Loading…
Pediatric central venous access devices: practice, performance, and costs
Background Healthcare delivery is reliant on a functional central venous access device (CVAD), but the knowledge surrounding the burden of pediatric CVAD-associated harm is limited. Methods A prospective cohort study at a tertiary-referral pediatric hospital in Australia. Children
Saved in:
| Published in: | Pediatric research 2022-11, Vol.92 (5), p.1381-1390 |
|---|---|
| Main Authors: | , , , , , , , , , , , |
| Format: | Article |
| Language: | English |
| Subjects: | |
| Citations: | Items that this one cites Items that cite this one |
| Online Access: | Get full text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| cited_by | cdi_FETCH-LOGICAL-c474t-e008785f83be659ed445d2940cb0c62fe636c62f136cb153382944ccfa25ada53 |
|---|---|
| cites | cdi_FETCH-LOGICAL-c474t-e008785f83be659ed445d2940cb0c62fe636c62f136cb153382944ccfa25ada53 |
| container_end_page | 1390 |
| container_issue | 5 |
| container_start_page | 1381 |
| container_title | Pediatric research |
| container_volume | 92 |
| creator | Ullman, Amanda J. Gibson, Victoria Takashima, Mari D. Kleidon, Tricia M. Schults, Jessica Saiyed, Masnoon Cattanach, Paula Paterson, Rebecca Cooke, Marie Rickard, Claire M. Byrnes, Joshua Chopra, Vineet |
| description | Background
Healthcare delivery is reliant on a functional central venous access device (CVAD), but the knowledge surrounding the burden of pediatric CVAD-associated harm is limited.
Methods
A prospective cohort study at a tertiary-referral pediatric hospital in Australia. Children |
| doi_str_mv | 10.1038/s41390-022-01977-1 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9700519</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2627135044</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-e008785f83be659ed445d2940cb0c62fe636c62f136cb153382944ccfa25ada53</originalsourceid><addsrcrecordid>eNp9UctOwzAQtBCIlsIPcECRuHAgsH7FMQckVPGoVAkOcLZcZ1NStUmx00r8PS4t5XHgtGvP7HjHQ8gxhQsKPL8MgnINKTCWAtVKpXSHdKnk8UoItUu6AJymXOu8Qw5CmABQIXOxTzpcUp5Rrbtk8IRFZVtfucRh3Xo7TZZYN4uQWOcwhKTAZRWbq2TurWtje57M0ZeNn9l6dbB1kbgmtOGQ7JV2GvBoU3vk5e72uf-QDh_vB_2bYeqEEm2KALnKZZnzEWZSYyGELJgW4EbgMlZixrNVjQu6UTTD8wgK50rLpC2s5D1yvdadL0YzLDZbm7mvZta_m8ZW5jdSV69m3CyNVgCS6ihwthHwzdsCQ2tmVXA4ndoao3HDMqYol_EPI_X0D3XSLHwd7RmmBFCVZ4JHFluznG9C8Fhul6FgVkmZdVImJmU-kzI0Dp38tLEd-YomEviaECJUj9F_v_2P7Ae5956X</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2740178643</pqid></control><display><type>article</type><title>Pediatric central venous access devices: practice, performance, and costs</title><source>Springer Link</source><creator>Ullman, Amanda J. ; Gibson, Victoria ; Takashima, Mari D. ; Kleidon, Tricia M. ; Schults, Jessica ; Saiyed, Masnoon ; Cattanach, Paula ; Paterson, Rebecca ; Cooke, Marie ; Rickard, Claire M. ; Byrnes, Joshua ; Chopra, Vineet</creator><creatorcontrib>Ullman, Amanda J. ; Gibson, Victoria ; Takashima, Mari D. ; Kleidon, Tricia M. ; Schults, Jessica ; Saiyed, Masnoon ; Cattanach, Paula ; Paterson, Rebecca ; Cooke, Marie ; Rickard, Claire M. ; Byrnes, Joshua ; Chopra, Vineet</creatorcontrib><description>Background
Healthcare delivery is reliant on a functional central venous access device (CVAD), but the knowledge surrounding the burden of pediatric CVAD-associated harm is limited.
Methods
A prospective cohort study at a tertiary-referral pediatric hospital in Australia. Children <18 years undergoing insertion of a CVAD were screened from the operating theatre and intensive care unit records, then assessed bi-weekly for up to 3 months. Outcomes were CVAD failure and complications, and associated healthcare costs (cost of complications).
