METHOD OF DETECTING ENDOTRACHEAL TUBE MISPLACEMENT

• US 20110100373A1
• Filed: 01/05/2011
• Published: 05/05/2011
• Est. Priority Date: 08/24/2005
• Status: Active Grant

• Current Assignee: Hospitech Respiration Ltd
• Original Assignee: Hospitech Respiration Ltd
• Inventors: EFRATI, Shai, Deutsch, Israel
• Granted Patent: US 9,004,069 B2
• Time in Patent Office: Days
• US Class Current: 128/207.15
• CPC Class Codes: A61M 16/0003 Accessories therefor, e.g. sensors, vibrators, negative pressure
• CPC Class Codes: A61M 16/0051 with alarm devices
• CPC Class Codes: A61M 16/021 operated by electrical means A61M16/202 – A61M16/205 take precedence
• CPC Class Codes: A61M 16/022 Control means therefor
• CPC Class Codes: A61M 16/024 including calculation means, e.g. using a processor
• CPC Class Codes: A61M 16/04 Tracheal tubes catheters in general A61M25/00
• CPC Class Codes: A61M 16/0434 Cuffs
• CPC Class Codes: A61M 16/044 External cuff pressure control or supply, e.g. synchronisation with respiration
• CPC Class Codes: A61M 16/0463 combined with suction tubes, catheters or the like; Outside connections
• CPC Class Codes: A61M 2016/0027 pressure meter
• CPC Class Codes: A61M 2016/0413 with detectors of CO2 in exhaled gases
• CPC Class Codes: A61M 2205/15 Detection of leaks
• CPC Class Codes: A61M 2205/3303 Using a biosensor
• CPC Class Codes: A61M 2205/3306 Optical measuring means
• CPC Class Codes: A61M 2205/3317 Electromagnetic, inductive or dielectric measuring means
• CPC Class Codes: A61M 2205/3327 Measuring
• CPC Class Codes: A61M 2205/3334 Measuring or controlling the flow rate
• CPC Class Codes: A61M 2205/3344 Measuring or controlling pressure at the body treatment site
• CPC Class Codes: A61M 2205/3375 Acoustical, e.g. ultrasonic, measuring means
• CPC Class Codes: A61M 2205/702 automatically during use
• CPC Class Codes: A61M 2210/0618 : Nose
• CPC Class Codes: A61M 2230/432 : partial CO2 pressure (P-CO2)

Abstract

A method of intubating a subject is disclosed. The method comprises inserting an endotracheal tube into the tracheal airway of the subject; inflating a cuff associated with the endotracheal tube within the airway below the vocal cords; measuring a level of at least one measure being indicative of leakage of secretion past the cuff to the lungs; comparing the level of the measure with an optimal level of the measure; and adjusting inflation of the cuff based on the comparison so as to generally minimize leakage of secretion from above the cuff to the lungs, while minimizing pressure associated damages to the airway. The measure(s) can be carbon dioxide concentration, a proxy measure from which such concentration can be inferred, or the level of one or more additives delivered to a subject during intubation.

Claims

1. A method of intubating a subject having an airway ending with lungs, comprising:

inserting an endotracheal tube into the airway;

inflating a cuff associated with said endotracheal tube within the airway below the vocal cords;

measuring a level of at least one measure being indicative of leakage of secretions past said cuff to the lungs; and

while monitoring inflation pressure of said cuff, adjusting inflation of said cuff responsively to said level of said at least one measure such as to reduce or prevent leakage of secretions from above said cuff to the lungs, wherein if said inflation pressure exceeds a predetermined threshold, then determining that said endotracheal tube is malpositioned.

2. The method of claim 1, further comprising repositioning said endotracheal tube if said endotracheal tube is malpositioned.

3. The method of claim 1, wherein said at least one measure comprises carbon dioxide concentration at least at one location selected from the group consisting of (i) between said cuff and said vocal cords;

(ii) above said vocal cords, and (iii) at a nostril of the subject.

4. The method of claim 1, wherein said at least one measure comprises acoustical data being indicative of leakage near said cuff outside said endotracheal tube.

5. The method of claim 1, wherein said at least one measure comprises pressure data being indicative of fluid flow near said cuff outside said endotracheal tube.

6. The method of claim 1, wherein said at least one measure comprises flow data being indicative of fluid flow near said cuff outside said endotracheal tube.

7. The method of claim 1, wherein said at least one measure comprises optical data being indicative of presence of secretions near said cuff outside said endotracheal tube.

8. The method of claim 1, wherein said at least one measure comprises electrical characteristics of fluid above said cuff outside said endotracheal tube.

9. The method of claim 1, further comprising delivering at least one identifiable additive through said endotracheal tube, wherein said at least one measure comprises presence or concentration of said at least one identifiable additive.

10. The method of claim 9, wherein said at least one identifiable additive is characterized by measurable electric properties.

11. The method of claim 9, wherein said at least one identifiable is characterized by measurable magnetic properties.

12. The method of claim 9, wherein said at least one identifiable is characterized by measurable optical properties.

13. The method of claim 9, wherein said at least one identifiable is characterized by measurable radiation properties.

14. The method of claim 9, wherein said at least one identifiable is characterized by measurable fluorescent properties.

15. The method of claim 9, wherein said at least one identifiable additive comprises at least one inert gas.

16. The method of claim 9, wherein said at least one identifiable additive comprises at least one colored gas.

17. The method of claim 9, wherein said at least one identifiable additive comprises at least one radioisotope.

18. A system for delivering gas to a subject having an airway ending with lungs and being intubated with an endotracheal tube associated with a cuff inflated below the vocal cords, comprising:

a measuring device for measuring at least one measure being indicative of leakage of secretions from above said cuff to the lungs; and

a controller configured for adjusting inflation of said cuff responsively to said level of said at least one measure such as to reduce or prevent leakage of secretions from above said cuff to the lungs, and for alerting that said endotracheal tube is malpositioned in said airway if an inflation pressure of said cuff exceeds a predetermined threshold.