Catheter pretreatment on the prevention of phlebitis induced by PICC: a network Meta-analysis

Abstract

Objective To explore the effect of catheter pretreatment on the prevention of PICC phlebitis, the best solution of catheter pretreatment was obtained by network Meta-analysis. Methods The databases of PubMed, Web of Science, EMBASE, Cochrane Library, EBSCO, CNKI, VIP, and Wanfang were searched by computer and analyzed by Stata14.0 software. Results A total of 16 randomized controlled trials, including 3 998 patients, involved 12 catheter pretreatment solutions. The forest map showed that the difference between normal saline and 0.125 mg/ml dexamethasone solution, 50 U/ml heparin sodium+0.25 mg/ml dexamethasone mixture, 0.08 mg/ml dexamethasone solution, 50 U/ml heparin sodium solution, 0.05 mg/ml dexamethasone solution and 1.67 mg/ml dexamethasone solution was statistically significant (P< 0.05) . There was statistically significant difference between 0.04 mg/ml dexamethasone solution and 0.125 mg/ml dexamethasone solution, 0.08 mg/ml dexamethasone solution, 0.05 mg/ml dexamethasone solution and 1.67 mg/ml dexamethasone solution (P< 0.05) . The results of area plot under cumulative sorting probability curve showed that the following four kinds of catheter pretreatment solutions had better effect on preventing PICC phlebitis: 1 600 U/ml gentamicin + 0.125 mg/ml dexamethasone solution, 50 U/ml heparin sodium+0.25 mg/ml dexamethasone mixture, 0.05 mg/ml dexamethasone solution and 50 U/ml heparin sodium solution. Conclusions Based on the results of network Meta-analysis and the results of Sucra sequencing, the catheter pretreatment solution is closely related to the occurrence of phlebitis, 1 600 U/ml gentamicin + 0.125 mg/ml dexamethasone solution, 50 U/ml heparin sodium+0.25 mg/ml dexamethasone mixture, 0.05 mg/ml dexamethasone solution and 50 U/ml hepatic sodium solution are better than other pretreatment solutions in the prevention of phlebitis, but large samples are still needed to verify. Key words: Peripherally inserted central catheter; Phlebitis; Pretreatment; Network Meta-analysis