A neonatologist and biomedical engineer at Drexel University are developing a way to use ultrasound to guide the insertion of endotracheal tubes for intubation in newborns that could cut the amount of time the process takes. It could also reduce radiation exposure these infants receive from repeated X-rays.
There’s scope for the technology to be applied to other areas of healthcare.
By inserting air voids into the tip of an endotracheal tube, it would enhance the visibility of the tip enough to be picked up with ultrasound. The person inserting the tube would be able to view its progression in real time on a screen the size of an iPhone so that it is small enough to be easily moved, said Dr. Peter Lewin, a biomedical engineer professor at Drexel working on the project.
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The Coulter-Drexel Translational Research Partnership has funded the project in its first year.
In an interview with MedCity News, Dr. Jane McGowan, director of NICU at St. Christopher’s Hospital for Children and a professor of pediatrics with Drexel University College of Medicine, explained that sometimes endotracheal tubes are not inserted correctly. If the tube is not inserted correctly, air is only delivered to one lung, or it’s not delivered properly to either lung. There is always the risk they can get knocked out of position by a restless baby, or need to be replaced for other reasons. Each time the endotracheal tubes are inserted, an X-ray needs to be taken to ensure the tube is in the correct position — a process that can take an hour. Using a real-time ultrasound monitor to guide endotracheal tube insertion could cut the process down to five to 10 minutes.
McGowan cautioned that X-rays would still need to be done for some infants to help identify the source of breathing problems, but the device could significantly reduce the number of times they are taken.
The next steps are to develop prototypes with a manufacturer and do animal studies followed by tests with infants. McGowan said that they would seek to have the prototype made with the same material that current endotracheal tubes use to make the 510(k) application process less complicated.
“We are still pretty far away from a commercial product,” cautioned McGowan. “But one of the things that has kept us going is we have gotten a lot of enthusiasm from other constituencies.” She said others have pointed out applications for the device for intensive care units and the operating room. “Patients often go to the OR and need a breathing tube for surgery … and it’s not practical to use an X-ray machine to verify its placement.”
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