Efectividad de nuevos métodos para canalización venosa periférica en edad pediátrica. Revisión sistemática y metaanálisis

• Autores: Francisca Zamora Zamora, Juana Gómez Macías, Mª Quiteria Rosa Barrios
• Localización: Metas de enfermería, ISSN 1138-7262, Vol. 21, Nº. 3, 2018, pág. 7
• Idioma: español
• DOI: 10.35667/metasenf.2019.21.1003081211
• Títulos paralelos:
  • Efficacy of new methods for peripheral venous catheterization in paediatric patients: A systematic review and meta-analysis
• Texto completo no disponible (Saber más ...)
• Resumen
  • español

    Objetivo: analizar la eficacia de diferentes métodos en el éxito en el primer intento de la canalización venosa periférica en edad pediátrica.

    Método: revisión sistemática con metaanálisis de ensayos clínicos aleatorizados (ECA). Búsqueda en diversas bases de datos: PubMed, Cochrane Plus, Medline, Scielo, Dare, Embase, Clinicaltrials.gov, Lilacs, y búsqueda inversa (hasta junio 2016), sin límites de tiempo ni de idioma. Se incluyeron ECA que compararon diversos métodos de canalización con el método tradicional y determinaron el éxito al primer intento en menores de 18 años. Se valoró la calidad del diseño y el riesgo de sesgo de los ECA. Se usó el programa Review Manager versión 5.3. El estimador del efecto fue el riesgo relativo (RR), con intervalo de confianza al 95% (IC95%). Significación estadística si p< 0,05.

    Resultados: se revisaron 813 estudios, se incluyeron 24 ECA. El uso de nuevos métodos actuó como factor protector frente al fallo de canalización RR (IC 95%)= 0,63 (0,49-0,83) (p< 0,001); heterogeneidad: I2= 67% (p< 0,001). La transiluminación y anestésicos tópicos disminuyeron la probabilidad de fallo de canalización en un 56% y 46%, respectivamente. La sedación (p= 0,02) y el efecto de la analgesia (p= 0,001) influyeron significativamente en los resultados. La ecografía, nitroglicerina tópica y dispositivos de luz de infrarrojo cercano no disminuyeron el riesgo de fallo de canalización. La edad explicó el 74,8% de la heterogeneidad (modelo de metaregresión de efectos aleatorios).

    Conclusión: la aplicación de nuevos métodos de canalización aumentó la probabilidad de éxito al primer intento.

  • English

    Objective: to analyze the efficacy of different methods for success at first attempt of peripheral venous catheterization in paediatric patients.

    Method: a systematic review with meta-analysis of randomized clinical trials (RCTs). Search in different databases: PubMed, Cochrane Plus, Medline, Scielo, Dare, Embase, Clinicaltrials.gov, Lilacs, and reverse search (until June, 2016), without time or language limitations. The study included RCTs comparing different catheterization methods vs. the traditional method, and determined the success at first attempt in patients < 18-year-old. There was an assessment of the quality of design and risk of bias of the RCTs; the Review Manager program, version 5.3, was used. The effect estimator was relative risk (RR), with 95% confidence interval (CI95%). Statistical significance if p< 0.05.

    Results: there was a review of 831 studies, and 24 RCTs were included. The use of new methods acted as a factor protecting against RR of catheterization failure (CI95%)= 0.63 (0.49-0.83) (p< 0.001); heterogeneity: I2=67% (p< 0.001). Transillumination and topical anaesthetics reduced the probability of catheterization failure by 56% and 46%, respectively. Sedation (p= 0.02) and the effect of analgesia (p= 0.001) had significant impact on results. Ultrasound test, topical nitroglycerin and near infrared light devices did not reduce the risk of catheterization failure. Age explained the 74.8% heterogeneity (random effect meta-regression model).

    Conclusion: the use of new catheterization methods led to an increase in the probability of success at first attempt.

