CVAD Complications in Pediatric Cancer: What We Know About the Risks

Central venous access devices (CVADs) are essential for delivering treatment to children with cancer. However, they carry a significant risk of complications that can delay therapy and impact outcomes. This scoping review explored the existing evidence on risk factors for CVAD-associated complications in pediatric oncology patients.

Study Overview
The review included 25 studies published between 2012-2022, covering over 10,000 patients across multiple regions. The focus was on identifying device, patient, and provider-related risk factors for complications like bloodstream infections, thrombosis, occlusion, and device failure.

Key Findings
Device-related risks were most common:

• External devices (e.g., TCVCs, PICCs) had higher rates of infection and failure.
• Multiple lumens and larger catheter sizes increased the risk of CLABSI and VTE.
• Patient-related risks included age extremes (infants, adolescents), obesity, and hematological malignancies.
• Provider-related risk factors were poorly reported across studies.
• There was a lack of data on complications such as dislodgement, rupture, or local infection.

Conclusion
This review highlights critical gaps in high-quality evidence about CVAD complications in children with cancer. The authors call for prospective studies and standardised reporting to guide safer device selection and care strategies.

Read more:https://onlinelibrary.wiley.com/doi/10.1155/ecc/9956694 

Authors: Jenna L. Nunn, Mari D. Takashima, Erin M. Wray-Jones, Trisha A. Soosay Raj, Diane M. Hanna, Amanda J. Ullman