Visualization of veins with near-infrared (NIR) technology for intravenous cannulation in children

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Intravenous literature: Cuper, N.J., de Graaff, J.C., Verdaasdonk, R.M. and Kalkman, C.J. (2013) Near-Infrared Imaging in Intravenous Cannulation in Children: A Cluster Randomized Clinical Trial. Pediatrics. 131(1), p.e191-e197.

Abstract:

OBJECTIVE: Intravenous cannulation is a widespread medical procedure that can be difficult in children. Visualization of veins with near-infrared (NIR) light might support intravenous cannulation. Therefore, we investigated the effectiveness of an NIR vascular imaging system (VascuLuminator) in facilitating intravenous cannulation in children in the operating room.

METHODS: This was a pragmatic, cluster randomized clinical trial in all consecutive children (0–18 years) scheduled for elective surgery and in need of intravenous cannulation at a tertiary pediatric referral hospital. Daily operating rooms (770 patients) were randomized for allocation of the VascuLuminator or control group. The primary outcome was success at first attempt; the secondary outcome was time to successful cannulation.

RESULTS: Success at first attempt was 70% (171/246) with and 71% (175/245) without the use of the VascuLuminator (P = .69). Time to successful cannulation was 162 (±14) seconds and 143 (±15) seconds respectively (P = .26). In 83.3%, the vein of first choice was visible with the VascuLuminator.

CONCLUSIONS: Although it was possible to visualize veins with NIR in most patients, the VascuLuminator did not improve success rate or time to obtain intravenous cannulation. There are 3 possible explanations for this result: first, it could be that localization of the vein is not the main problem, and therefore visualization is not a solution; second, the type of system used in this study could be less than optimal; and, third, the choice of the patient population in this study could be inappropriate.

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