A Randomized Crossover Study Comparing a Novel Needle Guidance Technology for Simulated Internal Jugular Vein Cannulation

Auyong, David B.; Yuan, Stanley C.; Rymer, Alyse N.; Green, Cynthia L.; Hanson, Neil A.

doi:10.1097/aln.0000000000000759

Cited by 22 publications

(18 citation statements)

References 27 publications

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“…Posterior wall injuries occurred in 71% of procedures using the navigation system and 71% using the free-hand technique. These results are different from those reported in the literature [ 6 ]. Further evaluation identified that the difference between our pilot study and previous results revealed that the authors used a shallow angle of approach for the needle.…”

Section: Introductioncontrasting

confidence: 99%

“…There are no studies which compare different puncture angles. The method described by Auyong et al used a slightly shallower insertion angle compared to the ASE and SCA recommended technique [ 6 ]. We performed a power analysis to determine an order of magnitude result.…”

Section: Discussionmentioning

confidence: 99%

“…The study was performed using a commercially available ultrasound device (eZono4000®, eZono AG, Jena, Germany), equipped with novel, real time, and needle navigation technology [ 6 ]. This system enables free-hand navigation to visualize the needle trajectory and needle tip position using ultrasound imaging.…”

Section: Methodsmentioning

confidence: 99%

“…A recent needle navigation system used with ultrasound imaging enables the operator to navigate the needle trajectory and depth in real time. Auyong et al [ 6 ] reported that this needle navigation technology yielded a high success rate and reduced the rate of posterior wall injuries.…”

Section: Introductionmentioning

confidence: 99%

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A Shallow Angle Short-Axis Out-of-Plane Approach Reduces the Rate of Posterior Wall Injuries in Central Venous Catheterization: A Simulation Study

Watanabe

Tokumine

Lefor

et al. 2018

BioMed Research International

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The short-axis out-of-plane approach (SAX-OOP) is commonly used in ultrasound-guided internal jugular vein catheterization. However, this approach has a risk of posterior vein wall injuries. The authors hypothesized that a shallow angle of approach may reduce the rate of posterior wall injuries compared with the conventional steep angle approach. The present study aimed to evaluate whether a difference in the angle of approach of the needle affects the rate of posterior wall injuries. The present study was a randomized crossover-controlled trial involving 40 medical residents, conducted in the clinical training center at a hospital with a residency program. The primary outcome measure was the rate of posterior vessel wall injuries. Subjects received a didactic lecture during which the instructors taught three SAX-OOP techniques including the conventional free-hand method (procedure C), a needle navigation system (procedure N), and a shallow puncture angle using a guidance system (procedure S). Participants were trained in these approaches under supervision and each technique tested in a simulation environment. Thirty-four of 40 residents had no previous experience with central venous catheterization and were included in the final analysis. The rate of posterior vessel wall injuries in procedure S (9%) was significantly lower than using the other approaches (procedure C, 53%; procedure N, 41%). In conclusion, a shallow angle of approach using the SAX-OOP technique resulted in significantly fewer posterior vein wall injuries in central venous catheterization compared with steep angle techniques.

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Section: Introductioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Shallow Angle Short-Axis Out-of-Plane Approach Reduces the Rate of Posterior Wall Injuries in Central Venous Catheterization: A Simulation Study

Watanabe

Tokumine

Lefor

et al. 2018

BioMed Research International

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“…) . Inexperienced participants using the Ezono 4000 (Ezono AG, Jena, Germany) needed fewer out‐of‐plane attempts, shorter procedure times and made significantly less posterior wall and carotid artery punctures in simulated internal jugular vein cannulation . A recently developed prototype by General Electric (Wisconsin, USA) uses passive magnetic characteristics of commercially available needles, omitting the magnetisation procedure and, thus, improving workflow.…”

Section: Resultsmentioning

confidence: 99%

Improving needle tip identification during ultrasound-guided procedures in anaesthetic practice

et al. 2017

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Ultrasound guidance is becoming standard practice for needle-based interventions in anaesthetic practice, such as vascular access and peripheral nerve blocks. However, difficulties in aligning the needle and the transducer can lead to incorrect identification of the needle tip, possibly damaging structures not visible on the ultrasound screen. Additional techniques specifically developed to aid alignment of needle and probe or identification of the needle tip are now available. In this scoping review, advantages and limitations of the following categories of those solutions are presented: needle guides; alterations to needle or needle tip; three- and four-dimensional ultrasound; magnetism, electromagnetic or GPS systems; optical tracking; augmented (virtual) reality; robotic assistance; and automated (computerised) needle detection. Most evidence originates from phantom studies, case reports and series, with few randomised clinical trials. Improved first-pass success and reduced performance time are the most frequently cited benefits, whereas the need for additional and often expensive hardware is the greatest limitation to widespread adoption. Novice ultrasound users seem to benefit most and great potential lies in education. Future research should focus on reporting relevant clinical parameters to learn which technique will benefit patients most in terms of success and safety.

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Standard Needle Magnetization for Ultrasound Needle Guidance: First Clinical Experiences in Fine‐Needle Aspiration Cytology of Thyroid Nodules

Freesmeyer

Kühnel

Gühne

et al. 2019

J of Ultrasound Medicine

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Fine-needle aspiration cytology using a novel ultrasound needle guidance system on the basis of standard needle magnetization was consecutively performed in 30 (15 in-plane and 15 out-of-plane) suspicious thyroid nodules. Nondedicated, commercially available needles were used. The technical effectiveness and safety of the system were satisfying; system failures were observed in 2 cases. The needle tip could be (at least occasionally) visualized inside the thyroid nodule in 96%, and the subjective procedure ratings were excellent in 57%. The out-of-plane technique was significantly superior in both respects (P = .021 and .027, respectively). Standard needle magnetization ultrasound needle guidance was easy to apply and cost-effective and has the potential to improve fine-needle aspiration cytology performance.

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A Randomized Crossover Study Comparing a Novel Needle Guidance Technology for Simulated Internal Jugular Vein Cannulation

Abstract: This real-time needle guidance technology (eZono) shows significant improvement in needle accuracy and cannulation time during simulated IJ vein puncture.

Cited by 22 publications

References 27 publications

A Shallow Angle Short-Axis Out-of-Plane Approach Reduces the Rate of Posterior Wall Injuries in Central Venous Catheterization: A Simulation Study

A Shallow Angle Short-Axis Out-of-Plane Approach Reduces the Rate of Posterior Wall Injuries in Central Venous Catheterization: A Simulation Study

Improving needle tip identification during ultrasound-guided procedures in anaesthetic practice

Standard Needle Magnetization for Ultrasound Needle Guidance: First Clinical Experiences in Fine‐Needle Aspiration Cytology of Thyroid Nodules

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