Strength of Evidence for Using C-I Sponges under Standard Dressings vs. Using Standard Dressings or Gauze among Patients Aged < 18 Years with Short-term, Non-tunneled Central Venous Catheters F
Outcome type, findings, quantity and type of evidence for patients under 18.
| Outcome |
Findings |
Quantity and Type of Evidence(Sample Size) |
GRADE of Evidence for Outcome(Limitations of the Evidence) |
| CRBSIB |
- 1 multicenter RCT6 (N=705) of NICU patients with tunneled and non-tunneled CVCs compared C-I sponge under transparent polyurethane dressing with transparent polyurethane dressing alone; yielded a subanalysis of neonates with percutaneous [non-tunneled] CVCs (n=620) that found no difference in the rate of CRBSI by dressing type: RR: 1.2 (CI: 0.5–2.7); p=0.65.
- 1 single-center RCT7 (N=100) of PICU patients aged 0–18 years with non-tunneled CVCs that compared C-I gel pad dressing with sterile gauze pad; suggested no statistically significant difference in the incidence of CRBSI by dressing type: 1/50 (2%) vs. 5/50 (10%); p > 0.05.
|
2 RCTs6,7
(N=720) |
Very Low
(Indirect, G Imprecise H) |
| CABSIB |
- 1 single-center RCT (N=145) of pediatric and neonatal PCICU patients with non-tunneled CVCs compared C-I sponge under semipermeable dressing with semipermeable dressing alone; suggested no difference in the proportion of patients with CABSI by dressing type: 4/74 (5.4%) vs. 3/71 (4.2%); p=1.0.
|
1 RCT8
(N=145) |
Low
(Imprecise I) |
| BSI without a source B |
- 1ulticenter RCT (N=705) of NICU patients with tunneled and non-tunneled CVCs that compared C-I sponge under transparent polyurethane dressing with transparent polyurethane dressing alone; yielded a subanalysis in neonates with percutaneous (non-tunneled) catheters (N=662) that suggested no difference in BSI without a source by dressing type: RR: 1.1 (0.8–1.7); p=0.44.
|
1 RCT6
(N=662) |
Very Low
(Indirect G, Imprecise J) |
| Local catheter infection B |
- 1 single-center RCT (N=100) of PICU patients with non-tunneled CVCs that compared C-I gel pad dressing with sterile gauze pad; suggested no statistically significant difference in the incidence of local catheter infection per patient by dressing type: 1/50 (2%) vs. 2/50 (4%); p> 0.05.
|
1 RCT7
(N=100) |
Low
(Imprecise I) |
| Product-related adverse events |
- 1 multicenter RCT6 (N=705) of NICU patients with tunneled or non-tunneled CVCs that compared C-I sponge under transparent polyurethane dressing with transparent polyurethane dressing alone; reported a higher incidence (per patient) of severe contact dermatitis among patients with sponge dressings: 19/335 (5.7%) vs. 0/370. In the C-I sponge group, 15/98 (15%) of patients weighing <1,000 grams developed dermatitis, compared with 4/237 (1.5%) of patients weighing ≥1,000 grams (p<0.01).
- 1 single-center RCT8 (N=145) of pediatric and neonatal PCICU patients with non-tunneled CVC compared C-I sponge under transparent polyurethane dressing with transparent polyurethane dressing alone; suggested a higher incidence (per patient) of local redness in patients with sponge dressings: 4/74 (5.4%) vs. 1/71 (1.4%). All intervention events occurred in neonates.
|
2 RCTs6,8
(N=850) |
Moderate
(Imprecise G) |
Footnotes
B A critical outcome
G Different skin antisepsis used for each study group.
H Wide confidence interval in one study, low power in second study.
I Underpowered; only 1 study.
J Only 1 study; wide confidence interval.
