CN118079165A - Visual tracheal catheter with acoustic monitoring function and monitoring method - Google Patents

Visual tracheal catheter with acoustic monitoring function and monitoring method Download PDF

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Publication number
CN118079165A
CN118079165A CN202410167767.7A CN202410167767A CN118079165A CN 118079165 A CN118079165 A CN 118079165A CN 202410167767 A CN202410167767 A CN 202410167767A CN 118079165 A CN118079165 A CN 118079165A
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sound
microphone
time
main
pipeline
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刁玉刚
叶涛
王凯
傅国强
王轶湛
赵柏杨
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Shanghai Lanjia Medical Technology Co ltd
General Hospital of Shenyang Military Region
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Shanghai Lanjia Medical Technology Co ltd
General Hospital of Shenyang Military Region
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/04Tracheal tubes
    • A61M16/0402Special features for tracheal tubes not otherwise provided for
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/04Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/267Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the respiratory tract, e.g. laryngoscopes, bronchoscopes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/08Detecting organic movements or changes, e.g. tumours, cysts, swellings
    • A61B8/0833Detecting organic movements or changes, e.g. tumours, cysts, swellings involving detecting or locating foreign bodies or organic structures
    • A61B8/085Detecting organic movements or changes, e.g. tumours, cysts, swellings involving detecting or locating foreign bodies or organic structures for locating body or organic structures, e.g. tumours, calculi, blood vessels, nodules
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/12Diagnosis using ultrasonic, sonic or infrasonic waves in body cavities or body tracts, e.g. by using catheters
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/44Constructional features of the ultrasonic, sonic or infrasonic diagnostic device
    • A61B8/4444Constructional features of the ultrasonic, sonic or infrasonic diagnostic device related to the probe
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/44Constructional features of the ultrasonic, sonic or infrasonic diagnostic device
    • A61B8/4444Constructional features of the ultrasonic, sonic or infrasonic diagnostic device related to the probe
    • A61B8/445Details of catheter construction
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/04Tracheal tubes
    • A61M16/0434Cuffs
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/04Tracheal tubes
    • A61M16/0486Multi-lumen tracheal tubes

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • Biomedical Technology (AREA)
  • Animal Behavior & Ethology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • General Health & Medical Sciences (AREA)
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  • Pulmonology (AREA)
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  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Radiology & Medical Imaging (AREA)
  • Hematology (AREA)
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  • Anesthesiology (AREA)
  • Optics & Photonics (AREA)
  • Vascular Medicine (AREA)
  • Otolaryngology (AREA)
  • Physiology (AREA)
  • External Artificial Organs (AREA)
  • Investigating Or Analyzing Materials By The Use Of Ultrasonic Waves (AREA)

Abstract

The invention relates to a visual tracheal catheter with an acoustic monitoring function and a monitoring method, wherein the visual tracheal catheter comprises a catheter assembly provided with a main pipeline, a shooting module comprising a lens, a sound monitoring module for emitting sound towards the inside of the main pipeline and receiving echo, a display module and a main control module respectively connected with the shooting module, the sound monitoring module and the display module, and the monitoring method provides a basis for real-time monitoring of an air channel by capturing real-time images in the air channel and acquiring real-time acoustic airway monitoring data and integrates two detection modes. The visual tracheal catheter with the acoustic monitoring function and the monitoring method have the characteristics of perfect performance, accurate detection effect and effective auxiliary establishment of an artificial airway.

Description

Visual tracheal catheter with acoustic monitoring function and monitoring method
Priority statement
The present application claims priority from China patent office, application No. CN 202310107440.6, chinese patent application entitled "visual endotracheal tube with Acoustic monitoring function and monitoring method" filed on 13/02/2023, the entire contents of which are incorporated herein by reference.
Technical Field
The invention relates to the technical field of medical equipment, in particular to a visual tracheal catheter with an acoustic monitoring function and a monitoring method.
Background
Artificial airways are often employed in the prior art to assist in therapy. In practice, the airway is typically created by placing an endotracheal tube into the trachea, either through the mouth or nose, or by direct tracheotomy, to assist the patient in effective ventilation and treatment of pulmonary disease.
However, the establishment of the artificial airway also affects the normal physiological regulation function of the airway, such as complications caused by untimely treatment and nursing, and even life is endangered, so that scientific and effective artificial airway management is very important. Common intubation problems in clinic include the failure of the catheter to enter the correct trachea, accidental extubation, blockage of sputum, etc. How to ensure that the correct airway can be normally inserted during intubation and ensure the correctness of the catheter position and the smoothness of the pipeline during intubation is a critical problem.
Therefore, a device capable of effectively monitoring the state of the intubation tube in real time and feeding back the abnormal condition existing in the intubation process in time is urgently needed.
Disclosure of Invention
The invention aims to overcome at least one of the defects in the prior art, and provides a visual tracheal catheter with an acoustic monitoring function and a monitoring method, wherein the visual tracheal catheter is convenient to use, can monitor an airway in real time and timely feed back abnormal conditions in the intubation process.
In order to achieve the above object, the visual tracheal catheter with acoustic monitoring function and the monitoring method of the present invention have the following constitution:
This possess visual endotracheal tube of acoustic monitoring function, its main characterized in that includes:
A catheter assembly comprising a body conduit;
the shooting module comprises a lens, wherein the lens is arranged on the side wall of the main body pipeline and is positioned at the front end of the main body pipeline;
The sound monitoring module is arranged at the rear end of the main pipeline, and is used for making sound towards the inside of the main pipeline and receiving echo;
A display module;
And the main control module is respectively connected with the shooting module, the sound monitoring module and the display module.
The main control module is used for receiving the echo and comparing the received echo with an echo threshold value prestored in the main control module so as to judge the intubation condition of the visual tracheal catheter.
This possess visual endotracheal tube of acoustic monitoring function, wherein, sound monitoring module includes sound production unit and radio reception unit, sound production unit with the radio reception unit all with main control module is connected, sound production unit locates main body pipe's rear end, radio reception unit locates on main body pipe's the inside wall, just radio reception unit with sound production unit is adjacent, and the radio reception unit is located towards in the sound production unit one side of camera lens.
This possess visual endotracheal tube of acoustic monitoring function, wherein, sound production unit includes the speaker, the speaker with main part pipeline coaxial arrangement, just the sound production direction orientation of speaker in the main part pipeline, the speaker with main control module is connected.
This possess visual endotracheal tube of acoustic monitoring function, wherein, the radio reception unit includes first microphone and second microphone, first microphone with the second microphone is followed the axis direction of main body pipeline, set up side by side on the inside wall of main body pipeline, just first microphone is located sound production unit with between the second microphone, first microphone with the second microphone respectively with the main control module is connected.
The visual tracheal catheter with the acoustic monitoring function comprises a side pipeline, wherein the side pipeline is arranged on the side wall of the main body pipeline, the side pipeline is positioned at the rear end of the main body pipeline, and the side pipeline is communicated with the main body pipeline.
This possess visual endotracheal tube of acoustic monitoring function, wherein, visual endotracheal tube still includes:
The sputum aspirator comprises a sputum aspirator and a sputum aspirator catheter, the sputum aspirator is connected with one end of the sputum aspirator catheter, and the sputum aspirator catheter can be selectively extended into the main body pipeline and can penetrate through the main body pipeline to enter the trachea.
This possess visual endotracheal tube of acoustic monitoring function, wherein, visual endotracheal tube still includes:
the spraying assembly comprises a sprayer and a spraying conduit, wherein the sprayer is connected with one end of the spraying conduit, and the spraying conduit can be selectively extended into the main body pipeline.
This possess visual endotracheal tube of acoustic monitoring function, wherein, visual endotracheal tube still includes:
The gas detection module comprises a gas monitoring device and a gas monitoring probe, wherein the gas monitoring device is connected with the gas monitoring probe, the gas monitoring probe is arranged in the main pipeline, and the gas monitoring probe is used for measuring the concentration of nitric oxide in the main pipeline.
The airway monitoring method is mainly characterized by being applied to a visual tracheal catheter with an acoustic monitoring function, and comprises the following steps:
Capturing real-time images in the airway by adopting the visual tracheal catheter with the acoustic monitoring function;
The visual tracheal catheter with the acoustic monitoring function is adopted to make sound towards the interior of the main pipeline and receive echo, and real-time acoustic airway monitoring data are obtained according to the sound made towards the interior of the main pipeline and the received echo;
and displaying the real-time image and the real-time acoustic airway monitoring data, and providing a basis for real-time airway monitoring.
