Optical detection of intravenous infiltration

Abstract

Infiltration of medications during infusion therapy results in complications ranging from erythema and pain to tissue necrosis requiring amputation. Infiltration occurs from improper insertion of the cannula, separation of the cannula from the vein, penetration of the vein by the cannula during movement, and response of the vein to the medication. At present, visual inspection by the clinical staff is the primary means for detecting intravenous (IV) infiltration. An optical sensor was developed to monitor the needle insertion site for signs of IV infiltration. Initial studies on simulated and induced infiltrations on a swine model validated the feasibility of the methodology. The presence of IV infiltration was confirmed by visual inspection of the infusion site and/or absence of blood return in the IV line. Potential sources of error due to illumination changes, motion artifacts, and edema were also investigated. A comparison of the performance of the optical device and blinded expert observers showed that the optical sensor has higher sensitivity and specificity, and shorter detection time than the expert observers. An improved model of the infiltration monitoring device was developed and evaluated in a clinical study on induced infiltrations of healthy adult volunteers. The performance of the device was compared with the observation of a blinded expert observer. The results show that the rates of detection of infiltrations are 98% and 82% for the optical sensor and the observer, respectively. The sensitivity and specificity of the optical sensor are 0.97 and 0.98, respectively.

Scoping Review of Early Intravenous Infiltration and Extravasation Detection Devices

“…The current literature search revealed 4 multimodal devices utilizing components from each category of sensors discussed above: mechanical deformation, temperature, and signal processors 13,17,22,25. Multimodal sensing involves any device that utilizes a combination of these technologies.…”

“…Lee and Lin25 used piezoelectric sensors, optical radiation, and a temperature sensor to create an open-source wearable infiltration sensor. Winchester and Chou13 used strain gauges and optical radiation, whereas Bhavasaar et al17 used a load cell and a heartbeat sensor to detect infiltration.…”

Sensing Technologies for Extravasation Detection: A Review

“…For the visual inspection, sometimes the extravasation was confirmed by the typical color of the fluorescein (yellowish orange) by the nurse, therefore in case the fluid is transparent only the sensor could detect the occurrence. The most likely sensitivity and specificity were estimated to be 0.93 and 0.95 . A device utilizing this sensor (Figure B) was developed and connected to the wireless network.…”

“…The beam is emitted and goes through the catheterization site, being reflected, scattered, and diffused, then is detected by the receiver ( Figure 7 A). 44 When an extravasation incident occurs, the fluid in the soft tissue changes the optical density of the beam and the reading of the beam receiver. The value at the receiver is compared to the baseline value that is performed before the extravasation, and then, a certain threshold is set to define an extravasation.…”

Toward Non-Invasive and Automatic Intravenous Infiltration Detection: Evaluation of Bioimpedance and Skin Strain in a Pig Model

“…Fluidic resistance was tested to detect IV infiltration in [7] . In [8] , an optical sensor-based system was used to detect IV infiltration. The sensing methods investigated in this proof-of-concept work are electrical bioimpedance (EBI) (to quantify local edema at IV site), and skin strain (to quantify the swelling of the skin as fluid accumulates locally at the IV site).…”