EP2632329A2 - Appareil, systèmes, procédés et support accessible par ordinateur permettant une identification de la trachée - Google Patents

Appareil, systèmes, procédés et support accessible par ordinateur permettant une identification de la trachée

Info

Publication number
EP2632329A2
EP2632329A2 EP11837098.0A EP11837098A EP2632329A2 EP 2632329 A2 EP2632329 A2 EP 2632329A2 EP 11837098 A EP11837098 A EP 11837098A EP 2632329 A2 EP2632329 A2 EP 2632329A2
Authority
EP
European Patent Office
Prior art keywords
arrangement
needle
electro
exemplary embodiment
trachea
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP11837098.0A
Other languages
German (de)
English (en)
Inventor
William C. Ii Warger
James L. Hancock
Joseph Gardecki
Melissa Suter
George Velmahos
Brett E. Bouma
Guillermo J. Tearney
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
General Hospital Corp
Original Assignee
General Hospital Corp
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by General Hospital Corp filed Critical General Hospital Corp
Publication of EP2632329A2 publication Critical patent/EP2632329A2/fr
Withdrawn legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments 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
    • A61B1/267—Instruments 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments 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
    • A61B1/00002—Operational features of endoscopes
    • A61B1/00043—Operational features of endoscopes provided with output arrangements
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/48—Other medical applications
    • A61B5/4887—Locating particular structures in or on the body
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/48—Other medical applications
    • A61B5/4887—Locating particular structures in or on the body
    • A61B5/489—Blood vessels

Definitions

  • the trachea is a cylinder formed by hyaline cartilage rings and connective tissue, and is immediately surrounded by muscle, fat, and the esophagus.
  • the cartilage rings can primarily be made up of collagen (Types II, XI), have limited blood flow, are stiff compared to the surrounding tissue types, and contain a homogeneous refractive index.
  • exemplary embodiments of systems, apparatus, methods and computer- accessible medium which can utilize optical diagnostic techniques for an identification of the trachea, e.g., either transcutaneously through a needle or other probe, such as a cannula, or transorally/transnasally using a device to guide intubation such as a bougie (intubation) tube.
  • the optical exemplary technique can comprise optical coherence tomography, optical frequency domain imaging, speckle imaging, refractive index measurement, absorption, autofluorescence, diffuse spectroscopy, and/or photoacoustic procedure(s).
  • the device can comprise a light source, such as a laser diode or LED, which is transmitted through an optical fiber or lens and attached to the needle, trocar, bougie tube or the like at its distal end.
  • the light can be received through the same fiber or through additional optical fibers within the device and transmitted to a detector.
  • the exemplary embodiment of the apparatus can be configured to also direct light to the specimen at different wavelengths or by use of a broad- bandwidth light source.
  • the light returned from the specimen may be detected by one or more point detectors, a one or two dimensional array of detectors, CCD or CMOS camera, or the like.
  • the detected signal can be processed by a processing apparatus to determine when the exemplary device is placed within the trachea or the trachea is near the distal end of the device.
  • a processing apparatus to determine when the exemplary device is placed within the trachea or the trachea is near the distal end of the device.
  • the processing apparatus can then provide an audible and/or visible cue as to whether or not the device is now contained in the trachea.
  • this cue can be provided by a light based indicator that turns a particular color when the device has entered the trachea.
  • a sound can be heard and analyzed when the device enters the trachea.
  • apparatus and method for determining information regarding at least one anatomical structure can be provided. For example, it is possible to forward at least one first optical electro-magnetic radiation to the at least one structure (e.g., using at least one first arrangement), and detect at least one second electro-magnetic radiation provided from the at least one structure which is based on first electro-magnetic radiation(s) (e.g., using and at least one second arrangement). It is also possible to determine at least one characteristic of the structure(s) inside thereof based on the second electro-magnetic radiation (e.g., using and at least one third arrangement). For example, the characteristic(s) can include an identification of the structure(s) upon a placement of an apparatus performing such procedure(s) at, within or near at least one airway portion of the structure(s).
  • the first and second arrangements can form (i) low coherence interferometric system, (ii) optical frequency domain imaging system, and/or (iii) spectral domain optical coherence tomography system.
