Aims This systematic review and meta-analysis evaluated the efficacy of infrared (IR) devices versus the traditional palpation technique for first-attempt success of peripheral intravenous catheter (PIVC) insertion in adults.

Design Systematic review and meta-analysis of randomised controlled trials (RCTs).

Data Sources A comprehensive search of PubMed, Embase, Cochrane Library, Scopus and CINAHL was conducted on 28 May 2024 and included articles in English or French published from 1st January 2000 onwards.

Review Methods Eligible studies included RCTs comparing IR devices with the traditional palpation method for PIVC insertion in adults. The primary outcome was first-attempt success. Secondary outcomes included overall success, number of attempts, cannulation time and patient pain. The risk of bias was assessed using the RoB2 tool, and a random-effects model was applied for meta-analysis.

Results Five RCTs were included, involving 690 patients and 704 catheters, including 289 PIVCs in patients with Difficult Intravascular Access (DIVA) criteria. First attempt insertion success was similar when using infrared devices (139/331, 42%) and traditional palpation (143/373, 38%) with Risk Ratio (RR) 1.08 (95% CI, 0.69 to 1.70). No significant statistical differences were noted in secondary outcomes: overall insertion success, number of attempts, time to cannulate and patient pain. Clinical and statistical heterogeneity were substantial (primary analysis I2 = 83%).

Conclusion Current evidence does not support the systematic use of infrared devices to improve PIVC insertion success, reduce the number of attempts or alleviate patient pain compared with traditional palpation in adults. Further high-quality studies with suitable sample sizes and varied populations are needed to better establish the potential place of infrared devices.

Impact This study highlights the limited benefit of IR devices in routine clinical practice and underscores the need for further research into their use in specialised settings.

Patient or Public Contribution No Patient or Public Involvement. This study did not include patient or public involvement in its design, conduct or reporting.