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    • 专利摘要:
    system and method for positioning a naso/orogastric feeding tube and a disposable naso/orogastric feeding tube, comprises a system for positioning a naso/orogastric feeding tube (99). the system (100) comprises an interface adapted to receive a combined impedance measurement, comprising a plurality of impedance readings from a plurality of impedance sensors disposed in a plurality of segments along a side surface of a naso/ orogastric (99), characterized in that one of the plurality of segments is located at least 1 centimeter above the other of the plurality of segments, when the naso/orogastric feeding tube (99) is in a feeding position, a storage code (106) for storing a code, a processor (107) coupled to the interface and the program store for implementing the stored code, the code comprising a code for calculating an estimate of a position of the naso/orogastric feeding tube (99 ), according to the combined impedance measurement, and the code to generate instructions to a caregiver to relocate the naso/orogas feeding tube tric (99), according to the estimate.
    公开号:BR112016021137B1
    申请号:R112016021137-5
    申请日:2015-03-12
    公开日:2021-08-17
    发明作者:Liron Elia；Gavriel J. Iddan
    申请人:Art Healthcare Ltd；
    IPC主号:
    专利说明:

    HISTORIC
    [001] The present patent application, in some respective applications, refers to the feeding system and method and, more particularly, but not exclusively, to systems and methods to guide a placement of a naso/orogastric feeding tube and monitoring of naso/orogastric feeding tube feeding events.
    [002] Naso/orogastric feeding, as well as esophageal, gastric, duodenal and/or enteral feeding, is a form of feeding and/or metabolic support in which nutrient or drug formulas are provided to the gastrointestinal tract, stomach, duodenum or to the jejunum. In most cases, nutrient delivery is achieved through the use of a tube located in the device or system, delivering the nutrient through the patient's pharynx and esophagus directly into the stomach, duodenum, or jejunum. One of the difficulties of naso/orogastric feeding is the increased occurrence of aspiration pneumonia caused by stomach reflux contents that rise to the pharynx due to incorrect initial positioning of the patient's feeding tube or migration tube during feeding.
    [003] A common preventive measure against the reflux of stomach contents has been to elevate the patient's upper body in a semi-reclined position (approximately 45°), thus reducing the rise of gastric material from the esophagus to the pharynx and lungs. SUMMARY
    [004] According to some applications of the present patent application, a system for positioning a naso/orogastric feeding tube is provided. The system comprises an interface adapted to receive a combined impedance measurement, comprising a plurality of impedance readings from a plurality of impedance sensors disposed in a plurality of segments along a side surface of a naso/orogastric feeding tube, characterized in that one of the plurality of segments is located at least 1 centimeter above the other of the plurality of segments when the naso/orogastric feeding tube is in a feeding position, a code store for storing a code, a processor coupled to the interface and program storage to implement the stored code, the code comprising: code to calculate an estimate of a naso/orogastric feeding tube position according to the combined impedance measurement, and code to generate instructions for a caregiver to relocate the naso/orogastric feeding tube according to the estimate. The.
    [005] Optionally, one of the plurality of segments is located in the lower esophageal sphincter (LES|lower esophageal sphincter) when the naso/orogastric feeding tube is in a feeding position in the esophagus and another among the plurality of segments is at least 1 cm above the LES when the naso/orogastric feeding tube is in the feeding position.
    [006] Optionally, the system comprises a man-machine interface (MMI|man machine interface) to present the instructions.
    [007] Optionally, the stored code also comprises a code to detect unwanted migration of the naso/orogastric feeding tube, characterized in that the instructions are instructions to present an alert to indicate to the caregiver to relocate the naso/orogastric feeding tube .
    [008] Optionally, the stored code also comprises a code to detect a reflux while the naso/orogastric feeding tube is in the feeding position, characterized in that the instructions are instructions to present an alert to indicate to the caregiver about the reflux .
    [009] Optionally, the stored code further comprises a code to detect when the naso/orogastric feeding tube is in the feeding position according to the combined impedance measurement.
    [0010] More optionally, the stored code further comprises a code that in response to detection performs at least one of the presentation instructions of a user interface, allowing the caregiver to initiate a feeding process using the feeding tube naso/orogastric and automatically instructing a feeding machine to start the feeding process.
    [0011] Optionally, the system further comprises a fluid source that is mechanically connected at least to the elastic body of the esophagus mounted on the naso/orogastric feeding tube. The stored code further comprises a code to monitor the matched impedance measurement, a code to detect an intervention event according to a change in the matched impedance measurement, a code to forward inflate or deflate instructions to the fluid source in response to detection of the intervention event.
    [0012] Optionally, the system also comprises a display that is electronically connected to the processor. The stored code further comprises a code to monitor the matched impedance measurement, a code to detect an intervention event according to the change in the matched impedance measurement, and a code to forward instructions to present an alert in response to the detection of the intervention event.
    [0013] Optionally, the stored code further comprises a code to detect a displacement of at least part of the naso/orogastric feeding tube in the trachea, according to the combined impedance measurement, and a code to forward instructions for displaying an alert in response to detection of displacement.
    [0014] Optionally, the instructions comprise instructions for pushing the naso/orogastric feeding tube and instructions for pulling the naso/orogastric feeding tube after a location of the plurality of segments in the stomach is estimated based on the combined impedance measurement .
    [0015] Optionally, the stored code further comprises a code to monitor the combined impedance measurement, a code to detect an intervention event, according to the change in the combined impedance measurement, and a code to forward instructions to regulate a feed rate in response to detection of the intervention event.
    [0016] Optionally, each of the plurality of impedance sensors is a pair of electrodes.
    [0017] More optionally, each pair of electrodes is a portion of a wire exposed by at least one recess in a side surface of the naso/orogastric feeding tube.
    [0018] Optionally, at least one of the plurality of segments comprises at least three electrodes that are circumferentially arranged in the respective segment around a perimeter of the naso/orogastric feeding tube, characterized by each one of the plurality of impedance sensors in the respective segment comprise an electrode pair of at least three electrodes.
    [0019] According to some applications of the present patent application, a method for positioning a naso/orogastric feeding tube is provided. The method comprises inserting a naso/orogastric feeding tube with a plurality of impedance sensors disposed in a plurality of segments along a side surface of the naso/orogastric feeding tube into a patient's esophagus; characterized in that one of the plurality of segments is located in the lower esophageal sphincter (LES) when the naso/orogastric feeding tube is in a feeding position in the esophagus and another of the plurality of segments is at least 1 centimeter above of the LES, receiving a plurality of impedance readings from the plurality of impedance sensors, calculating an estimate of a position of the naso/orogastric feeding tube in accordance with the plurality of impedance readings, and generating instructions for a caregiver to relocate the tube of naso/orogastric feeding according to the estimate.
