{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T13:24:40Z","timestamp":1791811480401,"version":"4.3.4"},"reference-count":35,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2025,7,4]],"date-time":"2025-07-04T00:00:00Z","timestamp":1751587200000},"content-version":"unspecified","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,6,5]]},"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to evaluate the utility of optical sensor-based technology in mitigating the frequency and severity of peripheral intravenous infiltration and\/or extravasation (PIVIE) in neonates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Single-centre, retrospective, observational cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Tertiary-level neonatal intensive care unit (NICU) (112 cots) at the Women\u2019s Wellness and Research Centre (WWRC), Hamad Medical Corporation (HMC), Doha, Qatar, January 2019\u2013December 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>All neonates admitted to the NICU requiring intravenous therapy via a neonatal short peripheral intravenous catheter (n-SPC) were included. Participants were excluded if the insertion was unsuccessful, if they had incomplete data, or if they received intravenous therapy exclusively through alternative vascular access devices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>The study analysed two cohorts representing different clinical practices over two distinct periods. In the conventional cohort (Phase 1, 2019\u20132020), PIVIE detection relied solely on periodic \u2018Touch Look Compare (TLC)\u2019 assessments. In the ivWatch cohort (Phase 2, 2021\u20132022), continuous optical sensor-based monitoring using the ivWatch system was implemented alongside TLC assessments. This sequential design allowed for a comparison of outcomes between the two phases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measurements<\/jats:title>\n                    <jats:p>The primary outcomes were the occurrence and severity of PIVIE. Secondary outcomes included the influence of patient demographics, vascular access characteristics, and management details on PIVIE incidence and severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Over the 4-year data collection period, 32 713 peripheral intravenous catheters were analysed across two cohorts. PIVIE was the most common reason for unplanned device removal. In the conventional cohort (Phase 1, 2019\u20132020), 4941 infiltration events were reported (29.9%), compared with 4872 events (30.1%) in the ivWatch cohort (Phase 2, 2021\u20132022). However, severity measures using the Intravenous Extravasation Grading Scale (IEGS) revealed a marked reduction in severe PIVIE cases, with severe events decreasing from 243 (4.9%) in the conventional cohort to 54 (1.1%) in the ivWatch cohort (p&lt;0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PIVIE remains a frequent complication in neonatal vascular access. Continuous site monitoring with optical sensor technology was associated with earlier detection of PIVIE events and reduced IEGS severity scores. These findings highlight the potential of integrating sensor-based monitoring with traditional observational methods to improve patient outcomes in neonatal care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-094464","type":"journal-article","created":{"date-parts":[[2025,7,5]],"date-time":"2025-07-05T09:45:28Z","timestamp":1751708728000},"page":"e094464","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Evaluation of optical sensor technology for the early detection of peripheral intravenous infiltration in neonates: a retrospective cohort study"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9359-0895","authenticated-orcid":false,"given":"Matheus F P T","family":"van Rens","sequence":"first","affiliation":[{"name":"Neonatal Intensive Care Unit, Women\u2019s Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar"},{"name":"Amalia Children\u2019s Hospital, Nijmegen, Gelderland, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Hugill","sequence":"additional","affiliation":[{"name":"Nursing Education, Hamad Medical Corporation, Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin","family":"van der Lee","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Amalia Children\u2019s Hospital, Nijmegen, Gelderland, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Airene L V","family":"Francia","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Hamad Medical Corporation, Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3854-6976","authenticated-orcid":false,"given":"Fredericus H J van","family":"van Loon","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Catharina Hospital, Eindhoven, The Netherlands"},{"name":"Fontys University of Applied Sciences, Eindhoven, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2627-4806","authenticated-orcid":false,"given":"Mohammad A A","family":"Bayoumi","sequence":"additional","affiliation":[{"name":"Hamad