Chlorhexidine-impregnated dressing for the prophylaxis of central venous catheter-related complications: a systematic review and meta-analysis

Abstract Background Several randomized controlled trials (RCTs) evaluated the role of Chlorhexidine-impregnated dressing for prophylaxis of central venous catheter (CVC) related complications, but the results remained inconsistent, updated meta-analyses on this issue are warranted. Methods A meta-an...

Full description

Bibliographic Details
Main Authors: Li Wei, Yan Li, Xiaoyan Li, Lanzheng Bian, Zunjia Wen, Mei Li
Format: Article
Language:English
Published: BMC 2019-05-01
Series:BMC Infectious Diseases
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12879-019-4029-9
id doaj-fd91859271364f96bcc49f27606c954d
record_format Article
spelling doaj-fd91859271364f96bcc49f27606c954d2020-11-25T03:58:30ZengBMCBMC Infectious Diseases1471-23342019-05-0119111210.1186/s12879-019-4029-9Chlorhexidine-impregnated dressing for the prophylaxis of central venous catheter-related complications: a systematic review and meta-analysisLi Wei0Yan Li1Xiaoyan Li2Lanzheng Bian3Zunjia Wen4Mei Li5Children’s Hospital of Nanjing Medical UniversityChildren’s Hospital of Nanjing Medical UniversityChildren’s Hospital of Nanjing Medical UniversityChildren’s Hospital of Nanjing Medical UniversityChildren’s Hospital of Nanjing Medical UniversityChildren’s Hospital of Nanjing Medical UniversityAbstract Background Several randomized controlled trials (RCTs) evaluated the role of Chlorhexidine-impregnated dressing for prophylaxis of central venous catheter (CVC) related complications, but the results remained inconsistent, updated meta-analyses on this issue are warranted. Methods A meta-analysis on the RCTs comparing Chlorhexidine-impregnated dressing versus other dressing or no dressing for prophylaxis of central venous catheter-related complications was performed. A comprehensive search of major databases was undertaken up to 30 Dec 2018 to identify related studies. Pooled odd ratio (OR) and mean differences (MDs) with 95% confidence intervals (CI) were calculated using either a fixed-effects or random-effects model. Subgroup analysis was performed to identify the source of heterogeneity, and funnel plot and Egger test was used to identify the publication bias. Results A total of 12 RCTs with 6028 patients were included. The Chlorhexidine-impregnated dressings provided significant benefits in reducing the risk of catheter colonization (OR = 0.46, 95% CI: 0.36 to 0.58), decreasing the incidence of catheter-related bloodstream infection (CRBSI) (OR = 0.60, 95% CI: 0.42 to 0.85). Subgroup analysis indicated that the Chlorhexidine-impregnated dressings were conducive to reduce the risk of catheter colonization and CRBSI within the included RCTs with sample size more than 200, but the differences weren’t observed for those with sample less than 200. No publication bias was observed in the Egger test for the risk of CRBSI. Conclusions Chlorhexidine-impregnated dressing is beneficial to prevent CVC-related complications. Future studies are warranted to assess the role and cost-effectiveness of Chlorhexidine-impregnated dressings.http://link.springer.com/article/10.1186/s12879-019-4029-9ChlorhexidineCRBSICentral venous catheterNursing careNosocomial infection
collection DOAJ
language English
format Article
sources DOAJ
author Li Wei
Yan Li
Xiaoyan Li
Lanzheng Bian
Zunjia Wen
Mei Li
spellingShingle Li Wei
Yan Li
Xiaoyan Li
Lanzheng Bian
Zunjia Wen
Mei Li
Chlorhexidine-impregnated dressing for the prophylaxis of central venous catheter-related complications: a systematic review and meta-analysis
BMC Infectious Diseases
Chlorhexidine
CRBSI
Central venous catheter
Nursing care
Nosocomial infection
author_facet Li Wei
Yan Li
Xiaoyan Li
Lanzheng Bian
Zunjia Wen
