Abstract：
BACKGROUND: Catheter-related thrombosis is a common complication of the peripherally inserted central catheter (PICC) in neonates, leading to unintended tube removal and significantly affecting neonatal health and safety. Despite widespread reporting on the estimated occurrence and factors contributing to neonatal PICC-related thrombosis, these findings have not been synthesized.
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.
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.
摘要：
背景：导管相关性血栓形成是新生儿外周中心静脉导管（PICC）的常见并发症，导致意外拔管，严重影响新生儿健康和安全。尽管广泛报道了新生儿PICC相关血栓形成的估计发生率和因素，这些发现尚未综合。
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。
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。
