Pediatric central venous access devices: practice, performance, and costs

Loading...
Thumbnail Image
File version

Version of Record (VoR)

Author(s)
Ullman, Amanda J
Gibson, Victoria
Takashima, Mari D
Kleidon, Tricia M
Schults, Jessica
Saiyed, Masnoon
Cattanach, Paula
Paterson, Rebecca
Cooke, Marie
Rickard, Claire M
Byrnes, Joshua
Chopra, Vineet
Primary Supervisor
Other Supervisors
Editor(s)
Date
2022
Size
File type(s)
Location
Abstract

Background: Healthcare delivery is reliant on a functional central venous access device (CVAD), but the knowledge surrounding the burden of pediatric CVAD-associated harm is limited. Methods: A prospective cohort study at a tertiary-referral pediatric hospital in Australia. Children <18 years undergoing insertion of a CVAD were screened from the operating theatre and intensive care unit records, then assessed bi-weekly for up to 3 months. Outcomes were CVAD failure and complications, and associated healthcare costs (cost of complications). Results: 163 patients with 200 CVADs were recruited and followed for 6993 catheter days, with peripherally inserted central catheters most common (n = 119; 60%). CVAD failure occurred in 20% of devices (n = 30; 95% CI: 15–26), at an incidence rate (IR) of 5.72 per 1000 catheter days (95% CI: 4.09–7.78). CVAD complications were evident in 43% of all CVADs (n = 86; 95% CI: 36–50), at a rate of 12.29 per 1000 catheter days (95% CI: 9.84–15.16). CVAD failure costs were A$826 per episode, and A$165,372 per 1000 CVADs. Comparisons between current and recommended practice revealed inconsistent use of ultrasound guidance for insertion, sub-optimal tip-positioning, and appropriate device selection. Conclusions: CVAD complications and failures represent substantial burdens to children and healthcare. Future efforts need to focus on the inconsistent use of best practices. Impact: Current surveillance of central venous access device (CVAD) performance is likely under-estimating actual burden on pediatric patients and the healthcare system.CVAD failure due to complication was evident in 20% of CVADs. Costs associated with CVAD complications average at $2327 (AUD, 2020) per episode.Further investment in key diverse practice areas, including new CVAD types, CVAD pathology-based occlusion and dislodgment strategies, the appropriate use of device types, and tip-positioning technologies, will likely lead to extensive benefit.

Journal Title

Pediatric Research

Conference Title
Book Title
Edition
Volume
Issue
Thesis Type
Degree Program
School
Publisher link
Patent number
Funder(s)
Grant identifier(s)
Rights Statement
Rights Statement

© The Author(s) 2022. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

Item Access Status
Note

This publication has been entered as an advanced online version in Griffith Research Online.

Access the data
Related item(s)
Subject

Paediatrics

Science & Technology

Life Sciences & Biomedicine

Pediatrics

MICHIGAN APPROPRIATENESS GUIDE

BLOOD-STREAM INFECTIONS

Persistent link to this record
Citation

Ullman, AJ; Gibson, V; Takashima, MD; Kleidon, TM; Schults, J; Saiyed, M; Cattanach, P; Paterson, R; Cooke, M; Rickard, CM; Byrnes, J; Chopra, V, Pediatric central venous access devices: practice, performance, and costs, Pediatric Research, 2022

Collections