Ethanol locks for the prevention of catheter-related infection in patients with central venous catheter: A systematic review and meta-analysis of randomized controlled trials
Autoři:
Jun Zhang aff001; Bo Wang aff001; Jinxia Wang aff001; Qin Yang aff002
Působiště autorů:
School of Nursing, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
aff001; Department of Special Surgery, the First Hospital of Lanzhou University, Lanzhou, Gansu, China
aff002
Vyšlo v časopise:
PLoS ONE 14(9)
Kategorie:
Research Article
doi:
https://doi.org/10.1371/journal.pone.0222408
Souhrn
Background
The widespread use of central venous catheters (CVCs) has exposed patients to a high risk of catheter-related infection (CRI), which is linked to substantial morbidity and mortality. Several strategies for preventing CRI, including ethanol lock prophylaxis, have been explored. This study aimed to provide a comprehensive summary of randomized controlled trials (RCTs) assessing the efficacy and safety of ethanol locks for preventing CRI in patients with CVC.
Methods
We searched six electronic databases, earlier relevant meta-analyses and the reference lists of the included studies for RCTs that assessed the effects of ethanol locks on CRI in patients with CVC versus a control group. Two authors independently assessed the methodological quality of the included studies using the Cochrane Risk of Bias tool and extracted relevant information according to a predesigned extraction form. Data were analyzed using the Cochrane Collaboration’s RevMan 5.3.
Results
Nine studies involving 2451 patients were included. Although limited in power, the results of the meta-analysis indicated a positive effect of ethanol lock prophylaxis on reducing catheter-related bloodstream infection (CRBSI) compared to heparin alone [OR = 0.53, 95% CI 0.34, 0.82, P = 0.004]. The effects on other outcomes, such as exit site infection, catheter dysfunction, catheter removal, thrombosis and mortality, were not statistically significant (P > 0.05). Moreover, although the effect of ethanol on CRBSI was in the expected direction compared to 0.9% NaCl locks, this effect was not statistically significant (P > 0.05).
Conclusions
The present data indicate that ethanol lock prophylaxis is a potential candidate for the prevention of CRBSI in patients with CVC. However, more attention should be paid to the uniform ethanol lock procedure and toxic effects after long-term ethanol lock exposure.
Klíčová slova:
Physical sciences – Chemistry – Chemical compounds – Organic compounds – Alcohols – Ethanol – Organic chemistry – Mathematics – Statistics – Biology and life sciences – Bioengineering – Biotechnology – Medical devices and equipment – Catheters – Engineering and technology – Medicine and health sciences – Pharmacology – Drugs – Heparin – Hematology – Blood coagulation – Coagulation disorders – Thrombosis – Cardiovascular medicine – Cardiovascular diseases – Vascular medicine – Nephrology – Medical dialysis – Research and analysis methods – Mathematical and statistical techniques – Statistical methods – Metaanalysis – Research design – Clinical research design – Adverse events – Research assessment – Systematic reviews
Zdroje
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Článek vyšel v časopise
PLOS One
2019 Číslo 9
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