PERIPHERALLY INSERTED CENTRAL CATHETER (PICC) IN NEONATAL INTENSIVE THERAPY NEWBORNS: SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CLINICAL TRIALS
DOI:
https://doi.org/10.47820/jht.v1i1.3Keywords:
Catheters. Peripheral catheterization. Neonatal Intensive Care Units. Newborn. Systematic ReviewAbstract
Objective: to identify and evaluate the effectiveness of the use of peripherally inserted central catheter (PICC) compared to the use of other intravenous catheters in newborns hospitalized in neonatal intensive care units. Method: This is a bibliographic study, a systematic review carried out according to the Cochrane methodology and regulations of the PRISMA check list. The Databases PubMed, EMBASE, Cochrane, Latin American and Caribbean Literature on Health Sciences (LILACS) were consulted until March 2021. Reviewers independently tracked eligible randomized
clinical trials (CRTs); extracted the data and assessed the risk of bias through the Cochrane
approach. Associations were reported as relative risks (RR) and their 95% confidence intervals (CI).
Heterogeneity was tested with the Cochrane χ2 test, and the degree of heterogeneity quantified with statistics I2 and its 95% CI. The Review Manager (RevMan) software was used for meta-analysis (version 5.3). The quality of the evidence was generated according to the Evaluation of the
Classification of Recommendations, Development and Evaluation (GRADE). Results: There was no
statistically difference for the occurrence of sepsis, mortality, catheter-related complications
(infections) and catheter length of stay between groups. For the number of venopunctures required for catheter insertion, the findings indicate that for PICC there are lower numbers (RR -6.17, 95% CI:-7.75 to -4.59) and that there is low heterogeneity (I2=32%) among the studies. However, these results should be interpreted with caution, since the evaluation of the quality of the evidence was low. Conclusion: No moderate or high-quality evidence was found in ECRs that proves that there is differentiated effectiveness between PICC compared to the use of other intravenous catheters in newborns hospitalized in neonatal intensive care units, thus evidencing the need for further studies
in the area.
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References
Montes SF, Teixeira JBA, Barbosa MH, Barichello E. Ocorrência de complicações ao uso de
Cateter Venoso Central de Inserção Periférica (PICC) em recém-nascidos.Enfermaria Global. 2011;
-19.
Sociedade Brasileira de Pediatria. Transporte do recém-nascido de alto risco: diretrizes da
Sociedade Brasileira de Pediatria- São Paulo: Sociedade Brasileira de Pediatria, 2015.
Vieira KBT, Costa R. Guia de cuidados em terapia intravenosa periférica neonatal: Uma
construção coletiva da equipe de enfermagem. Ciencia y Enfermería. 2015; 21(3): 87-99. DOI: https://doi.org/10.4067/S0717-95532015000300008
Cutler DM, McClellan M. Is technologicalchange In medicine worth it? When costs and benefits
are weighed together, technological advances have proved to be worth far more than their costs.
Health affairs. 2016; 20(5): 9-29.
Silva LK. Avaliação tecnológica e análise custo-efetividade em saúde: a incorporação de
tecnologias e a produção de diretrizes clínicas para o SUS. Ciências e Saúde Coletiva. 2003; 8(2):
-520.
Machado AF, Pedreira MLG, Chaud MN. Eventos adversos relacionados ao uso de cateteres
intravenosos periféricos em crianças de acordo com tipos de curativos. Revista Latino Americana
Enfermagem. 2008; 16(3): 1-7. v.1, n.2, 2022
Belo MPM, Silva RAMC, Nogueira ILM, Mizoguti DP, Ventura CMU. Conhecimento de enfermeiros
de Neonatologia acerca do cateter venoso central de inserção periférica. Revista Brasileira de
Enfermagem. 2012; 65(1)-42-48. DOI: https://doi.org/10.1590/S0034-71672012000100006
ROCHA, Karla da Silva Guimarães et al. Cateter Epicutâneo no Cotidiano do Cuidado de
Enfermagem à Criança em Pré-Operatório de Cirurgia Cardíaca: Limites e Desafios na Instalação
Precoce. Rio de Janeiro: [s.n.], 2006.
FEITOSA, José Leôncio; ANTUNES, José Ricardo Peret; ARANDA, Angela Christina. Rotinas
para Cateter Venoso Central de Inserção Periférica em Neonatos. Rio de Janeiro: Secretaria de
Estado de Saúde do Rio de Janeiro, 2002.
Mingorance P, Johann DA, Lazzari LSM, Pedrolo E, Oliveira GLR, Danski MTR. Complicações
do Cateter Central de Inserção Periférica (PICC) em neonatos, Ciências, Cuidado e Saude. 2014;
(3): 433-438.
Baggio MA, Bazzi FCS, Bilibio CAC. Cateter Central de Inserção Periférica: descrição da
utilização em UTI Neonatal e Pediatrica. Revista Gaucha de Enfermagem. 2010; 31(1):70-76. DOI: https://doi.org/10.1590/S1983-14472010000100010
Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions
Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from
www.handbook. cochrane.org.
Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews
and meta-analyses of studies that evaluate health care interventions: explanation and elaboration.
Ann Intern Med 2009;151:W65–94.
Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions
Version 5.1.0 [updated March 2011]. Part 2: General methods for Cochrane reviews > 8 Assessing
risk of bias in included studies. The Cochrane Collaboration, 2011. Available from
Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple,
graphical test. Bmj 1997;315:629-34. DOI: https://doi.org/10.1136/bmj.315.7109.629
Review Manager (RevMan) [Computer program]. Version 5.3. Copenhagen: The Nordic
Cochrane Centre, The Cochrane Collaboration, 2014.
Guyatt G, Oxman AD, Akl EA, Kunz R, Vist G, Brozek J, et al. GRADE guidelines: 1. Introduction
GRADE evidence profiles and summary of findings tables. J Clin Epidemiol. 2011; 64(4):383–94.
Epub 2011/01/05. https://doi.org/10.1016/j.jclinepi.2010.04.026 PMID: 21195583. DOI: https://doi.org/10.1016/j.jclinepi.2010.04.026
Barria MR, Lorca P, Muñoz S. Randomized Controlled Trial of Vascular Acess in newborns in
the Neonatal Intensive Care Unit. JOGNN. 2007; 36(5): 450-457. DOI: https://doi.org/10.1111/j.1552-6909.2007.00171.x
Janes M, Kalyn A, Pinelli J, Ontario BPH. A randomized Trial comparinf peripherally inserted
central venous catheters and peripheral intravenous catheters in infants with very low birth weight.
Journal of pediatric surgery. 2000; 35(7): 1040-1044. DOI: https://doi.org/10.1053/jpsu.2000.7767
Wilson D, Verklan MT, Kennedy Ka. Randomized trial of percutaneous central venous lines
versus perifheral intravenous lines. Journal of Perinatology. 2007;27:92-96. DOI: https://doi.org/10.1038/sj.jp.7211650
Ashish R Dongara, Dipen V Patel, Somashekhar M Nimbalkar, Nirav Potana, Archana S
Nimbalkar, Umbilical Venous Catheter Versus Peripherally Inserted Central Catheter in Neonates: A
Randomized Controlled Trial, Journal of Tropical Pediatrics, Volume 63, Issue 5, October 2017,
Pages 374–379, https://doi.org/10.1093/tropej/fmw099 DOI: https://doi.org/10.1093/tropej/fmw099
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