Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via della Commenda 12, 20122, Milan, Italy.
Department of Clinical Sciences and Community Health, Laboratory "G.A. Maccacaro", Università degli Studi di Milano, Milan, Italy.
Eur J Pediatr. 2022 Jul;181(7):2747-2755. doi: 10.1007/s00431-022-04480-1. Epub 2022 Apr 28.
Venipuncture is a painful and invasive procedure for hospitalised newborns and represents a challenge for neonatal healthcare professionals. This study evaluated the most efficient cannulation method based on the proportion of success at the first attempt, standard care or near-infrared (NIR) device use, and pain assessment. An observational study with two arms was conducted in the neonatal intensive care unit (NICU) of a tertiary-care university hospital in Italy. All newborns undergoing peripheral vein cannulation and only nurses with more than 5 years of professional experience in the NICU were eligible for the first arm. Only newborns with a body weight of >2500 g at cannulation and all nurses working in the NICU were involved in the second arm. In the first arm of the study, no statistically significant differences between the NIR and control groups were found in terms of proportion of successful at the first attempt 60.6% (confidence interval [CI] 95%: 48.8; 72.4) vs. 56.1% (CI 95%: 44.1; 68.0) and the mean premature infant pain profile score 6.3 (CI 95%: 5.4-7.1) vs. 5.8 (CI 95%: 5.0-6.6). In the second arm, only among less experienced nurses (<1 year), we observed a significant increase in the proportion of success in the NIR group compared with the control group, nearly tripling the success rate (72.7% [54.1; 91.3] vs. 23.1% [0.2; 46.0]). Conclusion: This study reported no differences between the NIR and control groups. The results also suggest that using a NIR device may be advantageous for healthcare professionals with less experience during first-time cannulation. What is Known: • Venipuncture is a painful procedure commonly used to place a peripheral venous catheter for administering nutrients or drugs. • Near-infrared light facilitates the visualisation of veins and consequently, the performance of cannulation in the paediatric population. What is New: • The near-infrared light device was not associated with fewer attempts and a lower premature infant pain profile score in placing venous access in newborns than the traditional method. • The near-infrared light device could help nurses with less professional experience place a peripheral venous catheter.
静脉穿刺术是一种对住院新生儿有疼痛和侵入性的操作，这对新生儿医护人员来说是一个挑战。本研究旨在评估首次尝试成功率、标准护理或近红外（NIR）设备使用以及疼痛评估方面最有效的置管方法。该研究为一项在意大利一家三级保健大学医院新生儿重症监护病房（NICU）进行的观察性研究，采用了双臂设计。第一臂研究对象为接受外周静脉置管的所有新生儿，且仅纳入在 NICU 工作超过 5 年的护士；第二臂研究对象为体重>2500g 时进行静脉置管的所有新生儿和所有在 NICU 工作的护士。在第一臂研究中，NIR 组和对照组首次尝试成功率（60.6%[95%置信区间（CI）：48.8%；72.4%] vs. 56.1%[95%CI：44.1%；68.0%]）和早产儿疼痛评分（6.3[95%CI：5.4-7.1] vs. 5.8[95%CI：5.0-6.6]）无统计学差异。在第二臂研究中，仅在经验较少的护士（<1 年）中，我们观察到 NIR 组的首次尝试成功率显著高于对照组，成功率几乎增加了两倍（72.7%[54.1%；91.3%] vs. 23.1%[0.2%；46.0%]）。结论：本研究报道 NIR 组与对照组之间无差异。结果还表明，在首次置管时，对于经验较少的医护人员，使用 NIR 设备可能更有利。已知：• 静脉穿刺术是一种常见的有创操作，用于为患儿建立外周静脉通路以输注营养物质或药物。• 近红外光有助于可视化静脉，从而有助于儿科人群进行置管操作。新发现：• 与传统方法相比，近红外光设备在为新生儿建立静脉通路时，并未减少尝试次数或降低早产儿疼痛评分。• 近红外光设备可以帮助经验较少的护士建立外周静脉通路。
