Use of smart glasses for ultrasound-guided central venous catheterization in adults: a randomized clinical trial

Background Head-mounted displays can be integrated with ultrasonography to overlay the image in the operator's field of view, improving hand-eye coordination during invasive procedures. The clinical efficacy of smart glasses for central venous catheterization (CVC) remains uncertain. This study aimed to evaluate whether using smart glasses can improve efficiency compared to conventional ultrasound-guided CVC. Methods This prospective, single-blinded, controlled study enrolled adult patients who underwent elective surgery requiring CVC. Patients were assigned to either the ultrasound screen (control) or smart glasses group using stratified randomization according to operator qualification. The primary outcome was the overall CVC procedural time. Secondary outcomes included ultrasound scanning and venous access time, number of needle redirections and probe repositionings, procedural success and complication rates. Results In total, 124 patients were analyzed. The overall procedural time was significantly reduced in the smart glasses group compared to that in the control group (158 [140, 189] s vs. 134 [117,150] s; median difference, 26.0 s; 95% CI, [16.0–37.0] s, P < 0.001). Specifically, the ultrasound scanning time (median difference, 3.0 s, P = 0.004), venous access time (median difference, 2.0 s, P = 0.013), number of needle redirections (median difference, 1.0, P = 0.003) and probe repositionings (median difference, 0.0, P = 0.005) were significantly reduced in the smart glasses group compared to those in the control group. However, the success and complication rates were comparable between groups. Conclusions Smart glasses modestly improved procedural efficiency in ultrasound-guided CVC, potientially for novices, without improving success or complication rates. Larger-sample studies with more diverse operators and patients are warranted. Trial registration Name of trial registry: ClinicalTrials.gov Registration number: NCT06469034 URL: https://clinicaltrials.gov/study/NCT06469034?id=NCT06469034&rank=1