  • the second electromagnetic radiation(s) can be a plurality of distinct radiation provided from (i) different spatial locations on the structure(s), or (ii) different temporal locations from the structure(s).
  • the characteristic(s) can include a speckle pattern of the portion(s).
  • the characteristic(s) can further include a distribution of a refractive index that is determined based on the speckle pattern.
  • the third arrangement(s) can correlate the speckle pattern with further speckle patterns obtained at different wavelengths or times from the portion(s).
  • the first and second electromagnetic radiations can be wavelength distinct.
  • the second electromagnetic radiation(s) can be a Raman radiation, a scattered light, and/or a fluorescent light.
  • the second arrangement can detects a plurality of the second electromagnetic radiation(s) at different wavelength.
  • the third arrangement(s) can determine the characteristic(s) of the structure(s) that is/are below (i) an epithelium, and/or (ii) mucosa of the airway portion(s).
  • a probe arrangement can be provide, whereas at least a portion of the first arrangement(s) can be part of the probe arrangement.
  • the probe arrangement can be associated with or inserted into a needle arrangement. Further, the probe arrangement can be within a needle of the needle arrangement.
  • the probe arrangement can be associated with or inserted into a tubular arrangement.
  • the tube arrangement can be structured to be inserted into the airway portion(s) transorally, transnasally and/or trascutaneously.
  • the tube arrangement can include an intubation tube, a bougie tube, or a tracheostomy tube.
  • the probe arrangement can include a further apparatus which can be configured to provide an audible signal or a visual signal when the probe arrangement is within or near (or not within or near) the airway portion(s).
  • the first arrangement(s) can also direct the first electromagnetic radiation(s) in a direction that is approximately non-parallel or approximately perpendicular to a long axis of the probe arrangement.
  • the first electromagnetic radiation(s) can impact the structure(s) at a first location.
  • the second electromagnetic radiation(s) can be provided from a second location of the structure(s). The first and second locations can be different from one another.
  • Figure 1 is an exemplary cross-sectional optical frequency domain interferometry ("OFDI") image of swine airway using an exemplary embodiment of a system and a method in accordance with the present disclosure
  • Figure 2 is a set of exemplary OFDI images of a cartilage ring, fat, muscle, and a cartilage ring with connective tissue using an exemplary embodiment of the system and method in accordance with the present disclosure
  • Figure 3A is an original optical domain frequency interferometry ("OFDI") image of a swine trachea using an exemplary embodiment of the system and method in accordance with the present disclosure
  • Figures 3B and 3B are a set of exemplary spectrally encoded endoscopy ("SEE") image reconstructions of the swine trachea obtained ex vivo with clear visualization of the cartilage rings using an exemplary embodiment of the system and method in accordance with the present disclosure;
  • SEE spectrally encoded endoscopy
  • Figure 4 is an exemplary graph of a decorrelation slope of speckle patterns originating from cartilage, fat, muscle, esophagus, and cartilage rings with connective tissue in accordance certain exemplary embodiments of the system and method of the present disclosure
  • Figure 5 is an exemplary graph of data derived from Raman spectra of the trachea ex vivo in accordance with certain exemplary embodiments of the system and method of the present disclosure
  • Figure 6 are exemplary images of excitation-emission matrices for the trachea compared to surrounding tissues obtained using exemplary embodiments of the system and method in accordance with the present disclosure
  • Figure 7A is an exemplary embodiment of the system according to the present disclosure (which can be provided in the form of a needle-based device), and an exemplary application thereof;
  • Figure 7B is a detailed illustration of the exemplary device shown in Figure 7A, and components thereof;
  • Figure 8 is an exemplary flow diagram for a process according to an exemplary embodiment of the present disclosure to identify the trachea using the exemplary device shown in Figures 7A and 7B;
  • Figure 9A is another exemplary embodiment of the system according to the present disclosure (which can be provided in the form of a guidewire-based device), and an exemplary application thereof;
  • Figure 9B is a detailed illustration of the exemplary device shown in Figure 9A, and components thereof;
  • Figure 10 is an exemplary flow diagram for a process according to another exemplary embodiment of the present disclosure to identify the trachea using the exemplary device shown in Figures 9 A and 9B;
  • Figure 1 1 A is still another exemplary embodiment of the system according to the present disclosure (which can be provided in the form of a cannula-based device), and an exemplary application thereof;
  • Figure 1 IB is a detailed illustration of the exemplary device shown in Figure 1 1 A, and components thereof;
  • Figure 12 is an exemplary flow diagram for a process according to another exemplary embodiment of the present disclosure to identify the trachea using the exemplary device shown in Figures 1 1A and 1 I B.
