Tuesday, 07 November 2023
The University of Nottingham has secured £1.1 million in funding from the Medical Research Council to undertake human trials for the world’s first optical fibre sensor-equipped endotracheal tube (iTraXS).
Seriously ill or anaesthetised patients are unable to breathe naturally, so clinicians often use endotracheal tubes (ETTs), which are placed in the trachea (windpipe) to maintain an open airway and allow the patient to breathe through a mechanical ventilator. To do this, the tube is placed into the airway and a cuff (balloon) is inflated at the trachea to create a gas seal that allows air to be delivered to the lungs effectively. However, incorrect cuff inflation pressure can cause two main problems.
If pressure is too low, it can risk fluid getting past the cuff and causing ventilator-associate pneumonia (VAP). VAP increases the likelihood of death, affecting up to 20% of people in intensive care, and costs the NHS between £10,000 and £20,000 per patient. Conversely, if pressure is too high it can cause a pressure injury in the trachea, ranging from moderate to severe sore throats through to permanent scarring and narrowing of the windpipe.
Professor Steve Morgan, Co-Director of the Centre for Healthcare Technologies and Professor of Biomedical Engineering at the university, said: “Currently, there’s no medical device on the market that can safely and accurately measure and monitor the contact pressure of the cuff and the blood flow in the tracheal lining.
“iTraXS aims to solve this real-world challenge by preventing pressure injuries to the airway and assisting with monitoring these vital signs."
The sensors can identify when the ETT has been incorrectly placed, which if undetected could be potentially fatal. This is an incredibly exciting time for the project as we’re now able to turn our research into reality as we prepare to conduct the first clinical evaluation in 40 adult participants undergoing planned surgery next year.
The concept has already received widespread support from the industry, including an award from the Association of Anaesthetists of Great Britain and Ireland in 2018.
There is a plethora of advantages to introducing technology like this. Not only will it aid those already in hospital, but it could also help when it comes to pre-hospital conditions.
David continued: "For example, it could remove the need for other devices such as oxygen saturation monitors attached to the finger, which can be inconvenient when travelling in an ambulance as well as inaccurate if a patient has low blood pressure. These technologies have the potential to be a real step change in the way we will be able to monitor patients moving forwards.”
iTraXS has been developed in collaboration with P3 Medical Ltd, a Bristol-based manufacturer of endotracheal tubes, and Nottingham University Hospitals NHS Trust (NUH) as well as CHEATA, Bluefrog Design Ltd and Derby Clinical Trials Support Unit.
Dr Andrew Norris, Anaesthetist, Honorary Associate Professor at the University of Nottingham and now based at King Abdullah bin Abdulaziz University Hospital, said: “This project has been a collaborative effort since we received the initial NIHR funding in 2014.2
Now we’re at the point of beginning to coordinate in-person trials, we’re engaging with key opinion leaders to amplify our research. Once the trial is complete, we aim to get the tube CE-marked so that it can be brought to market in the near future.
To read the latest research paper published about iTraXS in Biomedical Optics Express, please click here.
Story credits
More information is available from Steve Morgan, Faculty of Engineering at the University Of Nottingham, at steve.morgan@nottingham.ac.uk or; Danielle Hall, Media Relations Manager at the University of Nottingham, at danielle.hall@nottingham.ac.uk or 0115 846 7156.
About the Faculty of Engineering:
Made up of six departments – Architecture and Built Environment, Chemical and Environmental Engineering, Civil Engineering, Electrical and Electronic Engineering, Mechanical, Materials and Manufacturing Engineering and Foundation Engineering and Physical Sciences – the university’s Faculty of Engineering is home to more than 5,600 students and 800 staff.
The faculty, which has educated engineers and architects for more than 140 years, was the first in the country to be accredited with an Athena SWAN Gold Award for excellence in advancing gender equality across higher education and research and is home to multiple state-of-the-art facilities, including the recently opened £40m Power Electronics and Machines Centre (PEMC).
With research at its heart, 20 research groups are undertaking pioneering projects for a sustainable future across several themes – including net zero transport, sustainable energies and the built environment, advanced manufacturing, and healthcare technologies – and has delivered a positive impact in more than 20 countries. The faculty’s research has benefitted 500 companies and three governments and has also directly created jobs for around 3,000 people across the world.
Notes to editors:
About the University of Nottingham
Ranked 32 in Europe and 16th in the UK by the QS World University Rankings: Europe 2024, the University of Nottingham is a founding member of the Russell Group of research-intensive universities. Studying at the University of Nottingham is a life-changing experience, and we pride ourselves on unlocking the potential of our students. We have a pioneering spirit, expressed in the vision of our founder Sir Jesse Boot, which has seen us lead the way in establishing campuses in China and Malaysia - part of a globally connected network of education, research and industrial engagement.
Nottingham was crowned Sports University of the Year by The Times and Sunday Times Good University Guide 2024 – the third time it has been given the honour since 2018 – and by the Daily Mail University Guide 2024.
The university is among the best universities in the UK for the strength of our research, positioned seventh for research power in the UK according to REF 2021. The birthplace of discoveries such as MRI and ibuprofen, our innovations transform lives and tackle global problems such as sustainable food supplies, ending modern slavery, developing greener transport, and reducing reliance on fossil fuels.
The university is a major employer and industry partner - locally and globally - and our graduates are the second most targeted by the UK's top employers, according to The Graduate Market in 2022 report by High Fliers Research.
We lead the Universities for Nottingham initiative, in partnership with Nottingham Trent University, a pioneering collaboration between the city’s two world-class institutions to improve levels of prosperity, opportunity, sustainability, health and wellbeing for residents in the city and region we are proud to call home.
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