Efficacy of a vein visualisation device for facilitating peripheral venous line placement in adult patients with sickle cell disease: A randomised clinical trial

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.

Keywords: AccuVein; Nurse; Sickle cell disease; Vascular access; Vein cannulation.