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

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.