉导管插入术可提高首次尝试的成功率，并缩短手术时间，从而避免感染并发症。然而，超声引导下中心静脉导管插入术对导管相关血流感染的影响仍不清楚。我们的目的是进行系统回顾和荟萃分析，以评价超声引导在预防与中心静脉导管插入术相关的导管相关血流感染和导管定植方面的价值。检索了截至2022年5月9日的科克伦对照试验中心注册中心（CENTRAL）和MEDLINE（通过PubMed），以比较超声引导和解剖标志引导插入技术用于中心静脉导管插入的随机对照试验（RCT）。使用RCT的科克伦偏倚风险2（RoB 2）工具评估偏倚风险。对导管相关血流感染和导管定植分别作为主要和次要结局进行荟萃分析。4项随机对照试验共纳入1268例符合纳入标准的患者，并进行了分析。超声引导中心静脉导管插入术与导管相关血流感染的发生率略低相关（风险比，0.46; 95%置信区间[CI]，0.16-1.32），与导管定植的发生率较低无关（风险比，1.36; 95% CI，0.57-3.26）。超声引导下中心静脉置管可降低导管相关性血流感染的发生率。有必要进行更多的随机对照试验，以进一步评价超声引导在预防中心静脉置管引起的导管相关血流感染中的价值。在线版本包含补充材料，可通过10.1186/s12879-022-07760-1获得。
Ultrasonographic guidance is widely used for central venous catheterization. Several studies have revealed that ultrasound-guided central venous catheterization increases the rate of success during the first attempt and reduces the procedural duration when compared to the anatomical landmark-guided insertion technique, which could result in protection from infectious complications. However, the effect of ultrasound-guided central venous catheterization on catheter-related bloodstream infections remains unclear. We aimed to conduct a systematic review and meta-analysis to evaluate the value of ultrasound guidance in preventing catheter-related bloodstream infections and catheter colonization associated with central venous catheterization. The Cochrane Central Register of Controlled Trials (CENTRAL) and MEDLINE (via PubMed) were searched up to May 9, 2022 for randomized controlled trials (RCTs) comparing ultrasound-guided and anatomical landmark-guided insertion techniques for central venous catheterization. Risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool for RCTs. A meta-analysis was performed for catheter-related bloodstream infections and catheter colonization, as primary and secondary outcomes, respectively. Four RCTs involving 1268 patients met the inclusion criteria and were analyzed. Ultrasound-guided central venous catheterization was associated with a slightly lower incidence of catheter-related bloodstream infections (risk ratio, 0.46; 95% confidence interval [CI], 0.16–1.32) and was not associated with a lower incidence of catheter colonization (risk ratio, 1.36; 95% CI, 0.57–3.26). Ultrasound-guided central venous catheterization might reduce the incidence of catheter-related bloodstream infections. Additional RCTs are necessary to further evaluate the value of ultrasound guidance in preventing catheter-related bloodstream infections with central venous catheterization. The online version contains supplementary material available at 10.1186/s12879-022-07760-1.
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DOI：
10.1016/s0195-6701(13)60012-2
发表时间：
2014-01
期刊：
The Journal of hospital infection
影响因子：
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作者：
Loveday HP;Wilson JA;Pratt RJ;Golsorkhi M;Tingle A;Bak A;Browne J;Prieto J;Wilcox M;UK Department of Health
通讯作者：
UK Department of Health
影响因子：
15.8
作者：
Moher D;Liberati A;Tetzlaff J;Altman DG;PRISMA Group
通讯作者：
PRISMA Group
影响因子：
4.5
作者：
Marschall, Jonas;Mermel, Leonard A.;Yokoe, Deborah S.
通讯作者：
Yokoe, Deborah S.
影响因子：
3.6
作者：
Lamperti, Massimo;Biasucci, Daniele Guerino;Hopkins, Philip
通讯作者：
Hopkins, Philip
影响因子：
4.9
作者：
通讯作者：
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