Abstract

Management and successful use of vascular access are critical issues in pediatric patients affected by malignancies. Prolonged course of disease, complex and various treatment protocols require long-lasting vascular access providing adequate tools to administrate those therapies and to collect routine blood sampling without painful and repeated venipuncture. For these reasons, central venous catheters are currently an important component in pediatric onco-hematological care, with a direct influence on outcome. Indeed, there are peculiar issues (techniques of insertion, management, complications etc.) which must be well-known in order to improve the outcome and the quality of life of children with cancer.

Highlights

  • Cancer is a rare condition in children, it represents the second most common cause of death in patients older than 12 months [1,2]

  • (30% in 60’s to around 98% in 2020) [6] and Wilms tumor (20% to 93%) [7,8]. All those successes have been accomplished since the introduction of the concept of multidisciplinary treatment in pediatric onco-hematology: more intensive chemotherapy and radiotherapy regimens, possibility of stem cells/bone marrow transplantation, introduction of new therapies and different surgical approaches have been developed over the last decades, playing an important role in different treatment protocols and having a direct influence on the outcome

  • Patient’s requirements are the first and most important issue to consider for the choice of vascular access device (VAD), taking into account expected duration, type and previous history of onco-hematology treatment

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Summary

Introduction

Cancer is a rare condition in children, it represents the second most common cause of death in patients older than 12 months [1,2]. A more remarkable improvement has been reported for tumors like acute lymphoblastic leukemia (5% in early 50’s to 91% in 2020) [4,5], lymphomas (30% in 60’s to around 98% in 2020) [6] and Wilms tumor (20% to 93%) [7,8] All those successes have been accomplished since the introduction of the concept of multidisciplinary treatment in pediatric onco-hematology: more intensive chemotherapy and radiotherapy regimens, possibility of stem cells/bone marrow transplantation, introduction of new therapies (like immune and target therapy) and different surgical approaches have been developed over the last decades, playing an important role in different treatment protocols and having a direct influence on the outcome. The aim of this paper is the provide an updated review of the general recommendations for VADs management

General Principles
Indications
Placement Technique
Prevention and Management of Complications
Catheter Removal
Findings
Conclusions
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