Medical Corporation, Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,7,5]]},"reference":[{"key":"2025120600344600000_15.7.e094464.1","doi-asserted-by":"crossref","first-page":"326","DOI":"10.29252\/wjps.9.3.326","article-title":"Extravasation Injuries: A Trivial Injury Often Overlooked with Disastrous Consequences","volume":"9","author":"Alexander","year":"2020","journal-title":"World J Plast Surg"},{"key":"2025120600344600000_15.7.e094464.2","doi-asserted-by":"crossref","first-page":"72","DOI":"10.23736\/S0026-4946.16.04348-6","article-title":"Vascular access in neonates","volume":"69","author":"Rocha","year":"2017","journal-title":"Minerva Pediatr"},{"key":"2025120600344600000_15.7.e094464.3","article-title":"The NAVIGATE project: A GloVANet-WoCoVA position statement on the nomenclature for vascular access devices","volume":"2024","author":"van Rens","year":"2024","journal-title":"J Vasc Access"},{"key":"2025120600344600000_15.7.e094464.4","doi-asserted-by":"publisher","DOI":"10.5301\/jva.5000558"},{"key":"2025120600344600000_15.7.e094464.5","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1111\/apa.12963","article-title":"Peripheral venous catheter related complications are common among paediatric and neonatal patients","volume":"104","author":"Unbeck","year":"2015","journal-title":"Acta Paediatr"},{"key":"2025120600344600000_15.7.e094464.6","doi-asserted-by":"crossref","DOI":"10.3389\/fped.2022.980725","article-title":"The ABBA project (Assess Better Before Access): A retrospective cohort study of neonatal intravascular device outcomes","volume":"10","author":"van Rens","year":"2022","journal-title":"Front Pediatr"},{"key":"2025120600344600000_15.7.e094464.7","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1097\/NAN.0000000000000324","article-title":"Accepted but Unacceptable: Peripheral IV Catheter Failure: 2019 Follow-up","volume":"42","author":"Helm","year":"2019","journal-title":"J Infus Nurs"},{"key":"2025120600344600000_15.7.e094464.8","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2020-047788","article-title":"Evaluation of unmodifiable and potentially modifiable factors affecting peripheral intravenous device-related complications in neonates: a retrospective observational study","volume":"11","author":"van Rens","year":"2021","journal-title":"BMJ Open"},{"key":"2025120600344600000_15.7.e094464.9","article-title":"Case Series of Neonatal Extravasation Injury: Importance of Early Identification and Management","volume":"14","author":"Yew","year":"2022","journal-title":"Cureus"},{"key":"2025120600344600000_15.7.e094464.10","doi-asserted-by":"crossref","first-page":"S18","DOI":"10.12968\/bjon.2024.33.7.S18","article-title":"Extravasation and infiltration: under-recognised complications of intravenous therapy","volume":"33","author":"Barton","year":"2024","journal-title":"Br J Nurs"},{"key":"2025120600344600000_15.7.e094464.11","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1590\/S0080-623420160000100003","article-title":"Incidence of local complications and risk factors associated with peripheral intravenous catheter in neonates","volume":"50","author":"Danski","year":"2016","journal-title":"Rev Esc Enferm USP"},{"key":"2025120600344600000_15.7.e094464.12","doi-asserted-by":"crossref","first-page":"S31","DOI":"10.12968\/bjon.2022.31.8.S31","article-title":"Treatment of a neonatal peripheral intravenous infiltration\/extravasation (PIVIE) injury with hyaluronidase: a case report","volume":"31","author":"van Rens","year":"2022","journal-title":"Br J Nurs"},{"key":"2025120600344600000_15.7.e094464.13","doi-asserted-by":"publisher","DOI":"10.1097\/NAN.0b013e3181aac042"},{"key":"2025120600344600000_15.7.e094464.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.pedn.2012.01.005"},{"key":"2025120600344600000_15.7.e094464.15","doi-asserted-by":"crossref","first-page":"38","DOI":"10.33235\/va.5.2.38-41","article-title":"A new approach for early recognition of peripheral intravenous (PIV) infiltration: a pilot appraisal of a sensor technology in a neonatal population","volume":"5","author":"van Rens","year":"2019","journal-title":"VA"},{"key":"2025120600344600000_15.7.e094464.16","doi-asserted-by":"crossref","first-page":"1801","DOI":"10.1177\/11297298231185536","article-title":"Peripheral intravenous therapy infiltration\/extravasation (PIVIE) risks and the potential for earlier notification of events using a novel sensor technology in a neonatal population","volume":"25","author":"van Rens","year":"2024","journal-title":"J Vasc Access"},{"key":"2025120600344600000_15.7.e094464.17","doi-asserted-by":"crossref","first-page":"1780","DOI":"10.1177\/11297298231177723","article-title":"Optical detection of infiltration during peripheral intravenous infusion in neonates","volume":"25","author":"D\u2019Andrea","year":"2024","journal-title":"J Vasc Access"},{"key":"2025120600344600000_15.7.e094464.18","unstructured":"Naramore W , Brown S , Cole MA , et al . ivWatch