Comparison of Ultrasound Guided and Conventional Techniques for Peripheral Venous Catheter Insertion in Pediatric Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Abstract

BackgroundUltrasound guided cannulation for peripheral venous insertion is a well-established methodology. However, there has never been a systematic review completed to synthesize evidence within the pediatric population. The current systematic review and meta-analysis was completed to compare the efficacy and safety profile of ultrasound guided peripheral cannulation against the conventional palpation technique within pediatric patients.MethodsA comprehensive search was conducted within the digital databases including Medline, EMBASE, ScienceDirect, Google Scholar and Cochrane library from inception until August 2021. A meta-analysis was then completed with random-effects model and reported pooled risk ratio (RR) or standardized mean difference (SMD) with 95% confidence interval (CI).ResultsIn total, 9 studies were analyzed, which included 1,312 participants, and the majority of studies (5 out 9 studies) were considered high quality. Amongst efficacy outcomes, first attempt success rate had a pooled RR of 1.53 (95% CI: 1.14–2.04), overall success rate had a pooled RR of 1.13 (95% CI: 1.01–1.26), number of attempts before successful cannulation had a pooled SMD of −1.93 [95%CI: −3.44 to −0.42], time taken for successful cannulation had a pooled SMD of −0.46 [95%CI: −1.20 to 0.28], needle redirections before successful cannulation had a pooled SMD of −1.26 [95%CI: −2.47 to −0.06]. Amongst safety outcomes, venous extravasation had a pooled RR of 1.59 (95% CI: 0.99–2.54) and phlebitis had an RR of 0.31 (95% CI: 0.07–1.50).ConclusionWithin pediatric patients, ultrasound guided peripheral venous cannulation is more efficacious when compared to the conventional palpation technique.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021275305, identifier: CRD42021275305.