Measurement of Flow & Pressure

Drop across Endotracheal Tube

Presented By:
• Pratik Vaidya
(MT19CDM022)

Guided By :
• Dr. Rashmi Uddanwadiker (Asso. Professor, VNIT,
Nagpur)
• Dr. Satish Deopujari, Pediatrician (DCH, MD, MNAMS)
Aim
 To study the pressure-flow relationship in an ETT for
infants & children group for early detection of
obstruction.

Objectives
 To determine in vitro the pressure–flow characteristics
of ETTs with respect to their properties.
 To assess the significance of △PETT as an additional
impact on ventilator setting with varying obstacle area
in ETT.
 To compare the In -Vitro model values with the CFD
calculation values of △PETT
Problem Statement
Measurement of Flow and Pressure drop across
the Endotracheal tube for infants & children.
For Normal tube
For tubes with obstruction in cross section area

Causes of Resistance
Reduction in Cross Section area
Curvature of the ETT tube
Blockages by secretions
Partial Obstruction of the Endotracheal Tube by
the Plastic Coating Sheared from a Stylet
From Previous Discussions
Why to choose random values of
obstruction?

Do the assumption created for this study

are acceptable to the Doctors?

Why to measure the pressure values only

at tip of connector?
Modeling of ETT with Obstruction
 Input Parameters
Sr. no Parameter Value Unit

1 PIP 20 cm of H2O
2 PEEP 4 cm of H2O
3 Inspiration Velocity 2.22 m/s

Obstruction at mid-length of ETT tube

Diameter of ETT Tube at
obstruction Area

Case 1 Normal Tube 2 mm 3.1415 mm^2

Case 2 Tube with 5% Obstruction 1.9492 mm 2.9844 mm^2

Case 3 Tube with 10% Obstruction 1.8972 mm 2.8273 mm^2

Case 4 Tube with 15% Obstruction 1.8438 mm 2.6702 mm^2

Case 5 Tube with 20% Obstruction 1.7888 mm 2.5132 mm^2

Case 6 Tube with 25% Obstruction 1.7320 mm 2.3561 mm^2

Case 7 Tube with 50% Obstruction 1.4141 mm 1.5707 mm^2

Case 8 Tube with 75% Obstruction 0.9999 mm 0.7853 mm^2

 Analysis (Normal Tube)

Case 1
 Analysis
(Obstruction at 25% Length)

Case 2 Case 3 Case 4

Case 5 Case 6 Case 7

Case 8
 Analysis
(Obstruction at 50% Length)

Case 2 Case 3 Case 4

Case 5 Case 6 Case 7

Case 8
 Analysis
(Obstruction at 75% Length)

Case 2 Case 3 Case 4

Case 5 Case 6 Case 7

Case 8
Results
 Pressurevalues are measured at the distal tip of the
connector of the ETT.
Normal Tube (With zero obstruction) 8336.83 Pa

Obstruction\Length 25% Length 50% Length 75% Length

5 8523.18 Pa 8580.71 Pa 8460.56 Pa

10 8576.64 Pa 8589.06 Pa 8481.62 Pa

15 8717.06 Pa 8768.14 Pa 8683.65 Pa

20 8961.21 Pa 8824.68 Pa 8759.76 Pa

25 9185.08 Pa 9122.7 Pa 8705.65 Pa

50 12737.1 Pa 11934.2 Pa 12403.2 Pa

75 39633.5 Pa 11934.2 Pa 38586.1 Pa
Results
25% Length 50% Length 75% Length

Obstruction % Min Max Min Max Min Max

5 267.691 12972.7 266.506 13022 252.146 12909.3

10 238.513 13041.6 252.727 13041.3 242.974 12925.2

15 282.226 13179.6 241.284 13223.9 -125.187 13139.2

20 265.725 13406.4 251.046 13280.1 -1062.94 13220.6

25 268.086 13643.8 -622.752 13570 -2581.24 13167.2

50 -11590.1 17214.4 -13238.4 16371.4 -14390.6 16870.8

75 -56513.4 44066.3 -81926.9 41809.5 -70214.7 43048.1

All Values are in Pascal (Pa)

P r e ss u r e V a lu e s a t tip o f C o n n e c to r (P a )
Results

Obstruction Vs. Pressure

45000

40000

35000

30000

25000 25% Length

50% Length
20000 75% Length

15000

10000

5000

0
0 5 10 15 20 25 50 75

Obstruction in % reduction in Area

Discussion & Conclusion
 The pressure values at the distal end of the connector increases with
the increase in obstruction size.

 For a reduction in area of around 5%, the pressure values increases

by 150 to 200 Pa approximately.

 Thus, it is possible to calibrate these pressure values in terms of the

obstruction present in tube.

 The increase in the pressure values are more prone to increase in size
of obstruction rather than the length at which it is present. Thus we
can easily detect the presence of obstruction.

 Only one pressure sensor (at Proximal end) can be used to detect the
obstruction in tube rather than two (one at proximal & one at distal).
References
 E.G. Tsega,2018,Computational Fluid Dynamics Modeling of
Respiratory Airflow in Tracheobronchial Airways of Infant, Child
and Adult, Computational and Mathematical Methods in Medicine
Volume 2018, Article ID 9603451, 9 pages, https://
doi.org/10.1155/2018/9603451

 C.F. DOERSHUK & L.W. MATTHEWS,1969, Airway Resistance

and Lung Volume in the Newborn Infant, Airway resistance lung
conductance newborn infant , Pediat. Res. 3: 128-134 (1969)

 Yuan Lei, Medical Ventilator System Basics, Oxford University

Press (2017)