Validation of a Bedside Automated 3D Ultrasound-based Arteriovenous Fistula Cannulation Guidance Solution to Improve AV Fistula Outcomes
验证基于 3D 超声的床边自动动静脉内瘘插管引导解决方案,以改善 AV 瘘的结果
基本信息
- 批准号:10384715
- 负责人:
- 金额:$ 100万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2021
- 资助国家:美国
- 起止时间:2021-09-15 至 2023-03-14
- 项目状态:已结题
- 来源:
- 关键词:3D ultrasoundAdoptionAlgorithmsAneurysmAppointmentAreaArteriovenous fistulaBloodBlood CirculationCaliberCannulationsCathetersCentral Venous Access CatheterCessation of lifeClinicalComplexCustomDependenceDetectionDevelopmentDiagnosticDiagnostic testsDialysis SolutionsDialysis patientsDialysis procedureEffectivenessEnd stage renal failureFailureFeedbackFistulaHealth ExpendituresHematomaHemodialysisHemorrhageHospitalizationHumanInfectionInfiltrationInjuryInterventionKidneyKidney FailureLeadLocationMedicare/MedicaidMethodsModalityMorbidity - disease rateNavigation SystemNeedlesNephrologyOperative Surgical ProceduresOutcomePatient CarePatient-Focused OutcomesPatientsPhasePhysiciansProceduresRiskSepsisSystemTestingThrombosisTimeTrainingTraumaUltrasonographyValidationVenousVisitVisualWorkarteriovenous graftautomated algorithmbaseblood filtrationcostexperienceimage guidedimprovedimproved outcomeintervention costmortalitypreventskillssuccess
项目摘要
PROJECT SUMMARY/ABSTRACT
End Stage Renal Disease (ESRD) impacts 4.3M patients worldwide and accounts for 7% of all
Medicare and Medicaid costs. The most prevalent modality of renal replacement, hemodialysis,
requires access to the circulation through which dialysis machinery is connected. The preferred
method of access is an arteriovenous (AV) fistula as it confers lower rates of mortality, infection
and interventions, however they are the most challenging for dialysis technicians to cannulate.
Cannulation damage is one of the primary causes of AV fistula complications and failure.
Cannulation failures and injury occur in 91% of patients within 6 months. These injuries can lead
to serious complications, such as hematoma, infection, and aneurysm formation including death
from hemorrhage, with a secondary impact on morbidity, hospitalization, access revision, and loss
of access. The annual rate of major infiltration is 5.2%, with each incident leading to an extra 97
days of catheter dependency and a mean of 2.4 diagnostic tests, surgery appointments, or
interventions. When factoring in the additional catheter time and secondary interventions, the
financial impact is $21,441 per major infiltration.
Ultrasound has been demonstrated to dramatically improve outcomes by reducing CVC time by
>30% (50 days) and infections by 37%. However, this was in the hands of nephrology physicians
in a study setting and current ultrasound options are too challenging for dialysis technicians and
are therefore not used.
We have developed an automated 3D ultrasound-based navigation solution, EchoGuide, that is
purpose build for dialysis technicians to improve cannulation without specialized training. This
study proposes to prove that EchoGuide, when used by dialysis technicians, can substantially
reduce cannulation errors and infiltrations for AV fistulae.
In this Phase II proposal, we will (1) develop the integrated EchoGuide with custom probe/display
hardware, lumen detection algorithms, and real-time interactive navigation; (2) iterate user
interface via human factors development to optimize navigation guidance; and (3) extend a
validated AVF cannulation simulator to enable ultrasound compatibility in order to demonstrate
EchoGuide effectiveness in improving cannulation success by technicians across challenging
AVF scenarios.
OVERALL IMPACT: EchoGuide will allow rapid and successful cannulation of AV fistulae. This will
reduce both the morbidity and costs associated with major infiltration and the associated catheter
time and additional interventions.
项目总结/摘要
终末期肾病(ESRD)影响着全球430万患者,占所有患者的7%
医疗保险和医疗补助费用。最普遍的肾脏替代方式,血液透析,
需要进入连接透析机的循环。优选的
入路方法是动静脉(AV)瘘,因为它可以降低死亡率、感染率
和干预,但是它们对于透析技术人员来说是最具挑战性的插管。
套管损坏是动静脉瘘并发症和失败的主要原因之一。
91%的患者在6个月内发生插管失败和损伤。这些损伤会导致
严重并发症,如血肿、感染和动脉瘤形成,包括死亡
出血,对发病率、住院、入路翻修和丢失有次要影响
的访问。重大渗透事件的年发生率为5.2%,每起事件导致额外的97起
导管依赖天数和平均2.4次诊断性检查、手术预约,或
干预措施。当考虑到额外的导管时间和二次干预时,
每次重大渗透的财务影响为21 441美元。
超声已被证明可以通过以下方式减少CVC时间,从而显著改善结局:
> 30%(50天),感染率为37%。然而,这是在肾脏科医生的手中,
在研究环境中,目前的超声选项对透析技术人员来说太具有挑战性,
因此不使用。
我们开发了一种基于自动化3D超声的导航解决方案EchoGuide,
为透析技术人员构建的专用工具,无需专门培训即可改善插管。这
研究提出证明,当透析技术人员使用EchoGuide时,
减少动静脉瘘的插管错误和浸润。
在本阶段II提案中,我们将(1)开发带有定制探头/显示器的集成EchoGuide
硬件、管腔检测算法和实时交互式导航;(2)用户界面
通过人为因素开发接口来优化导航引导;以及(3)扩展
经确认的AVF插管模拟器可实现超声兼容性,以证明
EchoGuide在技术人员提高插管成功率方面的有效性,
AVF场景。
总体影响:EchoGuide将允许AV瘘的快速和成功插管。这将
降低与主要浸润和相关导管相关的发病率和成本
时间和其他干预措施。
项目成果
期刊论文数量(0)
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{{ truncateString('Xin Kang', 18)}}的其他基金
Validation of a Bedside Automated 3D Ultrasound-based Arteriovenous Fistula Cannulation Guidance Solution to Improve AV Fistula Outcomes
验证基于 3D 超声的床边自动动静脉内瘘插管引导解决方案,以改善 AV 瘘的结果
- 批准号:
10488261 - 财政年份:2021
- 资助金额:
$ 100万 - 项目类别:
Commercialization of Low-Cost Portable 3D Ultrasound for Surveillance of Arteriovenous Fistula Maturation by Point-of-Care Dialysis Clinicians
低成本便携式 3D 超声的商业化,用于护理点透析临床医生监测动静脉瘘的成熟度
- 批准号:
10480217 - 财政年份:2019
- 资助金额:
$ 100万 - 项目类别:
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