Authors

Francisca Zamora-Zamora1, Juana Gómez-Macías2, Mª Quiteria Rosa Barrios2

Position

1Doctora. Unidad de Gestión Clínica de Pediatría. Urgencias de Pediatría. Hospital Materno-Infantil. Complejo Hospitalario de Jaén2Enfermera Especialista en Enfermería Pediátrica. Unidad de Gestión Clínica de Pediatría. Urgencias de Pediatría. Hospital Materno-Infantil. Complejo Hospitalario de Jaén

Contact address

Francisca Zamora-Zamora. Complejo Hospitalario de Jaén. Avda. del Ejército español, 10. 23007 Jaén.

Contact email: francisca.zamora.sspa@juntadeandalucia.es

Abstract

Objective: to analyze the efficacy of different methods for success at first attempt of peripheral venous catheterization in paediatric patients.
Method: a systematic review with meta-analysis of randomized clinical trials (RCTs). Search in different databases: PubMed, Cochrane Plus, Medline, Scielo, Dare, Embase, Clinicaltrials.gov, Lilacs, and reverse search (until June, 2016), without time or language limitations. The study included RCTs comparing different catheterization methods vs. the traditional method, and determined the success at first attempt in patients < 18-year-old. There was an assessment of the quality of design and risk of bias of the RCTs; the Review Manager program, version 5.3, was used. The effect estimator was relative risk (RR), with 95% confidence interval (CI95%). Statistical significance if p< 0.05.
Results: there was a review of 831 studies, and 24 RCTs were included. The use of new methods acted as a factor protecting against RR of catheterization failure (CI95%)= 0.63 (0.49-0.83) (p< 0.001); heterogeneity: I2=67% (p< 0.001). Transillumination and topical anaesthetics reduced the probability of catheterization failure by 56% and 46%, respectively. Sedation (p= 0.02) and the effect of analgesia (p= 0.001) had significant impact on results. Ultrasound test, topical nitroglycerin and near infrared light devices did not reduce the risk of catheterization failure. Age explained the 74.8% heterogeneity (random effect meta-regression model).
Conclusion: the use of new catheterization methods led to an increase in the probability of success at first attempt.

Keywords:

Peripheral catheterization; child; meta-analysis; Systematic review; transillumination; ultrasound test

Versión en Español

Título:

Efectividad de nuevos métodos para canalización venosa periférica en edad pediátrica. Revisión sistemática y metaanálisis