THE FEASIBILITY OF A NOVEL ULTRASOUND GUIDED VASCULAR ACCESS

DEVICE: A PILOT STUDY

Robinson M Ferre, MD, FACEPVanderbilt University Medical Center

Robinson.Ferre@vanderbilt.edu

Shannon B Snyder, MD, FACEPVanderbilt University Medical Center

Shannon.Snyder@Vanderbilt.edu

Matthew Lipton, MDUniversity of Utah Medical Center

Matthew.Lipton@Utah.edu

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