    [0020] According to some applications of the present patent application, a disposable naso/orogastric feeding tube is provided. The disposable naso/orogastric feed tube comprises a naso/orogastric feed tube and a plurality of impedance sensors disposed in a plurality of segments along a side surface of the naso/orogastric feed tube. One of the plurality of segments is located in the lower esophageal sphincter (LES) when the naso/orogastric feeding tube is in a feeding position in the esophagus and another of the plurality of segments is at least 1 centimeter above the LES when the naso/orogastric feeding tube is in the feeding position.
    [0021] Optionally, each of the plurality of impedance sensors is on a pair of electrodes.
    [0022] More optionally, each pair of electrodes is a portion of a wire exposed by a recess in a side surface of the naso/orogastric feeding tube.
    [0023] Optionally, at least one of the plurality of segments comprises at least three electrodes that are circumferentially arranged in the respective segment around a perimeter of the naso/orogastric feeding tube, characterized by one of the The plurality of impedance sensors in the respective segment comprise an electrode pair of at least three electrodes.
    [0024] Unless defined otherwise, all technical and/or scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which the present patent application belongs. Although methods and materials similar or equivalent to those described herein can be used in practice or testing applications of the present application, exemplary methods and/or materials are described below. In case of conflict, the patent specification, including definitions, will prevail. Furthermore, the materials, methods and examples are illustrative only and are not intended to be necessarily limiting. BRIEF DESCRIPTION OF THE DIFFERENT VIEWS OF THE DRAWINGS
    [0025] Some applications of the present patent application are described here, as an example only, with reference to the attached drawings. With specific reference now to the detailed drawings, it is emphasized that the features shown are exemplary and for purposes of illustrative discussion of the applications of the present patent application. In this regard, the description taken with the drawings makes it apparent to those skilled in the art how the applications of the present patent application can be practiced. In the drawings:
    [0026] Figure 1 is a schematic illustration of a part of a naso/orogastric feeding tube with a plurality of impedance sensors to detect the positioning of the naso/orogastric feeding tube in the esophagus and/or a reflux in the esophagus and a control device which is electronically connected to impedance sensors, according to some applications of the present patent application.
    [0027] Figure 2 is an exemplary tip of a naso/orogastric feeding tube and the location of electrodes functioning as exemplary impedance sensors in it, according to some applications of the present patent application.
    [0028] Figures 3A-3C are exemplary electrodes functioning as exemplary impedance sensors, according to some applications of the present patent application.
    [0029] Figure 4 is a flowchart representing combined impedance measurement readings by threaded electrodes along the naso/orogastric feeding tube during a process of detecting a naso/orogastric feeding tube positioning in the esophagus, according to some applications of the present patent application.
    [0030] Figure 5A is a flowchart of a process for detecting a naso/orogastric feeding tube positioning in the esophagus based on a combined impedance measurement measured by sensors in two segments in the naso/orogastric feeding tube, according to with some applications of the present patent application.
    [0031] Figure 5B is a flowchart of a process of detecting intervention events during a feeding period based on a combined impedance measurement, for example, the combined impedance measurement as measured in figure 5A, according to some applications of the present patent application.
    [0032] Figures 6A-6I are exemplary images of the caregiver's instructions and alerts which are presented during a positioning process (for example, figure 5A) and/or monitoring process (for example, figure 5B) of according to some applications of the present patent application.
    [0033] Figures 7A-7D are exemplary combined impedance measurements measured at different events performed during the positioning of a naso/orogastric feeding tube of a naso/orogastric feeding device and monitoring impedance near the naso/orogastric feeding tube in real patients, according to some applications of the present patent application.
    [0034] Figure 8 is an X-ray image mirroring the location of the naso/orogastric feeding tube of a naso/orogastric feeding device used to measure the impedance measurements depicted in Figures 7C-7D. DETAILED DESCRIPTION
    [0035] The present patent application, in some respective applications, refers to the feeding system and method and, more particularly, but not exclusively, to the systems and methods to guide the placement of a naso/orogastric feeding tube and monitoring of feeding events from the naso/orogastric feeding tube.
    [0036] According to some applications of the present inventions, methods and systems for positioning a naso/orogastric feeding tube are provided based on a real-time analysis of sensor readings, such as impedance sensors that are eliminated to sense the digestive system response in at least two of the segments along the surface of the naso/orogastric feeding tube. For example, the combined impedance measurement that includes impedance readings from different segments along the surface of the naso/orogastric feeding tube is analyzed to determine if the lower segment is in the lower esophageal sphincter (LES), in the esophagus and/ or in the stomach. Optionally, the distance between the segments (for example, between the boundaries of each segment, for example, limits determined by the sensitive areas of the sensors) is at least 1 centimeter (cm), for example 1-5 cm or 4-5 cm or any intermediate value.
    [0037] Optionally, each sensor is a pair of electrodes. The electrodes are optionally pieces of wire threaded along the naso/orogastric feeding tube and exposed to the area around the naso/orogastric feeding tube through recesses. Optionally, electrodes are arranged circumferentially around the perimeter of the naso/orogastric feeding tube segment (eg, an annular segment). This allows detecting a displacement of the naso/orogastric feeding tube in the trachea. Optionally, the system includes presentation means such as a display to present instructions and/or alerts during the positioning process and based on a combined measurement that combines sensor readings from different segments, for example, combined impedance measurement. The display should instruct the user to push or pull the naso/orogastric feeding tube toward or from a feeding position. In use, after the naso/orogastric feeding tube is placed in the feeding position, feeding must be started and a monitoring process that is based on sensor readings can be initiated.
    [0038] According to some applications of the present patent application, methods and systems for monitoring a naso/orogastric feeding tube are provided based on a real-time analysis of sensor readings, such as impedance sensors that are eliminated to sense a digestive system response in at least two segments along the surface of the naso/orogastric feeding tube. For example, a combined impedance measurement that includes impedance readings from different segments along the surface of the naso/orogastric feeding tube is analyzed to determine if the lower segment or any other part of the naso/orogastric feeding tube has moved after be positioned in a feeding position. Optionally, the distance between the segments (for example, between the boundaries of each segment, for example, the boundaries determined by the sensor sensing areas) is at least 1 centimeter (cm), for example 1-3 or 3- 4 cm or any intermediate value. Optionally, a real-time analysis of a combined impedance measurement is conducted to identify backflow. When an intervention event, such as a desired movement of the naso/orogastric feeding tube or reflux is detected, automatic measurement can be instructed by a control unit implementation to the monitoring, for example, instructing the presentation of an alert, instructing changing pressure in an elastic body used to block backflow, and/or instructing the operation of values and/or the feed machine to control a feed flow rate.
