Central Venous Access Devices (CVAD) for Pediatric Patients with Hemophilia: A Review

Review Article

Central Venous Access Devices (CVAD) for Pediatric Patients with Hemophilia: A Review

Riten Kumar 1, K Rajiv Pruthi 2 3 and Vilmarie Rodriguez 1 3
Submission date: 22nd July 2009, Revision date: 10th September 2009, Acceptance date: 17th September 2009


ABSTRACT

Hemophilia A and B are X‐linked recessive bleeding disorders caused by deficiencies of blood coagulation factors VIII and IX, respectively. Management of hemophilia essentially entails the use of replacement factors which can be used on demand or on a prophylactic basis. Venous access is required irrespective of whether a patient receives prophylactic or on‐demand therapy. While central venous access devices (CVAD) are frequently used in pediatric hemophilia patients to facilitate repeated factor infusions, especially in young patients on prophylaxis or immune tolerance therapy for inhibitors, their use is associated with an increased risk of infections and/or thrombosis. The need for CVAD should be individualized with each patient. Patient and parental education about potential complications, use and care of CVAD are extremely important to ensure proper care.

Keywords: central venous access devices, hemophilia, complications, prophylaxis
Correspondence: Vilmarie Rodriguez, MD, Mayo Clinic Comprehensive Hemophilia Center, Department of Pediatrics and Adolescent Medicine, 200 First Street SW, Rochester, MN 55905