Cochrane · systematic review · CD007798
Clinically‐indicated replacement versus routine replacement of peripheral venous catheters
Webster, J, Osborne, S, Rickard, CM, et al. · Cochrane Database of Systematic Reviews · 2019 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
7
current version
GRADE rated
7
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 0 · 0%Low 1 · 14.3%Moderate 6 · 85.7%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyEffects of clinically‐indicated replacement compared to routine change of peripheral intravenous catheters
Population: any patient requiring a PIVC expected to remain in‐situ for at least 3 days
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Catheter‐related blood stream infection (during hospitalisation) Effects of clinically‐indicated replacement vs routine change of peripheral intravenous catheters | RR 0.61 [0.08, 4.68] | 7 studies · 7323 participants | Low Downgraded: inconsistency |
Thrombophlebitis (during hospitalisation) Effects of clinically‐indicated replacement vs routine change of peripheral intravenous catheters | RR 1.07 [0.93, 1.25] | 7 studies · 7323 participants | Moderate Downgraded: risk of bias |
Thrombophlebitis (per device days) (during hospitalisation) Effects of clinically‐indicated replacement vs routine change of peripheral intravenous catheters | RR 0.9 [0.76, 1.08] | 6 studies · 32709 participants | Moderate Downgraded: risk of bias |
All‐cause blood stream infection (during hospitalisation) Effects of clinically‐indicated replacement vs routine change of peripheral intravenous catheters | RR 0.47 [0.15, 1.53] | 1 study · 3283 participants | Moderate Downgraded: inconsistency |
Cost (during hospitalisation) Effects of clinically‐indicated replacement vs routine change of peripheral intravenous catheters | no estimate extracted | 3 studies · 4244 participants | Moderate Downgraded: risk of bias |
Infiltration (during hospitalisation) Effects of clinically‐indicated replacement vs routine change of peripheral intravenous catheters | RR 1.16 [1.06, 1.26] | 6 studies · 7123 participants | Moderate Downgraded: risk of bias |
Catheter blockage (during hospitalisation) Effects of clinically‐indicated replacement vs routine change of peripheral intravenous catheters | RR 1.14 [1.01, 1.29] | 7 studies · 7323 participants | Moderate Downgraded: risk of bias |
Clinically‐indicated versus routine changes for peripheral venous catheter‐related complications
Population: patients with peripheral venous catheter‐related complications
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Catheter‐related bloodstream infection Positive blood culture from a peripheral vein; clinical signs of infection; no other apparent source for the bloodstream infection except the intravenous catheter; and colonised intravenous catheter tip cultu... Clinically‐indicated vs routine changes | RR 0.61 [0.08, 4.68] | 5 studies · 4806 participants | Moderate Downgraded: risk of bias, inconsistency |
Phlebitis Any definition used by the author Clinically‐indicated vs routine changes | RR 1.14 [0.93, 1.39] | 5 studies · 4806 participants | High |
All‐cause bloodstream infection Clinically‐indicated vs routine changes | RR 0.47 [0.15, 1.53] | 1 study · 3283 participants | High |
Cost Estmated. Based on materials and staff costs5,6 Clinically‐indicated vs routine changes | no estimate extracted | 3 studies · 4244 participants | High |
Clinically‐indicated versus routine changes for peripheral venous catheter‐related complications
Population: patients with peripheral venous catheter‐related complications
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Catheter‐related bloodstream infection Positive blood culture from a peripheral vein; clinical signs of infection; no other apparent source for the bloodstream infection except the intravenous catheter; and colonised intravenous catheter tip cultu... Clinically‐indicated vs routine changes | RR 0.61 [0.08, 4.68] | 5 studies · 4806 participants | High |
Phlebitis Any definition used by the author Clinically‐indicated vs routine changes | RR 1.14 [0.93, 1.39] | 5 studies · 4806 participants | High |
All‐cause bloodstream infection Clinically‐indicated vs routine changes | RR 0.47 [0.15, 1.53] | 1 study · 3283 participants | High |
Cost Estmated. Based on materials and staff costs4,5 Clinically‐indicated vs routine changes | no estimate extracted | 3 studies · 4244 participants | High |
Routinely replaced peripheral intravenous catheters for preventing phlebitis and other intravenous catheter related complications
Population: patients with peripheral IV therapy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Catheter related bacteraemia Recording in patients medical record | OR 0.57 [0.17, 1.94] | 5 studies · 3408 participants | High |
Phlebitis | OR 1.24 [0.97, 1.6] | 6 studies · 3455 participants | High |
Cost Australian dollars10. Scale from: 30 to 100. | no estimate extracted | 2 studies · 961 participants | High |
Phlebitis per1000 device days Direct observation | OR 1.04 [0.81, 1.32] | 5 studies · 17201 participants | High |