    [0039] According to some applications of the present inventions, a naso/orogastric feeding tube is provided with impedance sensors electrically connected to a control unit to determine, based on a combined measurement that combines impedance readings from the impedance sensors , a current position, a reset and/or a presence or absence of reflux. Such determination allows a control unit to instruct and/or alert the caregiver in real time, preventing or reducing the risk of naso/orogastric feeding phylogenies, such as displacement tube, overfeeding, movement tube and/or the like.
    [0040] Before explaining at least one application of the present patent application in detail, it should be understood that the present patent application is not necessarily limited in its applications to the construction details and disposition of the components and/or methods set out in the description below and/or illustrated in the drawings and/or the examples. The present patent application is capable of other applications or of being practiced or carried out in various ways.
    [0041] The present patent application can be a system, a method and/or a computer program product. The computer program product must include a computer-readable storage medium (or media) with computer-readable program instructions thereon to cause a processor to carry out aspects of the present application.
    [0042] The computer-readable storage medium may be a tangible device that can hold and store instructions for use by an instruction execution device. The computer-readable storage medium may be, for example, but not limited to, an electronic storage device, a magnetic storage device, an optical storage device, an electromagnetic storage device, a semiconductor storage device, or any suitable combination of the above. A non-exhaustive list of more specific examples of computer-readable storage media includes the following: a portable computer floppy disk, a hard disk, a random access memory (RAM|Random Access Memory), a read-only memory (ROM| Read -Only Memory), an erasable programmable read-only memory (EPROM|Erasable Programmable Read-Only Memory), a static random access memory (SRAM|Static Random Access Memory), a portable compact disk memory-only read-only (CD-ROM|Portable Compact Disc Read-Only Memory), a digital versatile disk (DVD|Digital Versatile Disk), a memory card, a floppy disk, a mechanically encoded device such as punched cards or raised structures in a slot with instructions remembered in it, and any suitable combination of the above. A computer-readable storage medium, as used here, should not be constructed as transient signals per se, such as radio waves or other electromagnetic waves propagating freely, electromagnetic waves propagating through a waveguide or other transmission media (for example , light pulses passing through a fiber optic cable), or electrical signals transmitted through a wire.
    [0043] The computer-readable program instructions described here can be downloaded to a respective computer/processing device from a computer-readable storage medium or to an external computer or external storage device via a network, for example, the Internet, a local area network, a wide area network, and/or a wireless network. The network may comprise copper transmission cables, optical transmission fibers, wireless transmission, routers, firewalls, switches, gateway computers and/or edge servers. A network adapter or network interface card in each computing/processing device receives computer-readable program instructions from the network and directs to the computer-readable program instructions for storage on a computer-readable storage medium within the respective device. computing/processing.
    [0044] The computer-readable program instructions to perform operations of the present patent application can be assembled instructions, instruction set architecture (ISA|Instruction-Set-Architecture), instruction machine, dependent instruction machine, microcode , firmware instructions, state definition data, or even source code or object code written in any combination of one or more programming languages, including an object oriented programming language such as Smalltalk, C++ or similar, and languages procedural programming, such as the “C” programming language or similar programming languages. Computer-readable program instructions can run entirely on the user's computer, partially on the user's computer, as a standalone software package, partially on the user's computer, and partially on a remote computer, or entirely on the remote computer or server. In the last scenario, the remote computer can be connected to the user's computer through any type of network, including a local area network (LAN|Local Area Network) or a wide area network (WAN|Wide Area Network), or the connection can be made to an external computer (eg over the internet using an Internet Service Provider). In some applications, including electronic circuits, for example, programmable logic circuits, programmable field gate arrays (FPGA|Field-Programmable Gate Arrays), or programmable gate arrays (PLA|Programmable Logic Arrays) can execute program readable instructions by using computer-readable program instruction state information to customize the electronic circuitry in order to carry out aspects of the present application.
    [0045] Aspects of the present patent application are described herein with reference to flowchart illustrations and/or block diagrams of methods, apparatus (systems), and computer program product according to applications of the present application of invention. It will be understood that each block of the flowchart illustrations and/or block diagrams, and combinations of blocks in the flowchart illustrations and/or block diagrams, can be implemented by computer readable program instructions.
    [0046] These computer-readable program instructions may be provided to a general purpose computer processor, special purpose computer, or other programmable data processing apparatus to produce a machine, such as the instructions, which executes through the computer processor or other programmable data processing apparatus, create means to implement the functions/acts specified in the flowchart and/or block of block-to-block diagrams. Such computer-readable program instructions may also be stored on a computer-readable storage medium that can direct a computer, programmable data processing apparatus, and/or other devices to function in a particular manner, such as the computer-readable medium. computer readable storage with instructions stored therein comprises an article of manufacture including instructions that implement aspects of the function/act specified in the flowchart and/or block of block-to-block diagrams.
    [0047] Computer-readable program instructions may also be loaded into a computer, other programmable data processing apparatus, or other device to cause a series of operational steps to be performed on the computer, other programmable apparatus, or other device to produce a computer implemented process, such that instructions that execute on the computer, other programmable apparatus, or other device implement the functions/acts specified in the flowchart and/or block of the block block diagrams.
    [0048] The flowchart and block diagrams in the figures illustrate the architecture, functionality and operation of possible implementations of computer program systems, methods and products, according to various applications of the present patent application. In this regard, each block in the flowchart or block diagrams must represent a module, segment, or part of instructions that comprises one or more executable instruction(s) to implement the logical function(s) specified(s). In some alternative implementations, the functions observed in the block may occur outside the order observed in the figures. For example, two blocks shown in succession might actually run substantially simultaneously, or the blocks might sometimes run in reverse order, depending on the functionality involved. It should also be noted that each block of block diagrams and/or flowchart illustration, and combinations of blocks in block diagrams and/or flowchart illustration, can be implemented for special purposes based on hardware systems that perform the specific functions or acts or perform special-purpose combinations of computer hardware and instructions.
