Assessing the Effect of Augmented Reality on Procedural Outcomes During Ultrasound-Guided Vascular Access

Michele S. Saruwatari, Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Hospital, Washington, DC, USA; Department of Surgery, MedStar Georgetown University Hospital and Washington Hospital Center, Washington, DC, USA.
Trong N. Nguyen, IGI Technologies, Silver Spring, MD, USA.
Hadi Fooladi Talari, Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Hospital, Washington, DC, USA.
Andrew J. Matisoff, Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Hospital, Washington, DC, USA; George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Karun V. Sharma, Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Hospital, Washington, DC, USA; George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Kelsey G. Donoho, Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Hospital, Washington, DC, USA; George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Sonali Basu, Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Hospital, Washington, DC, USA; George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Pallavi Dwivedi, Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Hospital, Washington, DC, USA.
James E. Bost, Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Hospital, Washington, DC, USA; George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Raj Shekhar, Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Hospital, Washington, DC, USA; IGI Technologies, Silver Spring, MD, USA; George Washington University School of Medicine and Health Sciences, Washington, DC, USA. Electronic address: rshekhar@childrensnational.org.

Document Type

Journal Article

Publication Date

8-10-2023

Journal

Ultrasound in medicine & biology

DOI

10.1016/j.ultrasmedbio.2023.07.011

Keywords

Augmented reality; Head-mounted display; HoloLens; Ultrasound guidance; Vascular access

Abstract

OBJECTIVE: Augmented reality devices are increasingly accepted in health care, though most applications involve education and pre-operative planning. A novel augmented reality ultrasound application, HoloUS, was developed for the Microsoft HoloLens 2 to project real-time ultrasound images directly into the user's field of view. In this work, we assessed the effect of using HoloUS on vascular access procedural outcomes. METHODS: A single-center user study was completed with participants with (N = 22) and without (N = 12) experience performing ultrasound-guided vascular access. Users completed a venipuncture and aspiration task a total of four times: three times on study day 1, and once on study day 2 between 2 and 4 weeks later. Users were randomized to use conventional ultrasound during either their first or second task and the HoloUS application at all other times. Task completion time, numbers of needle re-directions, head adjustments and needle visualization rates were recorded. RESULTS: For expert users, task completion time was significantly faster using HoloUS (11.5 s, interquartile range [IQR] = 6.5-23.5 s vs. 18.5 s, IQR = 11.0-36.5 s; p = 0.04). The number of head adjustments was significantly lower using the HoloUS app (1.0, IQR = 0.0-1.0 vs. 3.0, IQR = 1.0-5.0; p < 0.0001). No significant differences were identified in other measured outcomes. CONCLUSION: This is the first investigation of augmented reality-based ultrasound-guided vascular access using the second-generation HoloLens. It demonstrates equivalent procedural efficiency and accuracy, with favorable usability, ergonomics and user independence when compared with traditional ultrasound techniques.

Department

Radiology

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