How We Approach Central Venous Access in Pediatric Hematology-Oncology: A Workflow-Based Strategy to Support Treatment Continuity.

Central venous access is essential for delivering chemotherapy and supportive care in children with cancer. Yet the practical decisions surrounding device selection, placement, maintenance, and salvage vary widely among institutions. In our center, we use a systematic, multidisciplinary workflow to anticipate the treatment trajectory, prioritize venous preservation, prevent complications, and support structured salvage strategies when device dysfunction or infection occurs. This "How I Approach" article outlines a pragmatic, experience-based model drawn from daily practice in a high-volume pediatric oncology setting. The focus is on applying established concepts to real-world clinical decision-making to maintain continuity of therapy and minimize morbidity.