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首页> 外文期刊>BMJ Open >Antimicrobial lock solutions for the prevention of catheter-related infection in patients undergoing haemodialysis: study protocol for network meta-analysis of randomised controlled trials
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Antimicrobial lock solutions for the prevention of catheter-related infection in patients undergoing haemodialysis: study protocol for network meta-analysis of randomised controlled trials

机译：预防血液透析患者导管相关感染的抗菌锁解决方案：随机对照试验网络荟萃分析的研究方案

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Introduction Catheter-related infection (CRI) is a difficult clinical problem in renal medicine, with blood stream infections occurring in up to 40% of patients with haemodialysis (HD) catheters, conferring significant rates of morbidity and mortality. Several approaches have been assessed as a means to prevent CRI. Currently, an intervention that is the source of much discussion is the use of antimicrobial lock solutions (ALS). A number of past conventional meta-analyses have compared different ALS with heparin. However, there is no consensus recommendation regarding which type of ALS is best. The purpose of our study is to carry out a network meta-analysis comparing the efficacy of different ALS for prevention of CRI in patients with HD and ranking these ALS for practical consideration. Methods and analysis We will search six electronic databases, earlier relevant meta-analyses and reference lists of included studies for randomised controlled trials (RCTs) that compared ALS for preventing episodes of CRI in patients with HD either head-to-head or against control interventions using non-ALS. Study selection and data collection will be performed by two reviewers independently. The Cochrane Risk of Bias Tool will be used to assess the quality of included studies. The primary outcome of efficacy will be catheter-related bloodstream infection (CRBSI). We will perform a Bayesian network meta-analysis to compare the relative efficacy of different ALS by WinBUGS (V.1.4.3) and STATA (V.13.0). The quality of evidence will be assessed by GRADE. Ethics and dissemination Ethical approval is not required given that this study includes no confidential personal data and no data on interventions on patients. The results of this study will be submitted to a peer-review journal for publication. Trial registration number CRD42015027010.
机译：引言导管相关感染（CRI）在肾脏医学中是一个棘手的临床问题，在多达40％的血液透析（HD）导管患者中发生血流感染，从而大大增加了发病率和死亡率。已经评估了几种方法来预防CRI。当前，引起广泛讨论的一项干预措施是使用抗菌锁解决方案（ALS）。许多过去的常规荟萃分析已将不同的ALS与肝素进行了比较。但是，没有关于哪种类型的ALS最好的共识建议。我们研究的目的是进行网络荟萃分析，比较不同ALS预防HD患者CRI的疗效，并对这些ALS进行分级以供实际考虑。方法和分析我们将搜索六个电子数据库，较早的相关荟萃分析和纳入研究的随机对照试验（RCT）的参考清单，这些试验比较了ALS与头对头或对照干预对预防HD患者CRI发作的作用使用非ALS。研究选择和数据收集将由两名审阅者独立进行。 Cochrane偏倚风险工具将用于评估纳入研究的质量。疗效的主要结果将是导管相关的血流感染（CRBSI）。我们将进行贝叶斯网络荟萃分析，比较WinBUGS（V.1.4.3）和STATA（V.13.0）对不同ALS的相对功效。证据的质量将由GRADE评估。道德与传播鉴于本研究不包括机密个人数据和患者干预措施数据，因此不需要道德批准。这项研究的结果将提交给同行评审期刊发表。试用注册号CRD42015027010。

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