Affiliation:
1. Teaching and Research Section of Clinical Nursing, Xiangya Hospital Central South University Changsha China
2. National Clinical Research Center for Geriatric Disorders, Xiangya Hospital Central South University Changsha China
3. Xiangya School of Nursing Central South University Changsha China
4. Xiangya Research Center of Evidence‐based Healthcare Central South University Changsha China
5. Xiangya Center for Evidence‐Based Practice & Healthcare Innovation: A Joanna Briggs Institute Affiliated Group Central South University Changsha China
Abstract
AbstractBackgroundCatheter‐related thrombosis is a common complication of the peripherally inserted central catheter (PICC) in neonates, leading to unintended tube removal and significantly affecting neonatal health and safety. Despite widespread reporting on the estimated occurrence and factors contributing to neonatal PICC‐related thrombosis, these findings have not been synthesized.ObjectivesThe purpose of this study was to determine the incidence and risk factors of neonatal PICC‐related thrombosis.DesignSystematic literature review and meta‐analysis.MethodsTwo independent researchers systematically explored multiple databases—such as PubMed, Medline, Embase and the Cochrane Library—from their inception until October 2023. Our study aggregates and scrutinizes studies specifically addressing the incidence and risk factors of neonatal PICC‐related thrombosis. Employing the RevMan 5.3 software, a meta‐analysis was executed to determine the incidence of both thrombosis and odds ratios (OR), accompanied by their respective 95% confidence intervals (CI) for the risk factors.ResultsA total of 327 articles were screened, and data from 24 studies were used in synthesis. Neonatal PICC‐related thrombosis incidence varied from 0.23% to 17.91%. The pooled incidence was 2% (95% CI: 1%–2%; I2 = 94%; p < .0001). The study identified 12 risk factors, including insertion sites in the lower extremities (OR = 0.22; 95% CI: 0.09–0.56; p = .001), gestational age <28 weeks, abdominal pathology, fresh frozen plasma by day 5 > 50 mL/kg, PICC tip location (proximal placement), two lumens, three lumens, prolonged hospital stay, infection, mothers' use of anticoagulants, patients with cardiac insufficiency and being twin‐to‐twin transfusion syndrome donor.ConclusionsThe analysis indicates an overall pooled incidence of neonatal PICC‐related thrombosis of 2%. Twelve factors were identified as risks associated with neonatal PICC‐related thrombosis. Understanding the risk factors can provide evidence‐based recommendations for improving awareness, control and treatment and better nursing management.Relevance to Clinical PracticeThis systematic review and meta‐analysis illuminates the incidence and risk factors linked to neonatal PICC‐related thrombosis, delivering essential insights pivotal for clinical decision‐making and enhancing patient care within neonatal health care settings.