Results
163 patients with 200 CVADs were recruited and followed for 6993 catheter days, with peripherally inserted central catheters most common (
n
= 119; 60%). CVAD failure occurred in 20% of devices (
n
= 30; 95% CI: 15–26), at an incidence rate (IR) of 5.72 per 1000 catheter days (95% CI: 4.09–7.78). CVAD complications were evident in 43% of all CVADs (
n
= 86; 95% CI: 36–50), at a rate of 12.29 per 1000 catheter days (95% CI: 9.84–15.16). CVAD failure costs were A$826 per episode, and A$165,372 per 1000 CVADs. Comparisons between current and recommended practice revealed inconsistent use of ultrasound guidance for insertion, sub-optimal tip-positioning, and appropriate device selection.
Conclusions
CVAD complications and failures represent substantial burdens to children and healthcare. Future efforts need to focus on the inconsistent use of best practices.
Impact
Current surveillance of central venous access device (CVAD) performance is likely under-estimating actual burden on pediatric patients and the healthcare system.
CVAD failure due to complication was evident in 20% of CVADs. Costs associated with CVAD complications average at $2327 (AUD, 2020) per episode.
Further investment in key diverse practice areas, including new CVAD types, CVAD pathology-based occlusion and dislodgment strategies, the appropriate use of device types, and tip-positioning technologies, will likely lead to extensive benefit.</description><identifier>ISSN: 0031-3998</identifier><identifier>EISSN: 1530-0447</identifier><identifier>DOI: 10.1038/s41390-022-01977-1</identifier><identifier>PMID: 35136199</identifier><language>eng</language><publisher>New York: Nature Publishing Group US</publisher><subject>Australia - epidemiology ; Catheterization, Central Venous - adverse effects ; Catheterization, Peripheral ; Catheters ; Central Venous Catheters - adverse effects ; Child ; Clinical ; Clinical Research Article ; Costs ; Failure ; Humans ; Incidence ; Medicine ; Medicine & Public Health ; Pediatric Surgery ; Pediatrics ; Prospective Studies ; Venous access</subject><ispartof>Pediatric research, 2022-11, Vol.92 (5), p.1381-1390</ispartof><rights>The Author(s) 2022</rights><rights>2022. The Author(s).</rights><rights>The Author(s) 2022. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-e008785f83be659ed445d2940cb0c62fe636c62f136cb153382944ccfa25ada53</citedby><cites>FETCH-LOGICAL-c474t-e008785f83be659ed445d2940cb0c62fe636c62f136cb153382944ccfa25ada53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35136199$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ullman, Amanda J.</creatorcontrib><creatorcontrib>Gibson, Victoria</creatorcontrib><creatorcontrib>Takashima, Mari D.</creatorcontrib><creatorcontrib>Kleidon, Tricia M.</creatorcontrib><creatorcontrib>Schults, Jessica</creatorcontrib><creatorcontrib>Saiyed, Masnoon</creatorcontrib><creatorcontrib>Cattanach, Paula</creatorcontrib><creatorcontrib>Paterson, Rebecca</creatorcontrib><creatorcontrib>Cooke, Marie</creatorcontrib><creatorcontrib>Rickard, Claire M.</creatorcontrib><creatorcontrib>Byrnes, Joshua</creatorcontrib><creatorcontrib>Chopra, Vineet</creatorcontrib><title>Pediatric central venous access devices: practice, performance, and costs</title><title>Pediatric research</title><addtitle>Pediatr Res</addtitle><addtitle>Pediatr Res</addtitle><description>Background
Healthcare delivery is reliant on a functional central venous access device (CVAD), but the knowledge surrounding the burden of pediatric CVAD-associated harm is limited.
Methods
A prospective cohort study at a tertiary-referral pediatric hospital in Australia. Children <18 years undergoing insertion of a CVAD were screened from the operating theatre and intensive care unit records, then assessed bi-weekly for up to 3 months. Outcomes were CVAD failure and complications, and associated healthcare costs (cost of complications).
Results
163 patients with 200 CVADs were recruited and followed for 6993 catheter days, with peripherally inserted central catheters most common (
n
= 119; 60%). CVAD failure occurred in 20% of devices (
n
= 30; 95% CI: 15–26), at an incidence rate (IR) of 5.72 per 1000 catheter days (95% CI: 4.09–7.78). CVAD complications were evident in 43% of all CVADs (
n
= 86; 95% CI: 36–50), at a rate of 12.29 per 1000 catheter days (95% CI: 9.84–15.16). CVAD failure costs were A$826 per episode, and A$165,372 per 1000 CVADs. Comparisons between current and recommended practice revealed inconsistent use of ultrasound guidance for insertion, sub-optimal tip-positioning, and appropriate device selection.
