Kleidon TM, Rickard CM, Schults JA, et al. - In paediatric central venous access devices (CVADs), researchers described practice evolution, complications and risk factors for multiple insertion attempts and device failure. Utilizing prospectively collected data from CVAD database 2012–2014, a paediatric retrospective cohort study was conducted. In total, 1,308 CVADs were observed over 273,467 catheter-days in 863 patients. Multiple insertion attempts remained static and significantly related to non-haematological oncology, respiratory, gastroenterology and other. Although advancement in CVAD practices improved overall CVAD insertion and failure outcomes, there is a need for more changes and creativity to ensure improved vessel health and preservation for children who need CVAD.