title: Distinguishing tracheal and esophageal tissues with hyperspectral imaging and fiber-optic sensing.
abstract: During emergency medical situations, where the patient has an obstructed airway or necessitates respiratory support, endotracheal intubation (ETI) is the medical technique of placing a tube into the trachea in order to facilitate adequate ventilation of the lungs. Complications during ETI, such as repeated attempts, failed intubation, or accidental intubation of the esophagus, can lead to severe consequences or ultimately death. Consequently, a need exists for a feedback mechanism to aid providers in performing successful ETI. Our study examined the spectral reflectance properties of the tracheal and esophageal tissue to determine whether a unique spectral profile exists for either tissue for the purpose of detection. The study began by using a hyperspectral camera to image excised pig tissue samples exposed to white and UV light in order to capture the spectral reflectance properties with high fidelity. After identifying a unique spectral characteristic of the trachea that significantly differed from esophageal tissue, a follow-up investigation used a fiber optic probe to confirm the detectability and consistency of the different reflectance characteristics in a pig model. Our results characterize the unique and consistent spectral reflectance characteristic of tracheal tissue, thereby providing foundational support for exploiting spectral properties to detect the trachea during medical procedures.
authors.affiliation: United States Army Institute of Surgical Research, 3698 Chambers Pass, Fort Sam Houston, Texas 78234, United StatesbOak Ridge Institute for Science and Education, 4692 Millennium Drive, Suite 101, Belcamp, Maryland 21017, United StatescUniversity of Texas at San Antonio, One UTSA Circle, San Antonio, Texas 78249, United StatesdUniversity of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, Mail Code 7736, San Antonio, Texas 78229, United States.
authors.forename: Corinne D
authors.initials: CD
authors.lastname: Nawn
authors.affiliation: United States Military Academy, 606 Thayer Road, West Point, New York 10996, United States.
authors.forename: Brian E
authors.initials: BE
authors.lastname: Souhan
authors.affiliation: United States Army Institute of Surgical Research, 3698 Chambers Pass, Fort Sam Houston, Texas 78234, United StatesdUniversity of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, Mail Code 7736, San Antonio, Texas 78229, United States.
authors.forename: Robert
authors.initials: R
authors.lastname: Carter
authors.affiliation: United States Military Academy, 606 Thayer Road, West Point, New York 10996, United States.
authors.forename: Caitlin
authors.initials: C
authors.lastname: Kneapler
authors.affiliation: United States Military Academy, 606 Thayer Road, West Point, New York 10996, United States.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Fell
authors.affiliation: University of Texas at San Antonio, One UTSA Circle, San Antonio, Texas 78249, United StatesdUniversity of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, Mail Code 7736, San Antonio, Texas 78229, United States.
authors.forename: Jing Yong
authors.initials: JY
authors.lastname: Ye
mesh_terms: D000818:Animals; D004947:Esophagus / Q000000981:diagnostic imaging* / Q000502:physiology; D005336:Fiber Optic Technology / Q000379:methods*; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D007442:Intubation, Intratracheal; D061848:Optical Imaging / Q000379:methods*; D025341:Principal Component Analysis; D013552:Swine; D014132:Trachea / Q000000981:diagnostic imaging* / Q000502:physiology