Evaluating NIR vascular imaging to support intravenous cannulation in awake children difficult to cannulate; a randomized clinical trial

Background: Recently, various near-infrared vascular imaging devices aimed at facilitating peripheral intravenous cannulation (PIC) were introduced, all claiming to increase success rate of PIC. We evaluated the clinical utility of a near-infrared vascular imaging device (VascuLuminator®) in pediatric patients who were referred to the anesthesiologist because of difficult cannulation. Methods: There were 226 consecutive children referred to pediatric anesthesiologists by the treating pediatrician of the in- and outpatient clinic, because of difficulties with intravenous cannulation, were included in this cluster randomized clinical trial. The presence and use of the near-infrared vascular imaging device for PIC was randomized in clusters of 1 week. Success at first attempt (Fisher exact test) and time to successful cannulation (Log-rank test) were assessed to evaluate differences between groups. Results: Success at first attempt in the group with the VascuLuminator® (59%) was not significantly different from the control group (54%, P = 0.41), neither was the median time to successful cannulation: 246 s and 300 s, respectively ( P = 0.54). Conclusions: Visualization of blood vessels with near-infrared light and with near-infrared vascular imaging device did not improve success of PIC in pediatric patients who are known difficult to cannulate.