Usability evaluation of augmented reality glasses for remote support during extracorporeal membrane oxygenation

Extracorporeal membrane oxygenation (ECMO) procedures may result in emergencies requiring the intervention of a perfusionist. However, their arrival results in waiting times that put patients at risk. Hence, nursing staff should be remotely supported using augmented reality (AR) in troubleshooting to improve patient safety. In this study, we aimed to investigate the usability of AR glasses <i>HMT-1</i> and <i>HoloLens 2</i> for remote support during ECMO and to determine the user acceptance of AR in intensive care. Ten nurses tested both glasses in a user test in randomized order under perfusionist guidance to rectify the three ECMO emergencies: a signal alert, a pump failure and reduced blood flow. An investigator rated their skills using a 3-step scheme, and success rates were calculated from the ratings and compared using the Wilcoxon test (α =.05). AR acceptance was assessed using the System Usability Scale (SUS) and User Experience Questionnaire (UEQ). We recorded 12 and 21 use errors with <i>HMT-1</i> and <i>HoloLens 2,</i> respectively. However, significantly fewer use errors occurred with the <i>HMT-1</i> than with <i>HoloLens 2</i> (Z = -1786, p = .046, n = 80) when troubleshooting the pump failure. Most participants rated <i>HoloLens 2</i> as more suitable. AR acceptance was rated as good with a SUS score of 72 (± 11). UEQ ratings for <i>attractiveness</i>, <i>dependability</i>, <i>stimulation</i>, <i>novelty</i>, and <i>efficiency</i> were excellent or good, while <i>perspicuity</i> was rated below average. The results indicate that both AR glasses are suitable for remote support; however, improvements to increase efficiency and patient safety in intensive care are necessary.