一种新型可扩展呼吸管,用于改善急诊护理中气道的安全。

David Berard, Juan David Navarro, Gregg Bascos, Angel Harb, Yusheng Feng, R. D. De Lorenzo, R. L. Hood, D. Restrepo
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引用次数: 5

摘要

挽救生命的干预措施利用气管插管来确保患者的气道,但临床护理标准气管插管(ETT)的表现是不足的。例如,在当前的COVID-19危机中,患者可能需要长时间插管。这种长期插管可能产生健康并发症,如气管狭窄、肺炎和气管组织坏死,因为目前的气管插管不适合长期使用。在这项工作中,我们提出了一种改进的ETT设计,旨在通过利用独特的几何形状来克服这些限制,从而实现一种新的扩展圆柱体。该机制提供了ETT和气管之间更好的接触力分布,这应该提高患者的耐受性。结果表明,在完全膨胀时,我们的新ETT在硅胶气管假体中施加压力,完全符合推荐的护理标准。此外,初步的人体模型测试表明,与目前的黄金标准ETT相比,新的ETT在气压和风量方面可以提供相似的性能。这种新型结构化ETT的潜在好处有三:通过简化插管过程限制医疗保健提供者对患者病原体的暴露,减少下游并发症,并且消除了多种尺寸ETT的需要,因为一个结构化ETT适合所有人。
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Novel expandable architected breathing tube for improving airway securement in emergency care.
Life-saving interventions utilize endotracheal intubation to secure a patient's airway, but performance of the clinical standard of care endotracheal tube (ETT) is inadequate. For instance, in the current COVID-19 crisis, patients can expect prolonged intubation. This protracted intubation may produce health complications such as tracheal stenosis, pneumonia, and necrosis of tracheal tissue, as current ETTs are not designed for extended use. In this work, we propose an improved ETT design that seeks to overcome these limitations by utilizing unique geometries which enable a novel expanding cylinder. The mechanism provides a better distribution of the contact forces between the ETT and the trachea, which should enhance patient tolerability. Results show that at full expansion, our new ETT exerts pressures in a silicone tracheal phantom well within the recommended standard of care. Also, preliminary manikin tests demonstrated that the new ETT can deliver similar performance in terms of air pressure and air volume when compared with the current gold standard ETT. The potential benefits of this new architected ETT are threefold, by limiting exposure of healthcare providers to patient pathogens through streamlining the intubation process, reducing downstream complications, and eliminating the need of multiple size ETT as one architected ETT fits all.
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