Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.
Former Department of Advanced Nursing Technology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.
J Vasc Access. 2024 Jul;25(4):1252-1260. doi: 10.1177/11297298231156489. Epub 2023 Mar 9.
Ultrasound guidance increases the success rate of peripheral intravenous catheter placement. However, the longer time required to obtain ultrasound-guided access poses difficulties for ultrasound beginners. Notably, interpretation of ultrasonographic images is considered as one of the main reasons of difficulty in using ultrasound for catheter placement. Therefore, an automatic vessel detection system (AVDS) using artificial intelligence was developed. This study aimed to investigate the effectiveness of AVDS for ultrasound beginners in selecting puncture points and determine suitable users for this system.
In this crossover experiment involving the use of ultrasound with and without AVDS, we enrolled 10 clinical nurses, including 5 with some experience in peripheral intravenous catheterization using ultrasound-aided methods (categorized as ultrasound beginners) and 5 with no experience in ultrasound and less experience in peripheral intravenous catheterization using conventional methods (categorized as inexperienced). These participants chose two puncture points (those with the largest and second largest diameter) as ideal in each forearm of a healthy volunteer. The results of this study were the time required for the selection of puncture points and the vein diameter of the selected points.
Among ultrasound beginners, the time required for puncture point selection in the right forearm second candidate vein with a small diameter (<3 mm) was significantly shorter when using ultrasound with AVDS than when using it without AVDS (mean, 87 vs 247 s). Among inexperienced nurses, no significant difference in the time required for all puncture point selections was found between the use of ultrasound with and without AVDS. In the vein diameter, significant difference was shown only in the absolute difference at left second candidate among inexperienced participants.
Ultrasonography beginners needed less time to select the puncture points in a small diameter vein using ultrasound with AVDS than without AVDS.
超声引导提高了外周静脉置管的成功率。然而,获得超声引导所需的时间较长,这对超声初学者来说是一个挑战。值得注意的是,超声图像的解读被认为是使用超声进行置管的主要困难之一。因此,开发了一种使用人工智能的自动血管检测系统(AVDS)。本研究旨在探讨 AVDS 对超声初学者选择穿刺点的有效性,并确定该系统的适用人群。
本研究采用超声联合和不联合 AVDS 的交叉实验设计,纳入了 10 名临床护士,包括 5 名有一定超声辅助外周静脉置管经验的超声初学者和 5 名无超声经验且外周静脉置管经验较少的非超声初学者。这些参与者在一名健康志愿者的每只前臂上选择两个穿刺点(直径最大和第二大的点)作为理想点。本研究的结果为选择穿刺点所需的时间和所选点的静脉直径。
在超声初学者中,使用 AVDS 进行右前臂小直径(<3mm)第二候选静脉穿刺点选择时,所需时间明显短于不使用 AVDS(平均 87 秒 vs 247 秒)。在非超声初学者中,使用超声联合和不联合 AVDS 进行所有穿刺点选择时,所需时间无显著差异。在静脉直径方面,仅在非超声初学者的左第二候选静脉的绝对差值上显示出显著差异。
与不使用 AVDS 相比,超声初学者使用 AVDS 进行小直径静脉穿刺点选择时所需时间更短。