Vital Times 2021 - 65

control group for arterial catheters in pediatric
patients younger than 2 years.4 Additionally, the
group using the HMD reported greater ergonomic
comfort as compared with the control group
(Figure 2).
In specialties such as pediatric anesthesia, the use
of this technology is particularly compelling, since
patients are often small with limited bedside space.
In certain situations, such as when intravenous
or arterial access is needed and a procedure has
already commenced, HMDs would be particularly
valuable, as they reduce the amount of equipment
that needs to be present at bedside. The ultrasound
machine can be behind the operator, improving
their ability to maneuver in a tight space. This
could also be beneficial before a case has started
when multiple procedures are being attempted at
once (placement of foley catheter, multiple lines,
neuromonitoring, etc.) and space around the patient
is limited.
As with any emerging technology, there are multiple
challenges to overcome before the widespread use
of HMDs could be implemented. Current HMDs have
a range of prices, but it is possible to buy one for
under $1000. Given high prices, it is reasonable
to presume that HMDs would be shared within
members of a department and therefore be subject
to infection prevention and control policies. Some
may find the use of an HMD cumbersome, especially
those who wear glasses.
HMDs connect via HDMI, and most commercially
available ultrasound machines have HDMI slots to
allow the use of this technology. Being tethered
to the ultrasound device with the wired HDMI
connection may not be a problem, since the
ultrasound probe is also tethered to the ultrasound
machine. Wireless devices may be more appealing,
but introduce new challenges such as the potential
for lag in image display as well as the duration of
the battery. An ultrasound device running out of
battery and shutting off in the middle of a procedure
is not a new phenomenon for anesthesiologists. It is
important to consider how much technical support
will be required to integrate and maintain the device
in optimal functioning conditions.
Great potential lies within this field. As
more institutions adapt and incorporate
HMDs, it will be imperative to study
outcomes and further potential of this
emerging technology.
Annual Publication 2021 | 65

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