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A vein entry indicator device for facilitating peripheral intravenous cannulation in children: a prospective,
Eliahu Simhi1, Ludmyla Kachko, Elhanan Bruckheimer
1Department of Anesthesia, Schneider Children's Medical Center of Israel, 14 Kaplan Street, Petah Tiqwa 49202, Israel.
Insights
The Vein Entry Indicator Device (VEID) improves peripheral venous access in children with difficult veins, reducing cannulation attempts and time. This device enhances procedural success for pediatric venous access.
Area of Science:
- Pediatric Anesthesiology
- Vascular Access Procedures
- Medical Device Technology
Background:
- Peripheral venous access in children presents challenges due to small, impalpable veins.
- Difficult venous access can prolong procedures and increase patient discomfort.
- Evaluating novel devices is crucial for improving pediatric care.
Purpose of the Study:
- To assess the efficacy of the Vein Entry Indicator Device (VEID) in facilitating peripheral venous access in pediatric patients.
- To compare cannulation success rates and procedural times between VEID-assisted and standard techniques.
- To identify factors influencing successful first-attempt venous cannulation in children.
Main Methods:
- A randomized controlled trial involving 202 healthy children undergoing same-day surgery.
- Participants were allocated to either VEID-assisted or standard peripheral venous cannulation.
- Primary outcomes included number of attempts, first-attempt success rate, and insertion time for a 22-gauge cannula.
Main Results:
- The VEID group showed significantly fewer attempts for successful cannulation compared to the control group (P < 0.01).
- In children with difficult or intermediate veins, first-attempt success was 89.7% with VEID versus 23.3% without (P < 0.001).
- VEID use was associated with a shorter overall time to cannulation (9.1s vs 22.5s).
Conclusions:
- The Vein Entry Indicator Device (VEID) effectively facilitates peripheral venous cannulation in pediatric patients.
- The device is particularly beneficial for children with intermediate or difficult venous access.
- VEID reduces the number of attempts and overall procedure time, improving efficiency and potentially patient experience.
Background:
Vascular access is often technically difficult in children because of the small caliber and impalpability of the veins. In this study, we sought to determine if use of the Vein Entry Indicator Device (VEIDtrade mark) in children facilitates peripheral venous access.
Methods:
Two-hundred-two healthy (ASA grade I and II) children scheduled for same-day surgery at a major tertiary hospital in Israel were randomly allocated to undergo VEID-assisted or standard peripheral venous cannulation. All cases involved the insertion of a 22-gauge cannula into an upper limb vein. Primary outcome measures were number of attempts to successful cannulation, rate of success at first attempt, and time required for insertion. The data were presented as mean (sd). Analyses of variance and Pearson chi(2) test or Fisher's exact test were used to compare the groups; forward stepwise logistic regression was used to identify the three variables (age, vein assessment category, use of the VEID) significantly associated with a successful first attempt. A P value of < or =0.05 was considered significant.
Results:
Successful cannulation was achieved at the first attempt in the majority of patients in both groups. Two attempts were needed in 8% of the VEID group and 28% of the control group, and 3 attempts were needed in 1% and 3%, respectively (P < 0.01). Analysis by vein assessment category yielded a similar rate of successful first-attempt cannulations in the two groups for easy veins. However, for the difficult and intermediate categories, the rate was 89.7% in the VEID group compared to 23.3% in the control group (P < 0.001). The fewer number of attempts in the study group was associated with a shorter time from the start of the search for an appropriate vein to successful cannulation (9.1 s versus 22.5 s in the control group).
Conclusions:
The VEID facilitates the insertion of peripheral venous cannulas in healthy children with intermediate/difficult veins undergoing same-day surgery, reducing the number of attempts and the overall time required.
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