Abstract:
Purpose: This study aimed to explore current central vascular access device (CVAD) management practices in pediatric cancer care globally and compare practices across high-income and middle-income (i.e., upper middle-income and lower middle-income) countries.
Methods: A descriptive cross-sectional international survey was conducted between May 2022 and December 2023. Clinicians involved in CVAD insertion/management for pediatric cancer patients were invited to participate through established clinical networks globally. The survey covered CVAD management practices, including dressings, securements, routine care, and maintenance procedures.
Results: A total of 220 responses from 42 countries were received. Polyurethane dressings were most commonly used across all CVAD types (55-65/34.2-40.4). Bordered dressings were the primary securement method for all CVAD types (69-96/161, 42.9-59.6%). Routine practices varied, with 31/102 (30.4%) assessing CVADs hourly during infusion in high-income countries and 22 (37.3%) assessing every shift in middle-income countries. Heparin and normal saline were the commonly used solutions for flushing and locking. Chlorhexidine 2% in 70% alcohol was the predominant decontamination solution in high-income countries (64/102, 62.8%), while alcohol was more common in middle-income countries (22/59, 37.3%). Differences were observed between high-income and middle-income countries in the types of dressings, securements, and maintenance practices used.
Conclusion: This study revealed significant variability in CVAD management practices for pediatric cancer care globally, particularly between high-income and middle-income countries. These findings highlight the need for standardized, evidence-based guidelines considering resource availability and contextual factors to improve CVAD management in pediatric oncology across diverse healthcare settings.
Reference:Hyun A, Takashima MD, de Souza S, Gibson V, Silva TL, Rocha PK, Vetcho S, Ullman AJ. Central venous access device management for children undergoing treatment for blood disorders and cancer: a descriptive international cross-sectional survey. Support Care Cancer. 2025 Feb 12;33(3):179. doi: 10.1007/s00520-025-09240-z. PMID: 39937270; PMCID: PMC11821666.