Central venous catheter-related infections: a systematic review, meta-analysis, trial sequential analysis and meta-regression comparing ultrasound guidance and landmark technique for insertion
Pooled resultResult — go to the resultRelative risk 0.68 95% CI 0.53–0.88Authors' conclusion
US-guided CVC placement significantly reduces the risk of catheter-related infections compared to the AL technique, particularly when performed by experienced operators.
Study context
- Population
- Central venous catheterization procedures12 studies (8 randomized controlled trials (RCTs), 4 non-randomized studies of intervention (NRSI))
- Participants
- 5,092 procedures
- Comparison
- Ultrasound (US)-guided vs anatomical landmark central venous catheterization (CVC) placement
- US-guidedn = 2,072
- Anatomical landmark (AL)-guidedn = 3,020reference
- Outcome
- Composite of all catheter-related infections (CRBSIs, CLABSIs, catheter colonization, any other reported infection)
Methodological detailstrial sequential analysis, meta-regression, subgroup analyses
- Trial sequential analysis
- Meta-regression
- Subgroup analyses
Pooled result
As reported in the abstract
Relative risk
0.68
95% CI 0.53–0.88
US-guided vs AL-guided
RR 0.68 (95% CI 0.53–0.88)
Further pooled results
Catheter-related infections, RCT subgroup (subgroup)
- Pooled RR, US-guided vs AL-guided CVC
- 0.65 (95% CI 0.49-0.87)
Catheter-related infections, experienced operators (subgroup)
- RR, US-guided vs AL-guided CVC; effect more pronounced
- 0.60 (95% CI 0.41-0.89)
Catheter-related infections, inexperienced operators (subgroup)
- Infection risk reduction not statistically significant
Catheter-related bloodstream infections (CRBSIs) and central line-associated bloodstream infections (CLABSIs) (pooled)
- RR, favored US guidance
- 0.65 (95% CI 0.48-0.87)
Original publication
Central venous catheter-related infections: a systematic review, meta-analysis, trial sequential analysis and meta-regression comparing ultrasound guidance and landmark technique for insertion. Crit Care. Published 19 November 2024. doi:10.
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