Effect of a liquid crystal vein locator on intravenous catheterization in young children: a randomized trial

Clinical Snapshot

Key Findings

• P Value: Not explicitly stated in abstract; statistical significance implied by CIs excluding null values

• Effect Size: Absolute difference: 31.5%; Adjusted OR for first-attempt success: 3.35; Adjusted rate ratio for puncture attempts: 0.77

• Primary Outcome: First-attempt PIVC success rate: 86.0% (study group) vs 54.5% (control group)

• Nnt Or Sensitivity: NNT = approximately 3.2 (calculated from absolute risk difference of 31.5%: 1/0.315 ≈ 3.2 additional first-attempt successes per 3–4 patients treated with the device)

• Confidence Interval: Absolute difference 95% CI: 15.2–47.8%; Adjusted OR 95% CI: 1.13–9.95; Adjusted rate ratio 95% CI: 0.66–0.90

Clinical Application

The device is a near-infrared liquid crystal vein locator — a non-invasive, portable technology. Implementation requires device procurement, staff training, and infection control protocols for shared use. The substantial reduction in procedural time (median total insertion time reduced from 185 s to 40 s) suggests efficiency gains that may offset device costs in high-volume paediatric emergency departments. Australian paediatric emergency departments (e.g., The Royal Children's Hospital Melbourne, Sydney Children's Hospital, Perth Children's Hospital) routinely manage difficult paediatric PIVC. The RACGP and Australasian College for Emergency Medicine (ACEM) do not currently have specific guidelines mandating vein visualisation technology for paediatric PIVC. The specific liquid crystal vein locator used in this study would require TGA registration as a Class IIa medical device before routine clinical use in Australia. Near-infrared vein finders (e.g., AccuVein, VeinViewer) are already used in some Australian paediatric centres, and this study adds to the evidence base for this device class. PBS listing is not applicable as this is a procedural device rather than a pharmaceutical. Cost would be borne by hospital procurement budgets. Children aged 0–3 years requiring peripheral intravenous catheterisation in emergency department settings, particularly those with anticipated difficult venous access

Abstract

BACKGROUND AND IMPORTANCE: Peripheral intravenous catheterization (PIVC) in young children is notoriously challenging because of factors like poor patient cooperation and small vessel diameter. Repeated attempts cause distress and delay critical emergency treatment. OBJECTIVES: This study aimed to evaluate the effect of a novel liquid crystal display-based near-infrared vein locator on PIVC performance in children aged under 3 years. DESIGN: This is a prospective, randomized controlled trial. SETTINGS AND PARTICIPANTS: A total of 105 children aged 0-3 years requiring PIVC were enrolled in a pediatric emergency department. INTERVENTION: Participants were randomly assigned to undergo PIVC using either a liquid crystal vein locator (study group, n  = 50) or the traditional landmark-based method (control group, n  = 55). OUTCOME MEASURES AND ANALYSIS: The primary endpoint was the first-attempt success rate. Secondary endpoints included the number of puncture attempts, vein localization time, and total insertion time. Multivariable logistic and Poisson regression models were used to adjust for covariates, such as vein difficulty and patient demographics. Analyses included effect sizes with 95% confidence intervals (CIs). MAIN RESULTS: The baseline characteristics of both groups were comparable. The first-attempt success rate was significantly higher in the study group compared to the control group (86.0% vs. 54.5%; absolute difference: 31.5%; 95% CI: 15.2-47.8%). The study group also demonstrated a significantly shorter median vein localization time (16.5 vs. 60.0 s) and median total insertion time (40.0 vs. 185.0 s). In addition, the device significantly reduced the median number of puncture attempts (adjusted rate ratio: 0.77; 95% CI: 0.66-0.90). Multivariable analysis revealed that device assistance was an independent predictor of first-attempt success (adjusted odds ratio: 3.35; 95% CI: 1.13-9.95). CONCLUSION: In this study, the use of a liquid crystal vein locator was associated with a significantly higher first-attempt success rate, fewer puncture attempts, and reduced procedural times for PIVC in young children.

References

1. 1.Wu, H.-P., Guo, B.-C., Chang, Y.-J., Chen, C.-Y., Jan, S.-L., & Lee, E.-P. (2026). Effect of a liquid crystal vein locator on intravenous catheterization in young children: a randomized trial. European Journal of Emergency Medicine, 33(4). https://doi.org/10.1097/MEJ.0000000000001355