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Augmented reality for point-of-care ultrasound-guided vascular access in pediatric patients using Microsoft HoloLens 2: a preliminary evaluation
Open accessAbstract
SignificanceConventional ultrasound-guided vascular access procedures are challenging due to the need for anatomical understanding, precise needle manipulation, and hand–eye coordination. Recently, augmented reality (AR)-based guidance has emerged as an aid to improve procedural efficiency and potential outcomes. However, its application in pediatric vascular access has not been comprehensively evaluated.AimWe developed an AR ultrasound application, HoloUS, using the Microsoft HoloLens 2 to display live ultrasound images directly in the proceduralist’s field of view. We presented our evaluation of the effect of using the Microsoft HoloLens 2 for point-of-care ultrasound (POCUS)-guided vascular access in 30 pediatric patients.ApproachA custom software module was developed on a tablet capable of capturing the moving ultrasound image from any ultrasound machine’s screen. The captured image was compressed and sent to the HoloLens 2 via a hotspot without needing Internet access. On the HoloLens 2, we developed a custom software module to receive, decompress, and display the live ultrasound image. Hand gesture and voice command features were implemented for the user to reposition, resize, and change the gain and the contrast of the image. We evaluated 30 (15 successful control and 12 successful interventional) cases completed in a single-center, prospective, randomized study.ResultsThe mean overall rendering latency and the rendering frame rate of the HoloUS application were 139.30 ms (σ=32.02 ms) and 30 frames per second, respectively. The average procedure completion time was 17.3% shorter using AR guidance. The numbers of puncture attempts and needle redirections were similar between the two groups, and the number of head adjustments was minimal in the interventional group.ConclusionWe presented our evaluation of the results from the first study using the Microsoft HoloLens 2 that investigates AR-based POCUS-guided vascular access in pediatric patients. Our evaluation confirmed clinical feasibility and potential improvement in procedural efficiency.
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“This systematic review and meta-analysis followed the PRISMA guidelines (Table S1) [2].”
From Strategies to Address Difficult Venous Access in Blood Sampling: A Comprehensive Meta-Analysis (2026) · cites this paper as [2]
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“The prevalence of DVA varies significantly, with rates between 10 and 26% in general hospitalized populations [1,2,6] and up to 60% in specialized populations [6,7] such as intensive care patients, those receiving chemotherapy, and individuals with chronic conditions.”
From Strategies to Address Difficult Venous Access in Blood Sampling: A Comprehensive Meta-Analysis (2026) · cites this paper as [2]
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Metadata
- Authors
- Zhang, G., Nguyen, T. N., Fooladi-Talari, H., Salvador, T., Thomas, K., Crowley, D., Dingeman, R. S., & Shekhar, R.
- Affiliations
- Children's National (US)
- AusculTech Dx LLC
- Children's National Health System
- Venue
- Journal of Medical Imaging
- Publisher
- SPIE-Intl Soc Optical Eng
- Published
- 2024-09-13
- Volume
- 11
- Issue
- 06
- Pages
- 1-15
- ISSN
- 2329-4302 (ISSN-L)
- 2329-4310
- PMC
- PMC11393663
- OpenAlex
- W4402524555
- Semantic Scholar
- 50070386ad18a2a0e12739445e1c8a03224e6757
- Cited by
- 7
- References
- 21
- Citations by year
- 2026: 5 · 2025: 1 · 2024: 1
- FWCI
- 0.98
- Type
- journal article
- Language
- en
- Open access
- green
- pmc.ncbi.nlm.nih.gov
- Locations
- Journal of medical imaging (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Physical Sciences › Computer Science › Computer Vision and Pattern Recognition › Augmented Reality Applications
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Ultrasound in Clinical Applications
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Central Venous Catheters and Hemodialysis
- Keywords
- augmented reality, point-of-care ultrasound, ultrasound-guided vascular access, pediatric patients, HoloLens 2, procedural efficiency, needle redirection, puncture attempts
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