# US 10,765,822 B2 · Endotracheal tube extubation detection > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 10,765,822 B2 - Document ID: US10765822B2 - Status: Granted - Kind: B2 - Application number: 15/489,315 - Filed: 2017-04-17 - Published: 2017-10-19 - Granted: 2020-09-08 - Earliest claimed: 2016-04-18 - Assignees: Covidien LP - Applicants: Covidien LP - Inventors: Nancy F. Dong; Gabriel Sanchez - Web page: https://patentgrep.com/patent/US10765822B2 ## CPC - A61M 16/0051: {with alarm devices} - A61M 16/04: Tracheal tubes (catheters in general A61M25/00) - A61M 16/0833: {T- or Y-type connectors, e.g. Y-piece} - A61M 16/0063: {Compressors} - A61M 2016/0027: {pressure meter} - A61M 2016/0036: {in the breathing tube and used in both inspiratory and expiratory phase} - A61M 2205/13: with means for the detection of operative contact with patient, e.g. lip sensor - A61M 2205/14: Detection of the presence or absence of a tube, a connector or a container in an apparatus - A61M 2205/18: with alarm - A61M 2205/502: User interfaces, e.g. screens or keyboards - A61M 2205/52: with memories providing a history of measured variating parameters of apparatus or patient - A61M 2240/00: Specially adapted for neonatal use - A61M: DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY (introducing media into or onto the bodies of animals A61D7/00; means for inserting tampons A61F13/26; devices for administering food or medicines orally A61J; containers for collecting, storing or administering blood or medical fluids A61J1/05); DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY (surgery A61B; chemical aspects of surgical articles A61L); DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR {(Electrotherapy, e.g. producing anaesthesia by the use of alternating or intermittent currents A61N1/36021)} ## Abstract Systems and methods for detecting extubation of an endotracheal tube (ETT) are described. Extubation of the ETT can be identified by comparing to a threshold, a difference between a determined first volume of breathing gas during a first inspiratory period to a determined second volume of breathing gas during a second inspiratory period. If the difference exceeds the threshold, an alarm can be activated indicating extubation. Extubation detection may also be based on a difference between inspiratory pressures during separate inspiratory periods. Partial extubation and full extubation may also be discerned. Further, extubation of an ETT may be detected without the use of an exhalation flow sensor. ## Claims ### Claim 1 A ventilator-implemented method for detecting extubation of an endotracheal tube during ventilation, the method comprising: determining, by the ventilator based on measurements from one or more sensors, a first volume of breathing gas delivered to a patient during a first inspiratory period; determining, by the ventilator based on measurements from the one or more sensors, a second volume of breathing gas delivered to a patient during a second inspiratory period; determining, by the ventilator, a difference between the first volume and the second volume; comparing, by the ventilator, the determined value for the difference between the first volume and the second volume to a threshold; and activating, by the ventilator, an alarm indicating extubation of the endotracheal tube when the determined value for the difference is greater than the threshold. ### Claim 2 (depends on 1) The method of claim 1, further comprising: measuring, by an inspiratory sensor, a first inspiratory pressure at the end of the first inspiratory period; measuring, by an expiratory sensor, a first expiratory pressure at the end the first inspiratory period; determining a first difference between the first inspiratory pressure measurement and the first expiratory pressure measurement; measuring a second inspiratory pressure at the end of the second inspiratory period; measuring a second expiratory pressure at the end of the second inspiratory period; determining a second difference between the second inspiratory pressure measurement and the second expiratory pressure measurement; comparing the first difference between the first inspiratory pressure measurement and the first expiratory pressure measurement to the second difference between the second inspiratory pressure measurement and the second expiratory pressure measurement; and wherein the alarm is activated only if the first difference between the first inspiratory pressure measurement and the first expiratory pressure measurement is less than the second difference between the second inspiratory pressure measurement and the second expiratory pressure measurement. ### Claim 3 (depends on 2) The method of claim 2, further comprising: measuring a first time duration of the first inspiratory period; measuring a second time duration of