Evaluation of clinical guidelines and consensus on the quality of central venous catheters_Chinese Journal of Evidence-Based Medicine

Authors：

WANG Daoxin ^1,2 , LIU Nan ² , SHI Zeyuan ³ , LI Haiyun ¹ , PENG Huizhen ¹ ,  ZHAO Wenli ¹

1. Department of Central Catheter Room, Henan Provincial People's Hospital, Zhengzhou 450003, P. R. China;
2. School of Nursing and Health, Henan University, Kaifeng 475004, P. R. China;
3. School of Clinical Medicine, Henan University, Kaifeng 475004, P. R. China;

Corresponding author：

ZHAO Wenli, Email: hhzhaowenli@126.com

Keywords：

Clinical guidelines; Consensus; Central venous catheter; AGREE Ⅱ; RIGHT

DOI：

10.7507/1672-2531.202211140

Video：

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Objective To evaluate the methodological quality and reporting quality of clinical guidelines and consensus on central venous catheters. Methods The PubMed, EMbase, Web of Science, CBM, WanFang Data, CNKI databases and Guidelines International Network, National Institute for Health and Clinical Excellence, National Guideline Clearinghouse, Medive.cn websites were searched to collect clinical guidelines and consensus related to central venous catheters. The retrieval time was from the establishment of the database to October 2022. Two researchers independently screened the literature, extracted data and used evaluation tools AGREE Ⅱ and RIGHT to evaluate the quality of the included studies. Results A total of 34 central venous catheter guidelines and consensus were included. The average score for each field of AGREE II was 53.73% for scope and purpose, 39.26% for participants, 39.57% for rigor, 46.76% for clarity, 30.23% for application and 49.18% for editorial independence. Items 1a, 1b, 3, and 4 (100.00%) had the highest reporting rate in the RIGHT evaluation items, followed by items 19a (97.05%), 2/19b (94.11%), 20 (91.17%), 7b/11a (88.23%), and 7a (85.29%). The reporting rate of the remaining items was below 60%. Subgroup analysis results showed that the average score and RIGHT score of the guidance class in the four fields of AGREE Ⅱ (rigor, clarity, application and editorial independence) were higher than those of the consensus class. Guidelines and consensus formulated based on evidence-based medicine methods were higher than those formulated based on expert opinions or reviews in the three fields of AGREE II (rigor, application and editorial independence). The average scores of foreign guidelines and consensus in 6 fields and RIGHT scores of AGREE Ⅱ were higher than those of domestic guidelines and consensus. Conclusion The AGREE Ⅱ of 6 fields average score and RIGHT score in foreign guidelines are higher than those in domestic guidelines.

Citation： WANG Daoxin, LIU Nan, SHI Zeyuan, LI Haiyun, PENG Huizhen, ZHAO Wenli. Evaluation of clinical guidelines and consensus on the quality of central venous catheters. Chinese Journal of Evidence-Based Medicine, 2023, 23(8): 955-962. doi: 10.7507/1672-2531.202211140 Copy

