Network Meta-analysis of the Safety and Efficacy of Different Routes of Implanting Central Venous Catheters
Objective To compare the safety and efficacy of central venous catheter(CVC)im-plantation via the internal jugular vein,subclavian vein,and axillary vein through network meta-a-nalysis,and to provide evidence-based support for the clinical selection of the optimal route of central venous catheter puncture.Methods Chinese and English databases,including China Na-tional Knowledge Infrastructure(CNKI),Wanfang Data,Wipu,China Biomedical Literature,PubMed,Web of Science and Cochrane Library,Cochrane library and Embase,were systematically searched;literature on different implantation routes of central venous catheters published as of 2022 were searched;Review Manager 5.3 software was used for traditional Meta-analysis and Sta-ta 14.0 software for network meta-analysis.Results A total of 18 randomized controlled trials with 6746 subjects were included.Meta-analysis showed that the three routes were statistically significant in the comparison of catheter placement complications and first puncture success rate(P＜0.05).The incidence of artery mispenetration was higher in the subclavian vein group than in the axillary vein group[RR(95％CI):2.36(1.02,5.45)],the incidence of pneumothorax was higher than that in the axillary vein group[RR(95％CI):2.36(1.03,5.39)]and the internal jugu-lar vein group[RR(95％CI):2.34(1.14,4.80)],and the incidence of catheter-related infection in the internal jugular vein group was higher than in the subclavian vein group[RR(95％CI):0.34(0.16,0.69)],all of which were statistically significant(P＜0.05).Conclusion CVC implantation via axillary vein can have advantages in the comparison of first puncture success rate and compli-cation rate,and the axillary vein route can be preferred for clinical CVC implantation,but the pa-tient's condition should be fully considered and the optimal route should be selected for implanta-tion of CVC in an individualized manner.
central venous catheterinternal jugular veinsubclavian veinaxillary veinNetwork meta-analysis
万方数据
维普
