2015 Neonatology Survey:
Top Concerns When Managing an Intubated Infant
Respondents were allowed to mark more than one answer to each question
In fact, 86% of neonatologists are dissatisfied with current endotracheal tube solutions, according to a 2015 Neonatology Survey. There are also enormous clinical, financial and emotional components that complicate the issue and impact not only the hospital and its staff, but the patient and family, too.
Each year, approximately 60 million intubations requiring endotracheal tubes are performed worldwide. Assuring proper placement of the endotracheal tube within the trachea and assuring that it hasn’t moved into a dangerous location or become obstructed are significant clinical problems. Failure to correct a misplaced or clogged endotracheal tube can lead to serious complications, most notably high-risk conditions consistent with lack of oxygen such as brain damage or death.
Common intubation issues include:
AirWave uses sound technology similar to sonar called acoustic reflectometry with innovative piezoelectric technology to monitor the patient’s airway, alerting clinicians in real time of situations that may lead to unplanned extubations, endotracheal tube obstructions, endobronchial intubation, or esophageal intubation.
Using principles similar to sonar, the SonarMed® AirWave™ Monitoring System sends a sound signal into the endotracheal tube and records the returning echoes that reverberate within the tube and patient airways. The timing and amplitude of these echoes are analyzed by the system to non-invasively measure:
The system analyzes the echo that comes from the tube tip to estimate the size of the passageway relative to tube diameter. This information helps clinicians identify and correct esophageal intubation and endobronchial intubation.
The system analyzes the timing and amplitude of echoes that come from within the tube to estimate the location and size of obstructions. This information helps clinicians identify an obstruction that forms in the endotracheal tube so it can be removed (suctioned) before the patient is harmed. It may also help the clinician differentiate tube kinking from lung secretion buildup by determining the location of the obstruction. Suctioning to remove obstructions is invasive and can result in serious physical conditions, such as infection and retinopathy caused by damaged blood vessels, and psychological effects such as ischemic brain injury due to hypoxemia (abnormally low level of oxygen in the blood) and hypercarbia (abnormally elevated carbon dioxide levels in the blood). If an obstruction is not cleared, it can cause brain damage, breathing failure, and death. The ability to confidently know the tube is clear of secretions helps clinicians best care for their patients.
The system identifies movements of the tip of the tube by tracking the timing of an echo that comes from within the lungs. This information helps clinicians identify and correct situations that can lead to unplanned extubation or endobronchial intubation.
The AirWave monitor is a handheld, portable device with a color LCD display that provides information about the endotracheal tube position, obstruction, and movement. The monitor has sophisticated circuitry for sending, receiving and processing audio signals from the AirWave sensor. SonarMed’s proprietary algorithms interpret the signals received from the patient’s airway and provide feedback to the clinician through intuitive text and graphics.
The AirWave sensor is a small, latex-free, single-patient use disposable device that inserts into the breathing circuit between the ventilator hose and the endotracheal tube. The AirWave sensor contains an array of acoustic sensors (speaker and a microphone array) used for interrogating the artificial airway and communicates with the AirWave monitor through a cable. The AirWave sensor can be connected to endotracheal tube sizes 2.5 to 9.0 mm.
Swivel & tilt mounting bracket to provide flexibility for positioning the monitor near the patient bedside. The bracket is designed to quickly attach to the back of the AirWave monitor. It allows the monitor to be mounted to a round pole (such as an IV stand), or a rectangular rail (such as those found on many ventilators). The bracket also rotates easily between vertical and horizontal orientations, and allows the monitor to be positioned to an optimum viewing angle.
Mounting pole to provide even more options for placing it at the patient bedside or attaching to a ventilator.
Hanging strap for carrying or hanging the unit and a kickstand for propping the unit on a cart or table.
The AirWave easily integrates with standard equipment in hospital ICU/NICU/PICUs, operating rooms, and emergency departments, including all major mechanical ventilation systems, any brand of endotracheal tube, in-line suction catheters, flow sensors and ETC02.
AirWave has been evaluated in several studies, demonstrating efficacy in providing direct, precise, real-time monitoring of endotracheal tube position, movement and obstructions.
AirWave received U.S. FDA 510(k) clearance in 2010 for indication in adults and in 2016 for neonate (pediatric) patients.
Journal of Critical Care
Novel device (AirWave) to assess endotracheal tube migration: A pilot study
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Society for Critical Care Medicine
Measuring ETT carina distance using the AirWave device in patients identified as a difficult airway
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Respiratory Therapy, The Journal of Pulmonary Technique
Assessment of Endotracheal Tube Obstruction Using a Test Lung Simulator and Sound Wave Technology
AARC 2012 Poster Session Presentation
Sonarmed AirWave ability to monitor endotracheal tube displacement when used during airway pressure release ventilation
AirWave continuously provides information related to endotracheal tube movement, position and obstruction.
Information is in real-time to assist clinicians in better monitoring their patients.
AirWave provides critical information enabling clinicians to improve the care of intubated patients.
Intuitive, easy-to-use interface displays, graphics, alarm configurations and user instructions help clinicians easily learn how to use AirWave.
AirWave is a small handheld, portable device that seamlessly integrates with clinicians’ current airway management workflow, including all major mechanical ventilation systems and any brand of endotracheal tube.
Studies show that AirWave demonstrates efficacy in providing direct, precise, real-time monitoring of endotracheal tube position, movement and obstructions, which may also result in improved patient safety and quality of care, including lower rate of unplanned extubations, fewer chest x-rays, lower rates of infections, and improved secretion management and suctioning practices.
AirWave may decrease complications associated with ventilation, potentially decreasing the length of a hospital/ICU stay, which reduces costs for both hospitals and patients.
Additional sources of savings may include reduced mechanical ventilation time, reduced chest x-rays, and reduced procedures such as suctioning and bronchoscopy and reduced therapeutic expenses.
2015 Neonatology Survey:
Most Attractive Features/Benefits of SonarMed AirWave
