University of Texas at San Antonio, Department of Mechanical Engineering, San Antonio, TX, USA.
University of Texas at San Antonio, Department of Biomedical Engineering, San Antonio, TX, USA.
J Mech Behav Biomed Mater. 2021 Feb;114:104211. doi: 10.1016/j.jmbbm.2020.104211. Epub 2020 Nov 24.
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.
救命干预措施利用气管内插管来确保患者的气道畅通,但临床标准的护理气管内插管(ETT)的性能并不理想。例如,在当前的 COVID-19 危机中,患者可能需要长时间的插管。这种长时间的插管可能会导致健康并发症,如气管狭窄、肺炎和气管组织坏死,因为目前的 ETT 不是为延长使用而设计的。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,从而实现新型扩张圆柱。该机制提供了 ETT 和气管之间接触力的更好分布,这应该提高患者的耐受性。结果表明,在完全扩张时,我们的新型 ETT 在硅树脂气管模型中产生的压力在推荐的护理标准范围内。此外,初步的人体模型测试表明,新型 ETT 在气压和空气量方面的性能与当前的黄金标准 ETT 相当。这种新型设计的 ETT 的潜在好处有三方面,通过简化插管过程限制医疗保健提供者接触患者病原体的机会,减少下游并发症,并消除对多种尺寸 ETT 的需求,因为一个设计的 ETT 适合所有。