  • Figure 13A is a further exemplary embodiment of the system according to the present disclosure (which can be provided in the form of a transnasal or transoral intubation-tube- based device) , and an exemplary application thereof;
  • Figure 13B is a detailed illustration of the exemplary device shown in Figure 13A, and components thereof.
  • Figure 14 is an exemplary flow diagram for a process according to another exemplary embodiment of the present disclosure to identify the trachea using the exemplary device shown in Figures 13A and 13B.
  • Figure 1 shows an exemplary image of a cross section of an ex vivo swine airway, where the cartilage ring (c), epithelium (e), lamina intestinal (lp), submucosa (sm), and perichondrium (p) using an exemplary embodiment of a system in accordance with the present disclosure can be visualized.
  • a variety of exemplary imaging techniques that can include optical coherence tomography, optical frequency domain imaging, spectral encoding confocal microscopy, and/or spectral encoding endoscopy can be used with a variety of scanning patterns that include linear, raster, circular, spiral, and rosette so as to generate the exemplary image.
  • An exemplary embodiment of such imaging technique can be configured to include a scanning technique such as a microelectromechanical (MEMS) mirror, rotating ( isley) prisms, rotating angle-cleaved lenses, resonant fiber, and rotary fiber.
  • MEMS microelectromechanical
  • Figure 2 shows a set of exemplary OFDI images of a cartilage ring, fat, muscle, and a cartilage ring (with a connective tissue) which illustrate a variation of a refractive index through the tissue types using an exemplary embodiment of the system, method and apparatus in accordance with an exemplary embodiment of the present disclosure.
  • the exemplary cartilage ring is shown to contain a homogeneous band of intensity, followed by a discontinuity and then a lower homogeneous intensity, which compares to a heterogeneous intensity within the fat and muscle.
  • refractive index depth profiling techniques such as optical coherence tomography, optical frequency domain imaging, low-coherence interferometry, spectral encoding endoscopy, and/or spectral encoding confocal microscopy, can be used in the scanning and non-scanning configurations.
  • Figure 3A shows an original optical domain frequency interferometry (“OFDI”) image 310 of a swine trachea using an exemplary embodiment of the system and method in accordance with the present disclosure.
  • Figures 3B and 3B illustrate a set of exemplary spectrally encoded endoscopy (“SEE”) image reconstructions 320, 325 of the swine trachea obtained ex vivo with clear visualization of the cartilage rings using an exemplary embodiment of the system and method in accordance with the present disclosure which can indicate the potential for a similar identification with the exemplary SEE device.
  • SEE spectrally encoded endoscopy
  • the hyaline cartilage within the cartilage rings can result in a mechanically stiffer tissue compared to the surrounding tissue types.
  • This stiffness can be assessed by analyzing exemplary correlation techniques, such as laser speckle imaging, that compare the diffusion of the particles within tissue.
  • Figure 4 shows an exemplary scatter graph of the slope of the speckle pattern decorrelation for cartilage 410, fat 450, muscle 440, esophagus 430, and cartilage rings 420 with connective tissue.
  • the cartilage rings can be differentiated from the other tissue types generated according to an exemplary embodiment of the present disclosure.
  • the decorrelation of the speckle pattern 410 can be much slower in cartilage due to the higher biomechanical stiffness compared to the speckle patterns 420-450 of other tissue types.
  • Each of the tissue types within and surrounding the trachea are made up of various biochemical signatures that can be probed by techniques that measure inelastic scattering, such as Raman spectroscopy.
  • Figure 5 shows an exemplary graph of a fit coefficient of protein 510 and triglycerides 520 along a scan between two cartilage rings generated using the system, method and/or apparatus according to an exemplary embodiment of the present disclosure. For example, as shown in Figure 5, a strong protein signal exists from the rings and a strong triglycerides signal exists from the connective tissue between the rings.
