Realtime and noninvasive assessment of endotracheal tube displacement using near-infrared and visible cameras

Endotracheal tube (ETT) intubation is a medical procedure routinely used for achieving mechanical ventilation in critically ill patients. Appropriate ETT placement is crucial as undetected tube migration may cause multiple complications or even fatalities. Therefore, prompt detection of unplanned movement of the ETT and immediate action to restore proper placement are essential to ensure patient safety. Despite this necessity, there is not a widely adopted tool for real-time assessment of ETT displacement. We have developed a device, a dual-camera endotracheal tube or DC-ETT, to address this unmet clinical need. This device uses a near-infrared (NIR) LED and a side-firing optical fiber embedded in the side of an ETT to light up the tracheal tissue and a visible and NIR camera module for the displacement detection. The NIR camera tracks the movement of the NIR pattern on the skin, while the visible camera is used to correct the body movements. The efficacy of the DC-ETT was assessed in two piglets with a linear displacement sensor as reference. A mean discrepancy of less than 0.5 mm between the DC-ETT and reference sensor was observed within a displacement range of ±15 mm. The results suggest that the DC-ETT can potentially provide a simple and cost-effective solution for real-time monitoring of ETT displacements in operating rooms, intensive care units, and emergency departments.