JMIR Publications

ABSTRACT

Background:

Vascular access is essential in pediatric inpatient care but often challenging due to small vessel size, patient agitation, and poor tolerance for repeated painful procedures. Short peripheral IV catheters (PIVs) are very frequently used, but they frequently fail before treatment completion. Longer peripheral catheters, often referred to as extended dwell catheters (EDCs) which are defined as peripheral catheters of at least 4 cm in length, may provide more stability and longevity while avoiding central venous catheter risks. Evidence in pediatrics is limited and mostly from observational data, with variable definitions and outcomes across studies. No pediatric specific systematic review has synthesized EDC literature. Objectives: The primary objective of this systematic review is to summarize longevity in extended dwell catheter and where possible compare it to other vascular access devices in the pediatric population. The secondary objective is to compare the rate of successful treatment completion through individual extended dwell catheters when compared to standard peripheral venous catheters. As an exploratory objective, we will also describe which other outcomes related to extended dwell catheters have been reported. Methods and analysis: This review will follow the proposed methodological standard of the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. A systematic search of MEDLINE, Embase, CINAHL and CENTRAL electronic will be performed. Eligible studies include prospective and retrospective studies that include children 0-18 years old, hospitalized in any type of pediatric unit, with reported dwell times for inserted EDCs with or without a comparator group. Titles and abstracts screening will be done by crowdsourcing and machine learning, and full-text screening will be done by two reviewers. Included studies risk of bias assessment and data extraction will be performed by at least two independent reviewers. Where possible, a meta-analysis using random effect models will be used to pool the primary and secondary outcomes. Discussion: This systematic review will provide the first comprehensive synthesis of evidence regarding EDCs in pediatrics. By consolidating data from diverse clinical contexts, we aim to generate a clearer understanding of how catheter design and insertion variables influence dwell time and complication risks.