Dexamethasone for Preventing PICC-Associated Phlebitis: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

 SHENDong-qin ¹ , DUYi ¹ , ZHANGCai-yun ¹ , SUNXiao-ming ² ,  WUShi-wen ³

1. Department of Nursing, First Hospital of Lanzhou University, Lanzhou 730000, China;
2. Department of Hematology, First Hospital of Lanzhou University, Lanzhou 730000, China;
3. Department of Clinical Laboratory, Lankong Agencies Hospital, Lanzhou 730000, China;

Corresponding author：

WUShi-wen, Email: wsw4668@163.com

Keywords：

Peripherally inserted central catheter (PICC); Dexamethasone; Phlebitis; Pre-treating; Systematic review; Meta-analysis; Randomized controlled trial; Clinical controlled trial

DOI：

10.7507/1672-2531.20140082

Video：

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Objective To systematically review the effect of pre-treating the catheters with dexamethasone for preventing PICC-associated phlebitis. Methods We electronically searched PubMed, EMbase, The Cochrane Library (Issue 4, 2012), CNKI, CBM, WanFang Data and CQVIP for studies about pre-treating the catheters with dexamethasone to prevent PICC-associated phlebitis from inception to March 2013. Relevant studies including grey literature were also manually searched. Two reviewers independently screened studies according to the inclusion and exclusion criteria, extracted data and evaluated the methodological quality of the included studies. Then meta-analysis was performed using the software RevMan 5.0. Results A total of 13 studies involving 1 965 cases (1 025 cases in the dexamethasone group, and 940 cases in the control group) were included. The results of meta-analysis showed that pre-treating the catheters with dexamethasone could significantly decrease the incidence of PICC-associated phlebitis (RR=0.29, 95%CI=0.22 to 0.39, P < 0.000 1). However, no significant difference was found for the PICC-associated other complications, such as pipe blockage, bleeding, swelling of puncture site, allergy and atopic catheter. Conclusion Pre-treating the catheters with dexamethasone soltion before inserting could reduce the incidence of PICC-associated phlebitis. The aforementioned conclusion needs to be further validated by more high-quality and large-scale randomized controlled trials.

Citation： SHENDong-qin, DUYi, ZHANGCai-yun, SUNXiao-ming, WUShi-wen. Dexamethasone for Preventing PICC-Associated Phlebitis: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2014, 14(4): 478-483. doi: 10.7507/1672-2531.20140082 Copy

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10.	曹维宁.地塞米松擦拭导管联合双氯芬酸二乙胺乳剂预防PICC致机械性静脉炎的效果.全科护理, 2012, 10(5B):1266-1267.
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12.	康建荣.改进置管法对PICC所致机械性静脉炎的影响.中国临床护理, 2012, 4(3):195-196.
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15.	尤从香, 张丽华, 张桂珍.预防性护理干预降低PICC导管致机械性静脉炎的效果评价.临床护理杂志, 2012, 11(3):70-72.
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20.	Westergaard B, Classen V, Walther-Larsen S.Peripherally inserted central catheters in infants and children-indications, techniques, complications and clinical recommendations.Acta Anaesthesiol Scand, 2013, 57(3):278-287.

1. Moureau N.Vascular safety:it's all about PICCs.Nurs Manage, 2006, 37(5):22-27, 50.
2. Infusion Nurses Society.Infusion Nursing Standards of Practice.J Infus Nurs, 2006, 29(1 Suppl):S1-S92.
3. Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.1.Available at:www.cochrane-handbook.org/.Accessed March102009.
4. 乙苏北, 王岩, 李丹, 等.经外周插管的中心静脉导管的预处理对乳腺癌化疗患者机械性静脉炎发生率的影响.中国肿瘤临床与康复, 2007, 14(1):93-95.
5. 杨洁, 王东平, 李薇.地塞米松浸泡PICC导管对预防静脉炎的作用.南京医科大学学报(自然科学版), 2008, 28(11):1523-1524.
6. 彭阳, 何美蓉, 蔡文智.庆大霉素和地塞米松擦拭导管预防PICC致机械性静脉炎的效果观察.护理学报, 2009, 16(6B):65-66.
7. 范植蓉, 王虹.肝素钠和地塞米松浸泡PICC导管预防机械性静脉炎.护理学杂志, 2010, 25(23):46-47.
8. 吕友红, 薛敏芬, 赵全娣, 等.地塞米松预防PICC置管后机械性静脉炎疗效观察.中国社区医师(医学专业), 2011, 13(14):79-80.
9. 邢彩英, 徐兵, 戴明红, 等.地塞米松预防早产儿PICC静脉炎的效果观察.中华全科医学, 2011, 9(6):986-987.
10. 曹维宁.地塞米松擦拭导管联合双氯芬酸二乙胺乳剂预防PICC致机械性静脉炎的效果.全科护理, 2012, 10(5B):1266-1267.
11. 陈桂英, 王惠琴, 林丹妮.地塞米松预处理导管对PICC所致静脉炎的预防作用.中华护理杂志, 2012, 47(1):6-9.
12. 康建荣.改进置管法对PICC所致机械性静脉炎的影响.中国临床护理, 2012, 4(3):195-196.
13. 李毅, 蒋永丰.地塞米松冲管联合喜疗妥外涂预防PICC置管后的机械性静脉炎的疗效分析.中国实用医药, 2012, 7(30):182-183.
14. 钱玉兰, 陆勤美, 张兰凤, 等.地塞米松肝素盐水预防PICC静脉炎的临床研究.实用临床医药杂志, 2012, 16(10):15-16.
15. 尤从香, 张丽华, 张桂珍.预防性护理干预降低PICC导管致机械性静脉炎的效果评价.临床护理杂志, 2012, 11(3):70-72.
16. 赵焕利, 陆印, 冒美娟.地塞米松浸泡导管预防PICC置管所致机械性静脉炎效果分析.护士进修杂志, 2012, 27(18):1703-1705.
17. Chopra V, O'Horo JC, Rogers MA, et al.The risk of bloodstream infection associated with peripherally inserted central catheters compared with central venous catheters in adults:a systematic review and meta-analysis.Infect Control Hosp Epidemiol, 2013, 34(9):908-918.
18. Pikwer A, Akeson J, Lindgren S.Complications associated with peripheral or central routes for central venous cannulation.Anaesthesia, 2012, 67(1):65-71.
19. 唐军, 熊英.肝素预防新生儿经外周中心静脉置管相关感染的回顾性研究.中国循证医学杂志, 2010, 10(09):1023-1026.
20. Westergaard B, Classen V, Walther-Larsen S.Peripherally inserted central catheters in infants and children-indications, techniques, complications and clinical recommendations.Acta Anaesthesiol Scand, 2013, 57(3):278-287.

Chinese Journal of Evidence-Based Medicine

Dexamethasone for Preventing PICC-Associated Phlebitis: A Systematic Review

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