    [0049] Reference is now made to figure 1, which is a schematic illustration of a system 100 with a control unit 101 that is electrically connected to impedance sensors in a plurality of segments, for example, see some or all of 110- 113, mounted on a naso/orogastric feeding tube 99 and adapted to guide a caregiver through a positioning process and/or manage intervention events during the monitoring procedure, according to some applications of the present patent application. The naso/orogastric feeding tube 99 is located in a feeding position in the esophagus. A control unit 101 guides and/or monitors according to the combined impedance measurement that matches the reading of the impedance sensors. A control unit can be a panel with one or more mechanical values to control the feed rate via a feed tube connected between the naso/orogastric feed tube 99 and the feed machine. During positioning, the combined impedance measurement allows a control unit 101 to instruct a caregiver how to manipulate the naso/orogastric feeding tube 99 to a feeding position in the esophagus. During monitoring, the combined impedance measurement allows a control unit 101 to automatically detect the positioning and/or movement of the naso/orogastric feeding tube 99 into the esophagus and/or reflux into the esophagus. A control unit 101 may include or be connected to a human-machine interface (MMI) 105, as well as a screen, e.g., a touch screen, and includes a code store 106 for storing a code to implement the described processes. below by a processor 107. A control unit 101 is optionally electrically connected to some or all of the 110-113 impedance sensors in a disposable naso/orogastric feed tube 99 via a communication interface such as an outlet . The control unit 101 is to be implemented as a measurement circuit with at least the processor, memory of one or more microcontroller(s). The 110-113 impedance sensors must be embedded in the 99 disposable naso/orogastric feeding tube or provided in a sheath placed on a feeding tube. When 110-113 impedance sensors are in a sheath, a regular feed tube can be used.
    [0050] The control unit 101 and/or the system and/or the impedance sensors are optionally as defined in International Patent Publication Number WO2011092701 which is incorporated herein by reference. Naso/orogastric feeding tube 99 having an internal lumen (not shown) for delivering nutrients, microorganisms, water and/or medication. The naso/orogastric feeding tube 99 is the size and shape of any commonly used naso/orogastric feeding tube, for example, a naso/orogastric feeding tube, a naso-esophageal catheter, a gastric feeding tube such as a tube nasal gastric feeding tube, a duodenal feeding tube and an enteral feeding tube. The naso/orogastric feeding tube 99 is sized and shaped to be disposed within the esophagus so that a respective distal end is placed in the lumen of a patient's stomach. Optionally, naso/orogastric feeding tube 99 comprises a small diameter flexible tube preferably made of clear plastic such as Polyvinyl Chloride or silicone. The length of the naso/orogastric feeding tube 99 is adjusted or selected according to the size of a specific patient. For example, a naso/orogastric feeding tube is greater than 120 cm long for a 14 Fr tube for adults and a naso/orogastric feeding tube for children is greater than 40 cm long for the 5 Fr tube.
    [0051] As described above, the naso/orogastric feeding tube 99 further comprises one or more impedance sensor(s) (at least in segments 111-112) to detect the impedance in a number of segments along the 99 naso/orogastric feeding tube and the esophagus. For example, while one or more impedance sensor(s) is/are interchangeably arranged (or mounted) to be located in the lower esophageal sphincter ( LES) when the naso/orogastric feed tube 99 is in a feed position, one or more other impedance sensor(s) is mounted to be located by the less than 2 centimeters above the LES when the naso/orogastric feeding tube 99 is in the feeding position. In use, when placed in the esophagus, the control unit 101 generates a combined impedance measurement to detect the positioning and/or movement of the naso/orogastric feeding tube in the esophagus and/or a reflux into the esophagus based on the reading of the sensors of impedance (at least in segments 111-112), for example, as described below.
    [0052] Optionally, one or more elastic body(s) of the esophagus having an adjustable volume, for the case of a pressure-dependent volume, such as balloons, is(are) positioned along the tube / orogastric power supply 99 and mechanically connected to be inflated or deflated by a fluid source such as a pump assembly or a pressure tank controlled by control unit 101. By For the sake of brevity, one or more elastic esophageal body(s) is (are) referred to herein as the elastic esophageal body 115. The elastic esophageal body 115 may be connected to a distal end of one or more air-carrying tube(s) to inflate and/or deflate the elastic body of the esophagus 115. The proximal end of the air-carrying tube is optionally connected to the fluid source that inflates the elastic body of the esophagus 115 based on the instructions of the control unit 101. Optionally, the elastic body of the esophagus 115, which is connected to the connecting tube, it is connected to the pressure tank which releases or increases pressure at high speed to deflate or inflate the elastic body at high speed, for example, as further described below. Optionally, the fluid source is a bidirectional pump set that makes it possible to inflate or deflate the elastic body of the esophagus 115. Optionally, when using the pressure tank, the deflation or inflation of the elastic body is controlled through the adaptation of the pressure tank fluid rate.
    [0053] Optionally, each impedance sensor includes a pair of electrodes along a line transverse to the longitudinal axis of the naso/orogastric feed tube 99 or located parallel to the longitudinal axis of the naso/orogastric feed tube 99.
    [0054] Pair(s) of electrodes are located in different segments where one segment is located above another segment, for example, so that at least 2 centimeters (cm) separate the electrodes in a segment of electrodes on another segment, eg 3cm, 4cm or any intermediate or longer distance, see eg Figure 2 which depicts segment 151 and segment 152 in dashed line squares. The lower segment 152 is located to be placed in the LES when the naso/orogastric feeding tube 99 matches the feed content and may be referred to here as an LES segment. The upper segment 151 is located to lie above the LES when the naso/orogastric feeding tube 99 carries the feed contents and may be referred to here as an esophageal segment 151.
    [0055] Optionally, each impedance sensor 102 includes one or more annular or helical electrode(s), for example, as shown in Figures 3C. Optionally, each impedance sensor 102 includes two or more strip electrodes, optionally parallel, that are circular and divided in shape placed around a common segment of naso/orogastric feeding tube 101.
    [0056] Optionally, the electrodes are segments of threads threaded along the naso/orogastric feeding tube 101, for example, as pictured in figures 3A and 3B or conductive elements connected to the threaded wires. In such applications, wires are threaded into the naso/orogastric feeding tube 99, for example, into channels that are formed therein; see also Figures 8 and 9A and 9B of International Patent Publication Number WO2011092701 which is incorporated herein by reference. In order to enable sensors formed along the wires to detect changes in impedance around the naso/orogastric feeding tube 99, for example, in the lumen of the esophagus, openings such as cuts, optionally longitudinally, are formed in one or further locations along the channels, optionally at different heights with reference to the end 120 of the naso/orogastric feeding tube 99, see, for example, figures 3A to 3B. In use, the wires that are framed above the surface of the naso/orogastric feeding tube 99 (eg, figure 3A) allow direct contact with the walls of the esophageal lumen. The wires that are located in the recesses formed in the surface of the naso/orogastric feeding tube 99 (eg figure 3B) make it possible to detect a presence of GI fluids around them. Both types of sensors detect impedance changes in different segments of the naso/orogastric feeding tube 101.
