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Comparison of 2 Transillumination Technologies to Improve First-Attempt Success at Peripheral Intravenous Catheter
Claudia Maria de Freitas Floriano1,2, Ariane Ferreira Machado Avelar1,2, Maria Angelica Sorgini Peterlini1,2
1Author Affiliation: Escola Paulista de Enfermagem - Universidade Federal de São Paulo, Santo André, São Paulo, Brazil.
Insights
Light-emitting diodes (LEDs) and infrared radiation (IR) vein visualization technologies showed similar success rates for first-attempt peripheral intravenous catheter (PIVC) insertion in children. Both devices aided visualization in difficult cases.
Area of Science:
- Pediatric Emergency Medicine
- Medical Device Technology
- Vascular Access
Background:
- Difficult intravenous access (DIVA) is common in children, leading to multiple insertion attempts and patient distress.
- Advanced visualization technologies aim to improve first-attempt success rates for peripheral intravenous catheter (PIVC) insertion.
- Light-emitting diodes (LEDs) and infrared radiation (IR) are two such technologies for vein visualization.
Purpose of the Study:
- To compare the efficacy of LED and IR vein visualization technologies for first-attempt PIVC insertion success in pediatric patients at risk of DIVA.
- To evaluate the impact of these technologies on children with previously identified difficult-to-access vessels or a history of IV therapy complications.
Main Methods:
- A randomized controlled crossover study involving 143 children at a university hospital.
- Participants were randomized to initially use either LED or IR vein visualization for PIVC insertion.
- Statistical analysis included McNemar test, paired t-test, and logistic regression models.
Main Results:
- No statistically significant difference in first-attempt PIVC insertion success was found between LED and IR technologies (P = .720).
- Overall first-attempt success rates were 65.2% (IR) and 44.9% (LED) in Group A, and 55.4% (IR) and 50.0% (LED) in Group B.
- Success rates were higher in patients with difficult-to-see vessels (51.5%) and those with prior IV complications (49.8%) using either device.
Conclusions:
- Both LED and IR vein visualization devices demonstrate comparable effectiveness for improving first-attempt PIVC insertion in children at risk of DIVA.
- These technologies are beneficial for visualizing veins, particularly in pediatric patients with challenging vascular access.
- Further research may explore patient comfort and long-term outcomes associated with these devices.
Abstract:
This randomized controlled crossover study, conducted in a university hospital, aimed to compare the success of the first attempt at peripheral intravenous catheter (PIVC) insertion using 2 technologies of the visualization of veins in children at risk of difficult intravenous access (DIVA) guided by light-emitting diodes (LEDs) or infrared radiation (IR). The allocation of the type of technology initially used was determined by randomization. The primary outcome was successful insertion of the PIVC on first attempt. Data were analyzed using the McNemar test, paired t-test, and multiple logistic regression models. This crossover study included 143 children: 69 in Group A and 74 in Group B. The first-attempt PIVC insertion success rate with IR and LED was 65.2% and 44.9% in Group A and 55.4% and 50.0% in Group B, respectively, without statistical significance (P = .720). The results also showed that 51.5% of patients with difficult-to-see vessels (P = .022) and 49.8% with previous complications related to intravenous therapy (P = .008) had first-attempt PIVC insertion success using either transillumination device. The first-attempt PIVC insertion success was statistically similar between the groups. The device also assists in visualizing the veins in children at risk of DIVA.
