Influence of vascular assessment/visualization in peripheral intravenous catheterization technologies: An integrative review

Santos, Luciano Marques dos; Santos, Sarah Almeida; Silva, Bianka Souza Martins; Santana, Rosana Castelo Branco de; Avelar, Ariane Ferreira Machado

doi:10.1590/2177-9465-EAN-2019-0355

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REVIEW • Esc. Anna. Nery 24 (3) • 2020 • https://doi.org/10.1590/2177-9465-EAN-2019-0355 linkcopy

Influence of vascular assessment/visualization in peripheral intravenous catheterization technologies: An integrative review

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Objective to verify the influence of vascular ultrasound, infrared light emission, and transdermal lighting on the success of peripheral intravenous catheterization, number of attempts, time to perform the procedure, catheter stay in situ and occurrence of complications in children, when compared to the traditional method.

Method this is an integrative literature review carried out from 2018 to 2020 at the Virtual Health Library, PubMed, Science Direct, Scopus, and Web of Science. Original studies, published between 2007 and 2019, comparing the use of these technologies with the traditional method of peripheral intravenous catheterization in children aged 0 - 18 years, were selected. Results: of 52 potential studies, 25 made up the final sample. Ten were related to vascular ultrasound use, 11 to infrared light and 4 to transdermal lighting.

Conclusion and implications for practice ultrasound seems to be the most effective technology to promote the successful achievement of peripheral intravenous catheterization. However, there is a need for further studies to better determine the effectiveness of the technologies studied in obtaining and maintaining peripheral intravenous catheterization. It may provide clinical practices based on recent evidence, improving the quality of care for hospitalized children and their families, by promoting patient safety.

