Optical confirmation and monitoring of endotracheal tube position in pediatric patients

儿科患者气管插管位置的光学确认和监测

• 批准号: 10371200
• 负责人: JOSEPH E KERSCHNER
• 金额: $ 20.78万
• 依托单位: MEDICAL COLLEGE OF WISCONSIN
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-04-01 至 2024-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10371200
• 关键词: Age; Anatomy; Animals; COVID-19; Caring; Cessation of life; Characteristics; Chest wall structure; Child; Childhood; Clinical; Critical Illness; Data; Delivery Rooms; Detection; Development; Devices; Endoscopes; Ensure; Family suidae; Fiber; Fiber Optics; Fright; Gases; Goals; Head; Human Resources; Impairment; Intensive Care Units; Interruption; Intratracheal Intubation; Intubation; Life; Light; Lighting; Lung; Manpower Need; Measurement; Measures; Mechanical Ventilators; Mechanical ventilation; Methods; Monitor; Monte Carlo Method; Morbidity - disease rate; Movement; Neonatal Intensive Care Units; Newborn Infant; Operative Surgical Procedures; Optics; Output; Patients; Pattern; Positioning Attribute; Procedures; Publications; Quality of Care; Radiation exposure; Rotation; Side; Signal Transduction; Site; Skin; Stress; System; Techniques; Technology; Testing; Thick; Thoracic Radiography; Time; Tissues; Trachea; Tube; Ultrasonography; Validation; Variant; aged; carina; clinical practice; cost; cost effective; detector; effectiveness testing; endotracheal; experimental study; improved; in vivo; in vivo Model; infectious disease treatment; light intensity; light transmission; mortality; novel; optical fiber; optical sensor; pediatric patients; prevent; sensor; usability; ventilation; vocal cord

Endotracheal tube (ETT) intubation is an important airway management procedure to enable appropriate ventilation and gas exchange in the lungs of critically ill patients or patients recovering from a major surgical intervention. Given that patients are not able to breathe and ventilate on their own, one of the most feared and life-threatening occurrences for apatient with an ETT is to have this tube displaced or dislodged so that adequate ventilation is no longer possible. The occurrenceof ETT misplacement is particularly high in newborns and young children due to their shorter trachea. Currently, there is no clinical system that can be utilized to provide accurate and real-time information to care teams about the appropriate position of the ETT and no previous publications of a system that is easily employed in an efficient and inexpensive manner. The current proposal will enable the next logical steps in the development of a novel, easily scalable, new device which will allow care teams to continuously monitor ETT position, limit complications from ETT movement or dislodgement, and substantively improve overall quality of care for any patient with an ETT by allowing this to occur without interruption to the workflow, high cost, and/or need of additional expertise or personnel on-site. Specifically, we propose to develop a near-infrared optical sensor (Opt-ETT) for noninvasive and continuous assessment of ETT position. Opt-ETT uses a side-firing optical fiber embedded in the ETT for tracheaillumination and a sticker with five photodetectors taped on the skin for light detection. Once the tube is precisely placed in the trachea, its position is displayed on the screen of the Opt-ETT in real-time and care teams are immediately notified if the tube moves beyond apreset limit. A proof-of-concept Opt-ETT system will be constructed and characterized on ex vivo porcine tracheal tissues, and the results will be compared and calibrated to that of Monte Carlo simulations in Aim 1. In Aim 2, in vivo studies with piglets will be conducted to test our central hypotheses that Opt-ETT will detect displacement up to ±20 mm with an accuracy of ±0.5 mm and this system is capable of accurately generating an alarm with different chest wall thickness and depth of the trachea. Opt-ETT is mass producible and cost effective, thus can be widely used in neonatal intensive care units and delivery rooms, particularly where a chest X-ray or ultrasonography is not available.

气管管（ET）插管是一个重要的气道管理程序，可实现适当的 重症患者或从主要手术中恢复的患者的肺中的通风和气体交换 鉴于患者无法自行通风，这是最令人恐惧的， Anet的Apatient的生命发生是该管管管管管 通风不再是可见的。 由于气管较短，儿童目前没有临床系统 和实时信息，以照顾团队有关ET的适当位置，而没有临近 一个容易廉价的系统的系统。 开发新颖，简单可扩展的新设备轮的下一个逻辑步骤使护理团队得以实现 连续监测ETT位置，限制ET移动或脱位的并发症，并实质上 通过允许这种中断发生这种情况，提高任何蚂蚁患者的总体护理质量 工作流程，高成本和/或需要其他专业知识或现场人员。 用于非侵入性和连续评估Etsition的近红外光传感器（OPT -ETT）。 使用嵌入在Etter气管中的侧面发射光纤和带有五个光电探测器的贴纸 将管子贴在皮肤上。 如果管子移动到apresett之外 限制。 组织，结果将比较和校准AIM 1中的Monte Carlo模拟的遗嘱。在AIM 2中 进行与仔猪进行的体内研究，以测试我们的中心假设-ETT -ETT -ETT -MISSPLACEMENT 上升到±20 mm，精度为±0.5 mm，该系统能够准确地发出警报。 胸壁的厚度和气管深度不同。 被广泛用于新生儿重症监护室和送货室，尤其是胸部X射线或或或或 超声检查不可用。