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Abstract

Endotracheal tube intubation is the third most frequent procedure, performed approximately 13-20 million times yearly in the United States (Mosier et al., 2020). Despite the regularity of the procedure, intubation-related complications such as tracheal injuries, laryngeal injuries, and ventilator-associated pneumonia are ubiquitous due to improper cuff pressure management methods (Ganti et al., 2018). Current techniques, such as the pilot balloon and minimal leak technique, have proven ineffective and inconsistent in managing pressure. As a result, over 71.6% of intubation patients have abnormally high cuff pressures (Ramírez, 2014). Therefore, the purpose of this research was to design an endotracheal tube with automated cuff pressure modulation synced with the respiratory cycle. Increasing and decreasing cuff pressures as patients inspire and expire should theoretically relieve pressure placed on the trachea during intubation and reduce many of the complications associated with endotracheal tubes. The device was designed using two pressure sensors to evaluate the instantaneous pressure and cuff pressure, two DC motors to inflate and deflate the cuff, and an Arduino microcontroller to control the units. To test the device for its functionality, intubation was simulated by blowing into the tube. The results found that the endotracheal tube successfully automatically modulated the cuff pressure to pressures of 25 cmH₂O and 14-15 cmH₂O with the respiratory cycle. Therefore, the presented proof-of-concept design to modulate the cuff pressure of endotracheal tubes is a viable solution to reduce intubation-related injuries.

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