  • An exemplary embodiment of an inelastic scattering technique can fit a library of biochemical signatures within the tissue types.
  • FIG. 6 illustrates a set of exemplary images of excitation-emission matrices for the exterior of the trachea, the lumen of the esophagus, and within fat and muscle from a swine generated using the system, method and/or apparatus according to an exemplary embodiment of the present disclosure.
  • the exemplary trachea images of Figure 6 indicate different excitation and emission patterns compared to the other tissue types and can be used to define specific combinations of excitation and emission patterns to differentiate between the trachea and the other tissue types.
  • the biological components within the tissue also provide unique absorption bands that may be probed with techniques such as diffuse spectroscopy and photoacoustics.
  • One exemplary approach can be to analyze the presence of blood within the region of interest because there is no blood flow within the cartilage rings.
  • Figure 7 A shows an exemplary embodiment of a device 701 according to the present disclosure, which is provided in the form of a needle-based device in this exemplary embodiment
  • Figure 7B illustrates a detailed illustration of the exemplary device shown in Figure 7A, and components thereof.
  • the device 701 can include a light source 702 (e.g., a light emitting diode, laser diode, laser, light bulb, or similar) which can transmit electro-magnetic radiation (e.g., light) along an optical fiber, optical fiber bundle, lens, etc. 703 that runs along the length of the needle 704 to illuminate tissue near a tip 715 of the needle 704.
  • a light source 702 e.g., a light emitting diode, laser diode, laser, light bulb, or similar
  • electro-magnetic radiation e.g., light
  • a lens 705 positioned at the tip of the fiber 703 can focus the electromagnetic radiation in a forward direction through a lumen of the needle 704 or at an angle to illuminate the tissue along the side of the needle 704 through an optical window 706 within a shaft of the needle 704.
  • the returning electro -magnetic radiation from the tissue is converted into an electrical signal with a single detector or series/array of detectors 707.
  • the converted electrical signal can be amplified, digitized, and/or processed using a processing arrangement 708 (e.g., a field-programmable gate array, a graphics processing hardware arrangement, a logic circuit, etc.).
  • the exemplary processing arrangement can transmit an electrical signal produced thereby to, e.g., a visual or audio indicator 709 (e.g., red/green/infrared light, speaker, or the like) when the tip 715 of the needle 704 is outside and/or within the trachea.
  • a visual or audio indicator 709 e.g., red/green/infrared light, speaker, or the like
  • Figure 8 shows an exemplary flow diagram of an exemplary procedure to identify the trachea with the exemplary embodiment of the device shown in Figures 7A and 7B according to an exemplary embodiment of the present disclosure.
  • the needle 704 can be inserted into the neck traveling through the skin, muscle, fat, and thyroid in 810. Then, in 820, the needle approaches/enters the trachea, and the visual or audio indicator 709 is activated upon sensing the appropriate tissue in 830.
  • a signal can be created using the visual or audio indicator 709 when the tip 715 of the needle 704 is located just outside the trachea.
  • a signal can be generated using the visual or audio indicator 709 when the tip 715 of the needle 704 is within the tracheal tissue.
  • the signal can be created with the visual or audio indicator 709 to differentiate when the tip 715 of the needle 704 is between two cartilage rings or going through a cartilage ring.
  • the signal can be generated using the visual or audio indicator 709 when the tip 715 of the needle 704 enters the trachea lumen.
  • the signal can be generated the visual or audio indicator 709 when the tip 715 of the needle 704 is located at the back of the trachea. In according to yet another exemplary embodiment, the signal can be generated using the visual or audio indicator 709 when the tip 715 of the needle 704 is located along the outside of the esophagus. According to a further exemplary embodiment, the signal can be generated using the visual or audio indicator 709 when the tip 715 of the needle 704 enters the esophagus lumen. In another embodiment, a signal will be created with the visual or audio indicator 109 when the needle goes completely through the trachea.
  • the signal can be generated using the visual or audio indicator 709 when the needle 704 misses the trachea. In a still further exemplary embodiment, the signal can be generated using the visual or audio indicator 709 when the tip 715 of the needle 704 is located just outside a blood vessel. In another embodiment, a signal will be created with the visual or audio indicator 109 when the needle is within a blood vessel.
