Bedside monitoring of endotracheal tube position

描述（由申请人提供）：本项目的目的是开发一种创新、准确和低成本的技术，用于气管插管（ETT）定位的床边连续（与间歇）监测。新的ETT错位检测器（ET-MD）使用呼吸音的自动分析，将能够检测支气管插管和拔管（分别为管滑入支气管或滑出气管）。气管插管可能由于插管操作或患者移动而发生，并可能导致严重缺氧和肺不张（以及可能的通气肺气压伤和气胸）。虽然拔管可能在一段时间后变得临床明显，但即时识别可以帮助避免缺氧。ET-MD手术利用了呼吸音依赖于肺通气的物理原理。ET-MD有两个基本组件：1）声学传感器和2）计算和显示模块，用于分析声学信号并报告指示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，将在动物中研究室内噪声、外来声音和传感器定位误差的影响。此外，该器械将在患有和不患有肺部疾病和肥胖症的人类受试者中进行测试。关键词：（8个最大值）声学，气管导管，插管，错位，呼吸音，诊断。 公共卫生相关性：本项目拟开发一种器械，以帮助改善呼吸衰竭、气道受损和/或全身麻醉期间患者使用的气管插管的监测。它将提醒医疗保健提供者管错位。这将可能允许改善管位置的早期校正，这将导致降低的发病率、死亡率和医疗保健成本。

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.