استفاده از کاتترهای آغشته به هپارین برای افزایش باز ماندن کاتترهای ورید مرکزی در کودکان
Appendices
Appendix 1. CENTRAL search strategy
| #1 | MeSH descriptor: [Catheterization, Central Venous] explode all trees | 718 |
| #2 | catheter* or device or line:ti,ab,kw (Word variations have been searched) | 36000 |
| #3 | central near/2 venous:ti,ab,kw (Word variations have been searched) | 1899 |
| #4 | #1 or #2 or #3 | 36670 |
| #5 | MeSH descriptor: [Coated Materials, Biocompatible] explode all trees | 475 |
| #6 | *bond*:ti,ab,kw (Word variations have been searched) | 2609 |
| #7 | coat*:ti,ab,kw (Word variations have been searched) | 3394 |
| #8 | impregnat*:ti,ab,kw (Word variations have been searched) | 570 |
| #9 | #5 or #6 or #7 or #8 | 6342 |
| #10 | MeSH descriptor: [Heparin] explode all trees | 3985 |
| #11 | *heparin*:ti,ab,kw (Word variations have been searched) | 7414 |
| #12 | heparin near/2 bonded | 81 |
| #13 | #10 or #11 or #12 | 7661 |
| #14 | #4 and #9 and #13 in Trials | 51 |
Appendix 2. MEDLINE search strategy
Database: Ovid MEDLINE(R) <1946 to August Week 3 2013>
Search Strategy:
‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐
1 exp Catheterization, Central Venous/ (11728)
2 (catheter$ or device or line).ti,ab. (655610)
3 (central adj2 venous).ti,ab. (17481)
4 or/1‐3 (664159)
5 exp Coated Materials, Biocompatible/ (10092)
6 bond$.ti,ab. (148604)
7 coat$.ti,ab. (105750)
8 impregnat$.ti,ab. (12101)
9 or/5‐8 (266464)
10 exp Heparin/ (56968)
11 heparin.ti,ab. (63062)
12 10 or 11 (82545)
13 4 and 9 and 12 (405)
14 randomized controlled trial.pt. (382845)
15 controlled clinical trial.pt. (88922)
16 randomized.ab. (281449)
17 placebo.ab. (154031)
18 clinical trials as topic.sh. (173835)
19 randomly.ab. (195836)
20 trial.ti. (121954)
21 or/14‐20 (879793)
22 (animals not (humans and animals)).sh. (3929804)
23 21 not 22 (810811)
24 13 and 23 (51)
Study flow diagram for updated review.
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
Forest plot of comparison: 1 Heparin‐bonded catheter versus non‐heparin bonded catheters, outcome: 1.1 Catheter‐related thrombosis at any time during catheter stay.
Forest plot of comparison: 1 Heparin‐bonded catheter versus non‐heparin bonded catheters, outcome: 1.8 Thrombocytopenia after catheter insertion.
Comparison 1 Heparin‐bonded catheter versus non‐heparin bonded catheters, Outcome 1 Catheter‐related thrombosis at any time during catheter stay.
Comparison 1 Heparin‐bonded catheter versus non‐heparin bonded catheters, Outcome 2 Catheter‐related thrombosis within one week of catheter insertion.
Comparison 1 Heparin‐bonded catheter versus non‐heparin bonded catheters, Outcome 3 Catheter‐related thrombosis after one week of insertion.
Comparison 1 Heparin‐bonded catheter versus non‐heparin bonded catheters, Outcome 4 Occlusion of catheter within one week of catheter insertion.
Comparison 1 Heparin‐bonded catheter versus non‐heparin bonded catheters, Outcome 5 Occlusion of catheter after one week of catheter insertion.
Comparison 1 Heparin‐bonded catheter versus non‐heparin bonded catheters, Outcome 6 Catheter‐related blood stream infection.
Comparison 1 Heparin‐bonded catheter versus non‐heparin bonded catheters, Outcome 7 Colonization of catheter with microbes.
Comparison 1 Heparin‐bonded catheter versus non‐heparin bonded catheters, Outcome 8 Thrombocytopenia after catheter insertion.
| Heparin‐bonded catheter compared with non‐heparin bonded catheter for central venous catheter in children | ||||||
| Participant or population: Children with central venous catheter Settings: Hospital Intervention: Heparin‐bonded central venous catheter Comparison: Non‐heparin bonded central venous catheter | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect | No of Participants | Quality of the evidence | Comments | |
| Assumed risk | Corresponding risk | |||||
| Non heparin‐bonded catheter | Heparin‐bonded catheter | |||||
| Days of catheter patency | median of 6 days | median of 7 days | 200 (1 study) | ⊕⊕⊝⊝ | Only one study reported this outcome | |
| Catheter‐related thrombosis at any time during catheter stay | 175 per 1000 | 59 per 1000 (2 to 1344) | RR 0.34 (0.01 to 7.68) | 287 (2 studies) | ⊕⊕⊕⊝ | |
| Occlusion of catheter within one week of catheter insertion | 78 per 1000 | 5 per 1000 (0 to 83) | RR 0.06 (0.00 to 1.07) | 200 (1 study) | ⊕⊕⊝⊝ | Only one study reported this outcome |
| Catheter‐related blood stream infection and CVC‐related colonization | 184 per 1000 | 11 per 1000 (2 to 75) | RR 0.06 (0.01 to 0.41) | 200 (1 study) | ⊕⊕⊝⊝ | Only one study reported this outcome |
| Side effects: Thrombocytopenia after catheter insertion | 133 per 1000 | 97 per 1000 (50 to 85) | RR 0.73 (0.38 to 1.39) | 287 (2 studies) | ⊕⊕⊝⊝ | No systematic evaluation of thrombocytopenia was conducted in either study |
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). | ||||||
| GRADE Working Group grades of evidence | ||||||
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 1 Catheter‐related thrombosis at any time during catheter stay Show forest plot | 2 | 287 | Risk Ratio (M‐H, Random, 95% CI) | 0.34 [0.01, 7.68] |
| 2 Catheter‐related thrombosis within one week of catheter insertion Show forest plot | 1 | Risk Ratio (M‐H, Fixed, 95% CI) | Totals not selected | |
| 3 Catheter‐related thrombosis after one week of insertion Show forest plot | 1 | Risk Ratio (M‐H, Fixed, 95% CI) | Totals not selected | |
| 4 Occlusion of catheter within one week of catheter insertion Show forest plot | 1 | Risk Ratio (M‐H, Fixed, 95% CI) | Totals not selected | |
| 5 Occlusion of catheter after one week of catheter insertion Show forest plot | 1 | Risk Ratio (M‐H, Fixed, 95% CI) | Totals not selected | |
| 6 Catheter‐related blood stream infection Show forest plot | 1 | Risk Ratio (M‐H, Fixed, 95% CI) | Totals not selected | |
| 7 Colonization of catheter with microbes Show forest plot | 1 | Risk Ratio (M‐H, Fixed, 95% CI) | Totals not selected | |
| 8 Thrombocytopenia after catheter insertion Show forest plot | 2 | 287 | Risk Ratio (M‐H, Random, 95% CI) | 0.73 [0.38, 1.39] |
