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ESRA19-0048 An alternative approach to difficult pediatric arterial cannulation using near-infrared projection
  1. SY Lee and
  2. TS Fabila
  1. KK Women’s and Children’s Hospital, Paediatric Anaesthesia, Singapore, Singapore


Background and aims Arterial puncture is frequently performed in the peri-operative setting to enable continuous arterial blood pressure monitoring or arterial blood sampling. Infants can be one of the most difficult patient populations for cannulation owing to their small veins, limited access points due to size and the need to manage the anxiety of both the children and their parents. Furthermore, arterial blood flow may not appear pulsatile in young infants, making cannulation process even more tricky. the typically described techniques to pediatric arterial cannulation include: direct (by palpating the pules), use of guidewire, or ultrasound (B-mode or doppler)-guided.

Methods In this report, we suggest another technique, using near-infrared light, VeinViewer® (Luminetx Corporation, Memphis, TN, USA), to help us achieve successful arterial cannulation in an infant, when all of the above techniques failed.

Results The infant’s arteries are still relatively superficial, so we could project the pulsating radial artery over the infant’s wrist using the VeinViewer®, and successfully cannulated the radial artery. the process did not require a gel interface and bore no risk of contamination by ultrasound probes.

Conclusions There are existing studies reporting that the infra-red devices such as VeinViewer® facilitating peripheral venous access for pediatric patients. However, this is a first description of its use to visualise superficial arteries, instead of veins, in a 10 month old infant, enabling successful arterial cannulation (figure 1). We hope this technique will add to the armamentarium of techniques and equipment currently used to assist difficult arterial cannulation in small infants.

Abstract ESRA19-0048 Figure 1

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