Effectiveness of head-mounted ultrasound display for radial arterial catheterisation in paediatric patients by anaesthesiology trainees: A randomised clinical trial.

IF 4.2 2区医学 Q1 ANESTHESIOLOGY

European Journal of Anaesthesiology Pub Date : 2024-07-01 Epub Date: 2024-03-21 DOI:10.1097/EJA.0000000000001985

Jin-Tae Kim, Jung-Bin Park, Pyoyoon Kang, Sang-Hwan Ji, Eun-Hee Kim, Ji-Hyun Lee, Hee-Soo Kim, Young-Eun Jang

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引用次数: 0

Abstract

Background: The effectiveness of head mounted real-time ultrasound displays (hereafter referred to as 'smart glasses') in improving hand-eye coordination in less experienced individuals, such as trainees in anaesthesia, is unclear.

Objectives: To compare the first-attempt success rate of smart glasses-assisted ultrasound-guided paediatric radial artery catheterisation with conventional ultrasound guided catheterisation performed by anaesthesiology trainees.

Design: Prospective randomised controlled trial.

Settings: Tertiary university hospital from September 2021 to February 2023.

Patients: One hundred and twenty-two paediatric patients (age <7 years, weight ≥3 kg) who required radial artery cannulation during general anaesthesia.

Interventions: The participants were randomly assigned to either the ultrasound screen group (control) or the smart glasses group prior to radial artery catheterisation.

Main outcome measures: The primary outcome was the first attempt success rate. Secondary outcomes included the number of attempts, use of transfixion technique, overall complication rate, and clinical anaesthesiology (CA) year of the operators.

Results: A total of 119 paediatric patients were included in the analysis. The smart glasses group exhibited higher first-attempt success rate than did the control group (89.8% [53/59] vs. 71.7% [43/60]; P = 0.023; odds ratio (OR) 3.49; (95% confidence interval (CI) 1.27-9.6). The overall number of attempts [median, 1; interquartile range (IQR), 1-1; range, 1-3 vs. median, 1; IQR, 1-2; range, 1-4; P = 0.006], use of transfixion technique (12/59 [20.3%] vs. 28/60 [46.7%]; P = 0.002), and overall complication rate (6.8% [4/59] vs. 30.0% [18/60]; P = 0.002) were lower in the smart glasses group than in the control group. However, among paediatric anaesthesiology fellows (CA 5 years), the first- (89.3% [25/28] vs. 80.8% [21/26]; P = 0.619) and second-attempt success rates (96.4% [27/28] vs. 80.8% [21/26]; P = 0.163) did not differ between the two groups.

Conclusions: Smart glasses-assisted ultrasound guided radial artery catheterisation improved the first attempt success rate among anaesthesiology trainees, reducing the number of attempts and overall complication rates in small paediatric patients. Smart glasses were more effective for anaesthesia residents (CA 2-4 years) but were not effective for paediatric anaesthesiology fellows (CA 5 years).

Trial registration: ClinicalTrials.gov (NCT05030649) ( https://classic.clinicaltrials.gov/ct2/show/NCT05030649 ).

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头戴式超声显示屏对麻醉科受训人员为儿科患者进行桡动脉导管插入术的效果：随机临床试验。

背景：头戴式实时超声显示屏（以下简称 "智能眼镜"）在提高麻醉实习生等经验较少的人的手眼协调能力方面的效果尚不明确：比较智能眼镜辅助超声引导小儿桡动脉导管术与麻醉学受训者在传统超声引导下进行导管术的首次尝试成功率：前瞻性随机对照试验：设置：2021年9月至2023年2月的三级大学医院：122名儿科患者（年龄干预：参与者在桡动脉导管术前被随机分配到超声波屏幕组（对照组）或智能眼镜组：主要结果是首次尝试成功率。次要结果包括尝试次数、经皮穿刺技术的使用、总体并发症发生率以及操作者的临床麻醉学（CA）年限：共有 119 名儿科患者参与了分析。智能眼镜组的首次尝试成功率高于对照组（89.8% [53/59] vs. 71.7% [43/60]；P = 0.023；几率比（OR）3.49；（95% 置信区间（CI）1.27-9.6）。智能眼镜组的总体尝试次数[中位数，1；四分位数间距（IQR），1-1；范围，1-3 vs. 中位数，1；四分位数间距（IQR），1-2；范围，1-4；P = 0.006]、输血技术使用率（12/59 [20.3%] vs. 28/60 [46.7%]；P = 0.002）和总体并发症发生率（6.8% [4/59] vs. 30.0% [18/60]；P = 0.002）均低于对照组。然而，在儿科麻醉学研究员（CA 5 年）中，两组的首次尝试成功率（89.3% [25/28] vs. 80.8% [21/26]；P = 0.619）和二次尝试成功率（96.4% [27/28] vs. 80.8% [21/26]；P = 0.163）没有差异：结论：智能眼镜辅助超声引导桡动脉导管术提高了麻醉科学员的首次尝试成功率，减少了尝试次数，降低了儿科小患者的总体并发症发生率。智能眼镜对麻醉住院医师（CA 2-4 年）更有效，但对儿科麻醉学研究员（CA 5 年）无效：ClinicalTrials.gov (NCT05030649; registered 1 September 2021; principal investigator, Prof. Jin-Tae Kim) (https://classic.clinicaltrials.gov/ct2/show/NCT05030649).

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来源期刊

European Journal of Anaesthesiology 医学-麻醉学

CiteScore

6.90

自引率

11.10%

发文量

351

审稿时长

6-12 weeks

期刊介绍： The European Journal of Anaesthesiology (EJA) publishes original work of high scientific quality in the field of anaesthesiology, pain, emergency medicine and intensive care. Preference is given to experimental work or clinical observation in man, and to laboratory work of clinical relevance. The journal also publishes commissioned reviews by an authority, editorials, invited commentaries, special articles, pro and con debates, and short reports (correspondences, case reports, short reports of clinical studies).