The airway monitoring method, wherein the visual tracheal catheter with the acoustic monitoring function comprises the following steps:
A catheter assembly comprising a body conduit;
The sound monitoring module comprises a sound generating unit, a first microphone and a second microphone, wherein the sound generating unit is arranged at the rear end of the main body pipeline and emits sound towards the front end direction of the main body pipeline, the first microphone and the second microphone are arranged on the inner side wall of the main body pipeline in parallel along the axial direction of the main body pipeline and are positioned at one side of the sound generating unit, which faces the lens, and the first microphone is positioned between the sound generating unit and the second microphone, and the first microphone and the second microphone are spaced by a preset distance;
The visual tracheal catheter with acoustic monitoring function is adopted to make sound towards the interior of the main pipeline and receive echo, and real-time acoustic airway monitoring data are acquired according to the sound made towards the interior of the main pipeline and the received echo, and the visual tracheal catheter comprises:
The visual tracheal catheter with the acoustic monitoring function performs the following airway monitoring operation once every first preset time interval:
The sound generating unit generates the sound towards the front end direction of the main pipeline so as to transmit a single-frequency pulse signal P i with a preset frequency towards the front end direction of the main pipeline;
The first microphone and the second microphone respectively acquire sound so as to respectively acquire a corresponding first output audio pulse signal and a corresponding second output audio pulse signal;
If the time when the first microphone receives the first output audio pulse signal is earlier than the time when the second microphone receives the second output audio pulse signal, determining that the sound collected at the moment is incident sound which propagates from the rear end of the main body pipeline to the front end direction of the main body pipeline, wherein the first incident signal is the single-frequency pulse signal incident sound P i, recording the time point when the first microphone obtains the first output audio pulse signal, and marking the time point as an output time point t 0;
If the time when the first microphone receives the first output audio pulse signal is later than the time when the second microphone receives the second output audio pulse signal, judging that the sound collected at the moment is reflected sound which propagates from the front end of the main body pipeline to the rear end direction of the main body pipeline;
When the reflected sound is collected, if the first output audio pulse signal collected at this time is a signal with the opposite phase to the single-frequency pulse signal P i, and the signal is the first signal with the opposite phase to the single-frequency pulse signal P i received by the first microphone after the first microphone receives the single-frequency pulse signal P i, it is determined that the reflected sound collected at this time is the first reflected wave P r1 reflected in the rear end direction of the main pipe after the incident sound is transmitted to the front end of the main pipe, and the time point when the first microphone collects the first reflected wave P r1 is marked as a first time point t 1;
When the reflected sound is collected, if the first output audio pulse signal collected at this time is a signal with an opposite phase to the single-frequency pulse signal P i, and the signal is a signal with an opposite phase to the single-frequency pulse signal P i, which is received by the first microphone after the first reflected wave P r1 is received, it is determined that the reflected sound collected at this time is a second reflected wave P r2 reflected toward the rear end of the main body pipe after the incident sound is transmitted to the carina, and the first microphone marks a time point when the second reflected wave P r2 is collected as a second time point t 2;
when the reflected sound is collected, if the first output audio pulse signal collected at this time is a signal in phase with the single-frequency pulse signal P i and the time of receiving the first output audio pulse signal is earlier than the time of receiving the first reflected wave P r1 by the first microphone, determining that the collected sound is the third reflected wave P r10 reflected in the rear end direction of the main body pipe after the incident sound is transmitted to the foreign matter in the main body pipe, determining that the foreign matter is present in the main body pipe, and marking the time point when the first microphone collects the third reflected wave P r10 as a third time point t 10;
when the reflected sound is collected, if the first output audio pulse signal is a signal in phase with the single frequency pulse signal P i and the time of receiving the first output audio pulse signal is later than the time of receiving the first reflected wave P r1 by the first microphone, it is determined that the sound collected at this time is the fourth reflected wave P r20 reflected in the direction of the rear end of the main pipe after the incident sound is transmitted to the foreign object in the air pipe, so that it is determined that the foreign object exists in the air pipe, and the time point when the first microphone collects the fourth reflected wave P r20 is marked as a fourth time point t 20.
The airway monitoring method, wherein the visual tracheal catheter with the acoustic monitoring function emits sound towards the interior of the main pipeline and receives echo, and acquires real-time acoustic airway monitoring data according to the sound emitted towards the interior of the main pipeline and the received echo, and the airway monitoring method further comprises the following steps:
the acoustic reflectance R 1 at the front end position of the main pipe is detected by the following formula 1:
And/or
The cross-sectional area a 1 of the portion where the main pipe is located is detected by the following formula 2:
wherein A 0 is the cross-sectional area of the main pipeline; or (b)
The sectional area A 1 of the part where the main pipeline is located is detected by the following method 3:
And comparing the sectional area A 1 of the part where the main pipeline is positioned with a tracheal sectional area threshold value pre-stored in a system to determine whether the visual tracheal catheter with the acoustic monitoring function is correctly inserted into a trachea.
The airway monitoring method, wherein the visual tracheal catheter with the acoustic monitoring function emits sound towards the interior of the main pipeline and receives echo, and acquires real-time acoustic airway monitoring data according to the sound emitted towards the interior of the main pipeline and the received echo, and the airway monitoring method further comprises the following steps:
detecting and obtaining real-time sound velocity c in the main pipeline:
when it is determined that the visual endotracheal tube having the acoustic monitoring function is correctly inserted into the trachea and it is determined that there is no foreign matter in the trachea and the visual endotracheal tube, a distance L t from the front end of the main body tube to the carina is detected by the following formula 4:
Or (b)
When it is determined that the visual endotracheal tube having the acoustic monitoring function is correctly inserted into the trachea and it is determined that there is no foreign matter in the trachea and the visual endotracheal tube, a distance L t from the front end of the main body tube to the carina is detected by the following formula 5:
Wherein L 1 is a distance from the first microphone to the front end of the main pipe.
The airway monitoring method, wherein the visual tracheal catheter with the acoustic monitoring function emits sound towards the interior of the main pipeline and receives echo, and acquires real-time acoustic airway monitoring data according to the sound emitted towards the interior of the main pipeline and the received echo, and the airway monitoring method further comprises the following steps:
monitoring the real-time airflow velocity v within the main conduit by the following formula 6:
Wherein L m is a distance between the first microphone and the second microphone, t i is a time difference when the first microphone and the second microphone are detected to collect the same incident sound, and t r is a time difference when the first microphone and the second microphone are detected to collect the same reflected sound;
And when the detected real-time airflow speed v is positive, judging that the current airway is in an inhaled air state, and when the detected real-time airflow speed v is negative, judging that the current airway is in an exhaled air state.
The airway monitoring method, wherein the visual tracheal catheter with the acoustic monitoring function emits sound towards the interior of the main pipeline and receives echo, and acquires real-time acoustic airway monitoring data according to the sound emitted towards the interior of the main pipeline and the received echo, and the airway monitoring method further comprises the following steps:
the instantaneous volumetric flow Q in the main conduit at the section of the first microphone acquired each time the airway monitoring operation is performed is monitored by the following formula 7:
q=v×s formula 7;
Wherein S is a cross-sectional area of the main body duct at a cross-section of the first microphone;
Recording the instantaneous volume flow Q acquired each time the airway monitoring operation is performed to monitor the gas flow change condition in the airway.
The airway monitoring method, wherein the visual tracheal catheter with the acoustic monitoring function emits sound towards the interior of the main pipeline and receives echo, and acquires real-time acoustic airway monitoring data according to the sound emitted towards the interior of the main pipeline and the received echo, and the airway monitoring method further comprises the following steps:
the real-time sound velocity c in the main pipe is obtained by the following detection of equation 8:
Wherein L m is a distance between the first microphone and the second microphone, t i is a time difference between the detected first microphone and the detected second microphone when the same incident sound is collected, and t r is a time difference between the detected first microphone and the detected second microphone when the same reflected sound is collected;
Or (b)
When the real-time airflow velocity v in the main pipeline is monitored to be 0, the real-time sound velocity c in the main pipeline can be obtained through detection according to the following formula 9:
Wherein L 1 is a distance from the first microphone to the front end of the main pipe.
The airway monitoring method, wherein the visual tracheal catheter with the acoustic monitoring function emits sound towards the interior of the main pipeline and receives echo, and acquires real-time acoustic airway monitoring data according to the sound emitted towards the interior of the main pipeline and the received echo, and the airway monitoring method further comprises the following steps:
Monitoring the real-time temperature T within the main conduit by the following formula 10:
Wherein z is a medium constant preset by the system;
And recording the real-time temperature T obtained when the airway monitoring operation is executed each time so as to monitor the temperature transformation condition in the airway.
The airway monitoring method, wherein, after judging that foreign matter exists in the main pipeline, the visual tracheal catheter with acoustic monitoring function is adopted to make sound towards the inside of the main pipeline, and receive echo, and according to the sound made towards the inside of the main pipeline and the received echo, real-time acoustic airway monitoring data are obtained, and the airway monitoring method further comprises the following steps:
Detecting a distance L t10 between the foreign matter in the main pipeline and the first microphone through the following 11:
Wherein L 1 is a distance from the first microphone to the front end of the main pipe; and/or
The maximum cross-sectional dimension a 10 of the foreign matter in the main pipe is detected by the following 12:
wherein A 0 is the sectional area of the main pipeline.
