Evidence map›Paper›PMID 38937641›Full record

ArticlePediatric research2025

Use of central venous access devices outside of the pediatric intensive care units.

Alina G Burek, Chris Bumgardner, Tracey Liljestrom, Kelsey Porada, Amy Y Pan, Melodee Liegl, Eric R Coon, Kathryn E Flynn, Amanda J Ullman, David C Brousseau

Abstract read
In one paragraph

Article in Pediatric research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Article
  5. Core Tenets of Central Venous Access in Children.Seminars in interventional radiology · 2025
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Alina G BurekChildren's Wisconsin, 8915 W Connell Ct, Milwaukee, WI, USA. aburek@mcw.edu.
Chris BumgardnerChildren's Wisconsin, 8915 W Connell Ct, Milwaukee, WI, USA.
Tracey LiljestromChildren's Wisconsin, 8915 W Connell Ct, Milwaukee, WI, USA.
Kelsey PoradaDepartment of Pediatrics, Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI, USA.
Amy Y PanDepartment of Pediatrics, Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI, USA.
Melodee LieglDepartment of Pediatrics, Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI, USA.
Eric R CoonDepartment of Pediatrics, University of Utah, Salt Lake City, UT, USA.
Kathryn E FlynnDepartment of Medicine, Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI, USA.
Amanda J UllmanSchool of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, QLD, Australia.
David C BrousseauDepartment of Pediatrics, Nemours Children's Health Delaware and the Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, DE, USA.

Funding

Clinical and Translational Science AwardUL1TR001436 · NCATS · MEDICAL COLLEGE OF WISCONSIN · PI FREED, JULIE K · 2015 to 2025
$47.5M
NCATS NIH HHS UL1 TR001436
6 · The paper itself

Abstract

backgroundCentral venous access devices (CVAD) are associated with central line associated bloodstream infection (CLABSI) and venous thromboembolism (VTE). We identified trends in non-intensive care unit (ICU) CVAD utilization, described complication rates, and compared resources between low and high CVAD sites.

methodsWe combined data from the Pediatric Health Information System (PHIS) database and surveys from included hospitals. We analyzed 10-year trends in CVAD encounters for non-ICU children between 01/2012-12/2021 and described variation and complication rates between 01/2017-12/2021. Using Fisher's exact test, we compared resources between low and high CVAD users.

resultsCVAD use decreased from 6.3% to 3.8% of hospitalizations over 10 years. From 2017-2021, 67,830 encounters with CVAD were identified. Median age was 7 (IQR 2-13) years; 46% were female. Significant variation in CVAD utilization exists (range 1.4-16.9%). Rates of CLABSI and VTE were 4.0% and 3.4%, respectively. Survey responses from 33/41 (80%) hospitals showed 91% had vascular access teams, 30% used vascular access selection guides, and 70% used midline/long peripheral catheters. Low CVAD users were more likely to have a team guiding device selection (100% vs 43%, p = 0.026).

conclusionsCVAD utilization decreased over time. Significant variation in CVAD use remains and may be associated with hospital resources. IMPACT: Central venous access device (CVAD) use outside of the ICU is trending down; however, significant variation exists between institutions. Children with CVADs hospitalized on the acute care units had a CLABSI rate of 4% and VTE rate of 3.4%. 91% of surveyed institutions have a vascular access team; however, the services provided vary between institutions. Even though 70% of the surveyed institutions have the ability to place midline/long peripheral catheters, the majority use these catheters less than a few times per month. Institutions with low CVAD use are more likely to have a vascular access team that guides device selection.

Indexed as

Catheterization, Central VenousCatheter-Related InfectionsCentral Venous CathetersIntensive Care Units, PediatricAdolescentChildChild, PreschoolDatabases, FactualFemaleHumansMaleVenous Thromboembolism

Identifiers

PMID38937641
PMCPMC12884970

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.