Quantified versus willful handgrip exercises for the prevention of PICC-related thrombosis: A meta-analysis and systematic review

Abstract

Background: Thrombosis is a common yet serious complication in patients with peripherally inserted central venous catheter (PICC), the prevention of thrombosis is very important to the prognosis of PICC patients. We aimed to evaluate the effects of quantified versus willful grip exercises for the prevention of PICC-related thrombosis, to provide evidence to the clinical nursing care of PICC patients.Methods: Two authors searched PubMed et al databases for randomized controlled trials (RCTs) comparing the effects of quantified versus willful grip exercises in PICC patients up to August 31, 2022. Quality assessment and data extraction were independently performed by 2 researchers, and meta-analysis was performed using RevMan 5.3 software.Results: 15 RCTs involving 1741 PICC patients were finally included in this meta-analysis. Synthesized outcomes indicated that compared with willful grip exercises, quantified grip exercises reduced the incidence of PICC-related thrombosis (odds ratio = 0.19, 95% confidence interval [CI]: 0.12-0.31) and infection (odds ratio = 0.30, 95% CI: 0.15-0.60) in PICC patients, increased the maximum venous velocity (mean difference = 3.02, 95% CI: 1.87-4.17) and mean blood flow (mean difference = 3.10, 95%CI: 1.57-4.62) in PICC patients (all P < .05). There were no publication biases amongst the synthesized outcomes (all P > .05).Conclusion: Quantified grip exercises can effectively reduce the occurrence of PICC-related thrombosis and infection, improve the venous hemodynamics. Limited by study population and regions, large-sample, and high-quality RCTs are still needed in the future to further evaluate the effects and safety of quantified grip exercises in PICC patients.Abbreviations: CI = confidence interval, OR = odds ratio, PICC = peripherally inserted central venous catheter, RCTs = randomized controlled trials.

A Randomized, Controlled Trial of Continuous Heparin Infusion to Prevent Asymptomatic Catheter-Related Thrombosis at Discharge in Infants After Cardiac Surgery: The CHIP-CRT Trial

“…The probable causes for CRT included endothelial damage during vein puncture, hemodynamic change in vessels, site of CVC placement, size of CVC, flow speed in CVC, medicine used through CVC, and so on. [26][27][28][29][30][31] There were no differences in these parameters between groups. Different from the previous studies using systemic heparin infusion at a speed of 0.5 to 10 units/kg/h, 2,5,8 we continuously evenly infused heparin through each CVC at a speed of 2 to 3 units/kg/h in the non-CRT subgroup and 10 to 15 units/kg/h in the CRT subgroup.…”

“…The probable causes for CRT included endothelial damage during vein puncture, hemodynamic change in vessels, site of CVC placement, size of CVC, flow speed in CVC, medicine used through CVC, and so on 26–31 . There were no differences in these parameters between groups.…”