    [0057] Optionally, each electrode covers an area of approximately 1mm2 and 150mm2. Optionally, between 2 and 20 electrodes are used in each 110-113 impedance sensor. Optionally, the distance between each pair of parallel electrodes is between approximately 3mm and approximately 30mm.
    [0058] Optionally, the electrode is made of steel, stainless steel, bronze, copper, platinum, silver, gold, aluminum alloy, zinc, nickel, tin, magnesium alloy, bronze, phosphor bronze, conductive polymers and/ or any respective composition and/or any medical grade league thereof.
    [0059] Optionally, the electrodes are printed on the peripheral surface of the naso/orogastric feeding tube 101. Optionally, the electrodes are coated in gold, silver, nickel, zinc, tin, copper and/or any respective composition and /or any league thereof.
    [0060] Optionally, the electrodes are formed as circular, rectangular and/or triangular points.
    [0061] Optionally, three or more electrodes are circumferentially disposed on the segment of LES 152, for example, so that approximately one third of the perimeter of the naso/orogastric feeding tube 99 separates between one electrode and the other. Each of these electrodes is optionally a piece of wire framed along the naso/orogastric feeding tube 99, as depicted in Figure 3A. In an exemplary arrangement, X1-X3 electrodes are located on the LES 152 segment to form 3 S1-S3 impedance sensors, each of a selected pair of X1-X3 electrodes (S1 - X1-X2 and S2 - X2-X3 and S3 - X3-X1) and Y3-Y4 electrodes are located in the esophageal segment 151 to form 2 Z3-Z4 impedance sensors (Z3- Y3-Y4 and Z4 - Y4-Y3). The LES 152 segment is sized and formed to be the LES when the esophageal segment is at least 2 cm above the LES.
    [0062] An arrangement of three or more electrodes along the perimeter of a segment of the naso/orogastric feeding tube 99 (for example, the LES segment 152) makes it possible to detect when the segment is in the esophagus, for example, in the LES, and when the segment is in the trachea 97, for example, vertically to the lungs 98. Such detection is possible as the lumen of the esophagus and LES contracts around the naso/orogastric feeding tube 99 and the tracheal lumen remains at a fixed perimeter . Reading impedance values from the circumferential arrangement of the impedance sensors make it possible to calculate a combined impedance measurement indicative of a placement of the LES 152 segment in the trachea or a placement of the LES 152 segment in the esophagus. This is based on an analysis of the combined impedance measurement and a detection of an impedance difference therein that is indicative of contact of some or all of the electrodes with the walls of the lumen.
    [0063] For example, when the impedance sensors are pairs of electrodes, the false insertion of the tip of the naso/orogastric feeding tube 99 into the trachea can be detected when the impedance difference between the impedance readings of different pairs of electrodes (each pair is an impedance sensor) is greater than a threshold. Such difference is indicative of partial contact with the walls of the surrounding lumen. This partial contact indicates that the tip of the naso/orogastric feeding tube 99 is positioned in the trachea where the walls do not contract in response to insertion of an object or esophageal peristalsis. In such applications, when the distance of each of the electrodes from the walls of the surrounding lumen is not similar, the control unit 101 triggers an alert and/or the presentation of operator instructions. As used herein, an alert and/or a presentation can be any audio or visual signals that are displayed to a caregiver (a term used here to describe any user who operates the control unit 101).
    [0064] As described above, the impedance sensor readings along a surface of the naso/orogastric feeding tube 99, in the LES segment 152 and in the esophagus segment 151, form the combined impedance measurement. This combined impedance measurement is indicative of different positions of the naso/orogastric feeding tube 99 in a patient's intracorporeal lumens, for example, during a process of positioning the naso/orogastric feeding tube 99 in the esophagus for feeding.
    [0065] For example, Figure 4 is a flowchart depicting a flow of different combined impedance measurements taken at different events during a process of positioning the naso/orogastric feeding tube 99 in the esophagus for feeding, according to some applications of the present patent application. As indicated at 501, the high impedance at each impedance sensor, for example approximately 20,000 ohms, is measured when the LES segment 152 and the esophagus segment 151 are located outside the body. As indicated at 502, when the naso/orogastric feeding tube 99 is in the esophagus, the readings from all impedance sensors are similar (eg, difference less than 2000 ohm); however, as shown at 503, when the naso/orogastric feeding tube 99 is in the tracheal, the impedance difference of the impedance readings of different impedance sensors (eg, electrode pairs) is much greater. For clarity, an impedance difference means a difference between any pair of impedance sensors in a segment. As shown in 504 and 506, the combined impedance measurement indicates when the LES segment 152 is in the LES, namely that the naso/orogastric feeding tube 99 is in a position for feeding. Such a combined impedance measurement shows that an impedance difference between the reading of the LES 152 segment impedance sensors (around 500 ohm) and the reading of the 151 esophageal segment impedance sensors is greater than a threshold, for example , more than 500 ohms, 1000 ohms, or around 2000 ohms or any impedance value.
    [0066] As shown in 505, the combined impedance measurement indicates when both the LES segment 152 and the esophageal segment 151 are in the stomach. Such a combined impedance measurement shows that the readings from all impedance sensors are less than a threshold.
    [0067] Reference is now also made to Figure 5A, which is a flowchart of a 600 positioning process for detecting a positioning of the naso/orogastric feeding tube 99 in the esophagus based on a combined impedance measurement, according to some applications of the present patent application. The positioning process can be implemented by the processor 107 of the control unit 101 when it implements a positioning code stored in the code store.
    [0068] First, as shown in 601, a combined impedance measurement is an array of readings from impedance sensors on segments 151, 152, eg as described for the case as exemplified in 501.
    [0069] Now, as shown in 602, a detection of the placement of the segment of LES 152 in the LES is identified by an analysis of the combined impedance measurement. For example, as exemplified in 504. Optionally, this identification is determined after a placement of the LES segment 152 in the esophagus is detected, for example, as depicted in 502.
    [0070] Now, as shown at 603, and in order to avoid a false estimate of the placement of the LES 152 segment in the LES due to diaphragm pressure caused, for example, by hiatal hernia, the caregiver is instructed to push the tube further of naso/orogastric feeding 99 along the esophagus. As shown at 604, when the impedance readings of the LES segment sensors and the esophageal segment sensors are below a threshold, as shown at 505, it is assumed that both the LES segment 152 and the esophagus segment 151 are in the stomach and the caregiver is instructed to pull the naso/orogastric feeding tube 99 and bring the lower segment sensors into the LES lumen, as shown at 605. As shown at 606, when the impedance difference between the reading of the LES segment sensors and the esophageal segment sensors is above a threshold as shown at 506, it is assumed that the LES segment 152 is now in the LES and that the patient has diaphragm pressure caused, for example, by hiatal hernia. As shown in 607, when the combined impedance measurement is not expected, repositioning is instructed, for example, advancing 5cm per drag.
