{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T15:00:37Z","timestamp":1772031637911,"version":"3.50.1"},"reference-count":18,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2017,5,24]],"date-time":"2017-05-24T00:00:00Z","timestamp":1495584000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Vasc Access"],"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p> Children with special health-care needs are an emerging and consistent population. In a subset of children with medical complexity (CMC) a continuous access to the central vascular system is advisable to eliminate unnecessary pain and stress and to improve home management and palliative care. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p> The surgical registry of a tertiary hospital was checked in order to identify CMC who underwent totally implantable venous access device (VAD) placement. Medical records were reviewed. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> From October 2009 to August 2014, a totally implantable VAD was placed in 10 children. Seven out of 10 patients were affected by cerebral palsy while 3 presented a genetic syndrome. The median duration of the indwelling catheter was 31 months (range 5 to 77 months). Six catheters are still in place since the first placement. Infectious complications were observed in two patients, respectively, a Candida albicans and a Staphylococcus aureus colonization; in both cases the VAD was removed. In another two cases, removal was planned for reservoir dislodgment within the subcutaneous tissue. No other major complications were observed during the procedure and the follow-up period. Emergency admissions decreased from a median value of 0.4\/month (range 0-1.5\/month) to 0.2\/month (range 0-0.6\/month) after the VAD placement. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p> A totally implanted VAD in CMC is safe and manageable. As expected, infection seems to be the major complication with no infection-related death. Malnutrition and musculoskeletal deformities, which are frequent comorbidities in CMC, should be considered to reduce the risk of dislodgment\/migration. <\/jats:p><\/jats:sec>","DOI":"10.5301\/jva.5000727","type":"journal-article","created":{"date-parts":[[2017,6,2]],"date-time":"2017-06-02T09:56:58Z","timestamp":1496397418000},"page":"426-429","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Totally Implantable Venous Access Devices in Children with Medical Complexity: Preliminary Data from a Tertiary Care Hospital"],"prefix":"10.1177","volume":"18","author":[{"given":"Caterina","family":"Geremia","sequence":"first","affiliation":[{"name":"Pediatrics, University Department of Pediatrics, Ospedale Pediatrico Bambino Ges\u00f9, IRCCS, Rome - Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Antonietta","family":"De Ioris","sequence":"additional","affiliation":[{"name":"Pediatrics, University Department of Pediatrics, Ospedale Pediatrico Bambino Ges\u00f9, IRCCS, Rome - Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Crocoli","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Unit, Department of Pediatric Surgery and Transplantation Center, Ospedale Pediatrico Bambino Ges\u00f9, IRCCS, Rome - Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ottavio","family":"Adorisio","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Unit, Department of Pediatric Surgery and Transplantation Center, Ospedale Pediatrico Bambino Ges\u00f9, IRCCS, Rome - Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raffaella","family":"Scrocca","sequence":"additional","affiliation":[{"name":"Pediatrics, University Department of Pediatrics, Ospedale Pediatrico Bambino Ges\u00f9, IRCCS, Rome - Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary Haywood","family":"Lombardi","sequence":"additional","affiliation":[{"name":"Pediatrics, University Department of Pediatrics, Ospedale Pediatrico Bambino Ges\u00f9, IRCCS, Rome - Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susanna","family":"Staccioli","sequence":"additional","affiliation":[{"name":"Neurorehabilitation Unit, Department of Neurosciences, Ospedale Pediatrico Bambino Ges\u00f9, IRCCS, Rome - Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pietro","family":"Stella","sequence":"additional","affiliation":[{"name":"Pediatrics, University Department of Pediatrics, Ospedale Pediatrico Bambino Ges\u00f9, IRCCS, Rome - Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paola","family":"Amendola","sequence":"additional","affiliation":[{"name":"Anaesthesia and Intensive Care Department, Ospedale Pediatrico Bambino Ges\u00f9, IRCCS, Rome - Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gaetano","family":"Ciliento","sequence":"additional","affiliation":[{"name":"Medical Direction, Bambino Ges\u00f9 Children's Hospital, IRCCS, Rome - Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"De Peppo","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Unit, Department of Pediatric Surgery and Transplantation Center, Ospedale Pediatrico Bambino Ges\u00f9, IRCCS, Rome - Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Campana","sequence":"additional","affiliation":[{"name":"Pediatrics, University Department of Pediatrics, Ospedale Pediatrico Bambino Ges\u00f9, IRCCS, Rome - Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2017,5,24]]},"reference":[{"issue":"5","key":"bibr1-jva.5000727","first-page":"1238","volume":"116","year":"2005","journal-title":"Council on children with disabilities. 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