Insertion-related complications after central venous catheterization in onco-hematologic children: A prospective clinical study.

In oncologic pediatric patients, central venous catheterization may be associated with relevant complications. In 2020, the Italian Group for Long Term Venous Access Devices (GAVeCeLT) has developed an insertion bundle for pediatric central venous catheterization, which includes seven evidence-based strategies apt to prevent such complications: preprocedural ultrasound evaluation, appropriate asepsis, ultrasound-guided venipuncture, intraprocedural tip location by non-radiological methods, proper choice of the exit site by tunneling, sutureless securement, and protection of the exit site using glue and transparent membranes. In this prospective study, we adopted the aforementioned insertion bundle in a cohort of children with oncologic disease requiring central venous catheterization. From January 2020 to April 2025, we inserted 138 central venous access devices in 109 children with solid tumor or hematologic diseases. There were no immediate or early complications; during the first month after insertion, we recorded 3 catheter-related bloodstream infections (0.7/1000 catheter days), 9 mechanical complications requiring removal of the device (6.5%), and no symptomatic catheter-related thrombosis.Conclusion: The results of this prospective study strongly validate the hypothesis that a well-designed insertion bundle is highly effective in optimizing the safety of central venous catheterization in children with neoplastic diseases.