Complications in Central Venous Access Devices in Paediatric Cancer Care: A Global Cross‐Sectional Survey

ABSTRACT Objective To examine global practices for identifying and managing central venous access device (CVAD) complications—catheter‐associated bloodstream infection (CABSI), thrombosis, and occlusion—in paediatric cancer care, comparing patterns between high‐ and other‐income countries. Methods A cross‐sectional international survey was conducted from 2022 to 2023 and analysed 2024 to 2025. Clinicians involved in paediatric CVAD cancer care were recruited through global networks. Results A total of 161 respondents from 38 countries completed the complication section, including 102 (63.4%) from high‐income and 59 (36.6%) from other‐income countries (lower‐ and upper‐middle income). For CABSI, blood culture was the main diagnostic method (122 [75.8%]; high‐income: 87 [85.3%], other‐income: 35 [59.3%]). Differential time to positivity was more often reported in other‐income settings (33 [55.9%] vs. 35 [34.3%]), who also more frequently initiated antibiotics based on nonspecific or immediate criteria. CABSI treatment varied, with intravenous antibiotics (68 [60.7%]) and catheter removal (47 [42.0%]) most reported. For thrombosis, anticoagulation before line removal was common (88 [54.7%]), and alteplase use was higher in high‐income countries (76 [74.5%] vs. 19 [32.2%]). Thrombolytic agents were the most reported treatment for occlusion (103 [64.0%]), especially in high‐income countries (77 [75.5%] vs. 26 [44.1%]). Conclusions CVAD complication management varies by country income level, highlighting the need for context‐adapted guidelines, training, and equitable access to key resources.