What is the best catheter lock solution in preventing catheter-related blood infections? A protocol for a Bayesian...

Area of Science:

• Medical Research
• Infectious Diseases
• Clinical Trials

Background:

• Catheter-related bloodstream infection (CRBSI) is a serious complication of central venous catheters, leading to increased morbidity, mortality, and healthcare costs.
• Traditional pairwise meta-analyses have limitations in summarizing evidence when not all treatments are compared directly.
• Network meta-analysis offers a method to synthesize evidence from multiple studies, even when head-to-head comparisons are absent.

Purpose of the Study:

• To evaluate the efficacy and safety of different lock solutions for preventing CRBSI using a network meta-analysis approach.
• To provide a more comprehensive and precise summary of evidence on CRBSI prevention strategies.
• To compare various lock solutions for CRBSI prevention beyond direct head-to-head comparisons.

Main Methods:

• A systematic search of PubMed, Embase, Web of Science, and Cochrane Library for relevant randomized controlled trials (RCTs).
• Data extraction and methodological quality assessment using the Cochrane risk of bias tool by two independent reviewers.
• Network meta-analysis conducted using WinBUGS and Stata to estimate pooled direct and indirect effects of lock solutions.

Main Results:

• The primary outcome is the incidence of CRBSI.
• Secondary outcomes include exit-site infection and catheter-related thrombosis.
• Pooled direct and indirect effects for all evaluated lock solutions will be estimated.

Conclusions:

• Network meta-analysis allows for a more robust comparison of CRBSI prevention strategies than traditional methods.
• This study will provide valuable insights into the comparative effectiveness and safety of different lock solutions.
• Findings will be disseminated through an international peer-reviewed journal.