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Published on: November 9, 2016
Effect of a liquid crystal vein locator on intravenous catheterization in young children: a randomized trial
Han-Ping Wu1,2, Bei-Cyuan Guo3, Yu-Jun Chang4
1College of Medicine, Chang Gung University, Taoyuan.
Insights
A new vein locator improved peripheral intravenous catheterization (PIVC) success rates in young children. This device significantly reduced attempts and procedure times, aiding emergency care.
Area of Science:
- Pediatric Emergency Medicine
- Medical Device Technology
- Vascular Access
Background:
- Peripheral intravenous catheterization (PIVC) in young children is challenging due to patient cooperation and small vessels.
- Difficulties in PIVC can cause distress and delay critical treatment.
- Improved PIVC techniques are crucial for pediatric emergency care.
Purpose of the Study:
- To evaluate the efficacy of a novel liquid crystal display (LCD)-based near-infrared vein locator.
- To assess the impact of the vein locator on PIVC performance in children under 3 years old.
- To compare PIVC outcomes between device-assisted and traditional methods.
Main Methods:
- Prospective, randomized controlled trial involving 105 children aged 0-3 years.
- Participants were randomized to receive PIVC with either an LCD vein locator or the traditional landmark-based method.
- Primary endpoint: first-attempt success rate. Secondary endpoints: number of attempts, vein localization time, total insertion time.
Main Results:
- The vein locator group showed a significantly higher first-attempt success rate (86.0% vs. 54.5%).
- Median vein localization time and total insertion time were significantly reduced with the device.
- The device was associated with fewer puncture attempts and was an independent predictor of first-attempt success.
Conclusions:
- The LCD-based near-infrared vein locator significantly improves PIVC success rates in young children.
- This technology reduces procedural time and the number of attempts required for PIVC.
- The vein locator offers a valuable tool for enhancing PIVC in pediatric emergency settings.
Background And Importance:
Peripheral intravenous catheterization (PIVC) in young children is notoriously challenging because of factors like poor patient cooperation and small vessel diameter. Repeated attempts cause distress and delay critical emergency treatment.
Objectives:
This study aimed to evaluate the effect of a novel liquid crystal display-based near-infrared vein locator on PIVC performance in children aged under 3 years.
Design:
This is a prospective, randomized controlled trial.
Settings And Participants:
A total of 105 children aged 0-3 years requiring PIVC were enrolled in a pediatric emergency department.
Intervention:
Participants were randomly assigned to undergo PIVC using either a liquid crystal vein locator (study group, n = 50) or the traditional landmark-based method (control group, n = 55).
Outcome Measures And Analysis:
The primary endpoint was the first-attempt success rate. Secondary endpoints included the number of puncture attempts, vein localization time, and total insertion time. Multivariable logistic and Poisson regression models were used to adjust for covariates, such as vein difficulty and patient demographics. Analyses included effect sizes with 95% confidence intervals (CIs).
Main Results:
The baseline characteristics of both groups were comparable. The first-attempt success rate was significantly higher in the study group compared to the control group (86.0% vs. 54.5%; absolute difference: 31.5%; 95% CI: 15.2-47.8%). The study group also demonstrated a significantly shorter median vein localization time (16.5 vs. 60.0 s) and median total insertion time (40.0 vs. 185.0 s). In addition, the device significantly reduced the median number of puncture attempts (adjusted rate ratio: 0.77; 95% CI: 0.66-0.90). Multivariable analysis revealed that device assistance was an independent predictor of first-attempt success (adjusted odds ratio: 3.35; 95% CI: 1.13-9.95).
Conclusion:
In this study, the use of a liquid crystal vein locator was associated with a significantly higher first-attempt success rate, fewer puncture attempts, and reduced procedural times for PIVC in young children.
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