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Evidence‐Based Strategies and Recommendations for Preservation of Central Venous Access in Children
Author(s) -
Baskin Kevin M.,
Mermel Leonard A.,
Saad Theodore F.,
Journeycake Janna M.,
Schaefer Carrie M.,
Modi Biren P.,
Vrazas John I.,
Gore Beth,
Drews Barbie B.,
Doellman Darcy,
Kocoshis Samuel A.,
AbuElmagd Kareem M.,
Towbin Richard B.
Publication year - 2019
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1002/jpen.1591
Subject(s) - medicine , intensive care medicine , multidisciplinary approach , referral , central venous catheter , venous access , medline , medical emergency , nursing , catheter , surgery , social science , sociology , political science , law
Children with chronic illness often require prolonged or repeated venous access. They remain at high risk for venous catheter–related complications (high‐risk patients), which largely derive from elective decisions during catheter insertion and continuing care. These complications result in progressive loss of the venous capital (patent and compliant venous pathways) necessary for delivery of life‐preserving therapies. A nonstandardized, episodic, isolated approach to venous care in these high‐need, high‐cost patients is too often the norm, imposing a disproportionate burden on affected persons and escalating costs. This state‐of‐the‐art review identifies known failure points in the current systems of venous care, details the elements of an individualized plan of care, and emphasizes a patient‐centered, multidisciplinary, collaborative, and evidence‐based approach to care in these vulnerable populations. These guidelines are intended to enable every practitioner in every practice to deliver better care and better outcomes to these patients through awareness of critical issues, anticipatory attention to meaningful components of care, and appropriate consultation or referral when necessary. *