BACKGROUND Hand-eye coordination and ergonomics are important for the success of delicate ultrasound-guided medical procedures. These can be improved using smart glasses (head-mounted display) by decreasing the head movement on the ultrasound screen. The hypothesis was that the smart glasses could improve the success rate of ultrasound-guided pediatric radial arterial catheterization. METHODS This prospective, single-blinded, randomized controlled, single-center study enrolled pediatric patients (n = 116, age less than 2 yr) requiring radial artery cannulation during general anesthesia. The participants were randomized into the ultrasound screen group (control) or the smart glasses group. After inducing general anesthesia, ultrasound-guided radial artery catheterization was performed. The primary outcome was the first-attempt success rate. The secondary outcomes included the first-attempt procedure time, the overall complication rate, and operators' ergonomic satisfaction (5-point scale). RESULTS In total, 116 children were included in the analysis. The smart glasses group had a higher first-attempt success rate than the control group (87.9% [51/58] vs. 72.4% [42/58]; P = 0.036; odds ratio, 2.78; 95% CI, 1.04 to 7.4; absolute risk reduction, -15.5%; 95% CI, -29.8 to -12.8%). The smart glasses group had a shorter first-attempt procedure time (median, 33 s; interquartile range, 23 to 47 s; range, 10 to 141 s) than the control group (median, 43 s; interquartile range, 31 to 67 s; range, 17 to 248 s; P = 0.007). The overall complication rate was lower in the smart glasses group than in the control group (5.2% [3/58] vs. 29.3% [17/58]; P = 0.001; odds ratio, 0.132; 95% CI, 0.036 to 0.48; absolute risk reduction, 24.1%; 95% CI, 11.1 to 37.2%). The proportion of positive ergonomic satisfaction (4 = good or 5 = best) was higher in the smart glasses group than in the control group (65.5% [38/58] vs. 20.7% [12/58]; P <0.001; odds ratio, 7.3; 95% CI, 3.16 to 16.8; absolute risk reduction, -44.8%; 95% CI, -60.9% to -28.8%). CONCLUSIONS Smart glasses-assisted ultrasound-guided radial artery catheterization improved the first-attempt success rate and ergonomic satisfaction while reducing the first-attempt procedure time and overall complication rates in small pediatric patients. EDITOR’S PERSPECTIVE

中文翻译：

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用于儿科患者桡动脉导管插入术的智能眼镜：一项随机临床试验。

背景手眼协调和人体工程学对于精细超声引导的医疗程序的成功是重要的。使用智能眼镜（头戴式显示器）可以通过减少超声波屏幕上的头部运动来改善这些。假设是智能眼镜可以提高超声引导下小儿桡动脉导管插入术的成功率。方法 这项前瞻性、单盲、随机对照、单中心研究招募了需要在全身麻醉期间进行桡动脉插管的儿科患者（n = 116，年龄小于 2 岁）。参与者被随机分为超声屏幕组（对照组）或智能眼镜组。诱导全身麻醉后，在超声引导下进行桡动脉导管插入术。主要结果是首次尝试成功率。次要结果包括首次尝试手术时间、总体并发症发生率和操作者的人体工程学满意度（5 分制）。结果 总共有 116 名儿童被纳入分析。智能眼镜组的首次尝试成功率高于对照组（87.9% [51/58] vs. 72.4% [42/58]；P = 0.036；优势比，2.78；95% CI，1.04 至 7.4 ；绝对风险降低，-15.5%；95% CI，-29.8 至 -12.8%）。智能眼镜组的首次尝试手术时间（中位数，33 秒；四分位距，23 至 47 秒；范围，10 至 141 秒）短于对照组（中位数，43 秒；四分位距，31 至 67 秒） ；范围，17 到 248 秒；P = 0.007）。智能眼镜组的总体并发症发生率低于对照组（5.2% [3/58] vs. 29.3% [17/58]；P = 0.001；优势比，0.132；95% CI，0。036 到 0.48；绝对风险降低，24.1%；95% 置信区间，11.1 至 37.2%）。智能眼镜组的积极人体工程学满意度（4 = 好或 5 = 最好）的比例高于对照组（65.5% [38/58] vs. 20.7% [12/58]；P <0.001；几率）比率，7.3；95% CI，3.16 至 16.8；绝对风险降低，-44.8%；95% CI，-60.9% 至 -28.8%）。结论智能眼镜辅助超声引导桡动脉导管插入术提高了首次尝试成功率和人体工程学满意度，同时减少了小型儿科患者的首次尝试手术时间和整体并发症发生率。编辑的观点 7% [12/58]；P <0.001；优势比，7.3；95% CI，3.16 至 16.8；绝对风险降低，-44.8%；95% 置信区间，-60.9% 至 -28.8%）。结论智能眼镜辅助超声引导桡动脉导管插入术提高了首次尝试成功率和人体工程学满意度，同时减少了小型儿科患者的首次尝试手术时间和整体并发症发生率。编辑的观点 7% [12/58]；P <0.001；优势比，7.3；95% CI，3.16 至 16.8；绝对风险降低，-44.8%；95% 置信区间，-60.9% 至 -28.8%）。结论智能眼镜辅助超声引导桡动脉导管插入术提高了首次尝试成功率和人体工程学满意度，同时减少了小型儿科患者的首次尝试手术时间和整体并发症发生率。编辑的观点