4. Discussion and conclusions
obese
OBESE
In the present study, we investigated whether near-infrared venous imaging or ultrasound guidance facilitates novices in obtaining difficult peripheral venous access using a simulated vein. The results show that obtaining difficult vascular access with near-infrared venous imaging was faster than when using ultrasound guidance, with no difference in success rate or proficiency using the technique. The simulator used in this study (a difficult venous access simulator) was designed to mimic the conditions under which veins are invisible to the naked eye, similar to the situation in some obese patients. The authors believe that near-infrared venous imaging may be useful for securing peripheral venous access in obese patients. Near-infrared venous imaging also has the advantage of requiring less training than ultrasound guidance.Near-infrared venous imaging was expected to improve the success rate for obtaining peripheral venous access in children.Recently, Yalçinli et al compared near-infrared venous imaging, ultrasound guidance, and conventional methods in adult patients and found that ultrasound guidance had a higher initial attempt success rate than near-infrared venous imaging or conventional methods.Cannulating veins using ultrasound guidance requires appropriate training and improves with experience. However, no consensus of a clear goal for technical skills acquisition has been established. In the present study, the simulation training given to participating medical students had the same content as preclinical basic training for residents.Ultrasound guidance has a great advantage over near-infrared venous imaging in that it can identify deeper veins. Near-infrared venous imaging has a limitation in its ability to locate deep veins, which cannot be observed over 5 mm deep. For this reason, ultrasound guidance is more clinically useful than near-infrared venous imaging. However, appropriate education is critical for this purpose. Near-infrared venous imaging may be useful as a method that requires less education and a useful way for novices to gain experience.Many studies have evaluated the teaching methods used for ultrasound guided venous access, but there is still no method accepted as the optimal approach.