title: Evaluating NIR vascular imaging to support intravenous cannulation in awake children difficult to cannulate; a randomized clinical trial.
abstract: BACKGROUND
  Recently, various near-infrared vascular imaging devices aimed at facilitating peripheral intravenous cannulation (PIC) were introduced, all claiming to increase success rate of PIC. We evaluated the clinical utility of a near-infrared vascular imaging device (VascuLuminator(®)) in pediatric patients who were referred to the anesthesiologist because of difficult cannulation.
  
  
  METHODS
  There were 226 consecutive children referred to pediatric anesthesiologists by the treating pediatrician of the in- and outpatient clinic, because of difficulties with intravenous cannulation, were included in this cluster randomized clinical trial. The presence and use of the near-infrared vascular imaging device for PIC was randomized in clusters of 1 week. Success at first attempt (Fisher exact test) and time to successful cannulation (Log-rank test) were assessed to evaluate differences between groups.
  
  
  RESULTS
  Success at first attempt in the group with the VascuLuminator(®) (59%) was not significantly different from the control group (54%, P = 0.41), neither was the median time to successful cannulation: 246 s and 300 s, respectively (P = 0.54).
  
  
  CONCLUSIONS
  Visualization of blood vessels with near-infrared light and with near-infrared vascular imaging device did not improve success of PIC in pediatric patients who are known difficult to cannulate.
authors.affiliation: Department of Pediatric Anesthesia, Wilhelmina Children's Hospital, University Medical Center, Utrecht, the Netherlands.
authors.forename: Jurgen C
authors.initials: JC
authors.lastname: de Graaff
authors.forename: Natascha J
authors.initials: NJ
authors.lastname: Cuper
authors.forename: Atty T H
authors.initials: AT
authors.lastname: van Dijk
authors.forename: Brigitte C M S
authors.initials: BC
authors.lastname: Timmers-Raaijmaakers
authors.forename: Désirée B M
authors.initials: DB
authors.lastname: van der Werff
authors.forename: Cor J
authors.initials: CJ
authors.lastname: Kalkman
mesh_terms: D002406:Catheterization, Peripheral / Q000295:instrumentation* / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012306:Risk; D019265:Spectroscopy, Near-Infrared / Q000379:methods*
keywords: child; infrared rays; peripheral catheterization; veins