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12 March 2024 Continuous monitoring of endotracheal tube position with near infrared light
Tongtong Lu, Pawjai Khampang, Ahmed Beydoun, Anna Berezovsky, Rebecca Rohde, Wenzhou Hong, Bing Yu, Joseph E. Kerschner
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Journal of Biomedical Optics, Vol. 29, Issue 3, 035001 (March 2024). https://doi.org/10.1117/1.JBO.29.3.035001
Abstract

Significance

Endotracheal intubation is a common approach for airway management in critically ill patients. However, the position of the endotracheal tube (ETT) may be altered during the procedure due to head movements. Accidental displacement or dislodge of the ETT may reduce the airflow, leading to moderate to severe complications, and in some cases even fatality. Therefore, timely detection of changes in ETT position in the trachea is critical to ensure immediate and intermediate interventions to maintain the ETT in the proper position. Currently, there are no widely utilized tools for real-time monitoring of ETT positions.

Aim

The goal of this study is to develop a cost-effective and easy-to-use near-infrared (NIR) device, named Opt-ETT, capable of continuously monitoring the ETT position in the trachea of a patient.

Approach

A side-firing fiber is attached to the side of the ETT to illuminate the trachea tissue with NIR light, and a detector board containing five phototransistors is affixed to the chest skin to measure the intensity of diffusely transmitted light. Displacement of the ETT is estimated using second-order polynomial fitting to the ratios of the phototransistor readings. Monte Carlo simulations, ex vivo experiment on porcine tissue, and in vivo experiments using a swine model have been conducted to assess the feasibility of the device.

Results

The design of the Opt-ETT device has been verified by the Monte Carlo simulations and ex vivo experiment. The estimation of displacement from in vivo experiments using the Opt-ETT exhibited a high degree of agreement with that measured by a reference sensor, with a discrepancy between −1.0 to +1.5 mm within a displacement range from −15 to +15 mm.

Conclusions

The Opt-ETT device provides a potentially cost-effective solution for real-time and continuous monitoring of ETT position in patient during an intubation procedure.
CC BY: © The Authors. Published by SPIE under a Creative Commons Attribution 4.0 International License. Distribution or reproduction of this work in whole or in part requires full attribution of the original publication, including its DOI.
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Tongtong Lu, Pawjai Khampang, Ahmed Beydoun, Anna Berezovsky, Rebecca Rohde, Wenzhou Hong, Bing Yu, and Joseph E. Kerschner "Continuous monitoring of endotracheal tube position with near infrared light," Journal of Biomedical Optics 29(3), 035001 (12 March 2024). https://doi.org/10.1117/1.JBO.29.3.035001
Received: 21 July 2023; Accepted: 12 January 2024; Published: 12 March 2024
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KEYWORDS
Sensors
Monte Carlo methods
Near infrared
Tissues
Calibration
Skin
Adipose tissue
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