The airway monitoring method, wherein, after judging that there is a foreign matter in the trachea, the visual tracheal catheter with acoustic monitoring function is adopted to make sound towards the interior of the main pipeline, and receive echo, according to the sound made towards the interior of the main pipeline and the received echo, acquire real-time acoustic airway monitoring data, and further comprise:
The distance L t20 of the endotracheal foreign body with respect to the front end of the main body tube is detected by the following 13:
Wherein L 1 is a distance from the first microphone to the front end of the main pipe; and/or
The first microphone collects a first refraction wave signal P t30 which is received after the fourth reflection wave P r20, is in phase with the single-frequency pulse signal P i, and propagates from the front end of the main body pipeline to the rear end direction of the main body pipeline;
the maximum cross-sectional dimension a 20 of the intratracheal foreign body is detected by the following formula 14:
wherein A 0 is the sectional area of the main pipeline.
The airway monitoring method includes the steps of collecting data detected by the visual tracheal catheter with the acoustic monitoring function in real time, comparing the largest cross-sectional dimension A 20 of the intra-tracheal foreign matters collected in a front-back time period, and determining that the intra-tracheal foreign matters comprise secretion when the increasing proportion of the largest cross-sectional dimension A 20 of the intra-tracheal foreign matters is detected to exceed a first change threshold preset by a system in a preset time period.
The airway monitoring method comprises the steps of performing early warning prompt when the increasing proportion of the maximum cross-sectional dimension A 20 of the intra-tracheal foreign body exceeds a first change threshold preset by a system in a preset time period, and performing secretion removal prompt when the maximum cross-sectional dimension A 20 of the intra-tracheal foreign body is larger than the threshold preset by the system.
The visual tracheal catheter with the acoustic monitoring function and the monitoring method have the beneficial effects that:
The invention effectively combines the acoustic detection function and the visual observation function, and better implements omnibearing monitoring. By utilizing acoustics to monitor, the position of the catheter and the blockage degree of the airway can be effectively monitored in real time; the visual detection function is utilized, the catheter intubation process is effectively assisted, the secretion condition in the trachea can be intuitively observed when a user intubates, the defects of the schemes are well overcome by combining the two schemes, the local visual detection can be realized through vision, the global real-time monitoring can be realized through acoustics, and the device has the characteristics of perfect performance, accurate detection effect and effectively assisting the establishment of an artificial airway. Specifically, the visual tracheal catheter with the acoustic monitoring function and the monitoring method can realize the following functions:
1. In the intubation process, the situation in front of the intubation can be observed through the camera, so that the intubation is indicated;
2. After the intubation, the specific position of the front end of the main pipeline is monitored in real time;
3. after intubation, the position, the size and the specific phenomenon of secretion in the catheter and the trachea are monitored in real time;
4. after intubation, secretion is accurately removed through visualization.
Drawings
The conception, specific structure, and technical effects of the present invention will be further described with reference to the accompanying drawings to fully understand the objects, features, and effects of the present invention.
Fig. 1 is a cross-sectional view of a visual endotracheal tube with acoustic monitoring capabilities of the present invention in one embodiment.
Fig. 2 is a schematic diagram of a propagation state of sound in a first pipe diameter state.
Fig. 3 is a schematic diagram of a propagation state of sound in a second pipe diameter state.
Fig. 4 is a schematic diagram of acoustic ranging of a visual endotracheal tube in a trachea, in one embodiment.
Fig. 5 is a schematic diagram of acoustic ranging in the presence of foreign objects in an endotracheal tube according to one embodiment.
Fig. 6 is a schematic diagram of acoustic ranging in the presence of foreign objects in the trachea, according to one embodiment.
Fig. 7 is a schematic diagram of an acoustic test respiratory airflow.
Fig. 8 is a cross-sectional view of a visual endotracheal tube with acoustic monitoring capabilities according to another embodiment of the present invention.
Reference numerals
1. Catheter assembly
11. Main body pipeline
Front end of 111 main body pipeline
12 Side pipeline
13 Connecting pipe
14 Air bag
21 Loudspeaker
22 First microphone
23 Second microphone
31 Lens
32 Signal line
33 Lens interface
4. Air pipe
5. Tracheal carina
61. Foreign matter in main pipeline
62 Intratracheal foreign bodies
7. Gas monitoring probe
8. Detachable catheter
Detailed Description
The invention is further described with reference to the following detailed description in order to make the technical means, the inventive features, the achieved objects and the effects of the invention easy to understand. The present invention is not limited to the following examples.
It should be understood that the structures, proportions, sizes, etc. shown in the drawings are for illustration purposes only and should not be construed as limiting the invention to the extent that it can be practiced, since modifications, changes in the proportions, or otherwise, used in the practice of the invention, are not intended to be critical to the essential characteristics of the invention, but are intended to fall within the spirit and scope of the invention.
The visual tracheal catheter with the acoustic monitoring function and the monitoring method solve the problem that the intubation cannot be performed normally in the intubation process through visualization, and monitor the specific position of the front end 111 of the main body pipeline in the intubation in the trachea 4 in real time by combining with an acoustic scheme, so that the ventilation failure and the human body injury caused by the later movement of the catheter are avoided; the size of the secretion (or foreign matter) in the catheter and the airway can also be monitored in real time through an acoustic scheme, and the medical staff can be better guided to remove the secretion (or foreign matter) through visual confirmation of the specific position and form of the secretion (or foreign matter).
The invention is further described below with reference to fig. 1 to 7 and specific embodiments:
first embodiment:
as shown in fig. 1, this embodiment provides a visual endotracheal tube with acoustic monitoring function, comprising:
A conduit assembly 1 comprising a main body duct 11 and a side duct 12, the side duct 12 being provided on a side wall of the main body duct 11, and the side duct 12 being located at a rear end of the main body duct 11, and the side duct 12 being in communication with the main body duct 11; in the concrete implementation, the main pipeline 11 and the side pipeline 12 are both formed by hollow cylindrical pipe bodies, the main pipeline 11 and the side pipeline 12 can be connected together through a connecting pipe 13, and an air bag 14 can be arranged at the front end 111 of the main pipeline to better fix the main pipeline 11 in the air pipe 4; wherein the side conduit 12 may be used in connection with an external ventilator or the like;
the shooting module comprises a lens 31, wherein the lens 31 is arranged on the side wall of the main body pipeline 11, the lens 31 is positioned at the front end 111 of the main body pipeline, and the lens 31 is a miniature camera;
the sound monitoring module is arranged at the rear end of the main pipeline 11, and is used for making sound towards the inside of the main pipeline 11 and receiving echo;
A display module;
And the main control module is respectively connected with the shooting module, the sound monitoring module and the display module.
The lens 31 may be connected to a lens interface 33 through a signal line 32 passing through the main body pipe 11, and connected to a main control module through the lens interface 33.
During implementation, the images captured by the lens and the sound data monitored by the sound monitoring module can be transmitted to the display module through the main control module for reference by a user.
In this embodiment, the main control module is configured to receive the echo, and compare the received echo with an echo threshold value pre-stored in the main control module, so as to determine the intubation condition of the visual tracheal catheter.
During implementation, the voice monitoring module can collect the audio signals and directly output the collected audio signals to the display module for reference by a user, and the user calculates a detection result according to the collected data; the collected audio signals can be processed and identified, and the audio data are converted into corresponding detection result data and output to the display module for reference of a user.
In this embodiment, the front end 111 of the main pipe 11 is formed by one end of the main pipe 11 for insertion into the human body, and the rear end of the main pipe 11 is formed by one end of the main pipe 11 disposed outside the human body, and in other embodiments, the main pipe 11 and the side pipe 12 may be connected by a connection pipe 13 having a size corresponding to the inner diameter of the main pipe 11, and in this case, the rear end of the main pipe is formed by one end of the connection pipe 13 for mounting the sound monitoring module.
In this embodiment, the sound monitoring module includes sound generating unit and radio receiving unit, sound generating unit with the radio receiving unit all with main control module is connected, sound generating unit locates main body pipe 11's rear end, the radio receiving unit is located on main body pipe 11's the inside wall, just the radio receiving unit with the sound generating unit is adjacent, and the radio receiving unit is located towards in the sound generating unit one side of camera lens.
In this embodiment, the sound generating unit includes a speaker 21, the speaker 21 is coaxially disposed with the main body pipe 11, and a sound generating direction of the speaker 21 faces the main body pipe 11, and the speaker 21 is connected with the main control module.