  • Figure 9A shows an exemplary embodiment of a device 901 according to the present disclosure, which is provided in the form of a guidewire-based device in this exemplary embodiment
  • Figure 9B illustrates a detailed illustration of the exemplary device shown in Figure 9A, and components thereof.
  • This exemplary embodiment is similar to the needle- based exemplary device with the optical fiber, optical fiber bundle, lens, or similar housed within a removable guide-wire 902 that fits within the needle 704.
  • a lens positioned at a tip 915 of the fiber 705 can focuses the electro-magnetic radiation (e.g., light) in the forward direction through the lumen of the needle 704 or at an angle to illuminate the tissue along a side of the needle 704 through the optical window 706 within the needle shaft 706.
  • electro-magnetic radiation e.g., light
  • the returning electro-magnetic radiation from the tissue is converted into an electrical signal with a single detector or series/array of detectors 707.
  • the converted electrical signal can be amplified, digitized, and/or processed using a processing arrangement 708 (e.g., a field- programmable gate array, a graphics processing hardware arrangement, a logic circuit, etc.).
  • the exemplary processing arrangement can transmit an electrical signal produced thereby to, e.g., a visual or audio indicator 709 (e.g., red/green/infrared light, speaker, or the like) when the tip 715 of the needle 704 is outside and/or within the trachea.
  • a visual or audio indicator 709 e.g., red/green/infrared light, speaker, or the like
  • Figure 10 shows an exemplary flow diagram of an exemplary procedure to identify the trachea with the exemplary embodiment of the device shown in Figures 9A and 9B according to an exemplary embodiment of the present disclosure.
  • the needle 704 can be inserted into the neck traveling through the skin, muscle, fat, and thyroid in 1010. Then, in 1020, the needle approaches/enters the trachea, and the visual or audio indicator 709 is activated upon sensing the appropriate tissue in 1030.
  • a signal can be created using the visual or audio indicator 709 when the tip 715 of the needle 704 is located just outside the trachea.
  • a signal can be generated using the visual or audio indicator 709 when the tip 715 of the needle 704 is within the tracheal tissue.
  • the signal can be created with the visual or audio indicator 709 to differentiate when the tip 715 of the needle 704 is between two cartilage rings or going through a cartilage ring.
  • the signal can be generated using the visual or audio indicator 709 when the tip 715 of the needle 704 enters the trachea lumen.
  • the signal can be generated the visual or audio indicator 709 when the tip 715 of the needle 704 is located at the back of the trachea. In according to yet another exemplary embodiment, the signal can be generated using the visual or audio indicator 709 when the tip 715 of the needle 704 is located along the outside of the esophagus. According to a further exemplary embodiment, the signal can be generated using the visual or audio indicator 709 when the tip 715 of the needle 704 enters the esophagus lumen. In another embodiment, a signal will be created with the visual or audio indicator 109 when the needle goes completely through the trachea.
  • the signal can be generated using the visual or audio indicator 709 when the needle 704 misses the trachea. In a still further exemplary embodiment, the signal can be generated using the visual or audio indicator 709 when the tip 715 of the needle 704 is located just outside a blood vessel. In another embodiment, a signal will be created with the visual or audio indicator 109 when the needle is within a blood vessel.
  • the guide-wire 902 can be provided through the needle into the trachea.
  • the guide-wire 902 can then be detached from a housing of the needle 704 in 1040, thus leaving the guide-wire 902 in place such that a cannula can slide over the guide-wire 902 into the trachea in 1050.
  • Figure 11A shows an exemplary embodiment of a device 1 101 according to the present disclosure, which is provided in the form of a cannula-based device in this exemplary embodiment
  • Figure 1 IB illustrates a detailed illustration of the exemplary device shown in Figure 1 1 A, and components thereof.
  • the device 1 102 can include a light source 702 (e.g., a light emitting diode, laser diode, laser, light bulb, or similar) which can transmit an electro-magnetic radiation (e.g., light) down an optical fiber, optical fiber bundle, lens, etc. 703 that extends along the length of the cannula 1 102 through a needle 1 103 positioned at a tip of the cannula 1 102.
