Bedside monitoring of endotracheal tube position

描述（由申请人提供）：该项目的目标是开发一种创新的、准确的、低成本的技术，用于床边连续（相对于间歇）监测气管内管（ETT）定位。新的ETT位错检测器（ET-MD）使用呼吸音的自动分析，并将能够检测支气管插管和拔管（分别将气管滑入支气管或从气管滑出）。气管插管可能由于管的操作或患者的运动而发生，并可能导致明显的缺氧和肺不张（以及通气肺的气压损伤和气胸）。虽然拔管可能在一段时间后临床表现明显，但立即识别有助于避免缺氧。ET-MD手术利用了呼吸音对肺通气依赖的物理原理。ET-MD有两个基本组成部分：1)声传感器和2)计算和显示模块，用于分析声信号并报告指示ETT位置的相关指标。我们建议在可能的使用条件下构建和测试原型。在这里，将在动物身上研究房间噪音、外来声音和传感器定位误差的影响。此外，该设备将在有或没有肺部疾病和肥胖的人类受试者中进行测试。关键词：声学，气管插管，插管，定位错位，呼吸音，诊断。

DESCRIPTION (provided by applicant): The objective of this project is to develop an innovative, accurate, and low-cost technology for bedside continuous (vs. intermittent) monitoring of endotracheal tube (ETT) positioning. The new ETT malposition detector (ET-MD) uses automated analysis of breath sounds and will be able to detect bronchial intubation and extubation (tube slippage into the bronchus or out of the trachea, respectively). Broncheal intubation may occur due to tube manipulation or patient movement and may lead to significant hypoxia and atelectasis (and possibly barotrauma and pneumothorax of the ventilated lung). Although extubation may become clinically apparent after some time, instant recognition can help avoid hypoxia. The ET-MD operation exploits the physics principle of the dependence of breath sounds on lung ventilation. There are two essential ET-MD components: 1) Acoustic sensors and 2) Computational and display module that analyzes acoustic signals and reports relevant metrics indicative of ETT location. We propose to construct and test a prototype under likely use conditions. Here, effects of room noise, adventitious sounds, and sensor positioning errors will be investigated in animals. In addition, the device will be tested in human subjects with and without pulmonary conditions and obesity. Key words: (8 maximum) Acoustics, endotracheal tube, intubation, malpositioning, breath sounds, diagnosis. PUBLIC HEALTH RELEVANCE: This project proposes to develop a device to help improve monitoring of endotracheal tubes used in patients with ventilatory failure, airway compromise, and/or during general anesthesia. It will alert health care providers to tube malposition. This wil likely allow improved early correction of tube position, which would result in reduced morbidity, mortality and cost of healthcare.