Comparison of clinically indicated and routine replacement of peripheral venous catheters
systematic review with meta-analysis
DOI:
https://doi.org/10.29352/mill029e.25004Keywords:
catheterization, peripheral, catheters, indwelling, phlebitis, infections, device removalAbstract
Introduction: The peripheral venous catheter is currently widely used in health care. Its placement represents an invasive procedure and there is an increased risk of complications such as phlebitis and bloodstream infection. The decision about the correct moment for its replacement is still a matter of debate.
Objectives: To assess the effects of peripheral venous catheter replacement when clinically indicated compared to routine replacement.
Methods: A systematic review with meta-analysis was carried out according to the methodology proposed by the Joanna Briggs Institute. Two independent reviewers perform the critical appraisal, extraction and synthesis of the data.
Results: The corpus of the review was composed of eight randomised controlled clinical trials and one quasi-experimental study. Results of the meta-analysis showed no differences in phlebitis rate (RR=1.31; 95%CI=0.93-1.84; p=0.13) and bloodstream infection (RR=0.82; 95%CI=0.20-3.4; p=0.997) when comparing exchange by clinical indication and routine.
Conclusion: Increasing the catheter's length of stay will not lead to a higher risk of phlebitis and bloodstream infection, so changing it routinely is an ineffective practice that should be changed. The replacement only when there is a clinical indication is a safe practice.
Downloads
References
Apóstolo, J. (2017). Síntese da evidência no contexto da translação da ciência. Coimbra, Portugal: Escola Superior de Enfermagem de Coimbra (ESEnfC). https://www.esenfc.pt/pt/download/3868/dXeLMhjdjCvHFwDpAvDd
Barker, P., Anderson, A. D., & MacFie, J. (2004). Randomised clinical trial of elective re-siting of intravenous cannulae. Annals of the Royal College of Surgeons of England, 86(4), 281–283. https://doi.org/10.1308/147870804317
Braga, L. M., Parreira, P. M. S. D., Arreguy-Sena, C., Carlos, D. M., Mónico, L. S. M., & Henriques, M. A. P. (2018). Taxa de incidência e o uso do flushing na prevenção das obstruções de cateter venoso periférico. Texto & Contexto Enfermagem, 27(4), 1-9. http://dx.doi.org/10.1590/010407072018002810017
Chang, W.P., & Peng, Y. X. (2018). Occurrence of phlebitis A systematic review and meta-analysis. Nursing Research, 67(3), 252-260. 10.1097/NNR.0000000000000279
Fernando, S. A., Gray, T.J., & Gottlieb, T. (2018). Letters to the Editor. Internal Medicine Journal, 48, 606–607. 10.1111/imj.13782
Gorski, L.A., Hadaway, L., Hagle, M., Broadhurst, D., Clare, S., Kleidon, T., Meyer, B., Nickel, B., Rowley, S., Sharpe, E., & Alexander, M. (2021). Infusion therapy standards of practice, 8th Editions. Journal of Infusion Nursing, 44(1), 1-224. 10.1097/NAN.0000000000000396
Lv, L., & Zhang, J. (2020). The incidence and risk of infusion phlebitis with peripheral intravenous catheters: A meta-analysis. Journal of Vascular Access, 21(3), 342-349. 10.1177/1129729819877323.
Maier, D. (2019). To replace or not to replace? Replacing short peripheral catheters based onclinical indication. Journal of Infusion Nursing, 42(3), 143-148. 10.1097/NAN.0000000000000322
Mermel, L. A. (2017). Short-term Peripheral Venous Catheter–Related Bloodstream Infections: A Systematic Review. Clinical Infectious Diseases, 65(10), 1757-1762. 10.1093/cid/cix562
Nishanth, S., Sivaram, G., Kalayarasan, R., Kate, V., & Ananthakrishnan, N. (2009). Does elective re-siting of intravenous cannulae decrease peripheral thrombophlebitis? A randomized controlled study. The National medical journal of India, 22(2). https://www.researchgate.net/publication/38031827
Nobre, A.S.P., & Martins, M.D.S. (2018). Prevalência de flebite da venopunção periférica: Fatores associados. Revista de Enfermagem Referência, IV(16), 127-138. https://doi.org/10.12707/RIV17058
O'Grady, N.P., Alexander, M., Burns, L.A., Dellinger, E.P., Garland, J., Heard, S. O., Lipsett, P. A., Masur, H., Mermel, L. A., Pearson, M. L., Raad, I. I., Randolph, A., Rupp, M. E., Saint, S., & Healthcare Infection Control Practices Advisory Committee (HICPAC). (2017, outubro). Guidelines for the prevention of intravascular catheter-related infections. https://www.cdc.gov/infectioncontrol/guidelines/bsi/index.html
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., … Moher, D. (2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Bmj, 372(71). https://doi.org/10.1136/bmj.n71