Keywords:
Ultrasonography; Transillumination; Child; Peripheral Catheterization

Authors	Objectives	Results
Avelar et al.¹⁵	Verifying if vascular ultrasound increases the assertiveness in peripheral intravenous catheter and catheter stay time use when compared to the traditional puncture method.	No significant differences were observed in the overall success rate (p=0.970), in first attempt success rate (p=0.232), or in the catheter stay time (p=0.121).
Benkhadra et al.¹¹	Comparing vascular ultrasound use with the standard technique in children <3 years of age who require general anesthesia.	Ultrasound reduced the average PIC time (63.5 seconds versus 420.5 seconds, p<0.001); the average number of punctures (1 versus 2.5, p= 0.004); and increased the first attempt success rate (85% versus 35%, p=0.0012), when compared to the traditional method. The overall success rate did not differ significantly between groups (90% versus 85%, ultrasound versus standard technique, p=0.63)
Bair et al.¹²	Determining whether a static ultrasound technique use could: a) allow clinicians to view peripheral veins; b) improve PIC success rates.	The groups that used ultrasound had the same success rate when compared to the traditional method (57%). Success of PIC on first attempt was greater in the ultrasound group when compared to the traditional method (35%, versus 29%).
Curtis et al.¹³	Determining whether ultrasound or infrared use to guide PIC would be more effective than the standard method in obtaining a successful catheter on first attempt.	There were no significant differences in the first attempt success rate - general population: (p=0.3) younger than 3 years: (p=0.2); nor in the procedure time (p <0.5) as well as the number of attempts both for the total sample (Ultrasound: 1 versus traditional method: 1) and in children under 3 years old (Ultrasound: 1.5 versus traditional method: 1).
Oakley & Wong¹⁴	Assessing the implantation and usefulness of vascular ultrasound to assist PIC in a pediatric emergency department.	Ultrasound increased the success rate in the general sample (42% versus 38%, p=0.08) and in patients with difficult access (success 35% versus 18%, p=0.003), as well as first attempt success rate (64% versus 49%, p=0.08). Attempts with vascular ultrasound use took longer than attempts with the traditional method (4 minutes versus 2 minutes and 15 seconds, p <0.001).
Avelar et al.¹⁵	Analyzing whether vascular ultrasound use during the routine insertion of peripheral catheters increases the success rate and reduces the incidence of infiltration and phlebitis, compared to the standard reference method for catheter insertion.	There were no significant differences in the success rate in any of the subgroups analyzed: > 2 years (p=0.148); 2-7 years (p=0.848); 7–12 years (p=0.538); 12 - 18 years old:(p=0.055). Regarding the occurrence of complications, infiltration increased significantly with vascular ultrasound use (73.9% versus 51.1%; p=0.026).
Takeshita et al.¹⁶	Examining the factors that affect the PIC of invisible and impalpable veins in children and assess the best site for ultrasound-guided catheterization.	Vascular ultrasound use increased the success rate of PIC (68% versus 39%; (p=0.002) and reduced the procedure time (54 “versus 180”; p=0.003)
Doniger et al.¹⁷	Assessing whether ultrasound use improves the success rate, reduces the number of attempts, the number of needle redirects and the total time for PIC in pediatric patients with difficult access in a pediatric emergency.	The overall success rates for the ultrasound group were 80% and for the control group 64% (p=0.208). Ultrasound reduced the total time (6.3 versus 14.4 minutes, p= 0.001); the number of attempts (average, 1 against 3; p= 0.004), when compared to the traditional method.
Vinograd et al.¹⁸	Determining whether ultrasound improves first attempt success rates at PIC compared to traditional palpation methods for children with difficult access.	Ultrasound increased the first attempt success rate (85.4% versus 45.8%), reduced the average number of attempts (2 versus 1) and the time to perform the procedure (28 minutes versus 14 minutes) and increased catheter stay (4.5 days versus 2.6 days). No significant differences were found in the occurrence of complications (48% in the control group versus 40% in the ultrasound group) (p> 0.05).
Gopalasingam et al.¹⁹	Comparing ultrasound use with the standard palpation technique for PIC in anesthetized children undergoing low-risk elective procedures.	First attempt success rate and overall success rate were higher with ultrasound use (84% versus 60%; p=0.029) and (100% versus 84%; p=0.008), respectively. There were no significant differences in the number of attempts (p=0.05) and the procedure was slightly longer in the ultrasound group (192s versus 102s), but without statistical significance (p=0.073).
Rothbart et al.²⁰	Assessing whether Accuvein^® (AV300) use facilitates PIC in children	Accuvein^® reduced the average time of successful PIC when compared to the traditional method (1 min versus 2 min, p <0.01), but it increased the average number of attempts (2 versus 1, p <0.01) and reduced the first attempt success rate (0.45% versus 0.73%, p <0.01).
Kaddoum et al.²¹	Assessing the effectiveness of Accuvein^® (AV300) to improve the first attempt success rate at PIC of anesthetized pediatric patients.	First attempt success rate did not increase with significant results in the general sample or in the subgroup of children under 2 years old (p=0.85 and 0.62, respectively), as well as the number of attempts (p=0.86) and the procedure time (p=0.047).
Demir et al.²²	Determining the effect of using a vein visualization device on the success of the procedure based on the number of attempts per patient, duration of the procedure and the first attempt success rate.	The procedure time was shorter with AccuVein^® use than with the traditional method (37.24 seconds versus 172.6 seconds; p=0.001), with fewer attempts (1.08 versus, 2.23 p <0.01). AccuVein^® use also increased the first attempt success rate (91.7% versus 47.4%; p=0.001).
Kim et al.⁷	Comparing the PIC first attempt success rate between traditional method use and VeinViewer^® use.	VeinViewer^® use obtained a higher first attempt success rate (72% versus 57%), but without statistical significance (p=0.526). When performing logistic regression considering patients with difficult venous access, the result was significant (p=0.048).
Hess²³	Assessing the effectiveness of a vein visualization device on the success of PICs performed by nurses in a pediatric surgical unit.	VeinViewer^® use increased the first attempt success rate (80%) when compared to the traditional method (49%) (p <0.01), as well as reducing the number of attempts from 1.97 to 1.29 (p <0.001).
Chapman et al.²⁴	Assessing whether VeinViewer^® use reduces the time and number of attempts at PIC in children in the pediatric emergency department.	First attempt success rate did not obtain significant results neither in the general sample nor in the subgroup of 0-2 years (p=0.53 and 0.19, respectively), as well as the number of attempts (p=0.3) the procedure time obtained a significant reduction with VeinViewer^® use in the subgroup of 0-2 years (121 minutes versus 167 minutes, p=0.047).
Szmuk et al.²⁵	Assessing whether VeinViewer^® improves the success rate in PIC by nurses experienced in pediatric patients.	PIC use obtained a higher success rate (61%) than VeinViewer^® use (47%), (p=0.0003)
Sun et al.²⁶	Assessing the effectiveness of VeinViewer^® use to visualize the venous network in sick children.	First attempt success rate was the same both with VeinViewer^® use and with the traditional method (30%), but the number of attempts and the procedure time were reduced with VeinViewer^® use (1 versus 2, p=0.04 and (186.16 minutes versus. 427.87 minutes, p=0.014).
Perry et al.²⁷	Determining whether infrared light device use (VeinViewer^®) improves PIC first attempt success rate in a pediatric emergency department.	First attempt success rate was higher with the traditional method use (79%) than with VeinViewer^® use (72.1%), but without statistical significance (p=0.36).
Rothbart et al.²⁰	Assessing whether Accuvein^® (AV300) use facilitates PIC in children	Accuvein^® reduced the average time of successful PIC when compared to the traditional method (1 min versus 2 min, p <0.01), but it increased the average number of attempts (2 versus 1, p <0.01) and reduced the first attempt success rate (0.45% versus 0.73%, p <0.01).
Peterson et al.²⁸	Examining the successful visualization of veins by two PIC auxiliary devices by nurses and pediatric surgical doctors.	WeeSight^® and VeinViewer^® use had success rates close to (35.3% and 32.3%, respectively) and lower than those obtained using the traditional method (52.2%), (p=0.001).
Van der Woude et al.²⁹	Verifying the effectiveness of an infrared device (VascuLuminator^®) to facilitate PIC in children with dark skin color.	VascuLuminator^® use increased the first attempt success rate (63% versus 51%) and reduced the procedure time (53 seconds versus 68 seconds), when compared to the control group, but did not obtain significant results (p=0.27 and 0.50, respectively). In the subgroup with difficult venous access, VascuLuminator^® significantly increased the first attempt success rate (p=0.03).
Hosokaw et al.³⁰	Comparing the success rate and duration of PIC with and without transillumination use.	The success rate with transillumination was higher (75%) when compared to the traditional method (61%), but without statistical significance (p=0.10), in children under 2 years old, transillumination achieved statistical significance (p=0.03). Regarding the procedure time, teransilumination use significantly reduced it (p=0.01).
Katsogridakis et al.³¹	Assessing PIC using Veinlite^®.	The success rate in two attempts was higher with Veinlite^® use (59.5% versus 56.3%, p=0.01), whereas first attempt success only obtained statistical significance after logistic regression (p=0.03).
Gümüş et al.³²	Assessing the effectiveness of Veinlite^® PEDI to improve the visualization of veins in the pediatric emergency department.	Veinlite^® increased the first attempt success rate (92.9% versus 72.2%, p <0.004); reduced the number of attempts 1.07 versus 1.31 p=0.04) and the total time of attempts compared to the control group (49.98 versus 59.68 seconds p=0.01)
Yamazaki et al.³³	Assessing success rates for PIC in children using transillumination.	Transillumination use with fiber optic lighting increased the success rate of PIC (p=0.0000002).

