Smart glasses improve success of radial arterial catheterization in small children: Study
Korea: A recent study in the journal Anesthesiology has reported that the use of smart glasses could improve the first-attempt success rate and ergonomic satisfaction in ultrasound-guided radial arterial catheterization in small pediatric patients. It also reduced the first-attempt procedure time and overall complication rates.
The success of delicate ultrasound-guided medical procedures is largely determined by hand-eye coordination and ergonomics. This can be improved by using smart glasses (head-mounted displays) which decrease the head movement on the ultrasound screen. In pediatric patients with small body sizes, there is a limited space allowed for the anesthetic procedure, and the position and posture of the operator must be adjusted accordingly.
Against the above background, Jin-Tae Kim, Seoul National University College of Medicine, Seoul, Republic of Korea, and colleagues hypothesized that smart glasses could improve the success rate of ultrasound-guided pediatric radial arterial catheterization.
To test their hypothesis, they designed a prospective, single-blinded, randomized controlled, single-center study enrolling 116 pediatric patients (age less than 2 yr) requiring radial artery cannulation during general anesthesia. They were randomized into the ultrasound screen group (control) or the smart glasses group. Following induction of general anesthesia, ultrasound-guided radial artery catheterization was performed.
The primary outcome was the first-attempt success rate. The secondary outcomes included the first-attempt procedure time, the overall complication rate, and operators' ergonomic satisfaction (5-point scale).
Based on the study, the researchers found the following:
- The smart glasses group had a higher first-attempt success rate than the control group (87.9% vs. 72.4%; odds ratio, 2.78; absolute risk reduction, –15.5%).
- The smart glasses group had a shorter first-attempt procedure time (median, 33 s; interquartile range, 23 to 47 s; range, 10 to 141 s) than the control group (median, 43 s; interquartile range, 31 to 67 s; range, 17 to 248 s).
- The overall complication rate was lower in the smart glasses group than in the control group (5.2% vs. 29.3%; odds ratio, 0.132; absolute risk reduction, 24.1%).
- The proportion of positive ergonomic satisfaction (4 = good or 5 = best) was higher in the smart glasses group than in the control group (65.5% vs. 20.7% [12/58]; odds ratio, 7.3; absolute risk reduction, –44.8%).
The researchers concluded, "smart glasses during radial artery cannulation improve the first-attempt success rate and ergonomic satisfaction and lower procedure time, the number of attempts, and procedure-related complications in pediatric patients aged less than 2 yr."
Young-Eun Jang, Sung-Ae Cho, Sang-Hwan Ji, Eun-Hee Kim, Ji-Hyun Lee, Hee-Soo Kim, Jin-Tae Kim; Smart Glasses for Radial Arterial Catheterization in Pediatric Patients: A Randomized Clinical Trial. Anesthesiology 2021; 135:612–620 doi: https://doi.org/10.1097/ALN.0000000000003914