The VascuLuminator: effectiveness of a near-infrared vessel imaging system as a support in arterial puncture in children

摘要

A practical near-IR blood vessel imaging system, the 'VascuLuminator', was developed to facilitate the puncturing of blood vessels for different procedures. Technical solutions were found for certain difficulties, such as obtaining a maximum image contrast by reducing the interference of IR light present in the surroundings. In phantom studies it was shown that the device is able to visualize blood vessels of different sizes to a clinically relevant maximum depth. In a preliminary clinical study, the use of the VascuLuminator resulted in decrease of the failure rate in blood withdrawal in young children from 13% to 2% and the laboratory technicians were satisfied with the practical application of the device. After this study, the effectiveness of the VascuLuminator was investigated to facilitate arterial cannulation in a group of children undergoing cardiac surgery. In an ongoing study, 71 children up to 3 years of age were included and time of arterial cannulation, number of punctures and puncture site were recorded. In 38 patients, cannulation was performed without the VascuLuminator and in 33 patients with VascuLuminator by pediatric anesthesiologists. The initial results do not show significant differences in time and in number of punctures with and without the use of the VascuLuminator. However, the VascuLuminator was able to visualize the arteries in most cases. In 11 of the 33 cases, the artery was located by using only the near-infrared image was used, without palpating for a pulse or knowledge of anatomical landmarks. Further clinical studies are needed to identify the patients groups that will benefit the most from VascuLuminator-assisted vessel punctures.