Novel Simulation Model That Realizes Arterial and Venous Blood Flow for Ultrasound-Guided Central Venous Catheter Insertion in Children

Abstract

We developed and validated a realistic simulation model for ultrasound-guided central venous catheter insertion in children that is easy to build and inexpensive and can automatically reproduce arterial and venous blood flow. Methods: The simulation model was constructed with a chicken breast, two DWP-385 water pumps, two types of tubes and a controller. An elastic rubber tourniquet and a silicone tube were connected to each water pump, which generated different continuous flows mimicking those of the pediatric internal carotid artery and internal jugular vein, respectively. Both tubes were inserted into a piece of chicken breast and connected to the controller. Then, we provided a simulation program of ultrasound-guided central venous catheter insertion using our novel model to resident emergency medicine physicians. We also collected data on their knowledge and confidence levels regarding the procedure before and after the simulation via questionnaires utilizing a 5-point Likert scale. Results: The flow patterns of the artery and vein were well demonstrated with our model. A total of 11 resident physicians were enrolled. The knowledge and confidence regarding the discrimination of arteries and veins were significantly improved after training with our simulation model (p-value < 0.01). The subjective similarity and usefulness of our model also scored high on the questionnaire (median: 4; interquartile range in both categories: 4-5). Conclusion: Our novel simulation model is useful and realistic for ultrasound-guided central venous catheter insertion training. Clinical impact: This controlled motor system can be applied to many simulation models of artery and vein circulation.

A new inexpensive ultrasound-guided central venous catheterization simulation model

“…For example, one study used a mixed reality trainer, which can project a 3D virtual anatomical image of needle placement tracing, to promote interactivity, 95.2% of 62 participants agreed that visual ability was helpful in placement and 93.5% participants thought that mixed reality should be included in the training [ 27 ]. In another study, the researchers build a simulation model that can automatically reproduce the blood flow of vessels and help residents distinuish arteries and veins in ultrasonography [ 28 ]. A total of 11 residents significantly enhanced their knowledge and confidence regarding the discrimination of arteries and veins [ 28 ].…”

“…In another study, the researchers build a simulation model that can automatically reproduce the blood flow of vessels and help residents distinuish arteries and veins in ultrasonography [ 28 ]. A total of 11 residents significantly enhanced their knowledge and confidence regarding the discrimination of arteries and veins [ 28 ]. Students improved manipulation ability through training on these technological or home-made modes.…”

Ultrasound-Guided Percutaneous Arteriovenous Fistula Creation Simulation Training in a Lifelike Flow Model

“…In particular, pediatric VUS-guided vascular cannulation models were introduced in order to address the challenges of small vessels and the high complication rates in this patient population. The feasibility and effectiveness of training for simple steps such as vascular cannulation [ 12 ] using chicken breast and silicone tubes to achieve a lifelike setting have been shown [ 13 ]. We adopted flow models for open surgical procedures [ 5 ] to facilitate complex ultrasound-guided maneuvers to avoid cadaveric tissue and guarantee reproducibility.…”

Ultrasonic Measurement of the Narrowest Transverse Diameter of Subglottic Airway in Children Undergoing Elective Tracheal Intubation under General Anesthesia

“…The common methods for selecting ETT type in clinical practice include weight equation method, body length equation method, maximum width of the fth nger nail, multi-parameter estimation method, and age equation method [27][28][29][30]. Scholars in the world have compared the above ve methods, and the results show that age equation method is the most accurate among these methods, followed by the maximum width of the fth nger nail.…”