In this embodiment, the sound receiving unit includes a first microphone 22 and a second microphone 23, where the first microphone 22 and the second microphone 23 are disposed on an inner sidewall of the main body pipe 11 in parallel along an axial direction of the main body pipe 11, and the first microphone 22 is located between the sound generating unit and the second microphone 23, and the first microphone 22 and the second microphone 23 are respectively connected with the main control module.
In this embodiment, the distance between the first microphone 22 and the second microphone 23 may be set to 25 mm, and the distance between the first microphone 22 and the front end 111 of the main pipe is set to 300 mm, and the main pipe 11 may be formed by using a conduit of 7.5 mm, 8 mm or 9 mm (in other embodiments, the dimensions may be set according to actual needs).
As shown in fig. 1, the installation surface of the speaker 21 in this embodiment is perpendicular to the diameter direction of the main body pipe 11, so that sound emitted from the speaker 21 can propagate along the axis direction of the main body pipe 11 and directly reach the microphone and the front end 111 of the main body pipe 11, effectively reducing the reflection process of sound in the pipe, thereby reducing the generation of redundant reflection signals, simplifying the later signal processing and recognition process, avoiding erroneous judgment due to erroneous recognition of signals, and the like.
The visual tracheal catheter with the acoustic monitoring function in the embodiment can effectively detect the airway by utilizing the shooting module and the acoustic monitoring module to be matched with each other, the position of the tracheal catheter in the airway can be detected by utilizing the shooting module, image guidance is provided for insertion of the catheter, and meanwhile, sound is emitted to the main pipeline by utilizing the acoustic monitoring module and echo is received, so that real-time feedback audio in the airway is compared with threshold audio, and whether the position which cannot be shot by the shooting module is abnormal or not is judged. Where the threshold audio is the audio value that should be detected if the airway is in a normal condition. The shooting module and the sound monitoring module are mutually supplemented with the data detected by the sound monitoring module to effectively assist the establishment of the artificial airway.
Second embodiment:
the airway monitoring method in this embodiment is applied to a visual tracheal catheter with an acoustic monitoring function, and the visual tracheal catheter with the acoustic monitoring function includes:
a catheter assembly 1 comprising a main body conduit 11;
The sound monitoring module comprises a sound generating unit, a first microphone 22 and a second microphone 23, wherein the sound generating unit is arranged at the rear end of the main body pipeline 11 and emits sound towards the front end 111 direction of the main body pipeline, the first microphone 22 and the second microphone 23 are arranged on the inner side wall of the main body pipeline 11 in parallel along the axial direction of the main body pipeline 11 and are positioned at one side of the sound generating unit towards the lens, the first microphone 22 is positioned between the sound generating unit and the second microphone 23, and the first microphone 22 and the second microphone 23 are spaced by a preset distance, and the method comprises the following steps:
Capturing real-time images in the airway by adopting the visual tracheal catheter with the acoustic monitoring function;
Adopt the visual endotracheal tube that possesses acoustic monitoring function is towards sound in the main part pipeline 11 to receive the echo, according to towards sound and the received that send in the main part pipeline 11 the echo obtains real-time acoustic airway monitoring data, specifically includes the following step:
The following airway monitoring operation is performed once every first preset time length of the visual tracheal catheter with the acoustic monitoring function, in this embodiment, the first preset time length is 10ms, and the first preset time length can be set as required in practical application:
the sound generating unit generates the sound toward the front end 111 of the main body pipe to propagate a single-frequency pulse signal P i with a preset frequency toward the front end 111 of the main body pipe, in this embodiment, pulses with a frequency of 500 Hz-4000 Hz may be selected to form a single-frequency pulse signal P i;
the first microphone 22 and the second microphone 23 collect sound respectively to obtain a corresponding first output audio pulse signal and a corresponding second output audio pulse signal respectively;
If the time when the first microphone 22 receives the first output audio pulse signal is earlier than the time when the second microphone 23 receives the second output audio pulse signal, determining that the sound collected at this time is an incident sound propagating from the rear end of the main pipe 11 to the front end 111 of the main pipe, that is, the single frequency pulse signal P i, recording a time point when the first microphone 22 obtains the first output audio pulse signal, and marking the time point as an output time point t 0;
If the time when the first microphone 22 receives the first output audio pulse signal is later than the time when the second microphone 23 receives the second output audio pulse signal, determining that the sound collected at this time is a reflected sound propagating from the front end 111 of the main pipe to the rear end direction of the main pipe 11;
When the reflected sound is collected, if the first output audio pulse signal collected at this time is a signal with an opposite phase to the single-frequency pulse signal P i, and the signal is a signal with an opposite phase to the single-frequency pulse signal P i, which is received by the first microphone 22 after receiving the single-frequency pulse signal P i, it is determined that the reflected sound collected at this time is the first reflected wave P r1 reflected in the rear end direction of the main pipe 11 after the incident sound is transmitted to the front end 111 of the main pipe, and a time point when the first microphone collects the first reflected wave P r1 is marked as a first time point t 1;
When the reflected sound is collected, if the first output audio pulse signal collected at this time is a signal with an opposite phase to the single-frequency pulse signal P i, and the signal is a signal with an opposite phase to the single-frequency pulse signal P i, which is received by the first microphone 22 after receiving the first reflected wave P r1, it is determined that the reflected sound collected at this time is the second reflected wave P r2 reflected in the rear end direction of the main body pipe 11 after the incident sound is transmitted to the tracheal carina 5, and a time point when the first microphone collects the second reflected wave P r2 is marked as a second time point t 2;
When the reflected sound is collected, if the first output audio pulse signal collected at this time is a signal in phase with the single-frequency pulse signal P i and the time of receiving the first output audio pulse signal is earlier than the time of receiving the first reflected wave P r1 by the first microphone 22, determining that the collected sound is the third reflected wave P r10 reflected in the rear end direction of the main pipe after the incident sound is transmitted to the foreign matter 61 in the main pipe, thereby determining that the foreign matter exists in the main pipe, and marking the time point when the first microphone collects the third reflected wave P r10 as a third time point t 10;
When the reflected sound is collected, if the time of the collected first output audio pulse signal is later than the time when the second microphone 23 receives the second output audio pulse signal, and the first output audio pulse signal is a signal in phase with the single-frequency pulse signal P i, and the time of the received first output audio pulse signal is later than the time when the first microphone 22 receives the first reflected wave P r1, determining that the collected sound is the fourth reflected wave P r20 reflected towards the rear end direction of the main pipe after the incident sound is transmitted to the tracheal foreign object 62, thereby determining that the tracheal foreign object exists, and marking the time point when the first microphone collects the fourth reflected wave P r20 as a fourth time point t 20;
(in other embodiments, the time point when each reflected wave is collected by the second microphone can be uniformly selected for marking, so as to provide basis for subsequent detection);
the acoustic reflectance R 1 at the front end 111 of the main pipe is detected by the following formula 1:
And/or
The cross-sectional area a 1 of the portion where the main pipe is located is detected by the following formula 2:
wherein A 0 is the cross-sectional area of the main pipeline; or (b)
The sectional area A 1 of the part where the main pipeline is located is detected by the following method 3:
Comparing the sectional area A 1 of the part where the main pipeline is positioned with a sectional area threshold value of the air pipe 4 pre-stored in the system to determine whether the visual air pipe with the acoustic monitoring function is correctly inserted into the air pipe 4;
detecting and obtaining real-time sound velocity c in the main pipeline:
When it is determined that the visual endotracheal tube having the acoustic monitoring function is correctly inserted into the trachea 4 and it is determined that there is no foreign matter in the visual endotracheal tube and the trachea 4, a distance L t from the front end 111 of the main body tube to the carina 5 is detected by the following formula 4:
Or (b)
When it is determined that the visual endotracheal tube having the acoustic monitoring function is correctly inserted into the trachea 4 and it is determined that there is no foreign matter in the visual endotracheal tube and the trachea 4, a distance L t from the front end 111 of the main body tube to the carina 5 is detected by the following formula 5:
Wherein L 1 is the distance from the first microphone 22 to the front end 111 of the main pipe;
monitoring the real-time airflow velocity v within the main conduit by the following formula 6:
Wherein L m is a distance between the first microphone 22 and the second microphone 23, t i is a time difference when the first microphone 22 and the second microphone 23 are detected to collect the same incident sound, and t r is a time difference when the first microphone 22 and the second microphone 23 are detected to collect the same reflected sound;
When the detected real-time airflow velocity v is positive, judging that the current airway is in an inhaled air state, and when the detected real-time airflow velocity v is negative, judging that the current airway is in an exhaled air state;
the instantaneous volumetric flow Q in the main conduit at the section of the first microphone 22 acquired each time the airway monitoring operation is performed is monitored by the following formula 7:
q=v×s formula 7;
Where S is the cross-sectional area of the main body conduit at the cross-section of the first microphone 22;
recording the instantaneous volume flow Q obtained when the airway monitoring operation is executed each time so as to monitor the gas flow conversion condition in the airway;
the real-time sound velocity c in the main pipe is obtained by the following detection of equation 8:
Wherein L m is a distance between the first microphone 22 and the second microphone 23, t i is a time difference when the first microphone 22 and the second microphone 23 are detected to collect the same incident sound, and t r is a time difference when the first microphone 22 and the second microphone 23 are detected to collect the same reflected sound;
Or (b)
When the real-time airflow velocity v in the main pipeline is monitored to be 0 (the real-time airflow velocity v can be obtained through the above formula 6, or the real-time airflow velocity v can be obtained through arranging an additional airflow detecting element in the main pipeline), the real-time sound velocity c in the main pipeline can be obtained through the following formula 9:
Wherein L 1 is the distance from the first microphone 22 to the front end 111 of the main pipe;
Monitoring the real-time temperature T within the main conduit by the following formula 10:
Wherein z is a medium constant preset by the system;
Recording the real-time temperature T obtained when the airway monitoring operation is executed each time so as to monitor the temperature transformation condition in the airway;
the distance L t10 of the foreign matter 61 in the main pipe with respect to the first microphone 22 is detected by the following 11:
Wherein L 1 is the distance from the first microphone 22 to the front end 111 of the main pipe; and/or
The maximum cross-sectional dimension a 10 of the foreign matter 61 in the main pipe is detected by the following 12:
Wherein A 0 is the cross-sectional area of the main pipeline;
The distance L t20 of the endotracheal foreign body 62 with respect to the front end 111 of the body tube is detected by the following 13:
Wherein L 1 is the distance from the first microphone 22 to the front end 111 of the main pipe; and/or
The first microphone 22 collects a first refracted wave signal P t30 which is received after the fourth reflected wave P r20, is in phase with the single-frequency pulse signal P i, and propagates from the front end 111 of the main pipe toward the rear end of the main pipe;
The maximum cross-sectional dimension a 20 of the endotracheal foreign body 62 is detected by the following 14:
Wherein A 0 is the cross-sectional area of the main pipeline;
and displaying the real-time image and the real-time acoustic airway monitoring data, and providing a basis for real-time airway monitoring.
