Near-Infrared Imaging in Intravenous Cannulation in Children: A Cluster Randomized Clinical Trial

作者：Cuper Natascha J^*; de Graaff Jurgen C; Verdaasdonk Rudolf M; Kalkman Cor J

来源：Pediatrics, 2013, 131(1): E191-E197.

DOI：10.1542/peds.2012-0968

• peripheral catheterization
• child
• infrared rays
• veins

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. %26lt;br%26gt;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. %26lt;br%26gt;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 (614) seconds and 143 (615) seconds respectively (P = .26). In 83.3%, the vein of first choice was visible with the VascuLuminator. %26lt;br%26gt;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. Pediatrics 2013;131:e191-e197

• 出版日期2013-1