Conclusions
CVAD complications and failures represent substantial burdens to children and healthcare. Future efforts need to focus on the inconsistent use of best practices.
Impact
Current surveillance of central venous access device (CVAD) performance is likely under-estimating actual burden on pediatric patients and the healthcare system.
CVAD failure due to complication was evident in 20% of CVADs. Costs associated with CVAD complications average at $2327 (AUD, 2020) per episode.
Further investment in key diverse practice areas, including new CVAD types, CVAD pathology-based occlusion and dislodgment strategies, the appropriate use of device types, and tip-positioning technologies, will likely lead to extensive benefit.</description><subject>Australia - epidemiology</subject><subject>Catheterization, Central Venous - adverse effects</subject><subject>Catheterization, Peripheral</subject><subject>Catheters</subject><subject>Central Venous Catheters - adverse effects</subject><subject>Child</subject><subject>Clinical</subject><subject>Clinical Research Article</subject><subject>Costs</subject><subject>Failure</subject><subject>Humans</subject><subject>Incidence</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Pediatric Surgery</subject><subject>Pediatrics</subject><subject>Prospective Studies</subject><subject>Venous access</subject><issn>0031-3998</issn><issn>1530-0447</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNp9UctOwzAQtBCIlsIPcECRuHAgsH7FMQckVPGoVAkOcLZcZ1NStUmx00r8PS4t5XHgtGvP7HjHQ8gxhQsKPL8MgnINKTCWAtVKpXSHdKnk8UoItUu6AJymXOu8Qw5CmABQIXOxTzpcUp5Rrbtk8IRFZVtfucRh3Xo7TZZYN4uQWOcwhKTAZRWbq2TurWtje57M0ZeNn9l6dbB1kbgmtOGQ7JV2GvBoU3vk5e72uf-QDh_vB_2bYeqEEm2KALnKZZnzEWZSYyGELJgW4EbgMlZixrNVjQu6UTTD8wgK50rLpC2s5D1yvdadL0YzLDZbm7mvZta_m8ZW5jdSV69m3CyNVgCS6ihwthHwzdsCQ2tmVXA4ndoao3HDMqYol_EPI_X0D3XSLHwd7RmmBFCVZ4JHFluznG9C8Fhul6FgVkmZdVImJmU-kzI0Dp38tLEd-YomEviaECJUj9F_v_2P7Ae5956X</recordid><startdate>20221101</startdate><enddate>20221101</enddate><creator>Ullman, Amanda J.</creator><creator>Gibson, Victoria</creator><creator>Takashima, Mari D.</creator><creator>Kleidon, Tricia M.</creator><creator>Schults, Jessica</creator><creator>Saiyed, Masnoon</creator><creator>Cattanach, Paula</creator><creator>Paterson, Rebecca</creator><creator>Cooke, Marie</creator><creator>Rickard, Claire M.</creator><creator>Byrnes, Joshua</creator><creator>Chopra, Vineet</creator><general>Nature Publishing Group US</general><general>Nature Publishing Group</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20221101</creationdate><title>Pediatric central venous access devices: practice, performance, and costs</title><author>Ullman, Amanda J. ; Gibson, Victoria ; Takashima, Mari D. ; Kleidon, Tricia M. ; Schults, Jessica ; Saiyed, Masnoon ; Cattanach, Paula ; Paterson, Rebecca ; Cooke, Marie ; Rickard, Claire M. ; Byrnes, Joshua ; Chopra, Vineet</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-e008785f83be659ed445d2940cb0c62fe636c62f136cb153382944ccfa25ada53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Australia - epidemiology</topic><topic>Catheterization, Central Venous - adverse effects</topic><topic>Catheterization, Peripheral</topic><topic>Catheters</topic><topic>Central Venous Catheters - adverse effects</topic><topic>Child</topic><topic>Clinical</topic><topic>Clinical Research Article</topic><topic>Costs</topic><topic>Failure</topic><topic>Humans</topic><topic>Incidence</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Pediatric Surgery</topic><topic>Pediatrics</topic><topic>Prospective Studies</topic><topic>Venous access</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ullman, Amanda J.</creatorcontrib><creatorcontrib>Gibson, Victoria</creatorcontrib><creatorcontrib>Takashima, Mari D.</creatorcontrib><creatorcontrib>Kleidon, Tricia M.</creatorcontrib><creatorcontrib>Schults, Jessica</creatorcontrib><creatorcontrib>Saiyed, Masnoon</creatorcontrib><creatorcontrib>Cattanach, Paula</creatorcontrib><creatorcontrib>Paterson, Rebecca</creatorcontrib><creatorcontrib>Cooke, Marie</creatorcontrib><creatorcontrib>Rickard, Claire M.</creatorcontrib><creatorcontrib>Byrnes, Joshua</creatorcontrib><creatorcontrib>Chopra, Vineet</creatorcontrib><collection>SpringerOpen</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Health and Medical</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Pediatric research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ullman, Amanda J.