Improving peripheral vein cannulation in neonates with skin transillumination: a prospective observational study by a neonatal fellow at a tertiary care centre

Authors

  • Priyanka C. Parmar Department of Neonatology, Arpan Newborn Care Centre, Ahmedabad, Gujarat, India
  • Binoy Shah Department of Neonatology, Arpan Newborn Care Centre, Ahmedabad, Gujarat, India
  • Ashish Mehta Department of Neonatology, Arpan Newborn Care Centre, Ahmedabad, Gujarat, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20250769

Keywords:

PIVC, Transillumination, Success rates, Time to successful cannulation

Abstract

Background: Peripheral vein cannulation (PIVC) is a common but challenging procedure in neonates, often requiring multiple attempts. Successful venous access is critical to ensure timely medical interventions while minimizing delay and complications. Skin transillumination has emerged as a potential tool to assist in visualizing veins, but its efficacy in improving procedural outcomes remains uncertain. This study evaluates the use of skin transillumination compared to the standard method, in improving the success rate of PIVC insertions. Objective was to assess the efficacy of skin transillumination in improving the procedural outcomes (success rates and time) of peripheral vein cannulation in neonates when performed by neonatal fellows.

Methods: A prospective observational study was conducted in a level 3 NICU, with neonates stratified by weight (≤1500 g and >1500 g). The intervention group used a transillumination device, while the control group used the standard procedure for cannulation. Data on success rates and time to successful cannulation were collected and analyzed using statistical methods.

Results: The use of transillumination led to significantly improved first-attempt success rates in neonates >1500 g (p=0.03). However, no significant improvement was observed in neonates ≤1500 g (p=0.72). Time to successful cannulation was significantly less in the control group for neonates >1500 g (p=0.003).

Conclusions: Transillumination significantly enhances first-attempt success rates for peripheral vein cannulation in neonates weighing over 1500 grams but does not show a substantial impact on neonates ≤1500 grams.

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References

Baye ND, Teshome AA, Ayenew AA, Amare TJ, Mulu AT, Abebe EC, et al. Incidence, time to occurrence and predictors of peripheral intravenous cannula-related complications among neonates and infants in Northwest Ethiopia: an institutional-based prospective study. BMC Nurs. 2023;22(1):11. DOI: https://doi.org/10.1186/s12912-022-01164-x

Haas NA. Clinical review: Vascular access for fluid infusion in children. Crit Care. 2004;8(6):478. DOI: https://doi.org/10.1186/cc2880

Batton DG BKWC. Prevention and Management of Pain in the Neonate: An Update. Pediatrics. 2006;118(5):2231-41. DOI: https://doi.org/10.1542/peds.2006-2277

Jöhr M, Berger TM. Venous access in children. Curr Opin Anaesthesiol. 2015;28(3):314-20. DOI: https://doi.org/10.1097/ACO.0000000000000181

Legemaat M, Carr PJ, van Rens RM, van Dijk M, Poslawsky IE, van den Hoogen A. Peripheral Intravenous Cannulation: Complication Rates in the Neonatal Population: A Multicenter Observational Study. J Vasc Access. 2016;17(4):360-5. DOI: https://doi.org/10.5301/jva.5000558

Phipps K, Modic A, O’Riordan MA, Walsh M. A randomized trial of the Vein Viewer versus standard technique for placement of peripherally inserted central catheters (PICCs) in neonates. J Perinatol. 2012;32(7):498-501.

Vyas V, Sharma A, Goyal S, Kothari N. Infrared vein visualization devices for ease of intravenous access in children: hope versus hype. Anaesthesiol Intensive Ther. 2021;53(1):69-78.

Katsogridakis YL, Seshadri R, Sullivan C, Waltzman ML. Veinlite Transillumination in the Pediatric Emergency Department. Pediatr Emerg Care. 2008;24(2):83-8. DOI: https://doi.org/10.1097/PEC.0b013e318163db5f

Atalay H, Erbay H, Tomatir E, Serin S, Oner O. The use of transillumination for peripheral venous access in paediatric anaesthesia. Eur J Anaesthesiol. 2005;22(4):317-8. DOI: https://doi.org/10.1017/S026502150524053X

Goren A, Laufer J, Yativ N, Kuint J, Ackon M Ben, Rubinshtein M, et al. Transillumination of the palm for venipuncture in infants. Pediatr Emerg Care. 2001;17(2):130-1. DOI: https://doi.org/10.1097/00006565-200104000-00013

Doniger SJ, Ishimine P, Fox JC, Kanegaye JT. Randomized Controlled Trial of Ultrasound-Guided Peripheral Intravenous Catheter Placement Versus Traditional Techniques in Difficult-Access Pediatric Patients. Pediatr Emerg Care. 2009;25(3):154-9. DOI: https://doi.org/10.1097/PEC.0b013e31819a8946

Hosokawa K, Kato H, Kishi C, Kato Y, Shime N. Transillumination by light‐emitting diode facilitates peripheral venous cannulations in infants and small children. Acta Anaesthesiol Scand. 2010;54(8):957-61. DOI: https://doi.org/10.1111/j.1399-6576.2010.02270.x

Curtis SJ, Craig WR, Logue E, Vandermeer B, Hanson A, Klassen T. Ultrasound or near-infrared vascular imaging to guide peripheral intravenous catheterization in children: a pragmatic randomized controlled trial. Can Med Assoc J. 2015;187(8):563-70. DOI: https://doi.org/10.1503/cmaj.141012

Vyas V, Sharma A, Goyal S, Kothari N. Infrared vein visualization devices for ease of intravenous access in children: hope versus hype. Anaesthesiol Intensive Ther. 2021;53(1):69-78. DOI: https://doi.org/10.5114/ait.2021.103515

Hinterstein S, Ehrhardt H, Zimmer KP, Windhorst AC, Kappesser J, Hermann C, et al. Skin Transillumination Improves Peripheral Vein Cannulation by Residents in Neonates: A Randomized Controlled Trial. Neonatology. 2024;121(6):733-41. DOI: https://doi.org/10.1159/000538880

Phipps K, Modic A, O’Riordan MA, Walsh M. A randomized trial of the Vein Viewer versus standard technique for placement of peripherally inserted central catheters (PICCs) in neonates. J Perinatol. 2012;32(7):498-501. DOI: https://doi.org/10.1038/jp.2011.129

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Published

2025-03-25

How to Cite

Parmar, P. C., Shah, B., & Mehta, A. (2025). Improving peripheral vein cannulation in neonates with skin transillumination: a prospective observational study by a neonatal fellow at a tertiary care centre. International Journal of Contemporary Pediatrics, 12(4), 626–631. https://doi.org/10.18203/2349-3291.ijcp20250769

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Original Research Articles