{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T17:05:01Z","timestamp":1790010301630,"version":"4.0.1"},"reference-count":142,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1,1]]},"abstract":"<jats:sec>\n                  <jats:title>CONTEXT<\/jats:title>\n                  <jats:p>The risk of invasive device\u2013related thrombosis and bleeding contributes to morbidity and mortality, yet their prevalence by device-types is poorly understood.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>This study aimed to estimate pooled proportions and rates of thrombotic and bleeding complications associated with invasive devices in pediatric health care.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>DATA SOURCES<\/jats:title>\n                  <jats:p>Medline, CINAHL, Embase, Web of Science, Scopus, Cochrane CENTRAL, clinical trial registries, and unpublished study databases were searched.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>STUDY SELECTION<\/jats:title>\n                  <jats:p>Cohort studies and trials published from January 2011 to June 2022, including (1) indwelling invasive devices, (2) pediatric participants admitted to a hospital, (3) reporting thrombotic and bleeding complications, and (4) published in English, were included.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>DATA EXTRACTION<\/jats:title>\n                  <jats:p>Meta-analysis of observational studies in epidemiology guidelines for abstracting and assessing data quality and validity were used.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>MAIN OUTCOMES AND MEASURES<\/jats:title>\n                  <jats:p>Device-specific pooled thromboses (symptomatic, asymptomatic, unspecified) and bleeding (major, minor).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Of the 107 studies, 71 (66%) focused on central venous access devices. Symptomatic venous thromboembolism in central venous access devices was 4% (95% confidence interval [CI], 3\u20135; incidence rate 0.03 per 1000 device-days, 95% CI, 0.00\u20130.07), whereas asymptomatic was 10% (95% CI, 7\u201313; incidence rate 0.25 per 1000 device-days, 95% CI, 0.14\u20130.36). Both ventricular assist devices (28%; 95% CI, 19\u201339) and extracorporeal membrane oxygenation (67%; 95% CI, 52\u201381) were often associated with major bleeding complications.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>This comprehensive estimate of the incidence and prevalence of device-related thrombosis and bleeding complications in children can inform clinical decision-making, guide risk assessment, and surveillance.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/hpeds.2023-007345","type":"journal-article","created":{"date-parts":[[2023,12,28]],"date-time":"2023-12-28T08:14:11Z","timestamp":1703751251000},"page":"e25-e41","source":"Crossref","is-referenced-by-count":4,"title":["Device Related Thrombosis and Bleeding in Pediatric Health Care: A Meta-analysis"],"prefix":"10.1542","volume":"14","author":[{"given":"Amanda","family":"Ullman","sequence":"first","affiliation":[{"name":"aSchool of Nursing, Midwifery and Social Work, The University of Queensland, Queensland, Australia"},{"name":"bCentre for Children\u2019s Health Research, Children\u2019s Health Queensland Hospital and Health Service, Queensland, Australia"},{"name":"cNHMRC Centre for Research Excellence in Wiser Wound Care, Griffith University, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Areum","family":"Hyun","sequence":"additional","affiliation":[{"name":"aSchool of Nursing, Midwifery and Social Work, The University of Queensland, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Gibson","sequence":"additional","affiliation":[{"name":"aSchool of Nursing, Midwifery and Social Work, The University of Queensland, Queensland, Australia"},{"name":"bCentre for 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