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.

在健康中，人们可以保持呼吸道自然而然的呼吸。但是，严重的患者或麻醉患者无法做到这一点，因此临床医生经常在气管（Windpipe）中使用气管内管（ETT）来维持敞开的通风道，并通过机械通风将空气传递到肺部。将管放入气道中，并在气管处充气袖口（气球），以形成一个燃气密封，使空气有效地传递到肺部。为了最大程度地减少伤害和疾病，重要的是要正确平衡这种压力，以避免泄漏并保护肺部免受污染。不幸的是，由于需要常规的压力测量，气管损伤和相关的肺炎是常见的。如果袖口压力太高，则可能导致损伤，在手术后一半的一半患者的喉咙中等到严重的喉咙痛（英国每年500,000）（英国为500,000）（英国每年500,000），到终生的气管狭窄（终生气管后期气管狭窄），遍布2,000，000，000，000，000，000，000年。如果袖口压力太低，则会导致漏气渗入肺部，从而导致呼吸机相关的肺炎（VAP）。 VAP在重症监护室中影响多达五分之一的人，将住院时间增加了6天，每集每集12,000英镑的费用，并增加了死亡的可能性。我们的目标是通过创建基于这个世界第一技术的新型医疗设备来使全球插管患者受益。Itraxs（气管内多路复用传感器）是一种新的气管导管，它使用袖口中使用精美的光纤传感器。传感器使用光来测量袖口和气管之间界面处的压力和血流。保持正确的袖口压力可以帮助减少气管损伤和呼吸机相关的肺炎。传感器测量生命体征，例如心率和氧气安全。传感器还可以识别何时将ETT错误地放置在食道中，这是一种潜在的致命情况。我们认为ITRAXS能够改善全球患者的每天手术体验，并会大大减少该项目中VAP或坑造成的痛苦，我们将对这项新技术进行首次临床评估，其中40名成人参与者正在接受选修手术。