Abstract:
Background: Intravenous (IV) access is often required for the treatment of vaso-occlusive crises in patients with sickle cell disease, but can be particularly challenging due to recurrent venous damage. The AccuVein® device, uses near-infrared light technology to visualise veins for easier venepuncture.
Methods: A randomised, controlled trial of the efficacy of the AccuVeinAV400® device in the replacement of peripheral venous lines during a vaso-occlusive crisis was conducted at two centres in France. Adult patients with sickle cell disease were randomised to the AccuVein® or routine IV cannulation procedures. The primary outcome was the number of cannulation attempts needed for effective replacement of the peripheral IV line.
Results: Between April 10th, 2018, and March 22nd, 2022, 127 patients were randomised and 126 were analysed (median age: 27.5 years [interquartile range-IQR: 21.3-33.8]; homozygous genotype: 106 (84.1 %)). Although patients in the AccuVein® group reported lower levels of procedure-related pain, use of the device was not associated with a lower median number of venepuncture attempts (2 [1-3], vs. 2 [1-4] in the routine procedure group: p = 0.49). There were no statistically significant intergroup differences in the time to IV line replacement (9.6 [4.1-20.8] in the AccuVein® group vs. 11.7 [4.2-24.7] minutes in the routine procedure group), changes in patient and nurse anxiety and satisfaction levels, or the complication rate.
Conclusion: Use of the AccuVeinAV400® device was not associated with a significant decrease of the number of venepuncture attempts or of the time needed for IV line replacement during the management of vaso-occlusive crises. The study’s results highlight the complexity of IV access in this clinical context.
Trial registration: ClinicalTrial.gov identifier: NCT03477552.
Reference:Corbasson A, Fischer E, Vilfaillot A, Da Costa AB, Charmettan M, Ferreira M, Barthélémy C, Namaoui W, Khimoud D, Beaudoin A, Berkani L, Guillaud C, Khellaf M, Flamarion E, Michon A, Lafont E, Cheminet G, Chatellier G, Pouchot J, Ranque B, Arlet JB. Efficacy of a vein visualisation device for facilitating peripheral venous line placement in adult patients with sickle cell disease: A randomised clinical trial. Int J Nurs Stud. 2024 Dec 19;163:104988. doi: 10.1016/j.ijnurstu.2024.104988. Epub ahead of print. PMID: 39787687.