{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T12:21:19Z","timestamp":1765887679864},"reference-count":17,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2015,3,31]],"date-time":"2015-03-31T00:00:00Z","timestamp":1427760000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100007788","name":"Blood Disease Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007788","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005744","name":"Lastentautien Tutkimuss\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005744","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Haemophilia"],"published-print":{"date-parts":[[2015,11]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Children with haemophilia require venous access for regular infusion of coagulation factors. A central venous access device (<jats:styled-content style=\"fixed-case\">CVAD<\/jats:styled-content>) ensures long\u2010term access but associates with infectious and non\u2010infectious complications with proposed risk factors of young age at initial <jats:styled-content style=\"fixed-case\">CVAD<\/jats:styled-content> implantation and presence of an inhibitor. Our aim was to evaluate the incidence and risk factors for complications associated with <jats:styled-content style=\"fixed-case\">CVAD<\/jats:styled-content> usage in a retrospective nationwide multicentre study in five Finnish Paediatric Haemophilia Treatment Centers. Our study investigated 106 <jats:styled-content style=\"fixed-case\">CVAD<\/jats:styled-content>s in 58 patients with 137\u00a0971 <jats:styled-content style=\"fixed-case\">CVAD<\/jats:styled-content> days. The median access survival was 1159 <jats:styled-content style=\"fixed-case\">CVAD<\/jats:styled-content> days, and most often a malfunction led to <jats:styled-content style=\"fixed-case\">CVAD<\/jats:styled-content> removal after a long survival (median of 1640 <jats:styled-content style=\"fixed-case\">CVAD<\/jats:styled-content> days). We detected a very low bloodstream infection rate (0.12\/1000 <jats:styled-content style=\"fixed-case\">CVAD<\/jats:styled-content> days). The presence of neutralizing inhibitor was a significant risk factor for infection. Heparin vs. saline flushing did not influence the <jats:styled-content style=\"fixed-case\">CVAD<\/jats:styled-content> outcome. We detected a lower infection rate than previously reported, although 90% of the patients were very young (&lt;2\u00a0years) at first insertion (median age\u00a0=\u00a01.02\u00a0year). Port access was frequent after initial implantation: six patients (10%) used the port daily for immune tolerance induction therapy and 74% at least twice weekly for prophylaxis. Young age did not increase the risk of infections, as 59% of the <jats:styled-content style=\"fixed-case\">CVAD<\/jats:styled-content>\u2010related infections were recorded in children over 6\u00a0years of age. Our national experience confirms the safety of prophylactic factor concentrate administration via ports even in very young children.<\/jats:p>","DOI":"10.1111\/hae.12665","type":"journal-article","created":{"date-parts":[[2015,3,31]],"date-time":"2015-03-31T20:11:30Z","timestamp":1427832690000},"page":"747-753","source":"Crossref","is-referenced-by-count":11,"title":["Complications associated with central venous access device in children with haemophilia: a nationwide multicentre study in Finland"],"prefix":"10.1111","volume":"21","author":[{"given":"K.","family":"Veps\u00e4l\u00e4inen","sequence":"first","affiliation":[{"name":"Department of Pediatrics Kuopio University Hospital Kuopio Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Lassila","sequence":"additional","affiliation":[{"name":"Coagulation Disorders Unit Department of Hematology and Cancer Center Helsinki University Central Hospital University of Helsinki Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Arola","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Tampere University Central Hospital Tampere Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"L\u00e4hteenm\u00e4ki","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Adolescent Medicine Turku University Central Hospital Turku Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"M\u00f6tt\u00f6nen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Adolescence Oulu University Hospital Oulu Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"M\u00e4kipernaa","sequence":"additional","affiliation":[{"name":"Coagulation Disorders Unit Department of Hematology and Cancer Center Helsinki University Central Hospital University of Helsinki Helsinki Finland"},{"name":"Children's Hospital Helsinki University Central Hospital Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"Riikonen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Kuopio University Hospital Kuopio Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,3,31]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2007.06703.x"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2516.2008.01906.x"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2516.2003.00840.x"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/jpc.12112"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2008.07087.x"},{"key":"e_1_2_8_7_1","first-page":"189","article-title":"Use of implantable venous access devices in children with 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