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.
| Original language | English |
|---|---|
| Pages (from-to) | e191-e197 |
| Number of pages | 7 |
| Journal | Pediatrics |
| Volume | 131 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Jan 2013 |
Keywords
- Adolescent
- Catheterization
- Catheterization, Peripheral
- Child
- Child, Preschool
- Cluster Analysis
- Female
- Humans
- Infant
- Male
- Spectroscopy, Near-Infrared
- Time Factors