This study is a systematic review looking at the proportion and rate of central venous access device (CVAD) failure and complications in pediatrics across CVAD types. It was found that 25% of all CVADs fail or have significant complications (i.e. become a source of infection or be obstructed from clots). PICCs had a high rate of failure and complications, approximately equal to umbilical catheters in neonates, while, as expected, totally implanted devices were found to have the lowest rates. Many of the causes of the failures were found to be preventable, as quality improvement initiatives in various studies did show improvement in the CVAD survival and function. This study advocates for the careful use of CVADs, which aren’t without their risks, and continued quality improvement initiatives to decrease the rates of failure and complications.
* Central venous access devices, including PICCs and ports, have significant rates of failure and complications, many of which are due to preventable factors.