Methods and apparatus for optoacoustic guidance and confirmation of placement of indwelling medical apparatus

• US 10,206,607 B2
• Filed: 04/30/2012
• Issued: 02/19/2019
• Est. Priority Date: 04/29/2011
• Status: Active Grant

• Current Assignee: Board of Regents of the University of Texas System (University of Texas System)
• Original Assignee: Board of Regents of the University of Texas System (University of Texas System)
• Inventors: Prough, Donald S., Esenaliev, Rinat O., Petrov, Yuriy, Petrov, Irene
• Primary Examiner(s): Hoffa, Angela M
• Application Number:
  US14/114,454
• Publication Number:
  US 20140058253A1
• Time in Patent Office: 2,486 Days
• Field of Search: 600438, 600473
• CPC Class Codes: A61B 1/0676 at distal tip of an endoscope
• CPC Class Codes: A61B 1/07 using light-conductive means, e.g. optical fibres
• CPC Class Codes: A61B 2505/05 Surgical care
• CPC Class Codes: A61B 5/0095 by applying light and detecting acoustic waves, i.e. photoacoustic measurements
• CPC Class Codes: A61B 5/06 Devices, other than using radiation, for detecting or locating foreign bodies for removing same A61B17/50 ; determining position of probes within or on the body of the patient
• CPC Class Codes: A61B 5/061 Determining position of a probe within the body employing means separate from the probe, e.g. sensing internal probe position employing impedance electrodes on the surface of the body A61B1/00158 takes precedence
• CPC Class Codes: A61M 16/0411 with means for differentiating between oesophageal and tracheal intubation
• CPC Class Codes: A61M 16/0434 Cuffs
• CPC Class Codes: A61M 16/0488 Mouthpieces; Means for guiding, securing or introducing the tubes guiding or introducing with laryngoscopes A61B1/267; holding devices on the body A61M25/02
• CPC Class Codes: A61M 2205/3375 Acoustical, e.g. ultrasonic, measuring means
• CPC Class Codes: A61M 2205/502 User interfaces, e.g. screens or keyboards
• CPC Class Codes: A61M 2205/581 by audible feedback
• CPC Class Codes: A61M 2205/583 by visual feedback

Abstract

Medical apparatus are disclosed for optoacoustic monitoring of an indwelling unit of the apparatus, where the indwelling unit includes one or more optical components capable of directing pulsed light into an overlying tissue. The apparatus also include one or more acoustic components in contact with an exterior surface of the tissue to detect induced pressure waves producing an acoustic output analyzed with an optoacoustic unit to monitor and confirm proper placement of the indwelling unit. Methods for using the apparatus are also disclosed.

Claims

1. A system for real-time placement tracking of an endotracheal tube, comprising:

an endotracheal tube comprising a cuff having an outer surface;

an optical component mounted to the outer surface of the cuff of the endotracheal tube cuff and adapted to emit light into tissue surrounding the trachea into which the endotracheal tube is inserted to induce ultrasonic pressure waves within the tissue;

an external acoustic detector adapted to receive the ultrasonic pressure waves induced in the tissue;

an analyzer in electrical communication with the external acoustic detector, wherein the analyzer is configured to produce an output based on the received ultrasonic pressure waves that indicates whether or not the endotracheal tube cuff is positioned within the mid-trachea; and

a display screen in electrical communication with the analyzer, wherein the display screen is configured to display the output from the analyzer as a graphical waveform that indicates whether or not the endotracheal tube is positioned within the mid-trachea.

2. The system of claim 1, further comprising a light conduit in optical communication with the optical component and adapted for connection to, and transmittal of light from, a light source external to the patient'"'"'s body.

3. The system of claim 2, wherein the light conduit is a fiber optic.

4. The system of claim 1, wherein the optical component includes a light source that is adapted to generate light locally from inside the patient'"'"'s body.

5. The system of claim 1, wherein the light is pulsed laser light.

6. The system of claim 1, wherein the light has a wavelength from about 750 nm to about 2500 nm.

7. The system of claim 1, wherein the analyzer generates a range of audible signals including a safety tone that indicates desired placement of the endotracheal tube and an alarm tone that indicates improper placement of the endotracheal tube.

8. The system of claim 1, wherein the external acoustic detector comprises a plurality of external acoustic detectors.

9. The system of claim 1, wherein multiple optical components are mounted to the outer surface of the cuff of the endotracheal tube at different positions around the periphery of the cuff.

10. The system of claim 1, wherein the optical component comprises a light-emitting diode.

11. The system of claim 1, wherein the graphical waveform results from plotting the output as a normalized optoacoustic signal as a function of depth.

12. A method of real-time placement tracking of an endotracheal tube comprising:

inserting into the trachea an endotracheal tube that includes an optical component mounted to an outer surface of a cuff of the endotracheal tube;

applying an external acoustic detector to an external surface of a patient on a region overlying the tissue;

applying power to the optical component to cause it to emit light into the tissue to induce ultrasonic pressure waves within the tissue;

receiving the induced ultrasonic pressure waves with the external acoustic detector;

producing an output with the analyzer that is based on the received ultrasonic pressure waves and that indicates whether or not the endotracheal tube cuff is positioned within the mid-trachea; and

displaying the output from the analyzer as a graphical waveform on a display screen that is in electrical communication with the analyzer, wherein graphical waveform indicates whether or not the endotracheal tube is positioned within the mid-trachea.

13. The method of claim 12, further comprising monitoring the output of the analyzer on a periodic basis for as long as the endotracheal tube is in place.

14. The method of claim 12, further comprising monitoring the output of the analyzer on a continuous basis for as long as the endotracheal tube is in place.

15. The method of claim 12, wherein the light has a wavelength from about 750 nm to about 2500 nm.

16. The method of claim 12, wherein the analyzer generates a range of audible signals including a safety tone that indicates desired placement of the endotracheal tube and an alarm tone that indicates improper placement of the endotracheal tube.

17. The method of claim 12, further comprising an initial step of affixing the optical component to the endotracheal tube.

18. The method of claim 12, wherein the graphical waveform results from plotting the output as a normalized optoacoustic signal as a function of depth.