1.	Lutwick L, Al-Maani AS, Mehtar S, et al. Managing and preventing vascular catheter infections: a position paper of the international society for infectious diseases. Int J Infect Dis, 2019, 84: 22-29.
2.	Gorski LA, Hadaway L, Hagle ME, et al. Infusion therapy standards of practice, 8th edition. J Infus Nurs, 2021, 44(Suppl 1): S1-S224.
3.	马力, 刘运江, 刘荫华. 中国乳腺癌中心静脉血管通路临床实践指南(2022版). 中国实用外科杂志, 2022, 42(2): 151-158.
4.	Heijting IE, Antonius TAJ, Tostmann A, et al. Sustainable neonatal CLABSI surveillance: consensus towards new criteria in the Netherlands. Antimicrob Resist Infect Control, 2021, 10(1): 31.
5.	亚洲急危重症协会中国腹腔重症协作组. 重症患者中心静脉导管管理中国专家共识(2022版). 中华消化外科杂志, 2022, 21(3): 313-322.
6.	田昕彤, 马腾, 孙璇, 等. 老年高血压临床指南现状分析及质量评价. 中国全科医学, 2022, 25(34): 4259-4266.
7.	沙茵茵, 徐立然, 马秀霞, 等. 成人艾滋病临床指南和共识的质量评价. 中国循证医学杂志, 2022, 22(6): 706-715.
8.	Roselló S, Blasco I, García Fabregat L, et al. Management of infusion reactions to systemic anticancer therapy: ESMO clinical practice guidelines. Ann Oncol, 2017, 28(Suppl 4): iv100-iv118.
9.	National Clinical Guideline Centre (UK). Infection: prevention and control of healthcare-associated infections in primary and community care: partial update of NICE clinical guideline 2. London: Royal College of Physicians (UK), 2012.
10.	Javeri Y, Jagathkar G, Dixit S, et al. Indian society of critical care medicine position statement for central venous catheterization and management 2020. Indian J Crit Care Med, 2020, 24(Suppl 1): S6-S30.
11.	de la Fuente R, Fuentes R, Munoz-Gama J, et al. Delphi method to achieve clinical consensus for a BPMN representation of the central venous access placement for training purposes. Int J Environ Res Public Health, 2020, 17(11): 3889.
12.	Chopra V, Flanders SA, Saint S, et al. The Michigan appropriateness guide for intravenous catheters (MAGIC): results from a multispecialty panel using the RAND/UCLA appropriateness method. Ann Intern Med, 2015, 163(6 Suppl): S1-S40.
13.	Pittiruti M, Hamilton H, Biffi R, et al. ESPEN guidelines on parenteral nutrition: central venous catheters (access, care, diagnosis and therapy of complications). Clin Nutr, 2009, 28(4): 365-377.
14.	Sousa B, Furlanetto J, Hutka M, et al. Central venous access in oncology: ESMO clinical practice guidelines. Ann Oncol, 2015, 26 Suppl 5: v152-v168.
15.	Loveday HP, Wilson JA, Pratt RJ, et al. epic3: national evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England. J Hosp Infect, 2014, 86 Suppl 1: S1-S70.
16.	Frykholm P, Pikwer A, Hammarskjöld F, et al. Clinical guidelines on central venous catheterisation. Swedish Society of Anaesthesiology and Intensive Care Medicine. Acta Anaesthesiol Scand, 2014, 58(5): 508-524.
17.	Practice guidelines for central venous access 2020: an updated report by the American Society of Anesthesiologists Task Force on Central Venous Access. Anesthesiology, 2020, 132(1): 8-43.
18.	Cheng YL, Tang HL, Tong MKL. Clinical practice guidelines for the provision of renal service in Hong Kong: haemodialysis. Nephrology (Carlton), 2019, 24(Suppl 1): 41-59.
