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The pediatric DAV-expert algorithm: A GAVeCeLT/GAVePed consensus for the choice of the most appropriate venous access
Mauro Pittiruti1, Alessandro Crocoli2, Clelia Zanaboni3
1Department of Surgery, Catholic University Hospital "A.Gemelli," Rome, Italy.
Insights
Choosing the right venous access device for pediatric patients is critical. This consensus provides evidence-based recommendations and a visual algorithm for optimal device selection in children.
Area of Science:
- Pediatric Medicine
- Vascular Access Devices
- Evidence-Based Practice
Background:
- Current selection of pediatric venous access devices relies on operator experience and resource availability.
- Limited options for pediatric venous access necessitate evidence-based decision-making.
- Existing algorithms for pediatric venous access device selection are not fully satisfactory for clinical practice.
Purpose of the Study:
- To develop a national consensus on the selection of venous access devices in pediatric patients.
- To provide structured recommendations based on a systematic review of available evidence.
- To create a practical visual algorithm for clinical use.
Main Methods:
- A systematic review of existing literature on pediatric venous access devices was conducted.
- A panel of Italian experts in venous access developed consensus recommendations.
- Recommendations were formulated based on 10 key questions covering various clinical scenarios.
Main Results:
- Structured recommendations were established for choosing venous access devices in children.
- Recommendations address both emergency and elective situations, for hospitalized and non-hospitalized children.
- Only statements with complete expert agreement were included in the final recommendations.
Conclusions:
- A consensus was reached on the optimal choice of venous access devices for pediatric patients.
- The developed recommendations and visual algorithm aim to improve clinical practice.
- This evidence-based approach supports informed decision-making for pediatric venous access.
Abstract:
In pediatric patients, the choice of the venous access device currently relies upon the operator's experience and preference and on the local availability of specific resources and technologies. Though, considering the limited options for venous access in children if compared to adults, such clinical choice has a great critical relevance and should preferably be based on the best available evidence. Though some algorithms have been published over the last 5 years, none of them seems fully satisfactory and useful in clinical practice. Thus, the GAVePed-which is the pediatric interest group of the most important Italian group on venous access, GAVeCeLT-has developed a national consensus about the choice of the venous access device in children. After a systematic review of the available evidence, the panel of the consensus (which included Italian experts with documented competence in this area) has provided structured recommendations answering 10 key questions regarding the choice of venous access both in emergency and in elective situations, both in the hospitalized and in the non-hospitalized child. Only statements reaching a complete agreement were included in the final recommendations. All recommendations were also structured as a simple visual algorithm, so as to be easily translated into clinical practice.
