Adjustment of endotracheal tube cuff filling
A method of intubating a subject is disclosed. The method comprises inserting an endotracheal tube into the tracheal airway of the subject; inflating a cuff associated with the endotracheal tube within the airway below the vocal cords; measuring a level of at least one measure being indicative of leakage of secretion past the cuff to the lungs; comparing the level of the measure with an optimal level of the measure; and adjusting inflation of the cuff based on the comparison so as to generally minimize leakage of secretion from above the cuff to the lungs, while minimizing pressure associated damages to the airway. The measure(s) can be carbon dioxide concentration, a proxy measure from which such concentration can be inferred, or the level of one or more additives delivered to a subject during intubation.
1. A method of intubating a subject having an airway ending with lungs and vocal cords, comprising:
inserting an endotracheal tube into the airway;
inflating a cuff associated with said endotracheal tube within the airway below the vocal cords;
delivering a breathing gas through said endotracheal tube into the lungs;
delivering at least one identifiable additive into the lungs or to a location outside said endotracheal tube and outside said cuff;
monitoring a level of said at least one identifiable additive at a monitoring location in the body of the subject, to identify leakage of secretions near said cuff outside said endotracheal tube; and
adjusting inflation of said cuff based on said monitoring so as to generally minimize leakage of said secretions from above said cuff to the lungs, while minimizing pressure associated damages to the airway.
2. The method of claim 1 , wherein said monitoring said level of said at least one identifiable additive comprises performing mass spectrometry.
3. The method of claim 1 , wherein said measuring device comprises a mass spectrometer.
4. The method of claim 1 , wherein said measuring device comprises a gas analyzer.
5. The method of claim 1 , wherein said at least one identifiable additive is characterized by measurable electric properties.
6. The method of claim 1 , wherein said at least one identifiable is characterized by measurable magnetic properties.
7. The method of claim 1 , wherein said at least one identifiable is characterized by measurable optical properties.
8. The method of claim 1 , wherein said at least one identifiable is characterized by measurable radiative properties.
9. The method of claim 1 , wherein said at least one identifiable is characterized by measurable fluorescent properties.
10. The method of claim 1 , wherein said at least one identifiable additive comprises at least one inert gas.
11. The method of claim 1 , wherein said at least one identifiable additive comprises at least one colored gas.
12. The method of claim 1 , wherein said at least one identifiable additive comprises at least one radioisotope.
13. A system for intubating a subject having an airway ending with lungs, comprising:
an endotracheal tube, adapted to be inserted into the airway and being associated with a cuff capable of being inflated below the vocal cords;
a measuring device for measuring at least one measure being indicative of leakage of secretion from above said cuff to the lungs, said at least one measure being other than carbon dioxide concentration between said cuff and said vocal cords; and
an inflating device for adjusting inflation of said cuff based on signals received from said measuring device so as to generally minimize leakage of secretion from above said cuff to the lungs, while minimizing pressure associated damages to the airway, said inflating device being in communication with said measuring device, thereby forming therewith a closed loop control.
14. The system of claim 13 , wherein said measuring device is designed and configured to signal when a level of said at least one measure exceeds an optimal level of said at least one measure.
15. The system of claim 14 , wherein said measuring device comprises a display device for displaying said level of said at least one measure.
16. The system of claim 14 , further comprising an alerting unit being in communication with said measuring device for producing an alert when said level of said at least one measure exceeds said optimal level.
17. The system of claim 13 , further comprising a measuring conduit extending from said measuring device to the airway above the cuff.
18. The system of claim 13 , further comprising a suctioning device operative for suctioning secretions at a suctioning location in the airway above the cuff.
19. The system of claim 18 , wherein said suctioning device is synchronized to operate intermittently with said measuring device.
20. The system of claim 18 , further comprising a suctioning conduit extending from said suctioning device to said suctioning location.
21. The system of claim 13 , further comprising a measuring and suctioning conduit, extending to said suctioning location, said a measuring and suctioning conduit being coupled to said measuring device and said suctioning device so as to facilitate said measuring and said suctioning at said location.
22. The system of claim 13 , wherein said at least one measure comprises acoustical data being indicative of leakage near said cuff outside said endotracheal tube.
23. The system of claim 22 , wherein said measuring comprises calculating frequency difference characterizing said acoustical data, said frequency difference being induced by the Doppler effect.
24. The system of claim 22 , wherein said measuring comprises calculating traveling time of acoustical signals and utilizing said traveling time for determining fluid flow near said cuff.
25. The system of claim 13 , wherein said at least one measure comprises pressure data being indicative of fluid flow near said cuff outside said endotracheal tube.
26. The system of claim 13 , wherein said at least one measure comprises flow data being indicative of fluid flow near said cuff outside said endotracheal tube.
27. The system of claim 13 , wherein said at least one measure comprises optical data being indicative of presence of secretions near said cuff outside said endotracheal tube.
28. The system of claim 13 , wherein said at least one measure comprises electrical characteristics of fluid above said cuff outside said endotracheal tube.
29. A system for intubating a subject having an airway ending with lungs, comprising:
an endotracheal tube, adapted to be inserted into the airway and being associated with a cuff capable of being inflated below the vocal cords;
an additive delivering unit operatively associated with said endotracheal tube and configured to deliver at least one identifiable additive into the lungs or to a location outside said endotracheal tube and outside said cuff;
a measuring device for measuring a level of said at least one identifiable additive; and
an inflating device for adjusting inflation of said cuff based on signals received from said measuring device so as to generally minimize leakage of secretion from above said cuff to the lungs, while minimizing pressure associated damages to the airway, said inflating device being in communication with said measuring device, thereby forming therewith a closed loop control.
30. The system of claim 29 , wherein said measuring device is designed and configured to signal when a level of said at least one identifiable additive exceeds an optimal level of said at least one identifiable additive.
31. The system of claim 29 , wherein said endotracheal tube comprises an additive delivery conduit configured to deliver said at least one identifiable additive.
32. The system of claim 31 , wherein said additive delivery conduit is disposed within a lumen of said endotracheal tube.
33. The system of claim 31 , wherein said additive delivery conduit is externally coupled to or embedded in a wall of said endotracheal tube.