Riemschneider Till, Schüthe Thorben, Werdehausen Robert, Schilling Thomas, Hachenberg Thomas
Department of Anesthesiology and Intensive Care Medicine, Medical Faculty, Otto von Guericke University of Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany.
Faculty of Engineering and Computer Sciences, University of Applied Sciences Hamburg, Berliner Tor 7, 20099, Hamburg, Germany.
Biomed Eng Online. 2025 Sep 15;24(1):105. doi: 10.1186/s12938-025-01441-1.
Dislocation of an endotracheal tube (ETT) during invasive ventilation can lead to serious events such as unilateral ventilation or unintentional extubation. The correct position of the endotracheal tube is determined visually. X-ray imaging or invasive procedures such as bronchoscopy are established for repeated position verification. However, these measures are time-consuming and only provide a limited number of snapshots. A new monitoring method can recognize dislocations of the ETT. The proposed system operates automatically without the need for continuous staff awareness or interaction.
A ring-shaped permanent magnet is attached to the ETT. A small device is placed extracorporeally on the patient to detect the magnetic field. This device uses 64 magnetic sensors arranged as a sensor array in an 8x8 matrix. The sensor signals are digitally converted, enabling the position of the ETT with the attached magnet to be determined by software. Two processing methods (image similarity and localization) are tested for monitoring. The prototype system detects displacements with millimeter scale positioning deviations in our tests.
Our system triggers an alarm upon detecting an impermissible dislocation, complete extubation, or unintended bronchial intubation. The proposed methods were validated on a sensor array prototype and assessed through a dedicated experimental setup. The results are promising and could lead to further development towards clinical usability.
Early warnings would be particularly advantageous, even for minor or beginning dislocations of the ETT. An automated continuous tube monitoring process could help reduce the workload of the staff and improve patient safety.
有创通气期间气管内插管（ETT）脱位可导致诸如单侧通气或意外拔管等严重事件。气管内插管的正确位置通过视觉确定。X线成像或诸如支气管镜检查等侵入性操作用于反复的位置验证。然而，这些措施耗时且仅提供有限数量的瞬间图像。一种新的监测方法能够识别气管内插管的脱位。所提出的系统自动运行，无需工作人员持续关注或互动。
在气管内插管上附着一个环形永久磁铁。在体外将一个小型设备放置在患者身上以检测磁场。该设备使用64个磁传感器，以8×8矩阵形式排列成传感器阵列。传感器信号进行数字转换，从而能够通过软件确定带有附着磁铁的气管内插管的位置。测试了两种处理方法（图像相似性和定位）用于监测。在我们的测试中，原型系统能够检测出具有毫米级定位偏差的移位。
我们的系统在检测到不允许的脱位、完全拔管或意外支气管插管时触发警报。所提出的方法在传感器阵列原型上得到验证，并通过专门的实验装置进行评估。结果很有前景，可能会朝着临床实用性进一步发展。
即使对于气管内插管的轻微或初始脱位，早期预警也将特别有益。自动化的连续导管监测过程有助于减轻工作人员的工作量并提高患者安全性。
