一种用于快速和自我引导插管的软机器人装置

IF 14.6 1区 医学 Q1 CELL BIOLOGY
David A. Haggerty, James R. Cazzoli, Marvin A. Wayne, Christopher J. Winckler, David A. Wampler, Jeffrey L. Jarvis, Lichy Han, Linus Rydell, Aman Mahajan, Jose P. Zevallos, David R. Drover, Elliot W. Hawkes
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引用次数: 0

摘要

气管插管是保护病人气道的一项重要医疗程序。目前的插管技术需要广泛的解剖学知识、训练、技术技能和声门开口的清晰视野。然而,所有这些可能在医院外的创伤和心脏骤停的紧急护理中受到限制,其中首次通过失败的比例接近35%。为了应对这一挑战,我们设计了一种软机器人设备,可以自主引导呼吸管进入气管,目标是实现快速、可重复、安全的插管,而无需大量的培训、技能、解剖学知识或声门视图。在人体模型和尸体上训练有素的用户进行的初始设备测试中,我们发现100%的成功率和平均插管时间低于8秒。然后,我们进行了一项初步研究,将该设备与视频喉镜进行比较,院前医疗提供者通过5分钟的设备培训对尸体进行插管。使用该设备时,用户的一次通过率为87%,总成功率为96%,平均插管次数为1.1次,插管成功时间为21 s,明显快于视频喉镜(P = 0.008)。使用视频喉镜时,用户一次通过成功率为63%,总成功率为92%,平均插管次数为1.6次,插管成功时间为44 s。这项初步研究为未来的临床研究提供了方向,下一步是测试一种设备,可以解决紧急气道管理的关键需求,并帮助插管大众化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A soft robotic device for rapid and self-guided intubation
Endotracheal intubation is a critical medical procedure for protecting a patient’s airway. Current intubation technology requires extensive anatomical knowledge, training, technical skill, and a clear view of the glottic opening. However, all of these may be limited during emergency care for trauma and cardiac arrest outside the hospital, where first-pass failure is nearly 35%. To address this challenge, we designed a soft robotic device to autonomously guide a breathing tube into the trachea with the goal of allowing rapid, repeatable, and safe intubation without the need for extensive training, skill, anatomical knowledge, or a glottic view. During initial device testing with highly trained users in a mannequin and a cadaver, we found a 100% success rate and an average intubation duration of under 8 s. We then conducted a preliminary study comparing the device with video laryngoscopy, in which prehospital medical providers with 5 min of device training intubated cadavers. When using the device, users achieved an 87% first-pass success rate and a 96% overall success rate, requiring an average of 1.1 attempts and 21 s for successful intubation, significantly (P = 0.008) faster than with video laryngoscopy. When using video laryngoscopy, the users achieved a 63% first-pass success rate and a 92% overall success rate, requiring an average of 1.6 attempts and 44 s for successful intubation. This preliminary study offers directions for future clinical studies, the next step in testing a device that could address the critical needs of emergency airway management and help democratize intubation.
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来源期刊
Science Translational Medicine
Science Translational Medicine CELL BIOLOGY-MEDICINE, RESEARCH & EXPERIMENTAL
CiteScore
26.70
自引率
1.20%
发文量
309
审稿时长
1.7 months
期刊介绍: Science Translational Medicine is an online journal that focuses on publishing research at the intersection of science, engineering, and medicine. The goal of the journal is to promote human health by providing a platform for researchers from various disciplines to communicate their latest advancements in biomedical, translational, and clinical research. The journal aims to address the slow translation of scientific knowledge into effective treatments and health measures. It publishes articles that fill the knowledge gaps between preclinical research and medical applications, with a focus on accelerating the translation of knowledge into new ways of preventing, diagnosing, and treating human diseases. The scope of Science Translational Medicine includes various areas such as cardiovascular disease, immunology/vaccines, metabolism/diabetes/obesity, neuroscience/neurology/psychiatry, cancer, infectious diseases, policy, behavior, bioengineering, chemical genomics/drug discovery, imaging, applied physical sciences, medical nanotechnology, drug delivery, biomarkers, gene therapy/regenerative medicine, toxicology and pharmacokinetics, data mining, cell culture, animal and human studies, medical informatics, and other interdisciplinary approaches to medicine. The target audience of the journal includes researchers and management in academia, government, and the biotechnology and pharmaceutical industries. It is also relevant to physician scientists, regulators, policy makers, investors, business developers, and funding agencies.
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