Peripherally inserted central catheter versus
central venous catheter for intravenous access
A protocol for systematic review and meta-analysis
Felipe Kenzo Yadoya Santosa , Ronald Luiz Gomes Flumignan, MD, PhDb, , Libnah Leal Areiasa ,
Anna Karina Paiva Sarpe, MDb , Fabio Cabral Freitas Amaral, MDb , Rafael Bernardes de vila, MDb
Vladimir Tonello de Vasconcelos, MD, PhDb
, Henrique Jorge Guedes Neto, MD, PhDb ,
Jorge Eduardo de Amorim, MD, PhDb
, Luis Carlos Uta Nakano, MD, PhDb
Background: Since the first description of the central venous catheter (CVC) in 1952, it has been used for the rapid administration
of drugs, chemotherapy, as a route for nutritional support, blood components, monitoring patients, or combinations of these. When
CVC is used in the traditional routes (eg, subclavian, jugular, and femoral veins), the complication rates range up to 15% and are
mainly due to mechanical dysfunction, infection, and thrombosis. The peripherally inserted central catheter (PICC) is an alternative
option for CVC access. However, the clinical evidence for PICC compared to CVC is still under discussion. In this setting, this
systematic review (SR) aims to assess the effects of PICC compared to CVC for intravenous access.
Methods: We will perform a comprehensive search for randomised controlled trials (RCTs), which compare PICC and traditional
CVC for intravenous access. The search strategy will consider free text terms and controlled vocabulary (eg, MeSH and Entree)
related to peripherally inserted central venous catheter, central venous access, central venous catheter, catheterisation,
peripheral, vascular access devices, infusions, intravenous, administration, intravenous, and injections, intravenous.
Searches will be carried out in these databases: MEDLINE (via PubMed), EMBASE (via Elsevier), Cochrane CENTRAL (via Wiley),
IBECS, and LILACS (both via Virtual Health Library). We will consider catheter-related deep venous thrombosis and overall successful
insertion rates as primary outcomes and haematoma, venous thromboembolism, reintervention derived from catheter dysfunction,
catheter-related infections, and quality of life as secondary outcomes. Where results are not appropriate for a meta-analysis using
RevMan 5 software (eg, if the data have considerable heterogeneity and are drawn from different comparisons), a descriptive analysis
will be performed.
Results: Our SR will be conducted according to the Cochrane Handbook of Systematic Reviews of Interventions and the findings
will be reported in compliance with PRISMA.
Conclusion: Our study will provide evidence for the effects of PICC versus CVC for venous access.
Ethics and dissemination: This SR has obtained formal ethical approval and was prospectively registered in Open Science
Framework. The findings of this SR will be disseminated through peer-reviewed publications or conference presentations.
Ethical approval: 69003717.2.0000.5505.
Abbreviations: CENTRAL = Cochrane Central Register of Controlled Trials, CIs = confidence intervals, CVC = central venous
catheter, EMBASE = Excerpta Medica database, GRADE = Grading of Recommendations, Assessment, Development and
Evaluation, IBECS = Indice Bibliogrfico Espaol de Ciencias de la Salud, LILACS = Latin American and Caribbean Centre on Health
There is not a conflict of interest either from the Division of Vascular and Endovascular Surgery of Universidade Federal de S
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