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PEDIATRIC ANESTHESIOLOGY

A Vein Entry Indicator Device for Facilitating Peripheral Intravenous Cannulation in Children: A Prospective, Randomized, Controlled Trial

Eliahu Simhi, MD^*, Ludmyla Kachko, MD^*, Elhanan Bruckheimer, MD, and Jacob Katz, MD^*

From the *Department of Anesthesia, Schneider Children’s Medical Center of Israel, Petah Tiqwa and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Anesthesiology and Critical Care Medicine, Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania; and Department of Pediatric Cardiology, Schneider Children’s Medical Center of Israel, Petah Tiqwa and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Address correspondence and reprint requests to Ludmyla Kachko, MD, Department of Anesthesia, Schneider Children’s Medical Center of Israel, 14 Kaplan Street, Petah Tiqwa 49202, Israel. Address e-mail to kachko_l{at}hotmail.com.

Abstract

BACKGROUND: Vascular access is often technically difficult in children because of the small caliber and impalpability of the veins. In this study, we sought to determine if use of the Vein Entry Indicator Device (VEID^TM) in children facilitates peripheral venous access.

METHODS: Two-hundred-two healthy (ASA grade I and II) children scheduled for same-day surgery at a major tertiary hospital in Israel were randomly allocated to undergo VEID-assisted or standard peripheral venous cannulation. All cases involved the insertion of a 22-gauge cannula into an upper limb vein. Primary outcome measures were number of attempts to successful cannulation, rate of success at first attempt, and time required for insertion. The data were presented as mean (sd). Analyses of variance and Pearson ² test or Fisher’s exact test were used to compare the groups; forward stepwise logistic regression was used to identify the three variables (age, vein assessment category, use of the VEID) significantly associated with a successful first attempt. A P value of 0.05 was considered significant.

RESULTS: Successful cannulation was achieved at the first attempt in the majority of patients in both groups. Two attempts were needed in 8% of the VEID group and 28% of the control group, and 3 attempts were needed in 1% and 3%, respectively (P < 0.01). Analysis by vein assessment category yielded a similar rate of successful first-attempt cannulations in the two groups for easy veins. However, for the difficult and intermediate categories, the rate was 89.7% in the VEID group compared to 23.3% in the control group (P < 0.001). The fewer number of attempts in the study group was associated with a shorter time from the start of the search for an appropriate vein to successful cannulation (9.1 s versus 22.5 s in the control group).

CONCLUSIONS: The VEID facilitates the insertion of peripheral venous cannulas in healthy children with intermediate/difficult veins undergoing same-day surgery, reducing the number of attempts and the overall time required.

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