19.	Lok CE, Huber TS, Lee T, et al. KDOQI clinical practice guideline for vascular access: 2019 update. Am J Kidney Dis, 2020, 75(4 Suppl 2): S1-S164.
20.	Shroff R, Calder F, Bakkaloğlu S, et al. Vascular access in children requiring maintenance haemodialysis: a consensus document by the European Society for Paediatric Nephrology Dialysis Working Group. Nephrol Dial Transplant, 2019, 34(10): 1746-1765.
21.	Chaves F, Garnacho-Montero J, Del Pozo JL, et al. Diagnosis and treatment of catheter-related bloodstream infection: clinical guidelines of the Spanish Society of Infectious Diseases and Clinical Microbiology and (SEIMC) and the Spanish Society of Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICYUC). Med Intensiva (Engl Ed), 2018, 42(1): 5-36.
22.	Pittiruti M, Bertoglio S, Scoppettuolo G, et al. Evidence-based criteria for the choice and the clinical use of the most appropriate lock solutions for central venous catheters (excluding dialysis catheters): a GAVeCeLT consensus. J Vasc Access, 2016, 17(6): 453-464.
23.	Lomonte C, Forneris G, Gallieni M, et al. The vascular access in the elderly: a position statement of the Vascular Access Working Group of the Italian Society of Nephrology. J Nephrol, 2016, 29(2): 175-184.
24.	Hentrich M, Schalk E, Schmidt-Hieber M, et al. Central venous catheter-related infections in hematology and oncology: 2012 updated guidelines on diagnosis, management and prevention by the Infectious Diseases Working Party of the German Society of Hematology and Medical Oncology. Ann Oncol, 2014, 25(5): 936-947.
25.	Debourdeau P, Farge D, Beckers M, et al. International clinical practice guidelines for the treatment and prophylaxis of thrombosis associated with central venous catheters in patients with cancer. J Thromb Haemost, 2013, 11(1): 71-80.
26.	Keller S, Salinas A, Williams D, et al. Reaching consensus on a home infusion central line-associated bloodstream infection surveillance definition via a modified Delphi approach. Am J Infect Control, 2020, 48(9): 993-1000.
27.	Lamperti M, Bodenham AR, Pittiruti M, et al. International evidence-based recommendations on ultrasound-guided vascular access. Intensive Care Med, 2012, 38(7): 1105-1117.
28.	Ling ML, Apisarnthanarak A, Jaggi N, et al. APSIC guide for prevention of central line associated bloodstream infections (CLABSI). Antimicrob Resist Infect Control, 2016, 5: 16.
29.	中心静脉血管通路装置安全管理专家组. 中心静脉血管通路装置安全管理专家共识(2019版). 中华外科杂志, 2020, 58(4): 261-272.
30.	儿童静脉输液治疗临床实践循证指南工作组, 中华医学会儿科学分会护理学组(筹), 复旦大学附属儿科医院临床指南制作和评价中心. 儿童静脉输液治疗临床实践循证指南. 中国循证儿科杂志, 2021, 16(1): 1-42.
31.	陈琼, 李颖馨, 胡艳玲, 等. 新生儿经外周置入中心静脉导管操作及管理指南(2021). 中国当代儿科杂志, 2021, 23(3): 201-212.
32.	国家卫生健康委办公厅医政医管局. 血管导管相关感染预防与控制指南(2021版). 中国感染控制杂志, 2021, 20(4): 387-388.
33.	孙红, 陈利芬, 郭彩霞, 等. 临床静脉导管维护操作专家共识. 中华护理杂志, 2019, 54(9): 1334-1342.
34.	中心静脉导管冲管及封管共识专家组. 中心静脉导管冲管及封管专家共识. 中华急诊医学杂志, 2022, 31(4): 442-447.
35.	成芳, 傅麒宁, 何佩仪, 等. 输液导管相关静脉血栓形成防治中国专家共识(2020版). 中国实用外科杂志, 2020, 40(4): 377-383.
36.	张海军, 邹英华. 多普勒超声腔内心电一体化引导建立和维护中心血管通路专家共识. 中国介入影像与治疗学, 2020, 17(4): 193-197.

