Central Venous Access Device Complications in Children With Leukemia: A Systematic Review and Meta-Analysis.
Mahesh Sakthivel, Pranathi Katneni, Ramesh M Nataraja et al.
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In 30 seconds
This systematic review and random-effects meta-analysis assessed central venous access device (CVAD) complications in children aged 18 years or younger receiving treatment for leukemia. Across 24 studies covering 13,879 CVADs, the pooled proportion of central line-associated bloodstream infection (CLABSI) was 31.3% (95% CI 23.6-39.6), while device failure was 18.5% (95% CI 10.8-27.8). These were the most frequent reported complications. Tunneled devices were associated with a higher proportion of complications than totally implantable devices, although the authors call for further prospective research.
Key findings
- CLABSI had a pooled proportion of 31.3% (95% CI 23.6-39.6).
- Device failure had a pooled proportion of 18.5% (95% CI 10.8-27.8).
- CVAD-associated venous thromboembolism had a pooled proportion of 5.2% (95% CI 2.9-8.3).
- Tunneled devices were associated with a higher proportion of complications than totally implantable devices.
Why it matters
Children receiving leukemia treatment often need prolonged central venous access, and this synthesis quantifies the range of associated complications across a substantial body of studies. The high pooled proportions of CLABSI and device failure underscore the clinical burden of access-related problems in this population and provide context for evaluating device-related risks.
What to keep in mind
The review included studies spanning 1970-2025, and the authors state that further large prospective studies with long-term follow-up are needed to investigate the findings and their impact on morbidity and mortality.