The principle of the visual endotracheal tube with acoustic monitoring function and the monitoring method of the present invention will be further described with reference to fig. 2 to 7:
As shown in fig. 2, when the section of the pipe is changed from large to small in the process of acoustic wave propagation, the reflected wave has the same phase as the incident wave; and as shown in fig. 3, when the section of the pipe is changed from small to large during the propagation of the acoustic wave, the reflected wave is opposite in phase to the incident wave. R p in fig. 2 and 3 is the sound pressure reflectance, P i、Pr and P t are the incident wave, the reflected wave, and the refracted wave, respectively, and a 0 and a 1 are the sectional areas of the two sections before and after the sound wave propagates, respectively.
When the visual tracheal catheter with the acoustic monitoring function is used for detection, the main body pipeline and the tracheal catheter can be approximately regarded as two catheters with uniform sections respectively when the visual tracheal catheter is inserted into a trachea, wherein the caliber of the trachea is larger than that of the main body pipeline, so that the state can be equivalently regarded as the state shown in fig. 3.
In operation, when the catheter is inserted into the trachea, the speaker 21 may be used to emit a pulse sound with a frequency of 500 to 4000Hz as the incident sound wave P i (i.e., the single-frequency pulse signal P i), since the sound wavelength is much larger than the tube diameter of the main body tube, the main body tube and the trachea can be approximately regarded as two catheters with uniform cross-sections, and referring to the structure shown in fig. 3, the formula of propagation reflection of sound in the main body tube and the trachea can be obtained as shown in the following formulas 15 and 16:
P i+Pr=Pt formula 16;
while the sound wave continues to propagate forward in the trachea to the carina 5, the cross-sectional area again becomes larger, and the sound wave is reflected as such.
Fig. 4 is a schematic diagram of acoustic ranging of a visual endotracheal tube in a trachea, in one embodiment. Figure 4 shows, in an embodiment, one cycle of propagation of the primary sound signal when there is no airflow velocity in the conduit when in the breathing gap after the main conduit has entered the normal trachea.
The loudspeaker 21 sends out a single-frequency pulse signal P i of 500 Hz-4000 Hz every 10ms, for convenience of understanding, the signal is preset to be in a positive phase, the single-frequency pulse signal P i is captured in real time when passing through the first microphone 22 and the second microphone 23 in sequence, at this time, whether the signal is an incident sound or a reflected sound can be judged according to the sequence of the first microphone 22 receiving the first output audio pulse signal and the second microphone 23 receiving the second output audio pulse signal, when the first microphone 22 receives the first output audio pulse signal earlier than the second microphone 23 receives the second output audio pulse signal, the signal is judged to be an incident sound, and the time point of the first microphone 22 receiving the first output audio pulse signal is marked as an output time point t 0;
When the pulse sound continues to propagate forward to the front end 111 of the main body pipe, the cross-sectional area of the propagation pipe changes, and a first reflected wave P r1 and a transmitted wave P t1 are generated at this time, and the first reflected wave P r1 is captured when sequentially passing through the second microphone 23 and the first microphone 22, and the signals are opposite phase signals, so that the signals can be analyzed to be reflected sound signals reflected from the front end 111 of the main body pipe according to the time sequence of the signals collected by the first microphone 22 and the second microphone 23, and the time point at this time is marked as t 1 (i.e., the time point at which the first reflected wave P r1 is collected is marked as a first time point t 1). The transmitted wave P t1 continues to propagate through the carina 5, which produces a corresponding second reflected wave P r2, which is also an opposite phase signal, marking the time t 2 at which the second reflected wave P r2 was acquired (i.e. the second time t 2).
The first microphone 22 and the second microphone 23 can directly identify the signals reflected again after the first reflected wave P r1 and the second reflected wave P r2 pass through the two microphones and continue to propagate forward as invalid signals according to the time sequence of grabbing, and remove the signals during post-processing.
According to the principle of acoustic propagation in pipes with different sections, the calculation formula of the propagation distance L is shown in the following formula 17:
L=c×t formula 17;
C in equation 17 is the speed of sound in the pipe, and t is the time that the sound propagates in the pipe. Because of individual differences and changes in factors such as time and temperature in the gaseous medium in the airway, the speed of sound needs to be confirmed in real time, whereas because the medium in the airway changes relatively slowly over time, the medium can be considered approximately unchanged during a test cycle.
The real-time speed of sound c in the main conduit can be obtained using the above equation 9 detection. Further, the distance L t from the distal end 111 of the main body pipe to the carina 5 can be detected by using the above equation 4.
Whereas, according to the principle of propagation of a plane acoustic wave in a finite duct, the relative formula of acoustic reflection at the end of the duct can be found as shown in equation 18 below:
therefore, the cross-sectional area A 1 of the portion where the main pipe is located can be detected using the above equations 2 and 3.
Meanwhile, the size range of the trachea is relatively fixed after adult, and the size range is greatly different from esophagus, bronchus, oral cavity and the like; therefore, whether the visual tracheal catheter is normally inserted into the trachea, but not into the esophagus, the bronchus, the oral cavity and the like can be judged according to whether the sectional area A 1 of the part where the main body pipeline is positioned is detected to be within the range of the sectional area of the trachea of a normal adult (the range of the sectional area of the trachea of the normal adult can be pre-stored in the system as a threshold value of the sectional area of the trachea).
Fig. 5 is a schematic diagram of acoustic ranging in the presence of foreign objects in an endotracheal tube according to one embodiment. As shown in fig. 5, when a foreign object exists in a certain position in the main pipeline, the single-frequency pulse signal P i is incident and then passes through the foreign object in the main pipeline to generate a third reflected wave P r10, the third reflected wave P r10 is a positive phase signal, and the third reflected wave P r10 is slightly before the time of the first reflected wave P r1, meanwhile, the signal can be determined to be a foreign object reflected signal according to the sequence of the third reflected wave P r10 passing through the second microphone 23 and the first microphone 22, and the time is recorded as t 10 (i.e. the time point when the third reflected wave P r10 is acquired is marked as a third time point t 10), so that the distance L t10 between the foreign object 61 in the main pipeline and the first microphone 22 can be detected through the above-mentioned 11 in combination with the above-mentioned acoustic wave transmission principle. Meanwhile, the maximum cross-sectional dimension a 10 of the foreign matter 61 in the main pipe may be detected in combination with the above formula 12.
