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Substantial harm associated with failure of chronic paediatric central venous access devices

Amanda J Ullman1,2,3, Tricia Kleidon3,4, Marie Cooke1,3

  • 1School of Nursing and Midwifery, Griffith University, Nathan, Australia.

BMJ Case Reports
|July 9, 2017
PubMed

Insights

Central venous access devices (CVADs) frequently fail in children with chronic conditions, leading to repeated procedures and high costs. Improving CVAD reliability is crucial for pediatric patient care and healthcare economics.

Area of Science:

  • Pediatric Healthcare
  • Biomedical Engineering
  • Vascular Access

Background:

  • Central venous access devices (CVADs) are vital for pediatric patients with chronic conditions like cancer and gastrointestinal disorders.
  • High rates of device failure and complications necessitate frequent interventions.

Observation:

  • A case study involving a child with short gut syndrome experienced ten CVAD insertions over 2.5 years, with nine failures.
  • This led to numerous anesthetic procedures, injuries, interrupted nutrition, and significant distress.

Findings:

  • Each tunnelled CVAD insertion or rewiring incurred an estimated institutional cost of $A10,253 (2016 AUD).
  • Device failures resulted in delayed treatment, increased patient morbidity, and substantial healthcare expenditure.

Implications:

  • Frequent CVAD failures significantly impact pediatric patient quality of life and family well-being.
  • The high cost associated with CVAD complications presents a considerable burden on international health services.

Keywords:
Congenital DisordersInfection Control In HospitalIntravenous / Infusion Nursing

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