• Referencias bibliográficas
  • Rauch D, Dowd D, Eldridge D, Mace S, Schears G, Yen K. Peripheral difficult venous access in 31 children. Clin Pediatr (Phila). 2009; 48:895-901.
  • Minville V, Pianezza A, Asehnoune K, Cabardis S, Smail N. Prehospital intravenous line placement assessment in the French emergency system:...
  • Lininger RA. Pediatric peripheral i.v. insertion success rates. Pediatr Nurs. 2003; 29:351-4.
  • O’Neill MB, Dillane M, Hanipah NF. Validating the difficult intravenous access clinical prediction rule. Pediatr Emerg Care. 2012; 28:1314-6.
  • Benkhadra M, Collignon M, Fournel I, Oeuvrard C, Rollin P, Perrin M, et al. Ultrasound guidance allows faster peripheral IV cannulation in...
  • Newbury C, Herd DW. Amethocaine versus EMLA for successful intravenous cannulation in a children’s emergency department: a randomised controlled...
  • Andrew M, Barker D, Laing R. The use of glyceryl trinitrate ointment with EMLA cream for i.v. cannulation in children under-going routine...
  • Hosokawa K, Kato H, Kishi C, Kato Y, Shime N. Transillumination by light-emitting diode facilitates peripheral venous cannulations in infants...
  • Kaddoum RN, Anghelescu DL, Parish ME, Wright BB, Trujillo L, Wu J, et al. A randomized controlled trial comparing the AccuVein AV300 device...
  • Urrutia G, Bonfil X. Declaración PRISMA: una propuesta para mejorar la publicación de revisiones sistemáticas y metaanálisis. Med Clin (Barc)....
  • R Core Team. R: A language and environment for statistical computing. R Foundation for Statistical Computing [internet] 2014 [cited 16 mar...
  • Black KJ, Pusic MV, Harmidy D, McGillivray D. Pediatric intravenous insertion in the emergency department: bevel up or bevel down? Pediatr...
  • Arendts G, Stevens M, Fry M. Topical anaesthesia and intravenous cannulation success in paediatric patients: a randomized double-blind trial....
  • Farion KJ, Splinter KL, Newhook K, Gaboury I, Splinter WM. The effect of vapocoolant spray on pain due to intravenous cannulation in children:...
  • Taddio A, Soin HK, Schuh S, Koren G, Scolnik D. Liposomal lidocaine to improve procedural success rates and reduce procedural pain among children:...
  • De Carvalho Onofre PS, da Luz Gonçalves Pedreira M, Peterlini MA. Placement of peripherally inserted central catheters in children guided...
  • Chapman LL, Sullivan B, Pacheco AL, Draleau CP, Becker BM. VeinvViewer-assisted Intravenous catheter placement in a pediatric emergency department....
  • Kim MJ, Park JM, Rhee N, Je SM, Hong SH, Lee YM, et al. Efficacy of VeinViewer in pediatric peripheral intravenous access: a randomized controlled...
  • Szmuk P, Steiner J, Pop RB, Farrow-Gillespie A, Mascha EJ, Sessler DI. The VeinViewer vascular imaging system worsens first-attempt cannulation...
  • Simhi E, Kachko L, Bruckheimer E, Katz J. A vein entry indicator device for facilitating peripheral intravenous cannulation in children: a...
  • Curtis SJ, Craig WR, Logue E, Vandermeer B, Hanson A, Klassen T. Ultrasound or near-infrared vascular imaging to guide peripheral intravenous...
  • Yamazaki S, Tomita S, Watanabe M, Kawaai H, Shimamura K. Effects of a transmitted light device for pediatric peripheral venipuncture and intravenous...
  • Singer AJ, Taira BR, Chisena EN, Gupta N, Chipley J. Warm lidocaine/tetracaine patch versus placebo before pediatric intravenous cannulation:...
  • Vaksmann G, Rey C, Dupuis C. Value of percutaneous trinitrin to facilitate access to the peripheral venous system in infants. Arch Fr Pediatr....
  • Avelar AF, Peterlini MA, da Pedreira ML. Assertiveness and peripheral intravenous catheters dwell time with ultrasonography-guided insertion...
  • Cuper NJ, de Graaff JC, Verdaasdonk RM, Kalkman CJ. Near-infrared imaging in intravenous cannulation in children: a cluster randomized clinical...
  • Maynard EC, Oh W. Topical nitroglycerin ointment as an aid to insertion of peripheral venous catheters in neonates. J Pediatr.1989; 114:474-6.
  • Sun CY, Lee KC, Lin IH, Wu CL, Huang HP, Lin YY, et al. Near-infrared light device can improve intravenous cannulation in critically ill children....
  • Zempsky WT, Anand KJ, Sullivan KM, Fraser D, Cucina K. Lidocaine iontophoresis for topical anesthesia before intravenous line placement in...
  • Nager A, Karasic R. Use of transillumination to assist placement of intravenous catheters in the pediatric emergency department. Pediatr Emerg...
  • Yen K, Riegert A, Gorelick MH. Derivation of the DIVA score: a clinical prediction rule for the identification of children with difficult...
  • Heinrichs J, Fritze Z, Klassen T, Curtis S. A systematic review and meta-analysis of new interventions for peripheral intravenous cannulation...