Study designs of evaluations included in the review
Randomised controlled trials (RCTs) were eligible for inclusion. Where evidence from RCTs was not available, controlled clinical trials were included after being assessed for quality.
Specific interventions included in the review
Interventions to be reviewed were: aseptic techniques or barrier precautions taken at the time of catheter insertion; infusate or flushing solution used; skin preparation, antiseptic or antimicrobial ointment; type of dressing; frequency of dressing changes; frequency of administration set changes; and whether an in-line filter was used. The trials included in the review investigated the effect of using an antibiotic (vancomycin), antiseptic (chorhexidine) or Tegaderm dressing in addition to infusate (normal saline, heparin, parenteral nutrition), povidone-iodine skin preparation or silk tape.
Participants included in the review
Only trials of hospitalised paediatric patients (between birth and aged 18 years) were eligible for the review. Trials of mixed adult and paediatric populations were excluded unless the data for children could be extracted separately. The included trials were of premature neonates, neonates, or children whose ages ranged (where reported) from 7 months to 21 years.
Outcomes assessed in the review
Studies reporting outcomes related to a decrease in CVC-related complications were eligible for inclusion. The outcomes reported in the included studies were catheter-related infections (including specifically bacteraemia and infections at the catheter tip and exit site), incidence of catheter colonisation, and incidence of exit site irritation.
How were decisions on the relevance of primary studies made?
A single reviewer assessed the relevance of studies for inclusion using a standard form. A second author was consulted only when the first reviewer was uncertain.