OBJECTIVE: The purpose of this study was to determine the incidence and risk factors of neonatal PICC-related thrombosis.
METHODS: Systematic literature review and meta-analysis.
METHODS: Two independent researchers systematically explored multiple databases-such as PubMed, Medline, Embase and the Cochrane Library-from their inception until October 2023. Our study aggregates and scrutinizes studies specifically addressing the incidence and risk factors of neonatal PICC-related thrombosis. Employing the RevMan 5.3 software, a meta-analysis was executed to determine the incidence of both thrombosis and odds ratios (OR), accompanied by their respective 95% confidence intervals (CI) for the risk factors.
RESULTS: A total of 327 articles were screened, and data from 24 studies were used in synthesis. Neonatal PICC-related thrombosis incidence varied from 0.23% to 17.91%. The pooled incidence was 2% (95% CI: 1%-2%; I2 = 94%; p < .0001). The study identified 12 risk factors, including insertion sites in the lower extremities (OR = 0.22; 95% CI: 0.09-0.56; p = .001), gestational age <28 weeks, abdominal pathology, fresh frozen plasma by day 5 > 50 mL/kg, PICC tip location (proximal placement), two lumens, three lumens, prolonged hospital stay, infection, mothers\' use of anticoagulants, patients with cardiac insufficiency and being twin-to-twin transfusion syndrome donor.
CONCLUSIONS: The analysis indicates an overall pooled incidence of neonatal PICC-related thrombosis of 2%. Twelve factors were identified as risks associated with neonatal PICC-related thrombosis. Understanding the risk factors can provide evidence-based recommendations for improving awareness, control and treatment and better nursing management.
CONCLUSIONS: This systematic review and meta-analysis illuminates the incidence and risk factors linked to neonatal PICC-related thrombosis, delivering essential insights pivotal for clinical decision-making and enhancing patient care within neonatal health care settings.
目的:本研究的目的是确定新生儿PICC相关性血栓的发生率和危险因素。
方法:系统文献综述和荟萃分析。
方法:两名独立研究人员系统地探索了多个数据库-例如PubMed,Medline,Embase和Cochrane图书馆-从成立到2023年10月。我们的研究汇总并审查了专门针对新生儿PICC相关血栓形成的发生率和危险因素的研究。使用RevMan5.3软件,进行荟萃分析以确定血栓形成的发生率和比值比(OR),伴随着他们各自的95%置信区间(CI)的危险因素。
结果:共筛选327篇,24项研究的数据用于合成。新生儿PICC相关血栓形成发生率从0.23%到17.91%不等。合并发生率为2%(95%CI:1%-2%;I2=94%;p<0.0001)。该研究确定了12个危险因素,包括下肢的插入部位(OR=0.22;95%CI:0.09-0.56;p=.001),胎龄<28周,腹部病理学,第5天新鲜冷冻血浆>50mL/kg,PICC尖端位置(近端放置),两个流明,三个流明,住院时间延长,感染,母亲使用抗凝剂,患者心功能不全和双胞胎对双胞胎输血综合征供者。
结论:分析显示新生儿PICC相关血栓形成的总体合并发生率为2%。12个因素被确定为与新生儿PICC相关血栓形成相关的风险。了解风险因素可以为提高认识提供基于证据的建议,控制和治疗以及更好的护理管理。
结论:本系统综述和荟萃分析阐明了与新生儿PICC相关血栓形成相关的发生率和危险因素。提供至关重要的见解,为临床决策和加强新生儿卫生保健环境中的患者护理至关重要。