title: Veinlite transillumination in the pediatric emergency department: a therapeutic interventional trial.
abstract: OBJECTIVE
  We hypothesized that transillumination would increase peripheral intravenous (IV) insertion success rates in pediatric emergency department patients. Primary outcome was success in first attempt, and secondary outcome was success within 2 attempts.
  
  
  METHODS
  We evaluated IV insertion by pediatric emergency department physicians and nurses using the Veinlite (TransLite, Sugar Land, Tex). Patients who required nonemergent IV insertion were enrolled if younger than 3 years or aged 3 to 21 years with a history of difficult access. Participants were randomly assigned to transillumination or nontransillumination. Analyses were performed using a mixed-effects logistic regression model adjusting for provider effect.
  
  
  RESULTS
  We evaluated 240 patients. After adjusting for significant covariates (safety catheter [P = 0.008], visibility [P = 0.01], and palpability [P = 0.03]) and controlling for provider effect, IV placement was more likely successful in first attempt in transilluminated patients (P = 0.03; odds ratio, 2.1 [95% confidence interval, 1.1-3.9]). After adjusting for significant covariates (safety catheter [P < 0.001], location [P = 0.005], and palpability [P = 0.05]) and controlling for provider effect, IV placement was more likely successful within 2 attempts in transilluminated patients (P = 0.01; odds ratio, 3.5 [95% confidence interval, 1.4-8.9]). Intracluster correlation for random effect of provider was 10% in first attempt and 16% within 2 attempts.
  
  
  CONCLUSIONS
  After adjusting for multiple significant covariates and controlling for random effect of provider, our results indicated a benefit in the use of Veinlite transillumination for IV insertion in first attempt and within 2 attempts. This technique seemed to facilitate nonemergent IV placement in pediatric patients compared with standard practice.
authors.affiliation: Department of Pediatrics, Division of Pediatric Emergency Medicine, Children's Memorial Hospital, Chicago, IL 60614-3394, USA. ykatsogridakis@childrensmemorial.org
authors.forename: Yiannis L
authors.initials: YL
authors.lastname: Katsogridakis
authors.forename: Roopa
authors.initials: R
authors.lastname: Seshadri
authors.forename: Christine
authors.initials: C
authors.lastname: Sullivan
authors.forename: Mark L
authors.initials: ML
authors.lastname: Waltzman
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007262:Infusions, Intravenous / Q000295:instrumentation* / Q000706:statistics & numerical data; D008029:Lighting; D008297:Male; D011446:Prospective Studies