Near infra-red device for difficult intravenous cannulations in children: A boon?

Background: Although securing an intravenous (IV) line is routine for most hospitalised patients, it is often a difficult and painful event for neonates and young children. Any method which improves the visibility of veins and assists during difficult venous access would be beneficial, and preferably, it should be inexpensive and easily operable. Objectives: To determine the efficacy of a near infrared (NIR) device over conventional vein visualisation in neonates and children with difficult intravenous access (DIVA) prediction score ≥4, which indicates that extra consideration may be needed. Method: It was a hospital based, randomised open label trial conducted from November 2020 to July 2022. The sample size was calculated to be 220, with 110 participants each in NIR and conventional group. Neonates and children less than 3 years of age with DIVA score ≥4, were enrolled and block randomisation was done. Results: Both groups were comparable in terms of sociodemographic features, DIVA scores, IV-line naivety and their admission diagnosis. The mean age in NIR group (17.65 months) was lower than conventional group (20.98 months) with significant p-value. In NIR group, 77.2% of lines were secured in first attempt compared to 51.8% in conventional (p-value <0.001). Further requirement of IV-line changes twice was noted in 63.3% of NIR group vs 41.8% in conventional group (p-value= 0.018). Conclusions: Despite the NIR group mean age being younger, there was significant improvement in securing IV lines on first attempt. The number of pricks received was also less than conventional group.