In order to provide reference for the prevention and treatment of CRBSI during clinical intravenous infusion therapy, this paper investigates the incidence of catheter-related bloodstream infection (CRBSI) in the treatment of midline catheters (MCs) and peripherally inserted central catheters (PICCs) by intravenous infusion. Web of Science, PubMed, Scopus, Embase, Cochrane Library, and ProQuest are searched to collect CRBSI-related studies on MC and PICC. The retrieval time is from the database construction to August 2020. Two researchers independently searched and screened literature quality evaluation and extracted data according to inclusion and exclusion criteria, and RevMan 5.3 software was used for analysis. Eleven studies are included, with a total of 33809 patients. The incidence of CRBSI in the MC group is 0.599% (43/7079), and that in the PICC group is 0.4993% (133/26630). Meta-analysis showed that the incidence of CRBSI in the MC group is higher than that in the PICC group (OR = 0.72, 95% CI = 0.43–1.08, P = 0.11 ), and the difference is statistically significant when low-quality studies are excluded (OR = 0.60, 95% CI = 0.39–0.93, P = 0.02 ). There is no significant difference in the incidence of CRBSI between MC group and PICC group ( P > 0.05 ), American subgroup (OR = 0.52), and British subgroup (OR = 4.86), the results of the two groups are opposite, and the incidence of CRBSI between the MC group and PICC group is statistically significant. There is no significant difference in the incidence of CRBSI between the adult and other subgroups (all P > 0.05 ). There is no significant difference in the incidence of CRBSI between the MC group and the PICC group ( P > 0.05 ). Overall, the inter-study stability is general, the quality is good and the medium is good, and there is no obvious publication bias. The risk of CRBSI in MC and PICC is systematically evaluated and meta-analyzed for the first time. The incidence of CRBSI in MC group is lower than that in PICC group during intravenous infusion therapy. Under the same conditions, MC patients can be given priority for intravenous infusion therapy. More high-quality and child-related studies are needed to further evaluate and explore the risk of CRBSI between MC and PICC.
Background. Positive end-expiratory pressure (PEEP) refers to the positive pressure in the respiratory tract at the end of the exhalation when we use a ventilator. The differences of higher PEEP and lower PEEP on clinical outcomes in acute respiratory distress syndrome (ARDS) patients are less well known. Methods. A comprehensive literature search of all randomized control trials (RCTs) was conducted using PubMed, Embase, World Health Organization (WHO) Global Index Medicus, WHO clinical trial registry, and Clinicaltrials.gov. Inclusion criteria included RCTs comparing the clinical outcomes of higher and lower PEEP in ARDS patients. Results. Eleven studies were included in the final analysis. In the higher PEEP group, the hospital mortality, 28-day mortality, and ICU mortality showed no significantly lower risk compared to the lower PEEP group (RR = 0.92, 95% CI 0.80–1.05, p = 0.22; RR = 0.88, 95% CI 0.73–1.05, p = 0.15; RR = 0.84, 95% CI 0.67–1.05, p = 0.12; respectively). High certainty could be obtained that there is no significant difference between the clinical outcomes of higher PEEP and lower PEEP in ARDS patients. Conclusions. There is no significant difference of the hospital mortality, 28-day mortality, and ICU mortality between higher and lower PEEP in ARDS patients.
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