The University of Texas Medical Branch, Texas, United States
Keywords: endotracheal tube, respiratory failure, trauma, mechanical ventilation, optoacousticDuring the transport of critically wounded warfighters, properly positioned endotracheal tubes (ETTs) are a critical aspect of life support. Both ground and air transportation impose severe constraints on space, equipment and personnel. An improperly positioned ETT, i.e., an ETT that is positioned too deeply or too shallowly, may be accidentally withdrawn or may compromise or render impossible mechanical ventilation. Despite the critical importance of a properly positioned ETT, there is no simple, user-friendly device for rapidly assessing proper ETT position immediately after intubation or during monitoring of previously placed ETTs. Maintenance of proper ETT position is most important during transport but would improve safety for any warfighter who is intubated for surgery or respiratory failure. Improved safety would be particularly valuable for warfighters in whom intubation was difficult, e.g., those with facial burns. The University of Texas Medical Branch (UTMB) has submitted patent applications for an innovative optoacoustic device that will rapidly confirm ETT position and provide frequent or continuous monitoring of ETT position in any clinical situation, including the high-noise, high-vibration environment of medical evacuation by ground, helicopter or fixed-wing aircraft. A clinical prototype has been successf ully tested in 50 critically ill adults and 30 children.