</au><au>Gibson, Victoria</au><au>Takashima, Mari D.</au><au>Kleidon, Tricia M.</au><au>Schults, Jessica</au><au>Saiyed, Masnoon</au><au>Cattanach, Paula</au><au>Paterson, Rebecca</au><au>Cooke, Marie</au><au>Rickard, Claire M.</au><au>Byrnes, Joshua</au><au>Chopra, Vineet</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pediatric central venous access devices: practice, performance, and costs</atitle><jtitle>Pediatric research</jtitle><stitle>Pediatr Res</stitle><addtitle>Pediatr Res</addtitle><date>2022-11-01</date><risdate>2022</risdate><volume>92</volume><issue>5</issue><spage>1381</spage><epage>1390</epage><pages>1381-1390</pages><issn>0031-3998</issn><eissn>1530-0447</eissn><abstract>Background
Healthcare delivery is reliant on a functional central venous access device (CVAD), but the knowledge surrounding the burden of pediatric CVAD-associated harm is limited.
Methods
A prospective cohort study at a tertiary-referral pediatric hospital in Australia. Children <18 years undergoing insertion of a CVAD were screened from the operating theatre and intensive care unit records, then assessed bi-weekly for up to 3 months. Outcomes were CVAD failure and complications, and associated healthcare costs (cost of complications).
Results
163 patients with 200 CVADs were recruited and followed for 6993 catheter days, with peripherally inserted central catheters most common (
n
= 119; 60%). CVAD failure occurred in 20% of devices (
n
= 30; 95% CI: 15–26), at an incidence rate (IR) of 5.72 per 1000 catheter days (95% CI: 4.09–7.78). CVAD complications were evident in 43% of all CVADs (
n
= 86; 95% CI: 36–50), at a rate of 12.29 per 1000 catheter days (95% CI: 9.84–15.16). CVAD failure costs were A$826 per episode, and A$165,372 per 1000 CVADs. Comparisons between current and recommended practice revealed inconsistent use of ultrasound guidance for insertion, sub-optimal tip-positioning, and appropriate device selection.
Conclusions
CVAD complications and failures represent substantial burdens to children and healthcare. Future efforts need to focus on the inconsistent use of best practices.
Impact
Current surveillance of central venous access device (CVAD) performance is likely under-estimating actual burden on pediatric patients and the healthcare system.
CVAD failure due to complication was evident in 20% of CVADs. Costs associated with CVAD complications average at $2327 (AUD, 2020) per episode.
Further investment in key diverse practice areas, including new CVAD types, CVAD pathology-based occlusion and dislodgment strategies, the appropriate use of device types, and tip-positioning technologies, will likely lead to extensive benefit.</abstract><cop>New York</cop><pub>Nature Publishing Group US</pub><pmid>35136199</pmid><doi>10.1038/s41390-022-01977-1</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0031-3998 |
| ispartof | Pediatric research, 2022-11, Vol.92 (5), p.1381-1390 |
| issn | 0031-3998 1530-0447 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9700519 |
| source | Springer Link |
| subjects | Australia - epidemiology Catheterization, Central Venous - adverse effects Catheterization, Peripheral Catheters Central Venous Catheters - adverse effects Child Clinical Clinical Research Article Costs Failure Humans Incidence Medicine Medicine & Public Health Pediatric Surgery Pediatrics Prospective Studies Venous access |
| title | Pediatric central venous access devices: practice, performance, and costs |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-01T13%3A05%3A57IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Pediatric%20central%20venous%20access%20devices:%20practice,%20performance,%20and%20costs&rft.jtitle=Pediatric%20research&rft.au=Ullman,%20Amanda%20J.&rft.date=2022-11-01&rft.volume=92&rft.issue=5&rft.spage=1381&rft.epage=1390&rft.pages=1381-1390&rft.issn=0031-3998&rft.eissn=1530-0447&rft_id=info:doi/10.1038/s41390-022-01977-1&rft_dat=%3Cproquest_pubme%3E2627135044%3C/proquest_pubme%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c474t-e008785f83be659ed445d2940cb0c62fe636c62f136cb153382944ccfa25ada53%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2740178643&rft_id=info:pmid/35136199&rfr_iscdi=true |