In critically ill patients, and under anaesthesia, endotracheal tubes play a vital role in maintaining an open airway, allowing artificial ventilation, and preventing aspiration of fluid into the lungs.
However, artificial ventilation, whilst necessary, often leads to other serious conditions such as post-intubation stenosis, affecting a patient’s ability to breathe and speak, and ventilator-associated pneumonia, which prolongs recovery and can be fatal. These complications are influenced by tracheal cuff design and use, in particular the quality of the contact between the cuff and the trachea, the pressure applied, and the effect of this pressure on local tracheal blood flow.
Avoiding tracheal damage and ventilator-associated pneumonia
Developed with NIHR i4i funding (II-LA-0813-20008), our iTraXS (intra tracheal multiplexed sensing) tube has incorporated optical fibre sensors into the cuffs of the tube which can measure tracheal contact pressure and blood flow, humidity, temperature, oxygen saturation and biofilm thickness. We aim to be able to optimise the level of inflation of the seal of the endotracheal tube to minimize tracheal injury during intubation as well as reduce the incidence of pneumonia.
In collaboration with medical device company P3 Medical
and anaesthetists from Nottingham University Hospitals NHS Trust, we have successfully completed proof of principle studies including our first in human series.