1. Lutwick L, Al-Maani AS, Mehtar S, et al. Managing and preventing vascular catheter infections: a position paper of the international society for infectious diseases. Int J Infect Dis, 2019, 84: 22-29.
2. Gorski LA, Hadaway L, Hagle ME, et al. Infusion therapy standards of practice, 8th edition. J Infus Nurs, 2021, 44(Suppl 1): S1-S224.
3. 马力, 刘运江, 刘荫华. 中国乳腺癌中心静脉血管通路临床实践指南(2022版). 中国实用外科杂志, 2022, 42(2): 151-158.
4. Heijting IE, Antonius TAJ, Tostmann A, et al. Sustainable neonatal CLABSI surveillance: consensus towards new criteria in the Netherlands. Antimicrob Resist Infect Control, 2021, 10(1): 31.
5. 亚洲急危重症协会中国腹腔重症协作组. 重症患者中心静脉导管管理中国专家共识(2022版). 中华消化外科杂志, 2022, 21(3): 313-322.
6. 田昕彤, 马腾, 孙璇, 等. 老年高血压临床指南现状分析及质量评价. 中国全科医学, 2022, 25(34): 4259-4266.
7. 沙茵茵, 徐立然, 马秀霞, 等. 成人艾滋病临床指南和共识的质量评价. 中国循证医学杂志, 2022, 22(6): 706-715.
8. Roselló S, Blasco I, García Fabregat L, et al. Management of infusion reactions to systemic anticancer therapy: ESMO clinical practice guidelines. Ann Oncol, 2017, 28(Suppl 4): iv100-iv118.
9. National Clinical Guideline Centre (UK). Infection: prevention and control of healthcare-associated infections in primary and community care: partial update of NICE clinical guideline 2. London: Royal College of Physicians (UK), 2012.
10. Javeri Y, Jagathkar G, Dixit S, et al. Indian society of critical care medicine position statement for central venous catheterization and management 2020. Indian J Crit Care Med, 2020, 24(Suppl 1): S6-S30.
11. de la Fuente R, Fuentes R, Munoz-Gama J, et al. Delphi method to achieve clinical consensus for a BPMN representation of the central venous access placement for training purposes. Int J Environ Res Public Health, 2020, 17(11): 3889.
12. Chopra V, Flanders SA, Saint S, et al. The Michigan appropriateness guide for intravenous catheters (MAGIC): results from a multispecialty panel using the RAND/UCLA appropriateness method. Ann Intern Med, 2015, 163(6 Suppl): S1-S40.
13. Pittiruti M, Hamilton H, Biffi R, et al. ESPEN guidelines on parenteral nutrition: central venous catheters (access, care, diagnosis and therapy of complications). Clin Nutr, 2009, 28(4): 365-377.
14. Sousa B, Furlanetto J, Hutka M, et al. Central venous access in oncology: ESMO clinical practice guidelines. Ann Oncol, 2015, 26 Suppl 5: v152-v168.
15. Loveday HP, Wilson JA, Pratt RJ, et al. epic3: national evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England. J Hosp Infect, 2014, 86 Suppl 1: S1-S70.
16. Frykholm P, Pikwer A, Hammarskjöld F, et al. Clinical guidelines on central venous catheterisation. Swedish Society of Anaesthesiology and Intensive Care Medicine. Acta Anaesthesiol Scand, 2014, 58(5): 508-524.
17. Practice guidelines for central venous access 2020: an updated report by the American Society of Anesthesiologists Task Force on Central Venous Access. Anesthesiology, 2020, 132(1): 8-43.
18. Cheng YL, Tang HL, Tong MKL. Clinical practice guidelines for the provision of renal service in Hong Kong: haemodialysis. Nephrology (Carlton), 2019, 24(Suppl 1): 41-59.
19. Lok CE, Huber TS, Lee T, et al. KDOQI clinical practice guideline for vascular access: 2019 update. Am J Kidney Dis, 2020, 75(4 Suppl 2): S1-S164.
20. Shroff R, Calder F, Bakkaloğlu S, et al. Vascular access in children requiring maintenance haemodialysis: a consensus document by the European Society for Paediatric Nephrology Dialysis Working Group. Nephrol Dial Transplant, 2019, 34(10): 1746-1765.
21. Chaves F, Garnacho-Montero J, Del Pozo JL, et al. Diagnosis and treatment of catheter-related bloodstream infection: clinical guidelines of the Spanish Society of Infectious Diseases and Clinical Microbiology and (SEIMC) and the Spanish Society of Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICYUC). Med Intensiva (Engl Ed), 2018, 42(1): 5-36.
22. Pittiruti M, Bertoglio S, Scoppettuolo G, et al. Evidence-based criteria for the choice and the clinical use of the most appropriate lock solutions for central venous catheters (excluding dialysis catheters): a GAVeCeLT consensus. J Vasc Access, 2016, 17(6): 453-464.
23. Lomonte C, Forneris G, Gallieni M, et al. The vascular access in the elderly: a position statement of the Vascular Access Working Group of the Italian Society of Nephrology. J Nephrol, 2016, 29(2): 175-184.
24. Hentrich M, Schalk E, Schmidt-Hieber M, et al. Central venous catheter-related infections in hematology and oncology: 2012 updated guidelines on diagnosis, management and prevention by the Infectious Diseases Working Party of the German Society of Hematology and Medical Oncology. Ann Oncol, 2014, 25(5): 936-947.
25. Debourdeau P, Farge D, Beckers M, et al. International clinical practice guidelines for the treatment and prophylaxis of thrombosis associated with central venous catheters in patients with cancer. J Thromb Haemost, 2013, 11(1): 71-80.
26. Keller S, Salinas A, Williams D, et al. Reaching consensus on a home infusion central line-associated bloodstream infection surveillance definition via a modified Delphi approach. Am J Infect Control, 2020, 48(9): 993-1000.
27. Lamperti M, Bodenham AR, Pittiruti M, et al. International evidence-based recommendations on ultrasound-guided vascular access. Intensive Care Med, 2012, 38(7): 1105-1117.
28. Ling ML, Apisarnthanarak A, Jaggi N, et al. APSIC guide for prevention of central line associated bloodstream infections (CLABSI). Antimicrob Resist Infect Control, 2016, 5: 16.
29. 中心静脉血管通路装置安全管理专家组. 中心静脉血管通路装置安全管理专家共识(2019版). 中华外科杂志, 2020, 58(4): 261-272.
30. 儿童静脉输液治疗临床实践循证指南工作组, 中华医学会儿科学分会护理学组(筹), 复旦大学附属儿科医院临床指南制作和评价中心. 儿童静脉输液治疗临床实践循证指南. 中国循证儿科杂志, 2021, 16(1): 1-42.
31. 陈琼, 李颖馨, 胡艳玲, 等. 新生儿经外周置入中心静脉导管操作及管理指南(2021). 中国当代儿科杂志, 2021, 23(3): 201-212.
32. 国家卫生健康委办公厅医政医管局. 血管导管相关感染预防与控制指南(2021版). 中国感染控制杂志, 2021, 20(4): 387-388.
33. 孙红, 陈利芬, 郭彩霞, 等. 临床静脉导管维护操作专家共识. 中华护理杂志, 2019, 54(9): 1334-1342.
34. 中心静脉导管冲管及封管共识专家组. 中心静脉导管冲管及封管专家共识. 中华急诊医学杂志, 2022, 31(4): 442-447.
35. 成芳, 傅麒宁, 何佩仪, 等. 输液导管相关静脉血栓形成防治中国专家共识(2020版). 中国实用外科杂志, 2020, 40(4): 377-383.
36. 张海军, 邹英华. 多普勒超声腔内心电一体化引导建立和维护中心血管通路专家共识. 中国介入影像与治疗学, 2020, 17(4): 193-197.

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