the feasibility of a novel ultrasound guided vascular access device: a pilot study
DESCRIPTION
THE FEASIBILITY OF A NOVEL ULTRASOUND GUIDED VASCULAR ACCESS DEVICE: A PILOT STUDY . Robinson M Ferre, MD, FACEP Vanderbilt University Medical Center [email protected]. Shannon B Snyder, MD, FACEP Vanderbilt University Medical Center [email protected]. - PowerPoint PPT PresentationTRANSCRIPT
THE FEASIBILITY OF A NOVEL ULTRASOUND GUIDED VASCULAR ACCESS
DEVICE: A PILOT STUDY
Robinson M Ferre, MD, FACEPVanderbilt University Medical Center
Shannon B Snyder, MD, FACEPVanderbilt University Medical Center
Matthew Lipton, MDUniversity of Utah Medical Center
Background • US Guided Central Venous Line (CVL) insertion is
endorsed by many professional organizations
• Many obstacles exist for widespread implementation
• Learning US guided CVL insertion can be challenging for physicians
• Complications reduced with US guided CVL insertion, but still occur
Methods• Observational Study of adult patients in ED or ICU receiving CVL
with AxoTrack™ System• IRB Approved• Convenience sample • Data collected by independent observer with video recordings of
CVL insertion• Primary Outcome: First Pass Success• Secondary Outcomes:
– Complications (Arterial puncture, arterial cannulation, pneumothorax, hemothorax, hematoma, catheter malposition)
– Successful Procedure– Number of attempts– Physician satisfaction
AxoTrack System
Magnetic Post:Uses Hall Effect technology to display location of the needle on the screen at all times
Needle hub:Magnetic ceramic hub needed for Hall Effect sensor
Transducer:Phased array
Hole in probe:Needle passes through a hole in the probe to maintain needle along trajectory line
Needle Trajectory Line
Holographic image of the needle
Results
• 30 Patients• Mean Age: 54 yo• Sex (Female): 47%• Hospital Location:
– 70% Emergency Department– 30% ICU
Results
Internal Jugular = 9 (30%)
Subclavian:Infraclavicular = 4 (13%) Supraclavicular =17 (57%)
Results
• Primary Outcome:– First Pass Success = 26/30
(87%)
• Secondary Outcomes:– Complications = 0– Successful Procedure = 29/30
(97%)• 1 failure was with infraclavicular
subclavian approach– Mean number of attempts = 1.1
Results• Physician Satisfaction:
– 25 (80%) rated the AxoTrack system very or relatively easy to use during the procedure
– 25 (86%) preferred AxoTrack System overall compared with the traditional US guidance
– 30 (100%) preferred AxoTrack Systems ability to guide the needle into the vein compared with the traditional technique
Conclusion
The AxoTrack system is a safe and effective means of performing central venous access in critically ill patients.
Disclosure• Robinson M Ferre: Research Support, Soma Access Systems• Shannon B Snyder: None• Matthew Lipton: None