Biblioteca Virtual en Salud

Objective To evaluate the influence of different types of needleless connector on central venous catheter-related thrombotic occlusions. Methods A detailed search was performed to identify literature about the impact of needleless connector on central venous catheter-related thrombotic occlusions , using the Cochrane Library and the databases of Pubmed,EMbase,CINAHL,CBM,CNKI and WanFang. The meta-analysis or descriptive review were performed after two authors independently searching databases,extracting data and assessing quality of included studies. Results Nine published studies were included for systematic review,which contained three randomized controlled trials,three non-randomized experimental studies and three retrospective observational studies. The results of meta-analysis for five studies showed that the split septum connector was associated with a significantly higher incidence of catheter-related thrombotic occlusions(complete occlusions and partial occlusions) than positive-displacement mechanical valve(RR=0.59,95％CI0.39-0.91,P=0.02). Standard connector and negative- displacement mechanical valve had a higher occlusions rates than positive- displacement mechanical valve ,but the difference did not reach statistical significance after merging the studies( P>0.05). Conclusion It is difficult to decide which needleless connector has the lowest rate of central venous catheter-related thrombotic occlusions because of the insufficient evidence. More large-scale and high-quality randomized controlled trials are required for further confirmation.