Fig. 6 is a schematic diagram of acoustic ranging in the presence of foreign objects in the trachea, according to one embodiment. As shown in fig. 6, when a foreign object exists in a trachea, a single-frequency pulse signal P i is incident and then passes through the front end of the main pipeline to generate a first reflected wave P r1 and a corresponding refracted wave P t1; after the refracted wave P t1 continues to propagate and encounters the endotracheal foreign object 62, a fourth reflected wave P r20 appears, where the reflectivity is R 20; and a new fifth reflected wave P r30 and a corresponding refracted wave P t30 appear after the reflected wave propagates to the front end 111 of the main pipe, where the reflectivity is R 30; the signal of the refracted wave P t30 corresponding to the fifth reflected wave P r30 is also a positive phase signal, and after the time delay of the signal corresponding to the first reflected wave P r1, the time corresponding to the mark recorded by the first microphone 22 is t 20 (i.e., the time point at which the fourth reflected wave P r20 is acquired is marked as a fourth time point t 20). Accordingly, the distance L t20 of the endotracheal foreign matter 62 with respect to the front end 111 of the body tube can be detected by the above formula 13.
Analyzing the propagation characteristics of the signals everywhere in fig. 6, the following formulas 19 to 22 can be obtained:
P i+Pr1=Pt1 formula 21;
p r20+Pr30=Pt30 formula 22;
The maximum cross-sectional dimension a 20 of the endotracheal foreign body 62 can be detected by equation 14 above.
Fig. 7 is a schematic diagram of an acoustic test respiratory airflow. Fig. 7 shows a state in which the flow rate of the air flow in the main body duct is v during breathing. Wherein the speaker 21 emits a single frequency pulse signal P i1. The single frequency pulse signal P i1 propagates at speed c in a stationary gas stream, and according to the doppler effect, propagates forward in the conduit at a speed c+v. Then, the first microphone 22 and the second microphone 23 with the distance L m are sequentially received, and when the method is implemented, the distance L m between the first microphone 22 and the second microphone 23 can be designed to be 25mm, and the time difference t i that the first microphone 22 and the second microphone 23 capture the same audio is recorded. As the audio signal continues to propagate forward to the front end 111 of the main conduit, a first reflected wave P r1 is generated due to abrupt changes in the conduit diameter, the reflected signal propagation velocity being c-v (the time difference between the incident and reflected signals is on the order of relatively very small milliseconds since the speed of sound propagation is much greater than the speed of the air flow, so the air flow velocity can be approximated as being the same over the time period). The reflected signal is then received by the second microphone 23 and the first microphone 22 in succession, and the time difference between the two microphones receiving the signal at this time is recorded as t r. The real-time airflow velocity v in the main conduit can be monitored according to equation 6 above.
And when the detected real-time airflow speed v is positive, judging that the current airway is in an inhaled air state, and when the detected real-time airflow speed v is negative, judging that the current airway is in an exhaled air state.
The product S of the real-time airflow velocity v and the cross-sectional area of the first microphone 22 is the instantaneous volumetric flow Q. The instantaneous volumetric flow Q in the main conduit at the cross-section of the first microphone 22 can be found according to equation 7 above.
When the speaker 21 emits the single-frequency pulse signal P i at a fixed frequency, the airflow speed corresponding to each time point can be obtained, so that a curve of the change of the volume flow with time is drawn to monitor the change of the gas flow in the air passage.
Meanwhile, the real-time sound velocity c in the main pipeline can be obtained according to the above formula 8:
The real-time temperature T in the main pipe is also monitored by equation 10 above in this example based on the relationship of sound velocity to temperature, where z is the dielectric constant and typically air is 20.05. Therefore, a curve of the real-time temperature change of the air flow along with time can be drawn to monitor the temperature change condition in the air passage.
In the embodiment, a lens is arranged at the whole section of the main pipeline so as to observe the influence in the process of catheterization in real time, and the catheterization is carried out after the main pipeline passes through organs such as glottis and the like through visual guidance in the process of catheterization; meanwhile, the intubation process of the left bronchus and the right bronchus can be guided. After intubation, conditions in the trachea, such as foreign objects, bumps, etc., in front of the catheter head may be observed, which may be directed to removal.
Third embodiment:
The basic structure of the visual endotracheal tube having an acoustic monitoring function in this embodiment is similar to that in the first embodiment, and only a portion differing from the first embodiment will be described, the visual endotracheal tube in this embodiment further includes:
The sputum aspirator comprises a sputum aspirator and a sputum aspirator catheter, the sputum aspirator is connected with one end of the sputum aspirator catheter, the sputum aspirator catheter can selectively extend into the main body pipeline and can penetrate through the main body pipeline to enter the trachea, wherein the sputum aspirator assembly works by utilizing the negative pressure principle;
When the sputum sucking operation is needed, the sputum sucking catheter can be put into the main pipeline, and then the sputum sucking device is controlled to clean sputum or other secretion;
A spray assembly comprising a sprayer and a spray conduit, said sprayer being connected to one end of said spray conduit, said spray conduit being selectively extendable into said main conduit; the use of a spray assembly allows for the delivery of a drug to a patient using a nebulizer, e.g., a drug such as salbutamol sulfate may be nebulized and delivered to the site of the secretion;
the gas detection module comprises a gas monitoring device and a gas monitoring probe 8, wherein the gas monitoring device is connected with the gas monitoring probe, the gas monitoring probe is arranged in the main pipeline, and the gas monitoring probe can be used for measuring the concentration of nitric oxide or other gases in the main pipeline so as to judge whether a patient has a potential disease or not through the concentration of respiratory gases.
The gas monitoring device can be connected with the main control module to transmit monitoring data to the main control module, and the main control module controls the display module to display related information.
The positions of the sputum suction catheter and the spray catheter extending into the main pipeline can be shown in fig. 8, and the positions of the detachable catheter 8 in fig. 8 are optional positions of the sputum suction catheter and the spray catheter extending into the main pipeline. In this embodiment, the sputum suction catheter and the spraying catheter may enter the main body pipeline from the side pipeline, in other embodiments, other openings may be provided on the side wall of the main body pipeline for the sputum suction catheter and the spraying catheter to extend into the main body pipeline, and only the position of the gas monitoring probe 8 is drawn, but the position of the gas monitoring device is not drawn in fig. 8, in actual operation, the probe may be connected with the gas monitoring device at the periphery of the tracheal catheter through a wire or other modes, the illustration is only a reference view, so that those skilled in the art can understand the approximate position of the related structure, and the method is not limited to a specific structure.
The visual tracheal catheter of the embodiment can also realize sputum cleaning on the basis of the visual tracheal catheter of the first embodiment, and the remote administration and the monitoring of the expired gas of a patient.
In the actual operation process, the data detected by the visual tracheal catheter with the acoustic monitoring function can be collected in real time, the maximum cross-sectional dimension A 20 of the tracheal foreign matters collected in the front and rear time periods is compared, if the increase proportion of the maximum cross-sectional dimension A 20 of the tracheal foreign matters is monitored to exceed the preset first change threshold value of the system in the preset time period, the fact that the tracheal foreign matters comprise secretion is determined, and the secretion is increasing. Such as: for the original tumor or foreign matter in the trachea, if the detection finds that the value A1 of the sectional area of the trachea changes by more than 15% in the trachea cannula process (the process that the trachea continuously goes deep into the patient), the position where A1 changes at the moment (namely the position of the distance L t from the front end of the main body pipeline to the carina of the trachea) can be considered to have the original tumor or foreign matter;
If the increase proportion of the maximum cross-sectional dimension A 20 of the intra-tracheal foreign body is monitored to be larger than the preset first change threshold value of the system in the preset time period, early warning prompt is carried out, and secretion removal prompt is carried out when the maximum cross-sectional dimension A 20 of the intra-tracheal foreign body is larger than the preset foreign body dimension threshold value of the system. If the value of the sectional area of the foreign matter A20 monitored by the system changes by more than 15% before and after the given time (more than 10 seconds), the secretion of the air pipe of the patient is judged to be increased, when the system monitors that the sectional area A20 of the foreign matter is more than 15% of the sectional area A0 of the main pipeline, the system gives an early warning, when the system monitors that the sectional area A20 of the foreign matter is more than 30% of the sectional area A0 of the main pipeline, the system reminds the therapist that the air pipe of the patient has foreign matter secretion and needs to be cleaned, and when the system monitors that the sectional area A20 of the foreign matter is more than 50% of the sectional area A0 of the main pipeline, the system reminds the therapist that the air pipe of the patient has excessive foreign matter secretion and needs to be cleaned.
Prior to performing the intubation procedure, the patient's airway may be examined for the presence of tumors or other foreign objects other than secretions by other means of detection (e.g., ultrasound). Meanwhile, the shooting module can be combined to judge whether tumors or other foreign matters except secretion exist in the airway.
Fourth embodiment:
The present invention also provides an airway monitoring apparatus comprising:
At least one processor; a memory coupled to the at least one processor, the memory storing executable instructions that when executed by the at least one processor cause the method of the second embodiment of the invention to be implemented.