  • a light source 702 e.g., a light emitting diode, laser diode, laser, light bulb, or similar
  • an electro-magnetic radiation e.g., light
  • a lens positioned at a tip of the fiber 705 can focus the electro-magnetic radiation in the forward direction through a lumen of the needle 1 103 and/or at an angle thereto so as to illuminate the tissue along the side of the needle 1 103 through an optical window within the needle shaft 706.
  • the returning electro-magnetic radiation from the tissue can be converted into an electrical signal using a single detector or a series/array of detectors 707.
  • the converted electrical signal can be amplified, digitized, and/or processed using a processing arrangement 708 (e.g., a field-programmable gate array, a graphics processing hardware arrangement, a logic circuit, etc.).
  • the exemplary processing arrangement can transmit an electrical signal produced thereby to, e.g., a visual or audio indicator 709 (e.g., red/green/infrared light, speaker, or the like) when the tip of the needle 1 103 is outside and/or within the trachea.
  • a visual or audio indicator 709 e.g., red/green/infrared light, speaker, or the like
  • Figure 12 shows an exemplary flow diagram of an exemplary procedure to identify the trachea with the exemplary embodiment of the device shown in Figures 1 1A and 1 IB according to an exemplary embodiment of the present disclosure.
  • the needle 704 can be inserted into the neck traveling through the skin, muscle, fat, and thyroid in 1210. Then, in 1220, the needle approaches/enters the trachea, and the visual or audio indicator 709 is activated upon sensing the appropriate tissue in 1230.
  • a signal can be created using the visual or audio indicator 709 when the tip of the needle 1 104 is located just outside the trachea.
  • a signal can be generated using the visual or audio indicator 709 when the tip of the needle 1 104 is within the tracheal tissue.
  • the signal can be created with the visual or audio indicator 709 to differentiate when the tip of the needle 1 104 is between two cartilage rings or going through a cartilage ring.
  • the signal can be generated using the visual or audio indicator 709 when the tip of the needle 1 104 enters the trachea lumen.
  • the signal can be generated the visual or audio indicator 709 when the tip of the needle 1 104 is located at the back of the trachea.
  • the signal can be generated using the visual or audio indicator 709 when the tip of the needle 1 104 is located along the outside of the esophagus. According to a further exemplary embodiment, the signal can be generated using the visual or audio indicator 709 when the tip of the needle 1 104 enters the esophagus lumen. In another embodiment, a signal will be created with the visual or audio indicator 109 when the needle goes completely through the trachea. In another exemplary embodiment, the signal can be generated using the visual or audio indicator 709 when the needle 704 misses the trachea. In a still further exemplary embodiment, the signal can be generated using the visual or audio indicator 709 when the tip of the needle 1 104 is located just outside a blood vessel. In another embodiment, a signal will be created with the visual or audio indicator 109 when the needle is within a blood vessel.
  • the needle 1103 can be retracted within the cannula or completely removed at 1240, and the cannula 1 102 can be inserted deeper within trachea at 1250. The cannula 1 102 can then be removed, and the tracheostomy tube can be inserted into the trachea.
  • Figure 13A shows an exemplary embodiment of a device 1301 according to the present disclosure, which is provided in the form of a transnasal or transoral intubation-tube- based device in this exemplary embodiment
  • Figure 13B illustrates a detailed illustration of the exemplary device shown in Figure 13 A, and components thereof.
  • This exemplary device 1301 is similar to the cannula-based device 1301 of Figures 1 1A and 1 1B with the optical fiber, optical fiber bundle, lens, or similar housed within an intubation tube 1302 that fits within the oral or nasal cavity.
  • a lens positioned at the tip of the fiber 705 focuses the electro-magnetic radiation in the forward direction through the lumen of the intubation tube or at an angle thereto to illuminate the tissue along the side of the intubation tube 1302 through the a window 1304 within the intubation tube 1302.
  • Figure 14 shows an exemplary flow diagram of an exemplary procedure to identify the trachea with the exemplary embodiment of the device shown in Figures 13A and 13B according to an exemplary embodiment of the present disclosure.
