Addressing Skin Complications and Mechanical Dysfunctions from Invasive Devices in Pediatric Healthcare

Introduction:
Indwelling invasive devices are frequently used in pediatric healthcare, but they come with risks of skin complications and mechanical dysfunctions. This systematic review and meta-analysis aimed to estimate the prevalence of these issues and highlight the need for improved surveillance and reporting.

Background:
Devices like central venous access devices, peripheral intravenous catheters, and nasogastric tubes are essential in pediatric care. However, the complications associated with these devices, including skin issues and mechanical failures, are not well-documented, especially in children.

Objective:
The study sought to estimate the proportion and rate of device-related skin complications and mechanical dysfunctions in pediatric patients, focusing on the need for standardized definitions and reporting methods.

Methods:
Data Sources: The review included studies from MEDLINE, CINAHL, Embase, Web of Science, Scopus, Cochrane CENTRAL, clinical trial registries, and unpublished databases.
Review Method: Included cohort studies and trials published between January 2011 and June 2022, focusing on pediatric patients with indwelling invasive devices.
Outcomes: The study reported pooled proportions and incidence rates of skin complications and mechanical dysfunctions, such as infiltration, leakage, occlusion, dislodgement, and breakage.

Key Findings:
- Device-Related Skin Complications: Reported in 40 of the 114 studies analyzed, yet none exclusively reported on pressure injuries caused by devices.
- Mechanical Dysfunctions: Well-reported for certain devices like central venous access devices and peripheral intravenous catheters but less so for devices like arterial catheters and extracorporeal membrane oxygenation systems.
- Incidence Rates: Highlighted the need for standardized definitions and reporting to better understand and mitigate these complications.

Conclusion:
This systematic review emphasizes the importance of standardized reporting and surveillance of device-related complications in pediatric care. Despite the widespread use of invasive devices, there is a significant gap in comprehensive data on the prevalence and impact of these complications, particularly for underreported device types.

Authors: Mari Takashima, Areum Hyun, Victoria Gibson, Eloise Borello, Amanda Ullman

Read More: https://pubmed.ncbi.nlm.nih.gov/38263365/