Key result
Intracavitary electrocardiogram-guided PICC decreased the incidence of phlebitis in neonates compared with traditional X-ray positioning (OR 0.33; 95% CI 0.19-0.56).
Why the study?
The impact of intracavitary electrocardiogram-guided PICC placement on phlebitis reduction compared with traditional X-ray positioning in neonates was controversial.
Does intracavitary electrocardiogram (IC-ECG)-guided PICC reduce the incidence of phlebitis in neonates compared to traditional X-ray positioning?
Meta-Analysis
Does intracavitary electrocardiogram (IC-ECG)-guided PICC reduce the incidence of phlebitis in neonates compared to traditional X-ray positioning?
Odds Ratio: 0.33 (95% CI 0.19–0.56)
IC-ECG-guided PICC significantly reduces phlebitis and total complications while improving tip location accuracy in neonates compared to traditional X-ray positioning.
Supports IC-ECG-guided PICC over X-ray in neonates to reduce phlebitis; confirms RCT evidence for broader adoption.
Because the application of intracavitary electrocardiogram (IC‐ECG)‐guided peripherally inserted central catheter (PICC) in the treatment of neonates is controversial in terms of phlebitis reduction compared with traditional X‐ray positioning technique, a systematical evaluation is needed on the impact of IC‐ECG on this common complication following PICC. Literature retrieval was conducted on large databases including PubMed, Google Scholar, Cochrane library, and CNKI. Randomised controlled trials (RTCs) of intracavitary electrocardiogram‐guided peripherally inserted central catheter tip placement in the treatment of neonates up to July 7, 2022, were collected. Then indicators of included studies were compared and analysed by two researchers. Meta‐analysis was performed on the STATA 17.0 software. After excluding invalid trials, 11 out of 316 randomised controlled trials were included for further analysis. Meta‐analysis results showed that compared with the control group, IC‐ECG‐guided PICC could decrease the incidence of phlebitis ( I 2 = 0.00%, P = 0.76, OR = 0.33, 95% CI 0.19–0.56) and that no significant difference was observed between preterm neonates and term neonates ( P = 0.74). Meanwhile, total complications were decreased in neonates ( I 2 = 0.00%, P = 0.00 OR = 0.23, 95% CI 0.16–0.33). IC‐ECG‐guided PICC could also improve the accuracy of optimal tip location ( I 2 = 0.00%, P = 0.53, OR = 5.37, 95% CI 3.80–7.59). IC‐ECG‐guided PICC could achieve reduced phlebitis incidence and total complications in the treatment of neonates, as well as increased accuracy of optimal tip location, no matter if those neonates were preterm or not. This study was registered in inplasy.com with No. INPLASY202280012 (DOI: 10.37766/inplasy2022.8.0012).
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Gan et al. (2022) conducted a meta-analysis in Neonates requiring peripherally inserted central catheter (PICC). Intracavitary electrocardiogram (IC-ECG)-guided PICC vs. Traditional X-ray positioning technique was evaluated on Incidence of phlebitis (OR 0.33, 95% CI 0.19-0.56). Intracavitary electrocardiogram-guided PICC decreased the incidence of phlebitis in neonates compared with traditional X-ray positioning (OR 0.33; 95% CI 0.19-0.56).
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