Ray-Barruel, G., Xu, H., Marsh, N., Cooke, M., & Rickard, C.M. (2019). Effectiveness of insertion and maintenance bundles in preventing peripheral intravenous catheter-related complications and bloodstream infection in hospital patients: A systematic review. Infection, Disease & Health, 24(3), 152-168. https://doi.org/10.1016/j.idh.2019.03.001
Rickard, C. M., McCann, D., Munnings, J., & McGrail, M. R. (2010). Routine resite of peripheral intravenous devices every 3 days did not reduce complications compared with clinically indicated resite: A randomised controlled trial. BioMed Central medicine, 8(53). https://doi.org/10.1186/1741-7015-8-53
Rickard, C. M., Webster, J., Wallis, M. C., Marsh, N., McGrail, M. R., French, V., Foster, L., Gallagher, P., Gowardman, J. R., Zhang, L., McClymont, A., & Whitby, M. (2012). Routine versus clinically indicated replacement of peripheral intravenous catheters: A randomised controlled equivalence trial. Lancet, 380(9847), 1066–1074. https://doi.org/10.1016/S0140-6736(12)61082-4
Salgueiro-Oliveira, A.S., Bastos, M.L., Braga, L.M., Arreguy-Sena, C., Melo, M.N., & Parreira, P.M.S.D. (2019). Práticas de enfermagem no cateterismo venoso periférico: A flebite e a segurança do doente. Texto & Contexto Enfermagem, 28, 1-13. http://dx.doi.org/10.1590/1980-265X-TCE-2018-0109
Santos, E. J. F., & Cunha, M. (2013). Interpretação Crítica dos Resultados Estatísticos de uma Meta‐Análise: Estratégias Metodológicas. Millenium, 44, 85‐98.
Tufanaru, C., Munn, Z., Aromataris, E., Campbell, J., & Hopp, L. (2017). Chapter 3: Systematic reviews of effectiveness. In E. Aromataris & Z. Munn (Eds.), Joanna Briggs Institute Reviewer's Manual. The Joanna Briggs Institute. https://reviewersmanual.joannabriggs.org/
Vendramim, P., Avelar, A., Rickard, C. M., & Pedreira, M. (2020). The RESPECT trial-replacement of peripheral intravenous catheters according to clinical reasons or every 96 hours: A randomized, controlled, non-inferiority trial. International journal of nursing studies, 107(103504). https://doi.org/10.1016/j.ijnurstu.2019.103504
Webster, J., Lloyd, S., Hopkins, T., Osborne, S., & Yaxley, M. (2007). Developing a research base for intravenous peripheral cannula re-sites (DRIP trial). A randomised controlled trial of hospital in-patients. International journal of nursing studies, 44(5), 664–671. https://doi.org/10.1016/j.ijnurstu.2006.02.003
Webster, J., Clarke, S., Paterson, D., Hutton, A., Dyk, S. v., Gale, C., & Hopkins, T. (2008). Routine care of peripheral intravenous catheters versus clinically indicated replacement: Randomised controlled trial. BMJ (Clinical research ed.), 337(7662),1-6. https://doi.org/10.1136/bmj.a339
Webster, J., Osborne, S., Rickard, C.M., & Marsh, N. (2019). Clinically-indicated replacement versus routine replacement of peripheral venous catheters. Cochrane Database of Systematic Reviews, 23 (1). 10.1002/14651858.CD007798.pub5
Xu, L., Hu, Y., Huang, X., Fu, J., & Zhang, J. (2017). Clinically indicated replacement versus routine replacement of peripheral venous catheters in adults: A nonblinded, cluster-randomized trial in China. Internacional Journal of Nursing Practice, 23(6), 1-8. 10.1111/ijn.12595
Zhang, Y. (2020). Replacement of peripheral venous catheters according to clinical indications or routine time: A meta-analysis. PROSPERO. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021224065ray
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who submit proposals for this journal agree to the following terms:
a) Articles are published under the Licença Creative Commons (CC BY 4.0), in full open-access, without any cost or fees of any kind to the author or the reader;
b) The authors retain copyright and grant the journal right of first publication, allowing the free sharing of work, provided it is correctly attributed the authorship and initial publication in this journal;
c) The authors are permitted to take on additional contracts separately for non-exclusive distribution of the version of the work published in this journal (eg, post it to an institutional repository or as a book), with an acknowledgment of its initial publication in this journal;
d) Authors are permitted and encouraged to publish and distribute their work online (eg, in institutional repositories or on their website) as it can lead to productive exchanges, as well as increase the impact and citation of published work
Documents required for submission
Article template (Editable format)
