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Researchers develop new device for inserting breathing tubes

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Inventors at Nottingham Trent University are using smart materials to develop a low-cost steerable medical device to help doctors insert a life-saving breathing tube into a patient’s windpipe to provide oxygen in emergency situations.

The steerable endotracheal bougie – which is being developed by a team led by Professor Philip Breedon, a professor of smart technologies at the School of Architecture, Design and the Built Environment - aims to improve the way that doctors insert endotracheal tubes into patients who are in intensive care or under a general anaesthetic.

More than a million of such procedures are carried out in the UK each year, but up to 11 per cent of patients have an airway which is difficult to navigate with a breathing tube, which can leave them at risk of reduced blood-oxygen levels and potential brain damage.

A bougie – a long, flexible rod which doctors insert into a patient’s airway to establish a route for the tube to be guided over – is already used today but existing models have to be routinely removed and reshaped while navigating a patient’s windpipe, which can lead to delays. In some cases it isn’t possible to insert a breathing tube at all.

“What we’ve developed through the use of smart materials is a steerable bougie tip which can be inserted quickly and with a much greater chance of success. The tip can move by more than 120 degrees within a second, which is more than adequate for the clinician’s needs. And it can be fully controlled by one person, which is ideal for the circumstances of an emergency.”

Professor Breedon: Professor of smart technologies - Nottingham Trent University

The design centres on the use of Flexinol, a nickel-titanium shape memory alloy which is used as an artificial muscle. Two Felxinol wires are situated in the disposable bougie casing and when heat is applied to one of the wires via an electric current it shortens, enabling the flexible tip to be steered via a detachable controller.

The research team comprises Professor Breedon, Luke Siena, a postgraduate researcher at the School of Architecture, Design and the Built Environment, and Dr James Armstrong of Nottingham University Hospitals NHS Trust.

“We think that this invention has real potential to fill a unique and sizeable gap in the market. The design is fully compatible with the endotracheal tubes currently used by the NHS and we expect it will be cost-effective to manufacture. Our ultimate aim is for it to be used routinely by clinicians and help improve the way that patients are dealt with in what can be very difficult situations for medical staff.”

Luke Siena

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