Ultrasound guidance versus near-infrared light versus the standard technique for first-attempt success of peripheral intravenous catheterisation in adults with difficult venous access in a medical imaging department (RÉUSSIR-VVP): protocol for a single-centre, three arms, randomised controlled trial

Introduction: Peripheral intravenous catheterisation fails at the first attempt in about one in four adults and far more often in patients with difficult intravenous access (DIVA). Repeated attempts increase pain, anxiety, infection and extravasation risk, delay imaging, consume staff time and costs. Ultrasound guidance and near-infrared (NIR) vein illumination can each improve cannulation but no trial has directly compared them in a population defined by a validated DIVA Score. We aim to compare first-attempt cannulation success between the standard technique, ultrasound guidance and NIR illumination in adults with difficult venous access referred for imaging.

Methods and analysis: RÉUSSIR-VVP is a single-centre, prospective, randomised, open-label, superiority trial conducted in the CT units of Poitiers University Hospital, France. A total of 264 adult patients referred for a medical imaging examination requiring a contrast product and presenting an Adult DIVA Score≥2 will be randomised in a 1:1:1 ratio to receive either ultrasound guidance or NIR illumination or standard technique. The primary outcome is first-attempt successful catheterisation, defined as the placement of a functional catheter without immediate complication at the first skin puncture. Secondary outcomes include second-attempt successful catheterisation, total number of attempts, maximal pain, patient and operator satisfaction, time to successful catheterisation and catheter gauge.