An observational study comparing the prototype device with the existing device for the effective visualization of invisible veins in elderly patients in Japan

Abstract

Objective:To compare the performance on the detection of the invisible veins between our modified prototype device and an existing device in elderly hospitalized patients.Methods:A prospective, cross-sectional, and observational study was performed in the invisible veins in elderly patients. The major variables, skin color near the invisible veins, and diameter and depth of the invisible veins were measured. The vein visualization rate was calculated as the ratio of the visualized veins to the invisible veins by the visualization device.Results:We analyzed 53 invisible veins in the cubital fossa and 56 invisible veins in the forearm in a total of 72 patients (median age, 73 years). The visualization rate for our prototype device was higher than that for an existing device in the cubital fossa and the forearm sites. The visualized veins of the prototype device had a higher intensity ratio than that of an existing device. No significant differences were observed in the body mass index, vein depth, and vein diameter of the visualized veins at the cubital fossa and forearm sites.Conclusion:The prototype surpassed the existing device in visualizing the invisible veins. However, the prototype was unable to visualize all the invisible veins. We need to look for ways to reduce noise and to visualize the invisible veins, and the visualization rate of devices needs to be investigated in further association with the percentage of success with actual intravenous access and locating time to vein.

Vein Pattern Locating Technology for Cannulation: A Review of the Low-Cost Vein Finder Prototypes Utilizing near Infrared (NIR) Light to Improve Peripheral Subcutaneous Vein Selection for Phlebotomy

“…From Table 2, Dhakshayani, M. et al, 2015 [47] showed that optimizing the wavelength by utilizing a multispectral IR source, can achieve good visibility of veins considering the types of patients based on color, age and tissue thickness, also the near infrared rays of shorter wavelengths 740, 765 nm exhibits high absorption of light by deoxygenated hemoglobin, with deep penetration at a longer wavelength of 770 and 780 nm. A similar study by Wang F et al, 2013 [50] stated that using multispectral imaging IR with a significant finding that a hairy forearm affects the image of the vein by the formation of a strong reflectance glare while, Kimori et al, 2015 [46] used 850 nm transmitted through the subcutaneous tissue and being compared as deeper than the light source of a commercial vein finder. Another study showed variation in the selected wavelength based on skin color.…”

“…In the elderly, vein access was challenging due to the changes in the vein structure as thin and fragile people lose elasticity while pediatrics have smaller peripheral veins with higher content of subcutaneous fat and are usually prone to vasoconstriction. This parameter was also considered in different studies [29,43,46,49].…”

“…It is worth mentioning that regarding the device with 15–20 cm distance above the site: The allowable distance was set to ensure the needed space in performing a vein puncture in Kimori et al, 2015 [46] and the prototype by Meng, G. et al, 2015 [48] with a head wearable model. While, there was direct skin contact noted in some of the developed prototypes, the vein finder was introduced with the same purpose as a tourniquet, which is used to help locate the vein.…”

Competitive Real-Time Near Infrared (NIR) Vein Finder Imaging Device to Improve Peripheral Subcutaneous Vein Selection in Venipuncture for Clinical Laboratory Testing

“…A total of 242 subjects/participants were enrolled in the study in the actual in-vitro testing of the developed vein finder device. The subjects’ demographics, such as gender, age, height, and weight for the body mass index (BMI), including the skin tone, were considered as parameters, the same with the previous studies [ 5 , 11 , 13 , 22 , 31 , 38 , 39 , 40 , 41 ], and with the inclusion of arm circumference measurement by the researchers in this study to maximize the assessment process. Specifically, two sites were selected; the arm and dorsal hand for testing, because the subcutaneous veins in the said areas are commonly used for venous blood specimen collection for laboratory testing and intravenous (IV) route for therapy, respectively.…”

“…In order to perform this procedure, the first step is to make the target vein visible, usually by using a tourniquet or by slightly tapping the site [ 4 ]. However, not all of the veins are visible, because they lack the distinguishing color or venous distention of the skin surface, even after the application of a tourniquet [ 5 ].…”