Application research of POCUS based on wireless mixed reality ultrasound imaging technology in pediatric arterial catheterization

Pediatric populations present unique anatomical challenges due to smaller vessel diameters. The purpose of this study was designed to ascertain whether the use of smart glasses with wireless ultrasound (W-US) increases first-attempt success rates compared to conventional ultrasound (C-US) in pediatric radial artery catheterization. In this randomized, controlled trial, 128 pediatric (age between 2 and 18 years) requiring radial artery catheterization under general anesthesia were allocated into either the C-US group or the W-US group. The primary outcome was first-attempt success rate. Secondary outcomes included intraprocedural maneuverability, procedure duration, and complication rates. The incidence of successful catheterization on the first attempt was higher in the W-US group than in the C-US group [86.0% vs. 70.3%; relative risk (RR) = 1.222; 95% confidence interval (CI), 1.013 to 1.474; P = 0.033]. The W-US group showed superior procedural coordination, evidenced by reduced intraoperative maneuvers: fewer head rotations (0 [0, 0] vs. 2 [2, 3]; median difference − 2; 95% CI, -3 to -2; P < 0.001), decreased ultrasound probe repositioning events (0 [0, 0] vs. 0 [0, 0]; median difference 0; 95% CI, 0 to 0; P = 0.022), and fewer needle redirections (0 [0, 0] vs. 0 [0, 1]; median difference 0, 95% CI, 0 to 0; P = 0.010). The integration of smart glasses with wireless ultrasound technology significantly improved first-attempt success rates and intraprocedural maneuverability during radial artery catheterization. The study was registered at Chinese Clinical Trial Registry (ChiCTR) with the number ChiCTR2500096195 on 20/01/2025.