Reducing Harm In Ventilated Patients: First In-patient Evaluation Of A Smart Endotracheal Tube

减少通气患者的伤害：智能气管插管的首次住院评估

• 批准号: MR/Y008642/1
• 负责人: Stephen Morgan
• 金额: $ 147.06万
• 依托单位: University of Nottingham
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2024
• 资助国家: 英国
• 起止时间: 2024 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FY008642%2F1
• 关键词: Reducing; Harm; Ventilated; Patients; First

In health, people can keep their airway open and breathe naturally. Seriously ill or anaesthetised patients however cannot do this, so clinicians often use an endotracheal tube (ETT) in the trachea (windpipe) to maintain an open airway and allow air to be delivered to the lungs via a mechanical ventilator. The tube is placed into the airway and a cuff (balloon) is inflated at the trachea to create a gas seal that allows air to be delivered to the lungs effectively. To minimise injury and illness, it is important that this pressure is balanced correctly to avoid leaks and to protect the lungs from contamination. Unfortunately, due to the need for routine pressure measurements, tracheal injuries and ventilator associated pneumonia are common.If the cuff pressure is too high this can cause injuries that range from moderate to severe sore throat in half of all patients after surgery (500,000 per year in the UK), to lifelong tracheal narrowing (Post Intubation Tracheal Stenosis, PITS) which occurs in around 2,000 patients per year in England. If the cuff pressure is too low this results in fluids leaking into the lungs which can lead to ventilator associated pneumonia (VAP). VAP affects as many as one in five people in intensive care, increases hospital stay by 6 days, costs the NHS £12,000 per episode and increases the likelihood of death. We aim to benefit intubated patients worldwide by creating a new medical device based on this world first technology.iTraXS (intra tracheal multiplexed sensing) is a new endotracheal tube which uses fine optical fibre sensors in the cuff. The sensors use light to measure the pressure and blood flow at the interface between the cuff and trachea. Maintaining the correct cuff pressure can help to reduce tracheal injury and ventilator associated pneumonia. The sensors measure vital signs such as heart rate and oxygen saturation. The sensors can also identify when the ETT is incorrectly placed in the oesophagus, a potentially fatal situation. We think iTraXS is capable of improving the everyday experience of surgery for patients worldwide and will significantly reduce the suffering caused by VAP or PITS Within this project we will conduct the first clinical evaluation of this new technology with 40 adult participants undergoing elective surgery.

在健康状况下，人们可以保持气道开放并自然呼吸，但重病或麻醉患者却无法做到这一点，因此冠军经常在气管（气管）中使用气管插管（ETT）来保持气道开放并允许输送空气。通过机械呼吸机将管子放入气道中，并在气管处对套囊（气球）进行充气，以形成气封，使空气能够输送到肺部。为了最大限度地减少伤害和疾病，重要的是正确平衡压力以避免泄漏并保护肺部免受污染。不幸的是，由于需要进行常规压力测量，气管损伤和呼吸机相关肺炎很常见。袖带压力过高，可能会导致一半患者术后（英国每年 500,000 例）中度至重度喉咙痛，甚至终生气管狭窄（插管后在英格兰，每年约有 2,000 名患者出现气管狭窄 (PITS)，如果袖带压力过低，则会导致液体渗漏到肺部，从而导致呼吸机相关性肺炎 (VAP) 的发生率高达五分之一。重症监护患者的住院时间增加了 6 天，NHS 每次发作的费用为 12,000 英镑，并增加了死亡的可能性。我们的目标是通过基于此创建一种新的医疗设备来造福全世界的插管患者。世界首创技术。iTraXS（气管内多路传感）是一种新型气管插管，其在袖带中使用细光纤传感器，传感器利用光来测量袖带和气管之间界面的压力和血流，以保持正确的袖带。压力有助于减少气管损伤和呼吸机相关肺炎。传感器还可测量心率和血氧饱和度等生命体征。我们认为 iTraXS 能够改善全世界患者的日常手术体验，并将显着减少 VAP 或 PITS 造成的痛苦。在该项目中，我们将针对 40 名成年人对这项新技术进行首次临床评估。接受择期手术的参与者。