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Incidence and risk factors of complications during central venous access devices removal in children

Sue Liu1, Ramesh M Nataraja1,2,3, Amiria Lynch3

  • 1Department of Paediatrics, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia.

The Journal of Vascular Access
|August 4, 2024
PubMed

Insights

Complications during central venous access device (CVAD) removal in children occur in nearly 10% of cases. Longer indwelling times, especially over 2 years, significantly increase the risk of difficult CVAD removal.

Area of Science:

  • Pediatric Medicine
  • Medical Devices
  • Surgical Complications

Background:

  • Central venous access devices (CVADs) are crucial for long-term therapy in pediatric patients.
  • Complications during CVAD removal can lead to patient distress and increased healthcare costs.

Purpose of the Study:

  • To determine the incidence of complications during central venous access device removal in children.
  • To identify risk factors associated with difficult CVAD removal in pediatric patients.

Main Methods:

  • Retrospective analysis of 208 CVAD removals in children from 2018-2023.
  • Logistic regression and ROC curve analysis were employed to identify risk factors and optimal cut-offs for indwelling time.

Main Results:

  • Approximately 9.6% of CVAD removals were complicated by difficulty.
  • Children with acute lymphoblastic leukemia (ALL) and longer indwelling times (>2.09 years) had a significantly higher risk of complicated removal.
  • An indwelling time exceeding 2.09 years was associated with a 2.87-fold increased risk of difficult removal.

Conclusions:

  • Nearly 10% of pediatric CVAD removals are associated with complications.
  • Longer indwelling times (>2 years) are a significant risk factor for complicated CVAD removal.
  • Preventive strategies should be considered for children with long-term central venous access to mitigate removal complications.
Abstract

Keywords:
Central vascular access deviceschildrencomplicationspaediatricremoval

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