Skin Transillumination Improves Peripheral Vein Cannulation by Residents in Neonates: A Randomized Controlled Trial.

Area of Science:

• Neonatal Medicine
• Pediatric Procedures
• Medical Device Technology

Background:

• Peripheral vein access is difficult for pediatric residents and painful for neonates.
• Red light-emitting diode transilluminators may aid in peripheral vein catheter insertion.

Purpose of the Study:

• To assess the efficacy of a red light-emitting diode transilluminator for peripheral vein catheter insertion by pediatric residents in neonates.

Main Methods:

• Neonates were stratified by weight (≤1,500 g and >1,500 g) and randomized to transillumination or control groups.
• Pediatric residents performed the first three attempts, followed by a neonatologist for subsequent attempts.
• Primary outcome was first-attempt success; secondary outcomes included time to insertion and overall success rates.

Main Results:

• Transillumination improved first-attempt success in neonates >1,500 g (55% vs. 34%, p < 0.001).
• Overall resident success rate was higher with transillumination in neonates >1,500 g (86% vs. 73%, p = 0.003).
• No significant benefit was found in neonates ≤1,500 g or for neonatologists' performance.

Conclusions:

• Red light transillumination enhances peripheral vein cannulation success rates for pediatric residents in larger neonates (>1,500 g).
• The device did not demonstrate a benefit in smaller neonates (≤1,500 g).