An intubation catheter integrated with flow sensors and smart actuators for characterizing airflow patterns in stenosed trachea: an objective guide for CAO management

Abstract

Stenosis reduces the effective lumen area in the tracheal and bronchial segments of the airway anatomy. Loss in patency due to obstruction increases resistance to airflow; thus, severe narrowing is often associated with morbidity and mortality. Etiologies such as congenital tracheal stenosis, tracheomalacia, laryngeal and subglottic stenosis, atresia are few among the many pathologies causing major airway obstruction and respiratory distress. Diagnosis of such anomalies is usually based on clinical suspicion due to the non-specificity of the associated clinical symptoms. Visual assessment using conventional bronchoscopy or radiography images from CT scan for precisely locating obstruction site is highly subject to clinician's expertise. Characterizing airflow patterns in stenosed airway calls for newer diagnostic tools that can effectively quantify changes in airflow due to construction sites. Our work presents a steerable intubation catheter that can quantitatively measure air velocity across various segments of the tracheobronchial tree. The catheter consists of a three-layer flexible printed circuit board integrated with micro-electro-mechanical system-based thermal flow sensors and a pair of sub-millimeter helical shape memory actuators. Flow distribution is measured in excised sheep tracheal tissues at 15, 30, 50, 65, and 80 l min −1 for normal and stenosed conditions. Even a 10% reduction in lumen area generated unique peaks corresponding to the obstruction site; thus, the catheter can locate stenosis at the precritical stage. For 50% tracheal obliteration, the sensor closest to stenosis showed a 2.4-fold increase in velocity when tested for reciprocating flows. Thus, flow rate scales quadratically with reducing cross-section area, contributing to increased airflow resistance.

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“…As one of the four major vital signs of human body, respiratory rate has been often overlooked largely due to the lack of an easily accessible tool for reliable and natural respiration monitoring. − Featured with high-performance and small size, the CTSC provides an opportunity to easily detect respiration by integrating the sensor into existing respiratory equipment. To fit the CTSC, a multichannel respiration monitoring and analysis system that is wireless and portable was designed (Figure S15 and Note S15).…”

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“…[ 175 ] Copyright 2012, Wiley‐VCH) and ii) suture for continuous monitoring with wireless communication [ 176 ] (Reprinted with permission. [ 176 ] Copyright 2021, The Author(s), under exclusive license to Springer Nature Limited), b) intubation tube: i) steerable intubation catheter for airflow measurement [ 177 ] (Reprinted with permission. [ 177 ] Copyright 2021, IOP Publishing, Ltd), and ii) cardiac and respiratory signal measurement with the endotracheal intubation tube [ 178 ] (top figure)(Reprinted with permission.…”

“…[ 176 ] Copyright 2021, The Author(s), under exclusive license to Springer Nature Limited), b) intubation tube: i) steerable intubation catheter for airflow measurement [ 177 ] (Reprinted with permission. [ 177 ] Copyright 2021, IOP Publishing, Ltd), and ii) cardiac and respiratory signal measurement with the endotracheal intubation tube [ 178 ] (top figure)(Reprinted with permission. [ 178 ] Copyright 2017, IEEE); and temperature compensated catheter flow sensor [ 207 ] (bottom figure) (reprinted with permission.…”

“…Therefore, an intubation tube with a MEMS heat flow sensor and helical shape memory actuators (SMA) has been reported (Figure 10b(i) ). [ 177 ] The heat flow sensor in the intubation tube was fabricated with MEMS fabrication of n‐doped silicon, which detected the airflow inside the tracheobronchial tree, while the SMA placed on a distal end of the tube was adopted to steer the tube tip. An increased air flow rate with decreasing lumen cross‐sectional area was observed using excised sheep tracheal tissue.…”