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Immediate versus delayed access of implantable venous access devices: does the timing of access make a difference to
Cathy Hanley1, Kim Nagel, Isaac Odame
1Undergraduate Medical Programme, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
Insights
Immediate access to implantable venous access devices in pediatric cancer patients is safe. This approach reduces painful needle punctures and provides secure central venous access without increasing complication risks.
Area of Science:
- Pediatric Oncology
- Vascular Access Devices
- Cancer Care
Background:
- Protocols for accessing implantable venous access devices (IVADs) in pediatric cancer patients are often lacking.
- The impact of immediate versus delayed IVAD access on complication rates is not well-established.
Purpose of the Study:
- To compare complication rates, including infection, hematoma, mechanical failure, and extravasation, between immediate and delayed access groups in pediatric cancer patients with IVADs.
- To determine if immediate IVAD access is associated with increased risks.
Main Methods:
- Retrospective study of pediatric patients undergoing IVAD insertion between 1998 and 2001.
- Comparison of complication incidence in an immediate access group (n=23) versus a delayed access group (n=74).
Main Results:
- Infection incidence was 22% in the immediate access group and 14% in the delayed access group; this difference was not statistically significant.
- All infections occurred in patients with acute lymphoblastic leukemia, with similar infection rates (33% vs. 36%) across both groups for this specific diagnosis.
Conclusions:
- Implantable venous access devices can be safely accessed immediately upon insertion in pediatric cancer patients.
- Immediate access minimizes painful needle punctures and ensures prompt central venous access.
- The study supports immediate IVAD access as a viable strategy in pediatric oncology care.
Purpose:
In many institutions protocols have not been developed as to when implantable venous access devices are accessed in children with cancer. The differences in complication rates (infection, hematoma, mechanical failure, and extravasation) between immediate versus delayed access remain unknown.
Patients And Methods:
This retrospective study looks at the incidence of complications in two groups of pediatric patients who had an implantable venous access device inserted between 1998 and 2001 at McMaster Children's Hospital. Group 1 (immediate access group) had 23 patients and group 2 (delayed access) had 74 patients.
Results:
The incidence of infection was 22% in group 1 and 14% in group 2. The difference between these infection rates was not statistically significant. All infections occurred in patients with a diagnosis of acute lymphoblastic leukemia. Of the patients in this study with acute lymphoblastic leukemia, 33% in group 1 and 36% in group 2 developed infections.
Conclusions:
These results suggest that implantable venous access devices can be accessed at the time of device insertion to decrease painful needle punctures in children with cancer and to provide secure immediate central venous access.
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