    [0071] As shown at 608, feeding can now be initiated by the control unit 101 after assuming that the LES segment 152 is in the LES and the distal end of the naso/orogastric feeding tube 99 is in the stomach.
    [0072] According to some applications of the present patent application, the positioning process depicted in Figure 5A is maintained while one or more instructions is (are) presented to the caregiver (for example, a doctor or a nurse ) to thus safely guide the positioning process.
    [0073] Figures 6A to 6E are exemplary screen captures of a graphical user interface (GUI | graphic user interface) presented to the caregiver on a screen connected to the control unit 101, according to some applications of the present patent application of invention. Screens are optionally generated and/or selected based on the combined impedance measurement. The GUI optionally includes a display of the impedance reading of each impedance sensor (eg S1-S3 and Z3-Z4) 701 and/or 702 emulation of the current positioning of at least part of the naso/orogastric feeding tube 99 is generated based on the combined impedance measurement.
    [0074] Figure 6A, optionally correlated with the combined impedance measurement measured at 601, depicts an initial state where the impedance sensors in segments 151, 152 are exposed to air. Figure 6B depicts an initial state of positioning where the impedance sensors in segments 151, 152 are still exposed to air, however, the caregiver indicated in the control unit 101 that he starts the positioning process, for example, using the MMI 105 Figure 6C, optionally correlated with the combined impedance measurement measured at 602, depicts a presentation of an indication of a detection of a state in which segments 151 and 152 of naso/orogastric feeding tube 99 are assumed to be in the esophagus. As indicated above with reference to 603, the caregiver is now instructed to push the naso/orogastric feeding tube 99 further into the stomach. Figure 6D depicts a presentation of an indication of a detection of a state where segment 151 of naso/orogastric feeding tube 99 is assumed to be the LES and segment 152 of naso/orogastric feeding tube 99 is assumed to be in the esophagus . As indicated above with reference to 605 and depicted in Figure 6E, the caregiver is now instructed to pull the naso/orogastric feeding tube 99 so the LES segment 152 is at the rear of the LES.
    [0075] As indicated above with reference to 608 and depicted in Figure 6F, the naso/orogastric feeding tube 99 is assumed to be in a feeding position when the LES segment 152 is at the rear of the LES and feeding can be initiated , either automatically and/or after receiving a confirmation from the user, for example, by manually pressing a button designated 703 (a fixed button or a button displayed on a touchscreen).
    [0076] Optionally, information about the feeding process, for example, the initiation time and/or events detected during the feeding process, for example, the intervention events described below are recorded. This information can be presented using the screen, for example, as shown in figure 6G.
    [0077] After feeding starts, the combined impedance measurement can be used to detect intervention events, for example, a backflow and/or a migration of the naso/orogastric feeding tube 99, for example, unintentional migration of the tube.
    [0078] Reference is now also made to Figure 5B which depicts a monitoring process in which a presence or absence of intervention events such as a backflow event or a tube migration event are monitored. 608 is as described above. During the power-up period, as shown at 609, changes in the combined impedance measurement are measured to detect intervening events after 608. The monitoring process can be implemented by the processor 107 of the control unit 101 when it implements a stored monitoring code in the code store.
    [0079] As shown at 610, when a pipe migration event is detected, the control unit 101 intervenes in the feeding process, for example, as shown at 612 by means of: - feeding stop instruction, for example, controlling a feed machine and/or one or more mechanical value(s) that change the flow of feed content to the naso/orogastric feed tube 99; - instruction of the deflation of the elastic body of the esophagus 115 by controlling the fluid source and/or one or more mechanical value(s) that change the flow of fluid to the elastic body of the esophagus 115; and/or - instruction of a presentation of an alert, for example, playing a sound and/or presenting a notification, as depicted in Figure 6H. Deflation is important to avoid damaging the tissues around the esophagus when the naso/orogastric feeding tube 99 is pulled. The tube migration event can be detected when the impedance difference between the readings in segments 151 and 152 falls below a threshold, for example, as region 151 and region 152 are both in the esophagus (for example, as shown in 502) or in the stomach (for example, as shown in 505). Optionally, as shown at 613, repositioning is instructed, for example, as described with reference to Figure 5A.
    [0080] As shown in 611, when a backflow event is detected, the control unit 101 intervenes in the feeding process, for example, as shown in 614 by means of: - feeding stop instruction, for example, by the instruction of a machine feeding or controlling the valves as described above; - instruction of the inflation of the elastic body of the esophagus 115, for example, instructing the fluid source or controlling the valves as described above; and/or - instructing a presentation of an alert, for example, playing a sound and/or presenting a notification as depicted in figure 6I. Inflation is important to prevent backflow from reaching the trachea and to reduce the risk of aspiration of food content. The backflow event can be detected when the impedance difference between readings on segments 151 and 152 falls below a threshold. Optionally, as shown at 613, repositioning is instructed, for example, as described with reference to Figure 5A.
    [0081] Reference is now made to figures 7A to 7D which depict the actual combined measurements taken using a naso/orogastric feeding tube 99 having impedance sensors in segments 152, 153, e.g. electrodes forming impedance sensors S1-S3 being located in the segment of LES 152 and electrodes that form impedance sensors Z3-Z4 being located in the segment of the esophagus 151. Measurements are in ohms. As shown in Figure 7A, the impedance measured at the LES is lower than the impedance measured above the LES, as the walls of the LES are in contact with electrodes S1-S3. Figure 7A depicts exemplary combined impedance measurement when LES segment 152 is in the LES and esophageal segment 151 is in the esophagus. The location of the naso/orogastric feeding tube 99 was verified by x-ray imaging. Figure 7B depicts a change in the combined impedance measurement when the LES 152 segment and the esophageal segment were pushed into the stomach during a feeding procedure. The change reflects how the impedance reading reduces in the esophageal segment and how the impedance difference between the segments is reduced. The location of the naso/orogastric feeding tube 99 was also verified by the x-ray image. Figure 7A depicts another exemplary combined impedance measurement measured when the naso/orogastric feeding tube 99 was positioned in another patient's esophagus such that the LES segment 152 was in the LES and the esophageal segment 151 was in the esophagus. As shown in Figure 8, the location of the naso/orogastric feeding tube 99 was verified by x-ray imaging. For example, the square delimits the location of the LES 151 segment impedance sensors in the LES.
