Laura J Olivieri1, David Zurakowski2,3, Karthik Ramakrishnan1, Lillian Su4, Fahad A Alfares1, Matthew R Irwin5, Jenna Heichel4, Axel Krieger6,7, Dilip S Nath8. 1. 1 Division of Cardiology, Children's National Medical Center, Washington, DC, USA. 2. 2 Department of Anesthesia, Boston Children's Hospital, Harvard School of Medicine, Boston, MA, USA. 3. 3 Department of Surgery, Boston Children's Hospital, Harvard School of Medicine, Boston, MA, USA. 4. 4 Division of Critical Care, Children's National Medical Center, Washington, DC, USA. 5. 5 Indicated LLC, Pennsauken, NJ, USA. 6. 6 Department of Bioengineering, Sheikh Zayed Institute for Surgical Innovation, Children's National Medical Center, Washington, DC, USA. 7. 7 Department of Mechanical Engineering, University of Maryland, College Park, MD, USA. 8. 8 Division of Cardiovascular Surgery, Children's National Medical Center, Washington, DC, USA.
Abstract
BACKGROUND: Postoperative care delivered in the pediatric cardiac intensive care unit (CICU) relies on providers' understanding of patients' congenital heart defects (CHDs) and procedure performed. Novel, bedside use of virtual, three-dimensional (3D) heart models creates access to patients' CHD to improve understanding. This study evaluates the impact of patient-specific virtual 3D heart models on CICU provider attitudes and care delivery. METHODS: Virtual 3D heart models were created from standard preoperative cardiac imaging of ten patients with CHD undergoing repair and displayed on a bedside tablet in the CICU. Providers completed a Likert questionnaire evaluating the models' value in understanding anatomy and improving care delivery. Responses were compared using two-tailed t test and Mann-Whitney U test and were also compared to previously collected CICU provider responses regarding use of printed 3D heart models. RESULTS: Fifty-three clinicians (19 physicians, 34 nurses/trainees) participated; 49 (92%) of 53 and 44 (83%) of 53 reported at least moderate to high satisfaction with the virtual 3D heart's ability to enhance understanding of anatomy and surgical repair, respectively. Seventy-one percent of participants felt strongly that virtual 3D models improved their ability to manage postoperative problems. The majority of both groups (63% physicians, 53% nurses) felt that virtual 3D heart models improved CICU handoffs. Virtual 3D heart models were as effective as printed models in improving understanding and care delivery, with a noted provider preference for printed 3D heart models. CONCLUSIONS: Virtual 3D heart models depicting patient-specific CHDs are perceived to improve understanding and postoperative care delivery in the CICU.
BACKGROUND: Postoperative care delivered in the pediatric cardiac intensive care unit (CICU) relies on providers' understanding of patients' congenital heart defects (CHDs) and procedure performed. Novel, bedside use of virtual, three-dimensional (3D) heart models creates access to patients' CHD to improve understanding. This study evaluates the impact of patient-specific virtual 3D heart models on CICU provider attitudes and care delivery. METHODS: Virtual 3D heart models were created from standard preoperative cardiac imaging of ten patients with CHD undergoing repair and displayed on a bedside tablet in the CICU. Providers completed a Likert questionnaire evaluating the models' value in understanding anatomy and improving care delivery. Responses were compared using two-tailed t test and Mann-Whitney U test and were also compared to previously collected CICU provider responses regarding use of printed 3D heart models. RESULTS: Fifty-three clinicians (19 physicians, 34 nurses/trainees) participated; 49 (92%) of 53 and 44 (83%) of 53 reported at least moderate to high satisfaction with the virtual 3D heart's ability to enhance understanding of anatomy and surgical repair, respectively. Seventy-one percent of participants felt strongly that virtual 3D models improved their ability to manage postoperative problems. The majority of both groups (63% physicians, 53% nurses) felt that virtual 3D heart models improved CICU handoffs. Virtual 3D heart models were as effective as printed models in improving understanding and care delivery, with a noted provider preference for printed 3D heart models. CONCLUSIONS: Virtual 3D heart models depicting patient-specific CHDs are perceived to improve understanding and postoperative care delivery in the CICU.
Authors: Ivan Lau; Yin How Wong; Chai Hong Yeong; Yang Faridah Abdul Aziz; Nor Ashikin Md Sari; Shahrul Amry Hashim; Zhonghua Sun Journal: Quant Imaging Med Surg Date: 2019-01