Zainudin Zurina, Nunis Melissa Anne, Lim Zi Han
Department of Pediatrics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, MYS.
Cureus. 2025 Aug 24;17(8):e90891. doi: 10.7759/cureus.90891. eCollection 2025 Aug.
Peripheral venous cannulation is an essential procedure in neonatal intensive care units (NICUs) but is often associated with high failure rates. Near-infrared vein visualization devices may enhance vein identification and reduce the number of attempts; however, evidence in neonatal populations remains limited. This study aimed to compare the first-attempt success rates of peripheral venous cannulation using a vein transillumination device versus the standard method in neonates with prior punctures. Secondary analyses explored patient- and performer-related factors associated with successful cannulation. Methodology: This study conducted a prospective, randomized controlled trial from October 2022 to January 2024 in the NICU at Hospital Sultan Abdul Aziz Shah, Universiti Putra Malaysia. Only neonates of ≥ 35 weeks of gestation requiring venous access with at least one prior venipuncture were enrolled. The participants were randomized into standard (control) and AccuVein AV500-assisted (intervention) cannulation groups. All procedures were performed by 14 trained medical officers. First-attempt success was documented as the primary outcome, while secondary outcomes included associations with patient, performer, and procedural factors.
A total of 120 neonates were enrolled (60 per group). The overall first-attempt peripheral venous cannulation success rate was 47 (39.2%). No significant differences were observed between the control (21, 35%) and the intervention (26, 43.3%) groups ( > 0.05). Vein palpability was notably associated with cannulation success (odds ratio (OR) 7.86, 95% confidence interval (CI): 2.22-27.85, = 0.001). Right-sided cannulation was also linked to improved cannulation success (OR 3.44; 95% CI: 1.15-10.32, = 0.028). Conversely, four or more previous punctures reduced the likelihood of successful peripheral venous cannulation (OR 0.30; 95% CI: 0.09-0.99, = 0.048).
Vein transillumination did not significantly improve the first-attempt peripheral venous cannulation success rate. However, vein palpability, fewer prior punctures, and right-sided cannulation were associated with superior outcomes.
外周静脉置管是新生儿重症监护病房（NICUs）的一项基本操作，但失败率往往较高。近红外静脉可视化设备可能会提高静脉识别率并减少穿刺次数；然而，新生儿群体中的相关证据仍然有限。本研究旨在比较在有过穿刺史的新生儿中，使用静脉透照设备与标准方法进行外周静脉置管的首次尝试成功率。次要分析探讨了与置管成功相关的患者和操作者相关因素。
本研究于2022年10月至2024年1月在马来西亚博特拉大学苏丹阿卜杜勒·阿齐兹·沙阿医院的新生儿重症监护病房进行了一项前瞻性随机对照试验。仅纳入孕周≥35周、需要静脉通路且至少有过一次静脉穿刺史的新生儿。参与者被随机分为标准（对照）组和AccuVein AV500辅助（干预）置管组。所有操作均由14名经过培训的医务人员进行。首次尝试成功被记录为主要结局，而次要结局包括与患者、操作者和操作因素的关联。
共纳入120名新生儿（每组60名）。外周静脉置管首次尝试的总体成功率为47例（39.2%）。对照组（21例，35%）和干预组（26例，43.3%）之间未观察到显著差异（>0.05）。静脉可触及性与置管成功显著相关（优势比（OR）7.86，95%置信区间（CI）：2.22 - 27.85，=0.001）。右侧置管也与更高的置管成功率相关（OR 3.44；95% CI：1.15 - 10.32，=0.028）。相反，既往有四次或更多次穿刺会降低外周静脉置管成功的可能性（OR 0.30；95% CI：0.09 - 0.99，=0.048）。
静脉透照并未显著提高外周静脉置管首次尝试的成功率。然而，静脉可触及性、较少的既往穿刺次数和右侧置管与更好的结局相关。
