Bexten Tobias, Boehm Adrian, Miller Jack, Yalamuri Suraj M, Read Matthew D, Simard Trevor, Wiebe Stefan
Intensive Care Unit, Helios Dr. Horst Schmidt Clinic, Wiesbaden, DEU.
Anesthesiology and Critical Care, Mayo Clinic, Rochester, USA.
Cureus. 2025 Jul 4;17(7):e87274. doi: 10.7759/cureus.87274. eCollection 2025 Jul.
BACKGROUND: Central venous catheter (CVC) insertion is a frequently performed procedure that requires precise hand-eye coordination and image interpretation. Despite ultrasound guidance being the standard of care, some problems, especially in ergonomics, like misalignment between the ultrasound monitors and the puncture site, remain a challenge. This study aimed to assess the integration of real-time ultrasound imaging into the Apple Vision Pro (AVP) headset (Apple Inc., Cupertino, CA) for ultrasound-guided CVC cannulation in a simulated environment. Specifically, we aimed to (1) evaluate technical feasibility, (2) quantify usability using an adjusted system usability questionnaire, and (3) compare usability perceptions across different experience levels. METHODS: In a prospective, observational pilot study, 42 intensivists performed CVC cannulation on a mannequin using a wireless ultrasound probe (GE Vscan Air™ CL, GE Healthcare, Chicago, IL) and AVP. Participants were grouped according to their experience and assessed through an evaluation that included a usability questionnaire, an observer checklist, and qualitative interviews. Usability, image quality, subjective satisfaction, and task performance were evaluated. RESULTS: Both junior and senior participants gave high ratings for the system's usability, image clarity, and educational potential, with no significant differences between groups. Notable strengths included intuitive handling, improved ergonomics, and precise image placement. The challenges identified were image resolution in the near field, as well as depth perception. Qualitative feedback supported the innovational character of the system and its potential sterile workflow. CONCLUSION: Integrating real-time ultrasound guidance into the AVP is feasible and highly rated by users with varying levels of experience. This concept promises to improve ergonomics, the CVC accuracy, and medical education. Further studies in clinical environments are needed to validate our findings and the impact on patient outcomes.
背景：中心静脉导管（CVC）置入是一项经常进行的操作，需要精确的手眼协调和图像解读能力。尽管超声引导是目前的标准护理方法，但仍存在一些问题，尤其是在人体工程学方面，如超声监视器与穿刺部位之间的错位，这仍然是一个挑战。本研究旨在评估在模拟环境中，将实时超声成像集成到苹果Vision Pro（AVP）头戴设备（苹果公司，加利福尼亚州库比蒂诺）中用于超声引导下CVC置管的可行性。具体而言，我们旨在：（1）评估技术可行性；（2）使用调整后的系统可用性问卷对可用性进行量化；（3）比较不同经验水平者对可用性的看法。 方法：在一项前瞻性观察性试点研究中，42名重症监护医生使用无线超声探头（GE Vscan Air™ CL，GE医疗集团，伊利诺伊州芝加哥）和AVP在模拟人身上进行CVC置管。参与者根据经验分组，并通过包括可用性问卷、观察者清单和定性访谈在内的评估进行评估。评估可用性、图像质量、主观满意度和任务表现。 结果：初级和高级参与者对系统的可用性、图像清晰度和教育潜力都给予了高度评价，两组之间没有显著差异。显著优点包括操作直观、人体工程学设计改进以及图像定位精确。发现的挑战是近场图像分辨率以及深度感知。定性反馈支持了该系统的创新性及其潜在的无菌工作流程。 结论：将实时超声引导集成到AVP中是可行的，并且受到不同经验水平用户的高度评价。这一概念有望改善人体工程学、CVC置管的准确性以及医学教育。需要在临床环境中进行进一步研究，以验证我们的发现以及对患者预后的影响。
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