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：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

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

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.	乙蘇北, 王巖, 李丹, 等.經外周插管的中心靜脈導管的預處理對乳腺癌化療患者機械性靜脈炎發生率的影響.中國腫瘤臨床與康復, 2007, 14(1):93-95.
5.	楊潔, 王東平, 李薇.地塞米松浸泡PICC導管對預防靜脈炎的作用.南京醫科大學學報(自然科學版), 2008, 28(11):1523-1524.
6.	彭陽, 何美蓉, 蔡文智.慶大霉素和地塞米松擦拭導管預防PICC致機械性靜脈炎的效果觀察.護理學報, 2009, 16(6B):65-66.
7.	范植蓉, 王虹.肝素鈉和地塞米松浸泡PICC導管預防機械性靜脈炎.護理學雜志, 2010, 25(23):46-47.
8.	呂友紅, 薛敏芬, 趙全娣, 等.地塞米松預防PICC置管后機械性靜脈炎療效觀察.中國社區醫師(醫學專業), 2011, 13(14):79-80.
9.	邢彩英, 徐兵, 戴明紅, 等.地塞米松預防早產兒PICC靜脈炎的效果觀察.中華全科醫學, 2011, 9(6):986-987.
10.	曹維寧.地塞米松擦拭導管聯合雙氯芬酸二乙胺乳劑預防PICC致機械性靜脈炎的效果.全科護理, 2012, 10(5B):1266-1267.
11.	陳桂英, 王惠琴, 林丹妮.地塞米松預處理導管對PICC所致靜脈炎的預防作用.中華護理雜志, 2012, 47(1):6-9.
12.	康建榮.改進置管法對PICC所致機械性靜脈炎的影響.中國臨床護理, 2012, 4(3):195-196.
13.	李毅, 蔣永豐.地塞米松沖管聯合喜療妥外涂預防PICC置管后的機械性靜脈炎的療效分析.中國實用醫藥, 2012, 7(30):182-183.
14.	錢玉蘭, 陸勤美, 張蘭鳳, 等.地塞米松肝素鹽水預防PICC靜脈炎的臨床研究.實用臨床醫藥雜志, 2012, 16(10):15-16.
15.	尤從香, 張麗華, 張桂珍.預防性護理干預降低PICC導管致機械性靜脈炎的效果評價.臨床護理雜志, 2012, 11(3):70-72.
16.	趙煥利, 陸印, 冒美娟.地塞米松浸泡導管預防PICC置管所致機械性靜脈炎效果分析.護士進修雜志, 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.	唐軍, 熊英.肝素預防新生兒經外周中心靜脈置管相關感染的回顧性研究.中國循證醫學雜志, 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.

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. 乙蘇北, 王巖, 李丹, 等.經外周插管的中心靜脈導管的預處理對乳腺癌化療患者機械性靜脈炎發生率的影響.中國腫瘤臨床與康復, 2007, 14(1):93-95.
5. 楊潔, 王東平, 李薇.地塞米松浸泡PICC導管對預防靜脈炎的作用.南京醫科大學學報(自然科學版), 2008, 28(11):1523-1524.
6. 彭陽, 何美蓉, 蔡文智.慶大霉素和地塞米松擦拭導管預防PICC致機械性靜脈炎的效果觀察.護理學報, 2009, 16(6B):65-66.
7. 范植蓉, 王虹.肝素鈉和地塞米松浸泡PICC導管預防機械性靜脈炎.護理學雜志, 2010, 25(23):46-47.
8. 呂友紅, 薛敏芬, 趙全娣, 等.地塞米松預防PICC置管后機械性靜脈炎療效觀察.中國社區醫師(醫學專業), 2011, 13(14):79-80.
9. 邢彩英, 徐兵, 戴明紅, 等.地塞米松預防早產兒PICC靜脈炎的效果觀察.中華全科醫學, 2011, 9(6):986-987.
10. 曹維寧.地塞米松擦拭導管聯合雙氯芬酸二乙胺乳劑預防PICC致機械性靜脈炎的效果.全科護理, 2012, 10(5B):1266-1267.
11. 陳桂英, 王惠琴, 林丹妮.地塞米松預處理導管對PICC所致靜脈炎的預防作用.中華護理雜志, 2012, 47(1):6-9.
12. 康建榮.改進置管法對PICC所致機械性靜脈炎的影響.中國臨床護理, 2012, 4(3):195-196.
13. 李毅, 蔣永豐.地塞米松沖管聯合喜療妥外涂預防PICC置管后的機械性靜脈炎的療效分析.中國實用醫藥, 2012, 7(30):182-183.
14. 錢玉蘭, 陸勤美, 張蘭鳳, 等.地塞米松肝素鹽水預防PICC靜脈炎的臨床研究.實用臨床醫藥雜志, 2012, 16(10):15-16.
15. 尤從香, 張麗華, 張桂珍.預防性護理干預降低PICC導管致機械性靜脈炎的效果評價.臨床護理雜志, 2012, 11(3):70-72.
16. 趙煥利, 陸印, 冒美娟.地塞米松浸泡導管預防PICC置管所致機械性靜脈炎效果分析.護士進修雜志, 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. 唐軍, 熊英.肝素預防新生兒經外周中心靜脈置管相關感染的回顧性研究.中國循證醫學雜志, 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

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content