Impact of near-infrared vein imaging on peripheral intravenous access success rates in geriatric patients: a systematic review and meta-analysis

To evaluate the efficacy of near-infrared (NIR) light devices in improving peripheral intravenous cannulation (PIVC) success rates among older patients. A systematic literature search of PubMed, EMbase, The Cochrane Library, and several Chinese databases (Wanfang Data, CNKI, CBM, VIP) was conducted from inception to July 16, 2025, for randomized controlled trials (RCTs) and observational studies involving patients aged ≥ 65 years. Two investigators independently screened studies, extracted data, and assessed methodological quality using predefined criteria. Meta-analyses were performed via RevMan 5.3 software. Eight studies were included (n = 1,022 participants). The meta-analysis demonstrated significantly higher first-attempt success rates in the NIR group compared to the standard care group (OR = 2.36, 95% CI: 1.73–3.21, P < 0.001,I2 = 59.0%). NIR technology also reduced procedure time (SMD = − 1.45, 95% CI: −1.64 to − 1.26, P < 0.001,I2 = 0%), lowered complication rates (OR = 0.37, 95% CI: 0.23–0.59, P < 0.001,I2 = 19%), improved patient satisfaction (OR = 1.90, 95% CI: 1.33–2.72, P = 0.0004,I2 = 30%), and reduced anxiety levels (SMD = − 1.70, 95% CI: −2.80 to − 0.59, P < 0.001,I2 = 96%). Compared to conventional methods, NIR-based vascular visualization technology may enhance first-attempt PIVC success rates in older patients while reducing procedure time, complication risks, and anxiety. However, the certainty of evidence is limited by study heterogeneity and risk of bias. These findings highlight its potential clinical utility for optimizing vascular access in geriatric care, particularly for patients with anticipated difficult venous access.