Patient Monitoring System Significantly Reduces Severity of IV Injuries in NICU

Peripheral intravenous infiltration or extravasation (PIVIE) injuries present a silent but serious threat in neonatal intensive care units (NICUs), often going undetected or misdiagnosed until they result in severe tissue damage. These injuries can lead to complications such as skin necrosis, scarring, nerve damage, medication dosing errors, and in extreme cases, amputation. Traditional identification methods rely on intermittent assessments, which can allow injuries to progress unnoticed. By identifying infiltration events at a much earlier stage, healthcare providers can intervene sooner and thereby reduce patient harm. Now, a new patient monitoring system that combines predictive optical technology with real-time alerts can detect peripheral infiltration injuries before they worsen.

The ivWatch technology, developed by ivWatch (Newport News, VA, USA), uses a predictive algorithm and visible and near-infrared light to detect changes in the optical properties of tissue around an IV site. When it detects these changes, it notifies clinicians in real time to check the IV site. The system has been tested in both lab and real-world settings and has demonstrated high sensitivity and specificity across various patient populations. Sensitivity in prior studies reached up to 93.3% and 100%, with all detections occurring before staff recognition. This allows earlier intervention and reduces tissue damage. The system was tested in a four-year study conducted in a NICU in which the first two years (2019–2020) relied solely on traditional ‘Touch Look Compare’ (TLC) assessments, while the latter two years (2021–2022) incorporated the ivWatch optical sensor technology alongside TLC.

The findings, published in the BMJ, revealed that with the introduction of the monitoring system, the number of severe PIVIE events with over 30% tissue involvement dropped from 243 to 54, while cases affecting more than 15% of tissue decreased from 2,613 to 180 — a 78% and 93% reduction, respectively. Median estimated tissue involvement fell from 15% to 5%, and average catheter dwell time was reduced, suggesting earlier detection and management. These findings underscore the potential of continuous monitoring to transform neonatal vascular access care by improving outcomes, reducing healthcare costs, and advancing clinical competency.

“The ability to detect PIVIEs early before they lead to severe harm could significantly improve patient outcomes and help raise the standard of care in neonatal vascular access,” said Roland van Rens, lead author of the study.

Related Links:
ivWatch