In this embodiment, the present invention also provides an airway monitoring apparatus, comprising: at least one processor; a memory coupled to the at least one processor. The processor and the memory may be provided separately or may be integrated.
For example, the memory may include random access memory, flash memory, read-only memory, programmable read-only memory, non-volatile memory, registers, or the like. The processor may be a central processing unit (Central Processing Unit, CPU), or the like. Or an image processor (Graphic Processing Unit, GPU) memory may store executable instructions. The processor may execute executable instructions stored in the memory to implement the various processes described herein.
It will be appreciated that the memory in this embodiment may be either volatile memory or nonvolatile memory, or may include both volatile and nonvolatile memory. The nonvolatile memory may be a ROM (Read-only memory), PROM (ProgrammableROM, programmable Read-only memory), EPROM (ErasablePROM, erasable programmable Read-only memory), EEPROM (ElectricallyEPROM, electrically erasable programmable Read-only memory), or flash memory, among others. The volatile memory may be a RAM (random access memory) which serves as an external cache. By way of example, and not limitation, many forms of RAM are available, such as SRAM (STATICRAM, static random access memory), DRAM (DYNAMICRAM, dynamic random access memory), SDRAM (SynchronousDRAM, synchronous dynamic random access memory), ddr SDRAM (DoubleDataRate SDRAM, double data rate synchronous dynamic random access memory), ESDRAM (ENHANCED SDRAM, enhanced synchronous dynamic random access memory), SLDRAM (SYNCHLINKDRAM, synchronous connected dynamic random access memory), and DRRAM (DirectRambusRAM, direct memory bus random access memory). The memory described herein is intended to comprise, without being limited to, these and any other suitable types of memory.
In some embodiments, the memory stores the following elements, an upgrade package, an executable unit, or a data structure, or a subset thereof, or an extended set thereof: an operating system and application programs.
The operating system includes various system programs, such as a framework layer, a core library layer, a driving layer, and the like, and is used for realizing various basic services and processing hardware-based tasks. And the application programs comprise various application programs and are used for realizing various application services. The program for implementing the method of the embodiment of the invention can be contained in an application program.
In an embodiment of the present invention, the processor is configured to execute the method steps provided in the second embodiment by calling a program or an instruction stored in the memory, specifically, a program or an instruction stored in an application program.
According to the visual tracheal catheter with the acoustic monitoring function and the monitoring method, the real-time images in the airway are captured, the real-time acoustic airway monitoring data are obtained, and the basis is provided for the real-time monitoring of the airway by combining two detection modes. The visual tracheal catheter with the acoustic monitoring function and the monitoring method have the characteristics of perfect performance, accurate detection effect and effective auxiliary establishment of an artificial airway.
The foregoing describes in detail preferred embodiments of the present invention. It should be understood that numerous modifications and variations can be made in accordance with the concepts of the invention without requiring creative effort by one of ordinary skill in the art. Therefore, all technical solutions which can be obtained by logic analysis, reasoning or limited experiments based on the prior art by the person skilled in the art according to the inventive concept shall be within the scope of protection defined by the claims.

Claims (21)

1. A visual endotracheal tube having acoustic monitoring capabilities, comprising:
A catheter assembly comprising a body conduit;
the shooting module comprises a lens, wherein the lens is arranged on the side wall of the main body pipeline and is positioned at the front end of the main body pipeline;
The sound monitoring module is arranged at the rear end of the main pipeline, and is used for making sound towards the inside of the main pipeline and receiving echo;
A display module;
And the main control module is respectively connected with the shooting module, the sound monitoring module and the display module.
2. The visual endotracheal tube with acoustic monitoring function according to claim 1, wherein said main control module is configured to receive said echo and compare said received echo with an echo threshold pre-stored in said main control module to determine an intubatton condition of said visual endotracheal tube.
3. The visual endotracheal tube with acoustic monitoring function according to claim 1, wherein the sound monitoring module comprises a sound generating unit and a sound receiving unit, the sound generating unit and the sound receiving unit are both connected with the main control module, the sound generating unit is arranged at the rear end of the main body pipeline, the sound receiving unit is arranged on the inner side wall of the main body pipeline, the sound receiving unit is adjacent to the sound generating unit, and the sound receiving unit is arranged at one side of the sound generating unit facing the lens.
4. The visual endotracheal tube with acoustic monitoring function according to claim 3, wherein the sound generating unit includes a speaker, the speaker is coaxially disposed with the main body pipe, and the sound generating direction of the speaker is toward the inside of the main body pipe, and the speaker is connected with the main control module.
5. The visual endotracheal tube with acoustic monitoring function according to claim 3, wherein the sound receiving unit includes a first microphone and a second microphone, the first microphone and the second microphone are disposed on an inner side wall of the main body tube in parallel along an axial direction of the main body tube, and the first microphone is located between the sound generating unit and the second microphone, and the first microphone and the second microphone are connected with the main control module, respectively.
6. The visual endotracheal tube with acoustic monitoring function of claim 1, wherein said tube assembly further comprises a side tube, said side tube being provided on a side wall of said main body tube, and said side tube being located at a rear end of said main body tube, and said side tube being in communication with said main body tube.
7. The visual endotracheal tube with acoustic monitoring function of claim 1, further comprising:
The sputum aspirator comprises a sputum aspirator and a sputum aspirator catheter, the sputum aspirator is connected with one end of the sputum aspirator catheter, and the sputum aspirator catheter can be selectively extended into the main body pipeline and can penetrate through the main body pipeline to enter the trachea.
8. The visual endotracheal tube with acoustic monitoring function of claim 1, further comprising:
the spraying assembly comprises a sprayer and a spraying conduit, wherein the sprayer is connected with one end of the spraying conduit, and the spraying conduit can be selectively extended into the main body pipeline.
9. The visual endotracheal tube with acoustic monitoring function of claim 1, further comprising:
the gas detection module comprises a gas monitoring device and a gas monitoring probe, wherein the gas monitoring device is connected with the gas monitoring probe, and the gas monitoring probe is arranged in the main pipeline.
10. An airway monitoring method applied to a visual tracheal tube with acoustic monitoring function, the method comprising:
Capturing real-time images in the airway by adopting the visual tracheal catheter with the acoustic monitoring function;
The visual tracheal catheter with the acoustic monitoring function is adopted to make sound towards the interior of the main pipeline and receive echo, and real-time acoustic airway monitoring data are obtained according to the sound made towards the interior of the main pipeline and the received echo;
and displaying the real-time image and the real-time acoustic airway monitoring data, and providing a basis for real-time airway monitoring.
11. An airway monitoring method according to claim 10 wherein the visual endotracheal tube with acoustic monitoring function comprises:
A catheter assembly comprising a body conduit;
The sound monitoring module comprises a sound generating unit, a first microphone and a second microphone, wherein the sound generating unit is arranged at the rear end of the main body pipeline and emits sound towards the front end direction of the main body pipeline, the first microphone and the second microphone are arranged on the inner side wall of the main body pipeline in parallel along the axial direction of the main body pipeline and are positioned at one side of the sound generating unit, which faces the lens, and the first microphone is positioned between the sound generating unit and the second microphone, and the first microphone and the second microphone are spaced by a preset distance;
The visual tracheal catheter with acoustic monitoring function is adopted to make sound towards the interior of the main pipeline and receive echo, and real-time acoustic airway monitoring data are acquired according to the sound made towards the interior of the main pipeline and the received echo, and the visual tracheal catheter comprises:
The visual tracheal catheter with the acoustic monitoring function performs the following airway monitoring operation once every first preset time interval:
The sound generating unit generates the sound towards the front end direction of the main pipeline so as to transmit a single-frequency pulse signal P i with a preset frequency towards the front end direction of the main pipeline;
The first microphone and the second microphone respectively acquire sound so as to respectively acquire a corresponding first output audio pulse signal and a corresponding second output audio pulse signal;
If the time when the first microphone receives the first output audio pulse signal is earlier than the time when the second microphone receives the second output audio pulse signal, determining that the sound collected at the moment is incident sound which propagates from the rear end of the main body pipeline to the front end direction of the main body pipeline, namely the single-frequency pulse signal P i, recording the time point when the first microphone obtains the first output audio pulse signal, and marking the time point as an output time point t 0;
If the time when the first microphone receives the first output audio pulse signal is later than the time when the second microphone receives the second output audio pulse signal, judging that the sound collected at the moment is reflected sound which propagates from the front end of the main body pipeline to the rear end direction of the main body pipeline;
When the reflected sound is collected, if the first output audio pulse signal collected at this time is a signal with the opposite phase to the single-frequency pulse signal P i, and the signal is the first signal with the opposite phase to the single-frequency pulse signal P i received by the first microphone after the first microphone receives the single-frequency pulse signal P i, it is determined that the reflected sound collected at this time is the first reflected wave P r1 reflected in the rear end direction of the main pipe after the incident sound is transmitted to the front end of the main pipe, and the time point when the first microphone collects the first reflected wave P r1 is marked as a first time point t 1;
When the reflected sound is collected, if the first output audio pulse signal collected at this time is a signal with the opposite phase to the single-frequency pulse signal P i, and the signal is a signal with the opposite phase to the single-frequency pulse signal P i, which is received by the first microphone after the first reflected wave P r1 is received, it is determined that the reflected sound collected at this time is a second reflected wave P r2 reflected towards the rear end direction of the main body pipe after the incident sound is transmitted to the tracheal carina, and a time point when the first microphone collects the second reflected wave P r2 is marked as a second time point t 2;
when the reflected sound is collected, if the first output audio pulse signal collected at this time is a signal in phase with the single-frequency pulse signal P i and the time of receiving the first output audio pulse signal is earlier than the time of receiving the first reflected wave P r1 by the first microphone, determining that the collected sound is the third reflected wave P r10 reflected in the rear end direction of the main body pipe after the incident sound is transmitted to the foreign matter in the main body pipe, determining that the foreign matter is present in the main body pipe, and marking the time point when the first microphone collects the third reflected wave P r10 as a third time point t 10;
When the reflected sound is collected, if the time of the collected first output audio pulse signal is later than the time of the second microphone receiving the second output audio pulse signal, and the first output audio pulse signal is a signal in phase with the single-frequency pulse signal P i, and the time of the received first output audio pulse signal is later than the time of the first microphone receiving the first reflected wave P r1, the collected sound is determined to be the incident sound, and then the collected sound is transmitted to the foreign matter in the air pipe, and the fourth reflected wave P r20 reflected towards the rear end direction of the main pipe is determined to be the foreign matter in the air pipe, and the time point when the first microphone collects the fourth reflected wave P r20 is marked as a fourth time point t 20.
