{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T03:07:11Z","timestamp":1784257631004,"version":"3.55.0"},"reference-count":27,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2017,6,9]]},"abstract":"<jats:p>Central venous access devices (CVADs) form an important component of modern paediatric healthcare, especially for children with chronic health conditions such as cancer or gastrointestinal disorders. However device failure and complications rates are high.<\/jats:p>\n               <jats:p>Over 2\u00bd years, a child requiring parenteral nutrition and associated vascular access dependency due to \u2018short gut syndrome\u2019 (intestinal failure secondary to gastroschisis and resultant significant bowel resection) had ten CVADs inserted, with ninesubsequently failing. This resulted in multiple anaesthetics, invasive procedures, injuries, vascular depletion, interrupted nutrition, delayed treatment and substantial healthcare costs. A conservative estimate of the institutional costs for each insertion, or rewiring, of her tunnelled CVAD was $A10\u2009253 (2016 Australian dollars).<\/jats:p>\n               <jats:p>These complications and device failures had significant negative impact on the child and her family. Considering the commonality of conditions requiring prolonged vascular access, these failures also have a significant impact on international health service costs.<\/jats:p>","DOI":"10.1136\/bcr-2016-218757","type":"journal-article","created":{"date-parts":[[2017,7,6]],"date-time":"2017-07-06T23:50:15Z","timestamp":1499385015000},"page":"bcr-2016-218757","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Substantial harm associated with failure of chronic paediatric central venous access devices"],"prefix":"10.1136","volume":"2017","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8860-5319","authenticated-orcid":false,"given":"Amanda J","family":"Ullman","sequence":"first","affiliation":[{"name":"School of Nursing and Midwifery, Griffith University, Nathan, Australia"},{"name":"Paediatric Critical Care Research Group, Lady Cilento Children's Hospital, Brisbane, Australia"},{"name":"Alliance for Vascular Access Teaching and Research Group, Menzies Health Institute Queensland, Brisbane, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tricia","family":"Kleidon","sequence":"additional","affiliation":[{"name":"Alliance for Vascular Access Teaching and Research Group, Menzies Health Institute Queensland, Brisbane, Queensland, Australia"},{"name":"Department of Anaesthetics, Lady Cilento Children's Hospital, Brisbane, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Cooke","sequence":"additional","affiliation":[{"name":"School of Nursing and Midwifery, Griffith University, Nathan, Australia"},{"name":"Alliance for Vascular Access Teaching and Research Group, Menzies Health Institute Queensland, Brisbane, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire M","family":"Rickard","sequence":"additional","affiliation":[{"name":"School of Nursing and Midwifery, Griffith University, Nathan, Australia"},{"name":"Alliance for Vascular Access Teaching and Research Group, Menzies Health Institute Queensland, Brisbane, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,7,6]]},"reference":[{"key":"2025082805312916000_2017.jul06_2.bcr-2016-218757.1","unstructured":"Australian Institute of Health and Welfare. 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