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Rate of Catheter-Related Bloodstream Infections Between Tunneled Central Venous Catheters Versus Peripherally Inserted Central Catheters in Adult Home Parenteral Nutrition: A Meta-analysis
- Source :
- JPEN. Journal of parenteral and enteral nutrition. 43(1)
- Publication Year :
- 2017
-
Abstract
- Background Tunneled central venous catheters (TCVCs) and peripherally inserted central catheters (PICC) are often used for the provision of home parenteral nutrition (HPN). There is no formal comparison being made to study the rate of catheter-related bloodstream infection (CRBSI) between TCVCs and PICC in HPN to recommend the use of 1 over the other. Methods An online MEDLINE, PubMed, and Scopus search was conducted. Studies reporting the rate of CRBSI in HPN patients were included. DerSimonian and Laird random effects meta-analyses were used to analyze comparative studies, whereas Begg and Pilote's random effects meta-analysis was used to pool and analyze single-arm studies. Results Seventeen studies (12 single-arm studies and 5 comparative studies) were included for analysis. Meta-analysis of comparative studies showed that PICC use was associated with a significantly lower rate of CRBSI (relative risk (RR) 0.40, 95% CI 0.19-0.83), whereas meta-analysis of single-arm studies revealed that the relative risk for CRBSI was not statistically significantly different from unity. Conclusion TCVC is more commonly used in long-term HPN. Our analysis of comparative studies showed a lower rate of CRBSI in HPN patients using PICC compared with TCVC; however, analysis of single-arm studies showed that the rate of CRBSI was comparable in PICC and TCVC use. The decision to which type of catheter is most suited for HPN patients should hence be based on the duration of treatment, level of care, patients' dexterity, as well patients' underlying comorbidities that may potentially contribute to other catheter-related complications.
- Subjects :
- Adult
Male
medicine.medical_specialty
Catheterization, Central Venous
030309 nutrition & dietetics
MEDLINE
Medicine (miscellaneous)
03 medical and health sciences
0302 clinical medicine
Risk Factors
Intestinal failure
Internal medicine
Bloodstream infection
Catheterization, Peripheral
medicine
Central Venous Catheters
Humans
0303 health sciences
Nutrition and Dietetics
business.industry
Middle Aged
Catheter
Parenteral nutrition
Relative risk
Meta-analysis
Catheter-Related Infections
Practice Guidelines as Topic
030211 gastroenterology & hepatology
Female
Level of care
business
Parenteral Nutrition, Home
Subjects
Details
- ISSN :
- 19412444
- Volume :
- 43
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- JPEN. Journal of parenteral and enteral nutrition
- Accession number :
- edsair.doi.dedup.....5a0946469a3f2f084b5e05d2aa303002