PERIPHERALLY INSERTED CENTRAL CATHETER (PICC) IN NEONATAL INTENSIVE THERAPY NEWBORNS: SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CLINICAL TRIALS

Abstract

Objective: to identify and evaluate the effectiveness of the use of peripherally inserted central catheter (PICC) compared to the use of other intravenous catheters in newborns hospitalized in neonatal intensive care units. Method: This is a bibliographic study, a systematic review carried out according to the Cochrane methodology and regulations of the PRISMA check list. The Databases PubMed, EMBASE, Cochrane, Latin American and Caribbean Literature on Health Sciences (LILACS) were consulted until March 2021. Reviewers independently tracked eligible randomizedclinical trials (CRTs); extracted the data and assessed the risk of bias through the Cochraneapproach. Associations were reported as relative risks (RR) and their 95% confidence intervals (CI).Heterogeneity was tested with the Cochrane χ2 test, and the degree of heterogeneity quantified with statistics I2 and its 95% CI. The Review Manager (RevMan) software was used for meta-analysis (version 5.3). The quality of the evidence was generated according to the Evaluation of theClassification of Recommendations, Development and Evaluation (GRADE). Results: There was nostatistically difference for the occurrence of sepsis, mortality, catheter-related complications(infections) and catheter length of stay between groups. For the number of venopunctures required for catheter insertion, the findings indicate that for PICC there are lower numbers (RR -6.17, 95% CI:-7.75 to -4.59) and that there is low heterogeneity (I2=32%) among the studies. However, these results should be interpreted with caution, since the evaluation of the quality of the evidence was low. Conclusion: No moderate or high-quality evidence was found in ECRs that proves that there is differentiated effectiveness between PICC compared to the use of other intravenous catheters in newborns hospitalized in neonatal intensive care units, thus evidencing the need for further studiesin the area.