Does needle positioning with magnetic field induction improve central venous catheterization performance by novice learners?

Abstract

Objective: The novel ultrasound magnetic needle navigation technique can visualize the entire needle and identify its projected trajectory. We hypothesized that this technique increases the first-attempt success rate of central venous puncture by novice learners compared with the conventional needle navigation technique. Methods: This prospective, randomized, controlled trial with a crossover design included 50 participants with limited prior experience in US-guided procedures. Participants were randomly assigned to novel or conventional technique groups and asked to perform central venous cannulation in a phantom task trainer. After the first successful attempt, participants were allocated to the other technique group. Results: Although participants in the novel technique group had a higher first-attempt success rate than did those in the conventional technique group, this difference was not statistically significant ( p = 0.17). The total number of attempts also did not significantly differ ( p = 0.16). The conventional technique group had more needle redirections ( p = 0.01) and a longer time to successful cannulation ( p = 0.01). The number of adverse effects ( p = 0.32) did not differ between groups. Participant confidence levels were higher in the novel technique group ( p < 0.001). Conclusions: Magnetic needle navigation can reduce the number of needle redirections, shorten the time to successful cannulation, and increase confidence levels by novice learners for successful US-guided central venous access.