    [0082] According to some applications of the present patent application, impedance sensors are replaced by pressure sensors, such as piezoelectric pressure transducers, force sensors, voltage sensors, piezoelectric film sensors (PVDF | Piezoelectric film ), electromagnetic sensors and/or any other sensors that can be mounted or embedded in the naso/orogastric feeding tube 99. In such applications, the impedance readings are replaced by pressure, voltage and/or force readings and the impedance measurement combined is replaced by a corresponding combined measurement.
    [0083] The methods, as described above, are used in the fabrication of integrated circuit chips.
    [0084] Descriptions of the various applications of the present patent application have been presented for purposes of illustration, but are not intended to be exhaustive or limited to the disclosed applications. Many modifications and variations will be evident to someone with ordinary skill in the technique without departing from the scope and spirit of the applications described. The terminology used here was chosen to better explain the principles of applications, practical application or technical improvement in technologies found on the market or to allow others with common skill in the art to understand the applications disclosed herein.
    [0085] It is expected that during the life of a patent developed from the present application, many relevant methods and systems will be developed and the scope of the term control unit, feed tube and feed content is intended to include all of these new technologies in advance.
    [0086] As used herein, the term "approximately" refers to ± 10%.
    [0087] The terms "comprises", "comprising", "includes", "including", "having" and its conjugates mean "including, but not limited to". This term covers the terms "consisting of" and "consisting essentially of".
    [0088] The phrase "consisting essentially of" means that the composition or method may include additional ingredients and/or steps, but only if additional ingredients and/or steps do not materially alter the basic and novel characteristics of the claimed composition or method.
    [0089] As used herein, the singular form "a", "an" and "the" includes plural references, unless the context clearly dictates otherwise. For example, the term "a compound" or "at least one compound" can include a plurality of compounds, including mixtures thereof.
    [0090] The word “exemplary” is used here to mean “serving as an example, case or illustration”. Any application described as “exemplary” should not necessarily be interpreted as preferred or advantageous over other applications and/or to exclude the incorporation of features from other applications.
    [0091] The word "optionally" is used herein to mean "is provided in some applications and not provided in other applications". Any specific application of this patent application may include a plurality of “optional” features, unless such features conflict.
    [0092] Throughout the present application, various applications of the present patent application may be presented in a band format. It should be understood that the description in striped format is for convenience and brevity only and is not to be construed as an inflexible limitation on the scope of the present patent application. Consequently, the description of a range should be considered to have specifically disclosed all possible sub-ranges as well as the individual numerical values within that range. For example, the description of a range, such as 1 to 6, should be considered specifically to have disclosed sub-ranges 1 to 3, 1 to 4, 1 to 5, 2 to 4, 2 to 6, of 3 to 6 etc., as well as individual numbers within that range, eg 1, 2, 3, 4, 5, and 6. This applies regardless of the range's amplitude.
    [0093] Whenever a numerical range is indicated here, it is intended to include any quoted numeral (fractional or integral) within the indicated range. The phrases "ranging/varies between" a first indicative number and a second indicative number and "ranging/varies from" a first indicative number "to" a second indicative number are used interchangeably herein and are intended to include the first and the second number indicated and all fractional and integral numerals in between.
    [0094] It is noted that certain features of the present patent application, which are, for the sake of clarity, described in the context of separate applications, may also be provided in combination in a single application. On the other hand, various features of the present patent application, which are, for brevity, described in the context of a single application, may also be provided separately or in any suitable subcombination or as suitable in any other described application of the present application for an invention patent. Certain features described in the context of various applications should not be considered essential features of those applications unless the application is inoperable without these elements.
    [0095] Although the present patent application has been described in conjunction with specific respective applications, it is evident that many alternatives, modifications and variations will be evident to those skilled in the art. Consequently, it is intended to cover all such alternatives, modifications and variations which fall within the spirit and broad scope of the appended claims.
    [0096] All publications, patents and patent applications mentioned in this specification are hereby incorporated in their entirety by reference in this specification, to the same extent as if each individual publication, patent or patent application were specifically and individually indicated herein. by reference. In addition, the citation or identification of any reference in this application should not be construed as an admission that such reference is available prior to prior art to the present application. As far as section headings are used, they should not be construed as necessarily limiting. Figure Legend Figure 4 T1) Feed tube positioning process T2) In air T3) In trachea T4) In LES T5) In stomach T6) In position Figure 5A 601) Generate a combined measurement of measured values in a lower segment and an upper segment (one above the other) along a surface of a feeding tube 602) Detect a lower segment placement in the lower esophageal sphincter (LES) according to the combined measurement 603) Instruct a lower segment placement in the stomach (drag instruction) 604) Detect, according to the combined measurement, a placement of the upper and lower regions in the stomach 605) Instruct the placement of the lower segment in the LES (instruct the pull) 605A) Detect a placement of the lower segment in the LES and the upper segment in the esophagus according to the combined measurement 606) Assume diaphragm pressure in the esophagus 607) Instruct the repositioning 608) Instruct the feed/supply state Figure 5B 609) Instruct the feed/supply state 610) Monitor the combined measurement 611) Detect a pipe migration event, according to the combined measurement 612) Detect an event of reflux, according to impedance measurement 613) Alert/Stop Esophageal Elastic Body Feed/Inflation 614) Instruct Repositioning 615) Alert/Stop Esophageal Elastic Body Feed/Deflation Figure 6A T7) Insertion tube in air T8) Start insertion tube insertion Figure 6B T9) Insertion started T10) Feed tube insertion started T11) Continue with insertion Figure 6C T11) Continue with insertion T12) Feed tube action in esophagus Figure 6D T13) Feeding tube in LES T14) Additional 5cm insertion Figure 6E T15) Feeding tube in stomach T16) Gently pull back until reaching position Figure 6F T17) Feeding tube in position T18) Press OK to continue Figure 6H T19) Supply tube out of position T20) Press OK to continue Figure 6I T21) Gastric reflux T22) Please perform suction to relieve gastric pressure T23) Balloon will deflate in 1:07
    权利要求:
    Claims (14)
    [0001]
    1.“NASO/OROGASTRIC SUPPLY TUBE POSITIONING SYSTEM”, consisting of an interface adapted to receive a combined impedance measurement, consisting of readings of a plurality of impedances from a plurality of impedance sensors (110-113) arranged in a plurality of segments (151, 152) along a side surface of a naso/orogastric feeding tube (115), characterized in that one of said plurality of segments is positioned to be at least one centimeter above the other. of said plurality of segments when said naso/orogastric feeding tube is in a feeding position; a code store (106) for storing a code; a processor (107) coupled to said interface and said program store for implementing said stored code, the code consisting of: a code for calculating estimates of positions of said naso/orogastric feeding tube, in accordance with said measurement of combined impedance; and a code for generating primary instructions for a caregiver to push said naso/gastric feeding tube and secondary instructions for said caregiver to pull said naso/orogastric feeding tube, in accordance with said estimates.