  • the intubation (or Bougie) tube 1302 can be inserted into the mouth or nose in 1410. Then, in 1420, a tip of the intubation tube 1302 approaches/enters in the larynx, and the visual or audio indicator 709 is activated upon sensing the appropriate tissue in 1430.
  • a signal can be generate with the visual or audio indicator 709 when the tube is located within the trachea lumen.
  • the signal can be generated using the visual or audio indicator 709 when the tube 1 102 is located within the esophagus.
  • the signal can be generated using the visual or audio indicator 709 when the tube 1 102 is located within the thyroid cartilage.
  • the signal can be generated using the visual or audio indicator 709 when the tube 1 102 is within the cricoid cartilage.
  • the signal can be generated using the visual or audio indicator 709 when the tube 1 102 reaches the carina.
  • the signal can be generated using the visual or audio indicator 709 when the tube 1 102 is located within the primary bronchi.
  • the exemplary device 1301 When the exemplary device 1301 indicates the tip of the intubation tube 1302 is within the proper location, the exemplary device 1301 can be removed in 1440. A balloon 1303 of the intubation tube 1303 can then be inflated to secure the tubing location within the trachea in 1450. According to another exemplary embodiment, the balloon 1303 can be inflated before the exemplary device 1301 is removed.

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  • Heart & Thoracic Surgery (AREA)
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  • Investigating, Analyzing Materials By Fluorescence Or Luminescence (AREA)
  • Investigating Or Analysing Materials By Optical Means (AREA)
  • Magnetic Resonance Imaging Apparatus (AREA)

Abstract

La présente invention se rapporte à un appareil et à un procédé donnés à titre d'exemple et qui permettent de déterminer des informations qui se rapportent à au moins une structure anatomique. Par exemple, il est possible de transmettre au moins un premier rayonnement électromagnétique à une ou plusieurs structures (par exemple, à l'aide d'au moins un premier agencement), et de détecter au moins un second rayonnement électromagnétique provenant de la structure, ou des structures, qui est basé sur le ou les premiers rayonnements électromagnétiques (par exemple, à l'aide d'au moins un deuxième agencement). Il est également possible de déterminer au moins une caractéristique de la structure ou des structures à l'intérieur de cette dernière ou de ces dernières sur la base du second rayonnement électromagnétique (par exemple, à l'aide d'au moins un troisième agencement). Par exemple, la ou les caractéristiques peuvent comprendre une identification de la structure, ou des structures, lors du placement d'un appareil qui effectue une telle intervention, ou de telles interventions, au niveau d'au moins une partie des voies respiratoires de la structure ou des structures, à l'intérieur de cette partie ou de ces parties ou près de cette partie ou de ces parties.
EP11837098.0A 2010-10-27 2011-10-27 Appareil, systèmes, procédés et support accessible par ordinateur permettant une identification de la trachée Withdrawn EP2632329A2 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US40737210P 2010-10-27 2010-10-27
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WO2017136523A1 (fr) 2016-02-06 2017-08-10 The United States Of America As Represented By The Secretary Of The Army Dispositif de gestion de voies aériennes pour l'identification de tissu trachéen et/ou oesophagien
JP2018094395A (ja) * 2016-11-03 2018-06-21 キヤノン ユーエスエイ, インコーポレイテッドCanon U.S.A., Inc 診断用スペクトル符号化内視鏡検査装置およびシステム、ならびにこれらと共に使用するための方法
WO2019213405A1 (fr) * 2018-05-02 2019-11-07 Canon U.S.A., Inc. Porte-aiguille et/ou appareils d'endoscopie et porte-aiguille et/ou appareils d'endoscopie d'approche directe, et mécanismes de pointe d'aiguille, procédés et supports de stockage pour utilisation avec ceux-ci

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US5400771A (en) * 1993-01-21 1995-03-28 Pirak; Leon Endotracheal intubation assembly and related method
US20040039252A1 (en) * 2002-06-27 2004-02-26 Koch Kenneth Elmon Self-navigating endotracheal tube
US8166967B2 (en) * 2007-08-15 2012-05-01 Chunyuan Qiu Systems and methods for intubation
US8457715B2 (en) * 2009-04-08 2013-06-04 Covidien Lp System and method for determining placement of a tracheal tube

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