Mei Li
author_sort Li Wei
title Chlorhexidine-impregnated dressing for the prophylaxis of central venous catheter-related complications: a systematic review and meta-analysis
title_short Chlorhexidine-impregnated dressing for the prophylaxis of central venous catheter-related complications: a systematic review and meta-analysis
title_full Chlorhexidine-impregnated dressing for the prophylaxis of central venous catheter-related complications: a systematic review and meta-analysis
title_fullStr Chlorhexidine-impregnated dressing for the prophylaxis of central venous catheter-related complications: a systematic review and meta-analysis
title_full_unstemmed Chlorhexidine-impregnated dressing for the prophylaxis of central venous catheter-related complications: a systematic review and meta-analysis
title_sort chlorhexidine-impregnated dressing for the prophylaxis of central venous catheter-related complications: a systematic review and meta-analysis
publisher BMC
series BMC Infectious Diseases
issn 1471-2334
publishDate 2019-05-01
description Abstract Background Several randomized controlled trials (RCTs) evaluated the role of Chlorhexidine-impregnated dressing for prophylaxis of central venous catheter (CVC) related complications, but the results remained inconsistent, updated meta-analyses on this issue are warranted. Methods A meta-analysis on the RCTs comparing Chlorhexidine-impregnated dressing versus other dressing or no dressing for prophylaxis of central venous catheter-related complications was performed. A comprehensive search of major databases was undertaken up to 30 Dec 2018 to identify related studies. Pooled odd ratio (OR) and mean differences (MDs) with 95% confidence intervals (CI) were calculated using either a fixed-effects or random-effects model. Subgroup analysis was performed to identify the source of heterogeneity, and funnel plot and Egger test was used to identify the publication bias. Results A total of 12 RCTs with 6028 patients were included. The Chlorhexidine-impregnated dressings provided significant benefits in reducing the risk of catheter colonization (OR = 0.46, 95% CI: 0.36 to 0.58), decreasing the incidence of catheter-related bloodstream infection (CRBSI) (OR = 0.60, 95% CI: 0.42 to 0.85). Subgroup analysis indicated that the Chlorhexidine-impregnated dressings were conducive to reduce the risk of catheter colonization and CRBSI within the included RCTs with sample size more than 200, but the differences weren’t observed for those with sample less than 200. No publication bias was observed in the Egger test for the risk of CRBSI. Conclusions Chlorhexidine-impregnated dressing is beneficial to prevent CVC-related complications. Future studies are warranted to assess the role and cost-effectiveness of Chlorhexidine-impregnated dressings.
topic Chlorhexidine
CRBSI
Central venous catheter
Nursing care
Nosocomial infection
url http://link.springer.com/article/10.1186/s12879-019-4029-9
work_keys_str_mv AT liwei chlorhexidineimpregnateddressingfortheprophylaxisofcentralvenouscatheterrelatedcomplicationsasystematicreviewandmetaanalysis
AT yanli chlorhexidineimpregnateddressingfortheprophylaxisofcentralvenouscatheterrelatedcomplicationsasystematicreviewandmetaanalysis
AT xiaoyanli chlorhexidineimpregnateddressingfortheprophylaxisofcentralvenouscatheterrelatedcomplicationsasystematicreviewandmetaanalysis
AT lanzhengbian chlorhexidineimpregnateddressingfortheprophylaxisofcentralvenouscatheterrelatedcomplicationsasystematicreviewandmetaanalysis
AT zunjiawen chlorhexidineimpregnateddressingfortheprophylaxisofcentralvenouscatheterrelatedcomplicationsasystematicreviewandmetaanalysis
AT meili chlorhexidineimpregnateddressingfortheprophylaxisofcentralvenouscatheterrelatedcomplicationsasystematicreviewandmetaanalysis
_version_ 1724456927660867584