1. THE FEASIBILITY OF A NOVEL ULTRASOUND GUIDED VASCULAR ACCESS DEVICE: A PILOT STUDY Robinson M Ferre, MD, FACEP Vanderbilt University Medical Center Robinson.Ferre@vanderbilt.edu Shannon B Snyder, MD, FACEP Vanderbilt University Medical Center Shannon.Snyder@Vanderbilt.edu Matthew Lipton, MD University of Utah Medical Center Matthew.Lipton@Utah.edu

2. Background US Guided Central Venous Line (CVL) insertion is endorsed by many professional organizations Many obstacles exist for widespread implementation Learning US guided CVL insertion can be challenging for physicians Complications reduced with US guided CVL insertion, but still occur

3. Methods Observational Study of adult patients in ED or ICU receiving CVL with AxoTrack™ System IRB Approved Convenience sample Data collected by independent observer with video recordings of CVL insertion Primary Outcome: First Pass Success Secondary Outcomes: – Complications (Arterial puncture, arterial cannulation, pneumothorax, hemothorax, hematoma, catheter malposition) – Successful Procedure – Number of attempts – Physician satisfaction

4. AxoTrack System Magnetic Post: Uses Hall Effect technology to display location of the needle on the screen at all times Needle hub: Magnetic ceramic hub needed for Hall Effect sensor Transducer: Phased array Hole in probe: Needle passes through a hole in the probe to maintain needle along trajectory line Needle Trajectory Line Holographic image of the needle

5. Results 30 Patients Mean Age: 54 yo Sex (Female): 47% Hospital Location: – 70% Emergency Department – 30% ICU

6. Results Internal Jugular = 9 (30%) Subclavian: Infraclavicular = 4 (13%) Supraclavicular =17 (57%)

7. Results Primary Outcome: – First Pass Success = 26/30 (87%) Secondary Outcomes: – Complications = 0 – Successful Procedure = 29/30 (97%) 1 failure was with infraclavicular subclavian approach – Mean number of attempts = 1.1

8. Results Physician Satisfaction: – 25 (80%) rated the AxoTrack system very or relatively easy to use during the procedure – 25 (86%) preferred AxoTrack System overall compared with the traditional US guidance – 30 (100%) preferred AxoTrack Systems ability to guide the needle into the vein compared with the traditional technique

9. Conclusion The AxoTrack system is a safe and effective means of performing central venous access in critically ill patients.

10. Disclosure Robinson M Ferre: Research Support, Soma Access Systems Shannon B Snyder: None Matthew Lipton: None