Prevention of skin antiseptic solutions for intravascular catheter-related infection in intensive care unit:a network Meta-analysis
Objective To systematically review the effect of skin antiseptic solutions for the prevention of intravascular catheter-related infection in critically ill patients.Methods PubMed,Cochrane Library,CNKI and Wanfang Data were searched to collect randomized controlled trials(RCTs)of skin disinfectantsin intensive care units with vascular catheter from inception to October 8th,2022.Statistical analysis was performed by Stata 17 and R 4.2 software.Results A total of 8 RCTs involving 4 990 patients and 8 749 catheters with eight antiseptic agents including 0.5%,1%and 2%CHG-alcohol,2%CHG-aqueous,CHG mixedsolution(0.25%chlorhexidine gluconate,0.025%benzalkonium chloride,and 4%benzylic alcohol,CBB),10%povidone-iodine(PVI),5%PVI-alcohol and 70%isopropyl alcohol were included.The network Meta-analysis showed that 2%CHG-alcohol had a significant reduction in the incidence of catheter colonization compared with 5%PVI-alcohol(OR=0.18,95%CI 0.04-0.89).The probabily rank were 2%CHG-alcohol>CBB>2%CHG-aqueous>1%CHG-alcohol>5%PVI-alcohol>0.5%CHG-alcohol>70%isopropyl alcohol>10%PVI.In reducing the catheter-related bloodstream infections,there was no statistically significant difference among the eight skin disinfectants,and the probabily rank were 2%CHG-alcohol>CBB>1%CHG-alcohol>2%CHG-aqueous>0.5%CHG-alcohol>70%isopropyl alcohol>5%PVI-alcohol>10%PVI.Conclusions 2%CHG-alcohol is a priority choice for the prevention and control of intravascular catheter-related infection in critically ill patients.
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