{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T12:20:49Z","timestamp":1771676449627,"version":"3.50.1"},"reference-count":21,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,11,4]],"date-time":"2022-11-04T00:00:00Z","timestamp":1667520000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Central venous access devices (CVAD) are vital for cancer therapeutics in pediatric oncology. Tunneled vascular access devices (TVAD) are preferred in children for prolonged and frequent vascular access. Data on insertion, care, and complications of CVAD in children from low middle\u2010income countries (LMIC) are scarce, heterogeneous, and retrospective.<\/jats:p><\/jats:sec><jats:sec><jats:title>Procedure<\/jats:title><jats:p>This prospective observational study on eligible children &lt;12\u00a0years with pediatric malignancies requiring chemotherapy for minimum 6\u00a0months from diagnosis excluded children with mucosal bleeding, coagulopathy, and infections. TVAD insertion was ultrasound (USG) guided. Number of catheter\u2010days, surgical and nonsurgical complications, and risk factors for catheter\u2010related bloodstream infections (CRBSI) were noted TVAD removal due to complications, therapy completion, tumor progression, or death.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Data from 61 of 86 eligible children with median age 42\u00a0months (range 1\u2013144) were analyzed. Hematological malignancy and severe thrombocytopenia were seen in 37\/61 (61%) and 18\/61 (30%) children, respectively. First\u2010attempt success rate was 74%. Surgical complications were seen in four of 61 (7%). Nonsurgical complications were seen in 33\/61 (54%) children; CRBSI was commonest 24\/61 (39%), causing removal of TVAD in 14\/61 (23%). Incidence per 1000 catheter\u2010days for CRBSI was 3.24. Antibiotic lock therapy could salvage nine of 24 TVAD with CRBSI. Thrombus and accidental removal was seen in six of 61 (10%) and four of 61 (7%). None of the studied risk factors were significantly associated with CRBSI. The mean insertion duration of TVAD was 121\u00a0\u00b1\u00a090\u00a0days.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>USG\u2010guided TVAD insertion is safe and reliable way for chemotherapy administration with acceptable complications in children with malignancies in LMIC, including children with severe thrombocytopenia.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.30029","type":"journal-article","created":{"date-parts":[[2022,11,4]],"date-time":"2022-11-04T11:45:38Z","timestamp":1667562338000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Safety and outcome of ultrasound\u2010guided tunneled central venous catheter in children with cancers from low middle\u2010income country: A prospective study"],"prefix":"10.1002","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4754-8340","authenticated-orcid":false,"given":"Sanjeev","family":"Khera","sequence":"first","affiliation":[{"name":"Department of Pediatrics Army Hospital Research and Referral  Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amit","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Army Hospital Research and Referral  Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Badal","family":"Parikh","sequence":"additional","affiliation":[{"name":"Department of Anesthesia Army Hospital Research and Referral  Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aashish Kumar","family":"Simalti","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Military Hospital Dehradun, Army Hospital Research and Referral  Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saket","family":"Davera","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Army Hospital Research and Referral  Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pooja","family":"Mahajan","sequence":"additional","affiliation":[{"name":"Department of Microbiology Army Hospital Research and Referral  Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandeep","family":"Dhingra","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Army Hospital Research and Referral  Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,11,4]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aeh109"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2019.00260"},{"issue":"1","key":"e_1_2_8_4_1","first-page":"70","article-title":"Vascular access in pediatric oncology and hematology: state of the art","volume":"9","author":"Crocoli A","year":"2022","journal-title":"Children (Basel)"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.5301\/jva.5000314"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2012.45.5733"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2015-1507"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.14423"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-017-4985-8"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2018.10.054"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.4103\/0971-5851.125234"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.4065\/81.9.1159"},{"key":"e_1_2_8_13_1","unstructured":"GuptaS HowardSC HungerSP et\u00a0al.Treating childhood cancer in low\u2010 and middle\u2010income countries. In: Cancer: Disease Control Priorities. Vol 3. 3rd ed.The International Bank for Reconstruction and Development\/The World Bank;2015.https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK343626\/. Assecced 9 June 2022."},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.3322\/CA.2008.0015"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.4103\/0971-5851.195732"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-020-04640-0"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2009.03171.x"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2018.06.956"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1086\/648439"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2017.06.013"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2009.03.015"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.2147\/PPA.S142556"}],"container-title":["Pediatric Blood &amp; Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pbc.30029","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pbc.30029","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pbc.30029","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,20]],"date-time":"2023-08-20T05:53:01Z","timestamp":1692510781000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pbc.30029"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,4]]},"references-count":21,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023,1]]}},"alternative-id":["10.1002\/pbc.30029"],"URL":"https:\/\/doi.org\/10.1002\/pbc.30029","archive":["Portico"],"relation":{},"ISSN":["1545-5009","1545-5017"],"issn-type":[{"value":"1545-5009","type":"print"},{"value":"1545-5017","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,4]]},"assertion":[{"value":"2022-06-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-09-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-11-04","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e30029"}}