Impact of a Novel Biplane User Interface on Ultrasound-Guided Vascular Access Performance: A Prospective, Randomized, Crossover Study.

Abstract

Background: Controversy exists regarding the optimal methods of employing ultrasound to enhance vascular access. A novel user interface which dynamically displays transverse (short) and longitudinal (long) planes simultaneously was developed to optimize ultrasound-guided vascular access. This study aimed to assess the impact of this novel biplane axis technology on central venous access performance.

Methods: Eighteen volunteer emergency medicine resident physicians and physician assistants were recruited from a single center to participate in this prospective, randomized crossover study. Following a brief instructional video, participants were randomized to perform ultrasound-guided vascular access using either short-axis or biplane axis approaches first, followed by the opposite technique following a brief washout period. Time to cannulation was the primary outcome measure. Secondary outcome measures included success rate, posterior wall and arterial puncture rates, time to scout, number of attempts, number of needle redirections, participant cannulization and visualization confidence, and interface preference.

Results: Short-axis imaged approach was associated with a significantly shorter time to cannulation (34.9 seconds versus 17.6, p is less than 0.001) and time to scout (30 versus 49 seconds, p is equal to 0.008) when compared to biplaneaxis imaging approach. No significant differences were noted when comparing first pass success, number of attempts, number of redirections, and posterior wall and arterial wall puncture. Participants' cannulation/visualization confidence and axis preference both favored the short-axis imaging approach.

Conclusion: Further studies are needed to assess the clinical value of novel biplane axis ultrasound imaging in the performance of ultrasound-guided procedures.