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Brattain LJ, Pierce TT, Gjesteby LA, Johnson MR, DeLosa ND, Werblin JS, Gupta JF, Ozturk A, Wang X, Li Q, Telfer BA, Samir AE. AI-Enabled, Ultrasound-Guided Handheld Robotic Device for Femoral Vascular Access. BIOSENSORS 2021; 11:522. [PMID: 34940279 PMCID: PMC8699246 DOI: 10.3390/bios11120522] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 11/17/2021] [Accepted: 12/15/2021] [Indexed: 05/27/2023]
Abstract
Hemorrhage is a leading cause of trauma death, particularly in prehospital environments when evacuation is delayed. Obtaining central vascular access to a deep artery or vein is important for administration of emergency drugs and analgesics, and rapid replacement of blood volume, as well as invasive sensing and emerging life-saving interventions. However, central access is normally performed by highly experienced critical care physicians in a hospital setting. We developed a handheld AI-enabled interventional device, AI-GUIDE (Artificial Intelligence Guided Ultrasound Interventional Device), capable of directing users with no ultrasound or interventional expertise to catheterize a deep blood vessel, with an initial focus on the femoral vein. AI-GUIDE integrates with widely available commercial portable ultrasound systems and guides a user in ultrasound probe localization, venous puncture-point localization, and needle insertion. The system performs vascular puncture robotically and incorporates a preloaded guidewire to facilitate the Seldinger technique of catheter insertion. Results from tissue-mimicking phantom and porcine studies under normotensive and hypotensive conditions provide evidence of the technique's robustness, with key performance metrics in a live porcine model including: a mean time to acquire femoral vein insertion point of 53 ± 36 s (5 users with varying experience, in 20 trials), a total time to insert catheter of 80 ± 30 s (1 user, in 6 trials), and a mean number of 1.1 (normotensive, 39 trials) and 1.3 (hypotensive, 55 trials) needle insertion attempts (1 user). These performance metrics in a porcine model are consistent with those for experienced medical providers performing central vascular access on humans in a hospital.
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Affiliation(s)
- Laura J. Brattain
- Lincoln Laboratory, Massachusetts Institute of Technology, Lexington, MA 02421, USA; (L.J.B.); (L.A.G.); (M.R.J.); (N.D.D.); (J.S.W.); (J.F.G.)
| | - Theodore T. Pierce
- Department of Radiology, Massachusetts General Hospital, Boston, MA 02114, USA; (T.T.P.); (A.O.); (X.W.); (Q.L.); (A.E.S.)
| | - Lars A. Gjesteby
- Lincoln Laboratory, Massachusetts Institute of Technology, Lexington, MA 02421, USA; (L.J.B.); (L.A.G.); (M.R.J.); (N.D.D.); (J.S.W.); (J.F.G.)
| | - Matthew R. Johnson
- Lincoln Laboratory, Massachusetts Institute of Technology, Lexington, MA 02421, USA; (L.J.B.); (L.A.G.); (M.R.J.); (N.D.D.); (J.S.W.); (J.F.G.)
| | - Nancy D. DeLosa
- Lincoln Laboratory, Massachusetts Institute of Technology, Lexington, MA 02421, USA; (L.J.B.); (L.A.G.); (M.R.J.); (N.D.D.); (J.S.W.); (J.F.G.)
| | - Joshua S. Werblin
- Lincoln Laboratory, Massachusetts Institute of Technology, Lexington, MA 02421, USA; (L.J.B.); (L.A.G.); (M.R.J.); (N.D.D.); (J.S.W.); (J.F.G.)
| | - Jay F. Gupta
- Lincoln Laboratory, Massachusetts Institute of Technology, Lexington, MA 02421, USA; (L.J.B.); (L.A.G.); (M.R.J.); (N.D.D.); (J.S.W.); (J.F.G.)
| | - Arinc Ozturk
- Department of Radiology, Massachusetts General Hospital, Boston, MA 02114, USA; (T.T.P.); (A.O.); (X.W.); (Q.L.); (A.E.S.)
| | - Xiaohong Wang
- Department of Radiology, Massachusetts General Hospital, Boston, MA 02114, USA; (T.T.P.); (A.O.); (X.W.); (Q.L.); (A.E.S.)
| | - Qian Li
- Department of Radiology, Massachusetts General Hospital, Boston, MA 02114, USA; (T.T.P.); (A.O.); (X.W.); (Q.L.); (A.E.S.)
| | - Brian A. Telfer
- Lincoln Laboratory, Massachusetts Institute of Technology, Lexington, MA 02421, USA; (L.J.B.); (L.A.G.); (M.R.J.); (N.D.D.); (J.S.W.); (J.F.G.)
| | - Anthony E. Samir
- Department of Radiology, Massachusetts General Hospital, Boston, MA 02114, USA; (T.T.P.); (A.O.); (X.W.); (Q.L.); (A.E.S.)
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