Managing CVAD Complications in Paediatric Cancer Care: A Global View

Study Overview

Central venous access devices (CVADs) are essential in paediatric cancer care, but complications such as bloodstream infection, thrombosis and occlusion can interrupt treatment and cause significant harm.

This global cross-sectional survey explored how clinicians identify and manage these complications across different healthcare settings. The study included 161 respondents from 38 countries, comparing practices in high-income countries with those in lower- and upper-middle-income settings.

Key Findings

• Blood cultures were the most commonly reported method for diagnosing catheter-associated bloodstream infection (CABSI), particularly in high-income countries.
• Management of CABSI varied, with intravenous antibiotics and catheter removal among the most commonly reported approaches.
• For catheter-related thrombosis, anticoagulation before catheter removal was frequently reported.
• Thrombolytic agents were the most common treatment for catheter occlusion, but access differed considerably between settings. Alteplase use was reported much more often in high-income countries.
• Overall, the survey showed substantial variation in how CVAD complications are diagnosed and managed depending on available resources and country income level.