Complications of Central Venous Access Devices: A Systematic Review

Abstract

CONTEXT: The failure and complications of central venous access devices (CVADs) result in interrupted medical treatment, morbidity, and mortality for the patient. The resulting insertion of a new CVAD further contributes to risk and consumes extra resources.OBJECTIVE: To systematically review existing evidence of the incidence of CVAD failure and complications across CVAD types within pediatrics.DATA SOURCES: Central Register of Controlled Trials, PubMed, and Cumulative Index to Nursing and Allied Health databases were systematically searched up to January 2015.STUDY SELECTION: Included studies were of cohort design and examined the incidence of CVAD failure and complications across CVAD type in pediatrics within the last 10 years. CVAD failure was defined as CVAD loss of function before the completion of necessary treatment, and complications were defined as CVAD-associated bloodstream infection, CVAD local infection, dislodgement, occlusion, thrombosis, and breakage. CONCLUSIONS: CVAD failure and complications in pediatrics are a significant burden on the health care system internationally.

A 4-arm randomized controlled pilot trial of innovative solutions for jugular central venous access device securement in 221 cardiac surgical patients

“…CVADs are commonly used medical devices in hospitals, with three million used in the United States of America (USA), and 250,000 in the UK each year alone [1,2]. In total, 25-30% of CVADs are reported to fail via dislodgement, blockage, breakage, thrombosis, or infection, resulting in premature device removal [3,4]. This adversely impacts patients" care through interrupted treatment (e.g.…”

Disminución de las infecciones asociadas al catéter venoso central mediante intervenciones sencillas y de bajo costo, en una unidad de cuidados intensivos pediátricos

“…Es importante recalcar que para la prácti -ca clínica del cuidado críti co, las intervenciones implementadas deben ser sencillas. Simplifi cando los procesos y procedimientos, podemos asegurar que los pacientes reciban una terapia efecti va y oportuna (23) .…”

The Care of Central Venous Catheters in the Oncopediatric Department

“…26 The failure of central venous access devices (CVADs) results in interrupted medical treatment, increased morbidity and mortality, and prolonged hospitalization for the patient. 27 Tunneled catheters may be maintained for a maximum period of 9 months, port catheters for 2-4 years, and this period varies largely, depending on how the patient tolerates it. In our center we experienced 2 cases of necrosis, because of which the port catheters were removed.…”

“…6 In these cases, the non-functional central line is simply removed and a new catheter needs to be inserted. 7 A multidisciplinary, best-practice central line maintenance care guideline reduces central line-associated blood stream infection rates in hospitalized pediatric oncology patients. 8 Care principles for preventing infections differ in function of catheter type.…”