    [0002]
    2. "NASO/OROGASTRIC FEEDING TUBE POSITIONING SYSTEM", according to claim 1, characterized in that one of said plurality of segments is positioned in the lower esophageal sphincter (LES), when said naso/orogastric feeding tube is in a feeding position in the esophagus, and another of said plurality of segments being at least one centimeter above the LES, when said naso/orogastric feeding tube is in said feeding position.
    [0003]
    3. "NASO/OROGASTRIC TUBE POSITIONING SYSTEM", according to claim 1, further consisting of a human-machine interface (HMI) (105) that is electronically connected to said processor (107); characterized in that said stored code further consists of: a code for monitoring said combined impedance measurement; a code for detecting an intervention event, in accordance with a change in said combined impedance measure; and a code for transmitting instructions to present repositioning instructions to a caregiver in response to said detection of intervention events.
    [0004]
    4. "NASO/OROGASTRIC FEEDING TUBE POSITIONING SYSTEM", according to claim 1, characterized in that said stored code further consists of a code to detect the unwanted migration of said naso/orogastric feeding tube, wherein said selected instructions are instructions to present an alert to direct said caregiver to relocate said naso/orogastric feeding tube.
    [0005]
    5. "NASO/OROGASTRIC FEEDING TUBE POSITIONING SYSTEM" according to claim 1, characterized in that said stored code further consists of a code to detect a backflow while said naso/orogastric feeding tube is in said feeding position, in which the selected instructions are instructions to present an alert to indicate to the referred caregiver about the referred reflux.
    [0006]
    6. "NASO/OROGASTRIC FEEDING TUBE POSITIONING SYSTEM" according to claim 1, characterized in that said stored code further consists of a code to detect when said naso/orogastric feeding tube is in said feeding position , according to said combined impedance measurement.
    [0007]
    7. "NASO/OROGASTRIC FEEDING TUBE POSITIONING SYSTEM", according to claim 6, characterized in that said stored code also consists of a code that, in response to said detection, performs at least one of the ordering presentation of a user interface that allows said caregiver to initiate a feeding process, using said naso/orogastric feeding tube, and automatically ordering a feeding machine to start said feeding process.
    [0008]
    8. "NASO/OROGASTRIC FEED TUBE POSITIONING SYSTEM" according to claim 1, further consisting of a fluid source that is mechanically connected to at least one esophageal elastic body (115) mounted on said tube naso/orogastric feeding, characterized in that said stored code further consists of: a code to monitor said combined impedance measurement; a code for detecting an intervention event, in accordance with a change in said combined impedance measure; a code for transmitting instructions to fill or empty said fluid source in response to said detection of intervening events.
    [0009]
    9. "NASO/OROGASTRIC FEEDING TUBE POSITIONING SYSTEM", according to claim 1, further consisting of a display that is electronically connected to said processor (107), characterized in that said stored code also consists of: a code to monitor said combined impedance measurement; a code for detecting an intervention event, in accordance with a change in said combined impedance measurement; a code for transmitting instructions to display an alert in response to said detection of intervening events.
    [0010]
    10. - "NASO/OROGASTRIC FEEDING TUBE POSITIONING SYSTEM", according to claim 1, characterized in that said stored code further comprises: a code to detect a misplacement of at least part of said feeding tube naso/orogastric in the trachea (97), according to said combined impedance measure; and a code for transmitting instructions for presenting an alert in response to said misplacement detection.
    [0011]
    11. "NASO/OROGASTRIC TUBE POSITIONING SYSTEM", according to claim 1, characterized in that said stored code further consists of: a code to monitor said combined impedance measurement; a code for detecting an intervention event, in accordance with a change in said combined impedance measure; and a code for transmitting instructions for regulating a feed rate in response to said detection of intervening events.
    [0012]
    12. "NASO/OROGASTRIC TUBE POSITIONING SYSTEM", according to claim 1, characterized in that each of said plurality of impedance sensors is a pair of electrodes.
    [0013]
    13. "NASO/OROGASTRIC FEED TUBE POSITIONING SYSTEM", according to claim 1, characterized in that at least one of said plurality of segments consists of at least three electrodes that are circumferentially disposed in said respective segments around a perimeter of said naso/orogastric feeding tube; wherein each of said plurality of impedance sensors in said respective segment consists of a pair of electrodes from at least three electrodes.
    [0014]
    14. "NASO/OROGASTRIC FEEDING TUBE POSITIONING METHOD", for use in the system defined in claim 1, consisting of: inserting a naso/orogastric feeding tube (115), having a plurality of sensors (110-113) of impedance arranged in a plurality of segments (151-152) along a lateral surface of said naso/orogastric feeding tube, in the esophagus of a patient, characterized in that one of said plurality of segments is positioned in the lower esophageal sphincter (LES) , when said naso/orogastric feeding tube is in a feeding position in the esophagus, and another of said plurality of segments is at least one centimeter above the LES; receiving readings of a plurality of impedance from said plurality of impedance sensors; calculating position estimates of said naso/orogastric feed tube in accordance with said plurality of impedance readings; and generating primary instructions for a caregiver to pull said naso/orogastric feeding tube, and secondary instructions for said caregiver to pull said naso/orogastric feeding tube, in accordance with said estimates.
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    同族专利:
    公开号 | 公开日
    US9713579B2|2017-07-25|
    US20160151248A1|2016-06-02|
    EP2999451B1|2018-05-02|
    AU2015228371A1|2016-10-20|
    DK2999451T3|2018-08-13|
    CN106456450A|2017-02-22|
    WO2015136540A1|2015-09-17|
    AU2015228371B2|2019-05-23|
    ES2675934T3|2018-07-13|
    EP2999451A1|2016-03-30|
    CN106456450B|2020-02-18|
    BR112016021137A2|2017-08-15|
    BR112016021137A8|2021-04-06|
    CA2943608A1|2015-09-17|
    EP2999451A4|2016-08-24|
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    法律状态:
    2020-02-04| B06U| Preliminary requirement: requests with searches performed by other patent offices: procedure suspended [chapter 6.21 patent gazette]|
    2021-06-08| B09A| Decision: intention to grant [chapter 9.1 patent gazette]|
    2021-07-20| B350| Update of information on the portal [chapter 15.35 patent gazette]|
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    PCT/IL2015/050262|WO2015136540A1|2014-03-13|2015-03-12|Combined measure positioning and/or monitoring of a naso/orogastric feeding tube|
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