Background Peripheral intravenous catheters (PIVCs) contribute substantially to the global burden of infections. This systematic review assessed 24 infection prevention and control (IPC) interventions to prevent PIVC-associated infections and other complications. Methods We searched Ovid MEDLINE, Embase, Cochrane Library, WHO Global Index Medicus, CINAHL and reference lists for controlled studies, from January 1, 1980–March 16, 2023. We dually selected studies, assessed risk of bias, extracted data, and rated the certainty of evidence (COE). For outcomes with three or more trials, we conducted Bayesian random-effects meta-analyses. Results 105 studies met our prespecified eligibility criteria, addressing 16 of the 24 research questions; no studies were identified for eight research questions. Based on findings of low to high COE, wearing gloves reduced the risk for overall adverse events related to insertion compared to no gloves (one non-randomised controlled trial [RCT]; adjusted risk ratio [RR]: 0.52, 95% confidence interval 0.33–0.85), and catheter removal based on defined schedules potentially resulted in a lower phlebitis/thrombophlebitis incidence (10 RCTs; RR: 0.74, 95% credible interval 0.49–1.01) compared to clinically indicated removal in adults. In neonates, chlorhexidine reduced the phlebitis score compared to non-chlorhexidine-containing disinfection (one RCT; 0.14 versus 0.68, p = 0.003). No statistically significant differences were found for other measures. Conclusions Despite their frequent use and concern about PIVC-associated complications, this review underscores the urgent need for more high-quality studies on effective IPC methods regarding safe PIVC management. In the absence of valid evidence, adherence to standard precaution measures and documentation remain the most important principles to curb PIVC complications.

中文翻译：

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预防与外周静脉导管相关的感染和其他并发症的措施的有效性和安全性：系统评价和荟萃分析

背景 外周静脉导管 (PIVC) 极大地增加了全球感染负担。本系统评价评估了 24 种感染预防和控制 (IPC) 干预措施，以预防外周静脉相关感染和其他并发症。方法 我们检索了 Ovid MEDLINE、Embase、Cochrane Library、WHO Global Index Medicus、CINAHL 和对照研究的参考文献列表，时间为 1980 年 1 月 1 日至 2023 年 3 月 16 日。我们双重选择研究，评估偏倚风险，提取数据并评级证据的确定性（COE）。对于三个或更多试验的结果，我们进行了贝叶斯随机效应荟萃分析。结果 105 项研究符合我们预先设定的资格标准，解决了 24 个研究问题中的 16 个；没有确定八个研究问题的研究。根据从低到高 COE 的结果，与不戴手套相比，戴手套可降低与插入相关的总体不良事件的风险（一项非随机对照试验 [RCT]；调整后的风险比 [RR]：0.52，95% 置信区间 0.33 –0.85），与临床指示的成人拔除相比，根据规定的时间表拔除导管可能会降低静脉炎/血栓静脉炎的发生率（10 项随机对照试验；RR：0.74，95% 可信区间 0.49-1.01）。在新生儿中，与不含氯己定的消毒剂相比，氯己定降低了静脉炎评分（一项随机对照试验；0.14 与 0.68，p = 0.003）。其他指标没有发现统计学上的显着差异。结论 尽管这些方法被频繁使用并担心 PIVC 相关并发症，但本次综述强调迫切需要对有关安全 PIVC 管理的有效 IPC 方法进行更多高质量的研究。在缺乏有效证据的情况下，遵守标准预防措施和记录仍然是遏制 PIVC 并发症的最重要原则。