SmartTouch Sensor: Device Validation for Non-Infiltrated Tissues, Available: https:\/\/www.ivwatch.com\/"},{"key":"2025120600344600000_15.7.e094464.19","unstructured":"Naramore W , Brown S , Schears GJ , et al . ivWatch SmartTouch Sensor: Device Validation for Infiltrated Tissues, 2019. Available: https:\/\/www.ivwatch.com\/"},{"key":"2025120600344600000_15.7.e094464.20","unstructured":"Children\u2019s C . Cincinnati Pediatric Intravenous Extravasation Assessment System 2017, 2017. Available: https:\/\/www.cincinnatichildrens.org\/"},{"key":"2025120600344600000_15.7.e094464.21","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijnurstu.2023.104604","article-title":"The impact of a structured assessment and decision tool (I-DECIDED\u00ae) on improving care of peripheral intravenous catheters: A multicenter, interrupted time-series study","volume":"148","author":"Ray-Barruel","year":"2023","journal-title":"Int J Nurs Stud"},{"key":"2025120600344600000_15.7.e094464.22","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1177\/11297298211023274","article-title":"European recommendations on the proper indication and use of peripheral venous access devices (the ERPIUP consensus): A WoCoVA project","volume":"24","author":"Pittiruti","year":"2023","journal-title":"J Vasc Access"},{"key":"2025120600344600000_15.7.e094464.23","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2019-3474I"},{"key":"2025120600344600000_15.7.e094464.24","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1097\/NAN.0000000000000532","article-title":"Infusion Therapy Standards of Practice, 9th Edition","volume":"47","author":"Nickel","year":"2024","journal-title":"J Infus Nurs"},{"key":"2025120600344600000_15.7.e094464.25","unstructured":"ivWatch . ivWatch Model 400 overview, how it works, 2019. Available: www.ivWatch.com\/how-it-works\/"},{"key":"2025120600344600000_15.7.e094464.26","unstructured":"ivWatch . Breakthrough in IV safety, 2019. Available: https:\/\/www.ivwatch.com\/wp-content\/ uploads\/2018\/05\/Model-400-Whitepaper-Rev-4-718.pdf"},{"key":"2025120600344600000_15.7.e094464.27","doi-asserted-by":"crossref","first-page":"44","DOI":"10.2309\/j.java.2019.002.003","article-title":"The Use of Optical Detection for Continuous Monitoring of Pediatric IV Sites","volume":"24","author":"Doellman","year":"2019","journal-title":"J Assoc for Vascular Access"},{"key":"2025120600344600000_15.7.e094464.28","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.2010.240"},{"key":"2025120600344600000_15.7.e094464.29","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.79.3.340"},{"key":"2025120600344600000_15.7.e094464.30","doi-asserted-by":"publisher","DOI":"10.1111\/j.1541-0420.2011.01619.x"},{"key":"2025120600344600000_15.7.e094464.31","first-page":"1075","article-title":"A randomized controlled trial to assess the effectiveness of VialonTM cannula versus Polytetrafluoroethylene (PTFE) cannula in terms of indwelling time and complications in patients requiring peripheral intravenous cannulation","volume":"4","author":"Chhugani","year":"2013","journal-title":"Int J Sci Res"},{"key":"2025120600344600000_15.7.e094464.32","doi-asserted-by":"crossref","first-page":"3272","DOI":"10.1021\/acssensors.3c00838","article-title":"Comment on \u201cSensing Technologies for Extravasation Detection: A Review\u201d","volume":"8","author":"van Rens","year":"2023","journal-title":"ACS Sens"},{"key":"2025120600344600000_15.7.e094464.33","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1016\/j.idh.2023.05.005","article-title":"Peripheral intravenous catheter material and design to reduce device failure: A systematic review and meta-analysis","volume":"28","author":"Matthews","year":"2023","journal-title":"Infect Dis Health"},{"key":"2025120600344600000_15.7.e094464.34","doi-asserted-by":"crossref","DOI":"10.1111\/jjns.12328","article-title":"Effectiveness of vialon biomaterial versus teflon catheters for peripheral intravenous placement: A randomized clinical trial","volume":"17","author":"Ku\u015f","year":"2020","journal-title":"Jpn J Nurs Sci"},{"key":"2025120600344600000_15.7.e094464.35","doi-asserted-by":"crossref","first-page":"1284","DOI":"10.1177\/11297298221080071","article-title":"Effect of peripheral intravenous catheter type and material on therapy failure in a neonatal population","volume":"24","author":"van Rens","year":"2023","journal-title":"J Vasc Access"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2024-094464","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T08:34:56Z","timestamp":1765010096000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2024-094464"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7]]},"references-count":35,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2025,7,5]]},"published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1136\/bmjopen-2024-094464"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2024-094464","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7]]}}}