London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK.
Statsconsultancy Ltd, Amersham, Bucks HP7?9EN, UK.
J Trop Pediatr. 2018 Jun 1;64(3):202-207. doi: 10.1093/tropej/fmx049.
Difficult intravenous (IV) access can compromise patient care in neonatal practice, and transillumination is often used to improve the visibility of veins. Current devices are expensive, prone to bacterial contamination and unaffordable in low-resource settings. We conducted a study comparing the quality of transillumination provided by "cold lights" that are currently in use with low-cost (<£1) red silicone LED bicycle lights.
Photographs of the hands and feet of neonates were taken with parental consent: first without transillumination (control group), second by transillumination with a cold light, and third with a bicycle light. Thirty photographs were sent in a survey to pediatric doctors who were blinded to the method of transillumination. Survey respondents then rated the visibility of the veins (easily visible, moderately visible, barely visible and invisible).
Completed surveys of 114 respondents were included in the analysis. The majority (94.8%) of respondents rated the veins moderately to easily visible with the bicycle light compared with 87.6% with the cold light, and 42.6% in the control group with no transillumination. There was a strong evidence of an improvement in visibility with bicycle lights compared with cold lights (p < 0.001).
Low-cost red silicone LED bicycle lights were found to improve visibility of veins in neonates. Given their quality of transillumination, portability and reduced cost, they may provide a useful method of transillumination in all settings, but particularly in low-income settings, where there is currently no affordable alternative.
在新生儿护理中,静脉穿刺(IV)困难可能会影响患者的护理,而透照法通常用于提高静脉的可视性。目前的设备昂贵,容易受到细菌污染,在资源匮乏的环境中无法承受。我们进行了一项研究,比较了目前使用的“冷光灯”和低成本(<£1)红色硅胶 LED 自行车灯提供的透照质量。
在获得家长同意的情况下,对新生儿的手和脚进行拍照:首先不进行透照(对照组),其次用冷光灯进行透照,再次用自行车灯进行透照。将 30 张照片发送给参与调查的儿科医生,他们对透照方法一无所知。调查受访者然后根据静脉的可见度(容易看到、中度可见、勉强可见和不可见)进行评分。
在分析中纳入了 114 名受访者的完整调查。与冷光灯相比,大多数(94.8%)受访者认为自行车灯照射下的静脉更容易看到,而冷光灯的比例为 87.6%,对照组无透照时为 42.6%。与冷光灯相比,自行车灯的可视度明显提高(p<0.001)。
发现低成本红色硅胶 LED 自行车灯可提高新生儿静脉的可视度。鉴于其透照质量、便携性和降低的成本,它们可能为所有环境,特别是在目前没有负担得起的替代方案的低收入环境中,提供一种有用的透照方法。