BREATHS: A Novel Endotracheal Tube Design to Decrease the Incidence of Tracheal Lesions
Bibliographic record
Abstract
Abstract Background Prolonged intubation is associated with the development of tracheal stenosis due to cuff pressures causing endothelial ischemia, potentially leading to tracheal stenosis at the cuff site. This may result in airway obstructions requiring surgical intervention. Objective to develop a modification to endotracheal tube cuffs to put less pressure against the tracheal walls to decrease the risk of developing post-ventilation tracheal stenosis. Methods A modified endotracheal tube cuff was designed using a double balloon cuff design, with an outer fixed cuff and an inner cuff that expands and deflates with the respiratory cycle. The design allows for the cuff pressure applied to the trachea to be maximal during inspiration and minimal during expiration, coinciding with pressures required to maintain an air seal. Results During inspiration, the pressure on the tracheal wall is equal to that of a standard endotracheal tube. During expiration, the pressure applied on the tracheal walls is less than that of a standard endotracheal tube. The minimal pressure throughout the cycle decreased to baseline throughout the respiratory cycle due to minimal cuff inflation by the end of expiration, as most air is removed. Conclusions The modified cuff demonstrates an overall decreased pressure applied to the trachea, with potential to enable microvascular perfusion, improve blood flow, and decrease risk of tracheal lesions and stenosis. Further testing with more ventilatory conditions, endotracheal tube, tracheal, and lung analog sizes, and in-vivo testing efforts are required to ascertain if this innovation’s clinical benefit.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".