@article{91f4d7f0da604aab83d3c2d019ba5753,
title = "Evidence-Based Strategies and Recommendations for Preservation of Central Venous Access in Children",
abstract = "Children with chronic illness often require prolonged or repeated venous access. They remain at high risk for venous catheter–related complications (high-risk patients), which largely derive from elective decisions during catheter insertion and continuing care. These complications result in progressive loss of the venous capital (patent and compliant venous pathways) necessary for delivery of life-preserving therapies. A nonstandardized, episodic, isolated approach to venous care in these high-need, high-cost patients is too often the norm, imposing a disproportionate burden on affected persons and escalating costs. This state-of-the-art review identifies known failure points in the current systems of venous care, details the elements of an individualized plan of care, and emphasizes a patient-centered, multidisciplinary, collaborative, and evidence-based approach to care in these vulnerable populations. These guidelines are intended to enable every practitioner in every practice to deliver better care and better outcomes to these patients through awareness of critical issues, anticipatory attention to meaningful components of care, and appropriate consultation or referral when necessary.*.",
keywords = "central venous access complications, coordination of care, guidelines, pediatrics, shared decision-making, venous access",
author = "{Venous Access: National Guideline and Registry Development (VANGUARD) Initiative Affected Persons Advisory Panel} and Baskin, {Kevin M.} and Mermel, {Leonard A.} and Saad, {Theodore F.} and Journeycake, {Janna M.} and Schaefer, {Carrie M.} and Modi, {Biren P.} and Vrazas, {John I.} and Beth Gore and Drews, {Barbie B.} and Darcy Doellman and Kocoshis, {Samuel A.} and Abu-Elmagd, {Kareem M.} and Towbin, {Richard B.}",
note = "Funding Information: From the 1VANGUARD, Venous Access (VANGUARD) Task Force, Society of Interventional Radiology (SIR), Pittsburgh, Pennsylvania, USA; 2Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA; 3Nephrology Associates of Delaware, Newark, Delaware, USA; 4Jimmy Everest Center for Cancer and Blood Disorders in Children, University of Oklahoma, Oklahoma City, Oklahoma, USA; 5Pediatric Interventional Radiology, Phoenix Children{\textquoteright}s Hospital, Phoenix, Arizona, USA; 6Center for Advanced Intestinal Rehabilitation, Children{\textquoteright}s Hospital of Boston, Harvard Medical School, Boston, Massachusetts, USA; 7Royal Children{\textquoteright}s Hospital, Melbourne, Victoria, Australia; 8Association for Vascular Access, Herriman, Utah, USA; 9Children{\textquoteright}s Medical Center of Dallas, Dallas, Texas, USA; 10Vascular Access Team, Children{\textquoteright}s Hospital of Cincinnati Medical Center, Cincinnati, Ohio, USA; 11Pediatric Nutrition and Intestinal Care Center, Children{\textquoteright}s Hospital of Cincinnati Medical Center, University of Cincinnati, Cincinnati, Ohio, USA; 12Cleveland Clinics Foundation Hospitals and Clinics, Case Western Reserve University, Cleveland, Ohio, USA; and the 13Department of Radiology, Phoenix Children{\textquoteright}s Hospital, Phoenix, Arizona, USA. A complete list of nonauthor contributors appears in Appendix 1. *These recommendations have been endorsed by the Board of Directors of the American Society for Parenteral and Enteral Nutrition. Financial disclosure: None declared. No funding was secured for this study. Conflict of interest: None declared. Disclaimer: These standards do not constitute medical or other professional advice and should not be taken as such. To the extent that the information published herein may be used to assist in the care of patients, this is the result of the sole professional judgment of the attending healthcare professional whose judgment is the primary component of quality medical care. The information presented in these standards is not a substitute for the exercise of such judgment by the healthcare professional. Circumstances in clinical settings and patient indications may require actions different from those recommended in this document and in those cases, the judgment of the treating professional should prevail. Publisher Copyright: {\textcopyright} 2019 American Society for Parenteral and Enteral Nutrition",
year = "2019",
month = jul,
doi = "10.1002/jpen.1591",
language = "English (US)",
volume = "43",
pages = "591--614",
journal = "Journal of Parenteral and Enteral Nutrition",
issn = "0148-6071",
publisher = "SAGE Publications Inc.",
number = "5",
}