12. The method for monitoring an airway according to claim 11, wherein the adopting the visual tracheal catheter with acoustic monitoring function makes a sound toward the main pipeline and receives an echo, and acquiring real-time acoustic airway monitoring data according to the sound made toward the main pipeline and the received echo, further comprising:
the acoustic reflectance R 1 at the front end position of the main pipe is detected by the following formula 1:
And/or
The cross-sectional area a 1 of the portion where the main pipe is located is detected by the following formula 2:
wherein A 0 is the cross-sectional area of the main pipeline; or (b)
The sectional area A 1 of the part where the main pipeline is located is detected by the following method 3:
And comparing the sectional area A 1 of the part where the main pipeline is positioned with a tracheal sectional area threshold value pre-stored in a system to determine whether the visual tracheal catheter with the acoustic monitoring function is correctly inserted into a trachea.
13. The method for monitoring an airway according to claim 11, wherein the adopting the visual tracheal catheter with acoustic monitoring function makes a sound toward the main pipeline and receives an echo, and acquiring real-time acoustic airway monitoring data according to the sound made toward the main pipeline and the received echo, further comprising:
detecting and obtaining real-time sound velocity c in the main pipeline:
when it is determined that the visual endotracheal tube having the acoustic monitoring function is correctly inserted into the trachea and it is determined that there is no foreign matter in the trachea and the visual endotracheal tube, a distance L t from the front end of the main body tube to the carina is detected by the following formula 4:
Or (b)
When it is determined that the visual endotracheal tube having the acoustic monitoring function is correctly inserted into the trachea and it is determined that there is no foreign matter in the trachea and the visual endotracheal tube, a distance L t from the front end of the main body tube to the carina is detected by the following formula 5:
Wherein L 1 is a distance from the first microphone to the front end of the main pipe.
14. The method for monitoring an airway according to claim 11, wherein the adopting the visual tracheal catheter with acoustic monitoring function makes a sound toward the main pipeline and receives an echo, and acquiring real-time acoustic airway monitoring data according to the sound made toward the main pipeline and the received echo, further comprising:
monitoring the real-time airflow velocity v within the main conduit by the following formula 6:
Wherein L m is a distance between the first microphone and the second microphone, t i is a time difference when the first microphone and the second microphone are detected to collect the same incident sound, and t r is a time difference when the first microphone and the second microphone are detected to collect the same reflected sound;
And when the detected real-time airflow speed v is positive, judging that the current airway is in an inhaled air state, and when the detected real-time airflow speed v is negative, judging that the current airway is in an exhaled air state.
15. The method for monitoring an airway according to claim 14, wherein the adopting the visual tracheal catheter with acoustic monitoring function makes a sound toward the main pipeline and receives an echo, and acquiring real-time acoustic airway monitoring data according to the sound made toward the main pipeline and the received echo, further comprising:
the instantaneous volumetric flow Q in the main conduit at the section of the first microphone acquired each time the airway monitoring operation is performed is monitored by the following formula 7:
q=v×s formula 7;
Wherein S is a cross-sectional area of the main body duct at a cross-section of the first microphone;
Recording the instantaneous volume flow Q acquired each time the airway monitoring operation is performed to monitor the gas flow change condition in the airway.
16. The method for monitoring an airway according to claim 11, wherein the adopting the visual tracheal catheter with acoustic monitoring function makes a sound toward the main pipeline and receives an echo, and acquiring real-time acoustic airway monitoring data according to the sound made toward the main pipeline and the received echo, further comprising:
the real-time sound velocity c in the main pipe is obtained by the following detection of equation 8:
Wherein L m is a distance between the first microphone and the second microphone, t i is a time difference between the detected first microphone and the detected second microphone when the same incident sound is collected, and t r is a time difference between the detected first microphone and the detected second microphone when the same reflected sound is collected;
Or (b)
When the real-time airflow velocity v in the main pipeline is monitored to be 0, the real-time sound velocity c in the main pipeline can be obtained through detection according to the following formula 9:
Wherein L 1 is a distance from the first microphone to the front end of the main pipe.
17. The method for monitoring an airway according to claim 16, wherein the adopting the visual tracheal catheter with acoustic monitoring function makes a sound toward the main pipeline and receives an echo, and acquiring real-time acoustic airway monitoring data according to the sound made toward the main pipeline and the received echo, further comprising:
Monitoring the real-time temperature T within the main conduit by the following formula 10:
Wherein z is a medium constant preset by the system;
And recording the real-time temperature T obtained when the airway monitoring operation is executed each time so as to monitor the temperature transformation condition in the airway.
18. The method according to claim 11, wherein after determining that a foreign object exists in the main pipe, the adopting the visual endotracheal tube with acoustic monitoring function makes a sound toward the inside of the main pipe, and receives an echo, and obtains real-time acoustic airway monitoring data according to the sound made toward the inside of the main pipe and the received echo, further comprising:
Detecting a distance L t10 between the foreign matter in the main pipeline and the first microphone through the following 11:
Wherein L 1 is a distance from the first microphone to the front end of the main pipe; and/or
The maximum cross-sectional dimension a 10 of the foreign matter in the main pipe is detected by the following 12:
wherein A 0 is the sectional area of the main pipeline.
19. The method according to claim 11, wherein when it is determined that the foreign object exists in the trachea, the step of using the visual endotracheal tube with acoustic monitoring function to sound into the main body tube and receive the echo, and acquiring real-time acoustic airway monitoring data according to the sound that sound into the main body tube and the received echo, further comprises:
The distance L t20 of the endotracheal foreign body with respect to the front end of the main body tube is detected by the following 13:
Wherein L 1 is a distance from the first microphone to the front end of the main pipe; and/or
The first microphone collects a first refraction wave signal P t30 which is received after the fourth reflection wave P r20, is in phase with the single-frequency pulse signal P i, and propagates from the front end of the main body pipeline to the rear end direction of the main body pipeline;
the maximum cross-sectional dimension a 20 of the intratracheal foreign body is detected by the following formula 14:
wherein A 0 is the sectional area of the main pipeline.
20. The method of airway monitoring of claim 19 wherein,
And collecting data detected by the visual tracheal catheter with the acoustic monitoring function in real time, comparing the maximum cross-sectional dimension A 20 of the tracheal foreign matters collected in the front and rear time periods, and determining that the tracheal foreign matters comprise secretion and the secretion is increasing if the increasing proportion of the maximum cross-sectional dimension A 20 of the tracheal foreign matters is monitored to exceed the preset first change threshold value of the system in the preset time period.
21. The method according to claim 20, wherein if the ratio of the increase in the maximum cross-sectional dimension a 20 of the endotracheal foreign body exceeds a first change threshold preset by the system within a preset time period, an early warning is given, and when the maximum cross-sectional dimension a 20 of the endotracheal foreign body is greater than the preset foreign body dimension threshold preset by the system, a secretion removal is given.
CN202410167767.7A 2023-02-13 2024-02-06 Visual tracheal catheter with acoustic monitoring function and monitoring method Pending CN118079165A (en)

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