the second inspiratory period; wherein the alarm is activated only if the first time duration is shorter than the second time duration. ### Claim 4 (depends on 1) The method of claim 1, further comprising: measuring a first time duration of the first inspiratory period; measuring a second time duration of the second inspiratory period; wherein the alarm is activated only if the first time duration is shorter than the second time duration. ### Claim 5 (depends on 4) The method of claim 4, wherein the method is performed during pressure-support ventilation. ### Claim 6 (depends on 1) The method of claim 1, wherein the ventilator does not include an exhalation flow sensor. ### Claim 7 (depends on 1) The method of claim 1, wherein the endotracheal tube is a high-resistance neo-natal endotracheal tube. ### Claim 8 (depends on 1) The method of claim 1, wherein the predetermined threshold is within the range of 0.2 to 0.7. ### Claim 9 (depends on 2) The method of claim 2, wherein the inspiratory pressure sensor is located in an inspiratory limb. ### Claim 10 A ventilator system comprising: a pressure generating system adapted to generate a flow of breathing gas; a ventilation tubing system including a patient interface for connecting the pressure generating system to a patient, wherein the ventilation tubing system further includes an inspiratory limb, an expiratory limb, an endotracheal tube, and a wye connecting the inspiratory limb, the expiratory limb, and the endotracheal tube; an inspiratory flow sensor coupled to at least one of the pressure generating system and the ventilation tubing system; an inspiratory pressure sensor coupled to the inspiratory limb; an expiratory pressure sensor coupled to the expiratory limb; an interface for displaying operational data for the ventilator system; one or more processors operatively coupled to at least the inspiratory pressure sensor and the expiratory sensor; and a memory operatively coupled to the one or more processors, wherein the memory includes instructions configured cause the ventilator system to perform a set of operations upon execution by the one or more processors, the set of operations comprising: determining a first volume of the breathing gas delivered to a patient during a first inspiratory period; determining a second volume of breathing gas delivered to a patient during a second inspiratory period; determining a difference between the first volume and the second volume; comparing a value for the determined difference between the first volume and the second volume to a threshold; and activating an alarm in the interface indicating extubation of the endotracheal tube when the determined value for the difference is greater than the threshold. ### Claim 11 (depends on 10) The system of claim 10, wherein the set of operations further comprises: measuring, by the inspiratory pressure sensor, a first inspiratory pressure at the end of the first inspiratory period; measuring, by the expiratory pressure sensor, a first expiratory pressure at the end the first inspiratory period; determining a first difference between the first inspiratory pressure measurement and the first expiratory pressure measurement; measuring, by the inspiratory pressure sensor, a second inspiratory pressure at the end of the second inspiratory period; measuring, by the expiratory pressure sensor, a second expiratory pressure at the end of the second inspiratory period; determining a second difference between the second inspiratory pressure measurement and the second expiratory pressure measurement; comparing the first difference between the first inspiratory pressure measurement and the first expiratory pressure measurement to the second difference between the second inspiratory pressure measurement and the second expiratory pressure measurement; and wherein the alarm is activated only if the first difference between the first inspiratory pressure measurement and the first expiratory pressure measurement is less than the second difference between the second inspiratory pressure measurement and the second expiratory pressure measurement. ### Claim 12 (depends on 11) The system of claim 11, wherein the set of operations further comprises: measuring a first time duration of the first inspiratory period; measuring a second time duration of the second inspiratory period; wherein the alarm is activated only if the first time duration is shorter than that second time duration. ### Claim 13 (depends on 12) The system of claim 12, wherein the ventilator system is configured to deliver pressure-support ventilation. ### Claim 14 (depends on 10) The system of claim 10, wherein the threshold is within the range of about 0.2 to 0.7. ### Claim 15 (depends on 10) The system of claim 10, wherein the endotracheal tube is a high-resistance neo-natal endotracheal tube.