USING ACOUSTIC REFLECTOMETRY TO DETERMINE BREATHING TUBE POSITION AND PATENCY

A new technique to guide and determine the patency of tubes placed within the human body was developed using the principles of time domain acoustic reflectometry. An audible sound pulse is introduced into the proximal end of the tube or catheter and the sonic reflections from the tube lumen and body cavity are analyzed to provide patency and position information, respectively. The information can be used to initially place the tube and monitor its position and patency thereafter. A dedicated instrument was developed for use with breathing tubes, known as endotracheal tubes (ETT), that are necessary for the mechanical ventilation of patients. The incident sound pulse is generated and it is measured along with the resulting reflections in a small wave tube connected to the ETT. When the ETT is properly placed in the trachea below the vocal folds, a characteristic reflection from the airways is measured and the timing between the incident pulse and this reflection is used to determine ETT position or movement. The reflection from the discontinuity between the distal ETT tip and the airway is used to estimate the diameter of the airway at this point. In addition, reflections from the ETT lumen are used to generate a profile of the lumen area over the length of the tube. This information allows reliable differentiation between proper and erroneous tube placement, quantification of movement over time, and provides the location and degree of obstructions within the lumen.