Research Appraisals

European journal of emergency medicine : official journal of the European Society for Emergency Medicine

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

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.