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[1] Source: prepared by the authors.

Vascular Ultrasonography	Authors/Year of Publication	Type of Study/ Technology used	Population/Sample/Age
	Avelar et al.¹⁵	RCT/Ultrasound	335 children (0 to 18 years)
	Benkhadra et al.¹¹	RCT/Ultrasound	40 children (<3 years)
	Bair et al.¹²	RCT/Ultrasound	44 children (<7 years)
	Curtis et al.¹³	RCT/Ultrasound	428 children (≤16 years)
	Oakley & Wong¹⁴	Observational Prospective Study/Ultrasound	84 children (<18 years)
	Avelar et al.¹⁵	RCT/Ultrasound	335 children (12 days to 17 years)
	Takeshita et al.¹⁶	RCT/Ultrasound	96 children (1 to 2 years)
	Doniger et al.¹⁷	RCT/Ultrasound	50 children (<10 years)
	Vinograd et al.¹⁸	RCT/Ultrasound	167 children (0 to 18 years)
	Gopalasingam et al.¹⁹	RCT/Ultrasound	50 children (> 6 months and <4 years)
Infrared light	Rothbart et al.²⁰	RCT/AccuVein^®	238 children (0 to 17 years)
	Kaddoum et al.²¹	RCT/AccuVein^®	146 children (0 to 17 years)
	Demir et al.²²	RCT/AccuVein^®	129 children (3 to 18 years)
	Kim et al.⁷	RCT/VeinViewer^®	111 children (1 month to 16 years)
	Hess²³	Prospective non-randomized study/VeinViewer^®	241 children (11 days to 17 years)
	Chapman et al.²⁴	RCT/VeinViewer^®	336 children (0 to 17 years)
	Szmuk et al.²⁵	RCT/VeinViewer^®	299 children (0 to 17 years)
	Sun et al.²⁶	RCT/VeinViewer^®	60 children (3 months to 17 years)
	Perry et al.²⁷	RCT/VeinViewer^®	123 children (0 to 20 years)
	Peterson et al.²⁸	Prospective non-randomized study/WeeSight^® and VeinViewer^®	546 children (0 to 3 years)
	Van der Woude et al.²⁹	RCT/VascuLuminator^®	88 children (0 to 15 years)
Transillumination	Hosokaw et al.³⁰	RCT/(LED)-powered	136 children (0 to 3.7 years)
	Katsogridakis et al.³¹	RCT/Veinlite^®	240 children (5 days to 15 years)
	Gümüş et al.³²	RCT/Veinlite^®	112 children (1 to 10 years)
	Yamazaki et al.³³	RCT/Transmitted Light Fibreoptic	100 children (2 to 5 years)