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WO2024118091A1 - Système d'éclairage pulmonaire - Google Patents

Système d'éclairage pulmonaire Download PDF

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Publication number
WO2024118091A1
WO2024118091A1 PCT/US2022/080479 US2022080479W WO2024118091A1 WO 2024118091 A1 WO2024118091 A1 WO 2024118091A1 US 2022080479 W US2022080479 W US 2022080479W WO 2024118091 A1 WO2024118091 A1 WO 2024118091A1
Authority
WO
WIPO (PCT)
Prior art keywords
elongated body
electromagnetic radiation
light
phototherapy system
lung
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/US2022/080479
Other languages
English (en)
Inventor
Alan Greszler
Carolyn GUZIK
Sean WAITHE
Shawn Lamont BRAXTON
Joseph Dombrowski
Anton ZONNEVELD
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Lumitex Inc
Original Assignee
Lumitex Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Lumitex Inc filed Critical Lumitex Inc
Priority to PCT/US2022/080479 priority Critical patent/WO2024118091A1/fr
Publication of WO2024118091A1 publication Critical patent/WO2024118091A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00—Radiation therapy
    • A61N5/06—Radiation therapy using light
    • A61N5/0601—Apparatus for use inside the body
    • A61N5/0603—Apparatus for use inside the body for treatment of body cavities
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/04—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/267—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the respiratory tract, e.g. laryngoscopes, bronchoscopes
    • A61B1/2676—Bronchoscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00—Radiation therapy
    • A61N5/06—Radiation therapy using light
    • A61N5/0601—Apparatus for use inside the body
    • A61N5/0603—Apparatus for use inside the body for treatment of body cavities
    • A61N2005/0604—Lungs and/or airways

Definitions

  • the present disclosure relates generally to phototherapy and more particularly to illuminating the lungs during a medical procedure.
  • Endotracheal tubes are commonplace in the medical field, both in medical facilities and in the field.
  • An endotracheal tube is a catheter that is inserted into the trachea (through the mouth or nose) for the primary purpose of establishing and maintaining a patent airway and to ensure the adequate exchange of oxygen and carbon dioxide.
  • an endotracheal tube may be placed to support breathing if someone is having difficulty breathing due to pneumonia, a collapsed lung (pneumothorax), respiratory failure or impending respiratory failure, or heart failure.
  • An endotracheal tube may also be used for removing foreign bodies (e.g., if the trachea is obstructed). Endotracheal intubation is perhaps most commonly used during surgery, because general anesthesia temporarily paralyzes the muscles of the body and an endotracheal tube is used to maintain the airway open.
  • Bronchoscopy is an endoscopic technique of visualizing the inside of the airways for diagnostic and therapeutic purposes.
  • a bronchoscope is inserted into the airways, usually through the nose or mouth, or occasionally through a tracheostomy. This allows the practitioner to examine the patient's airways for abnormalities such as foreign bodies, bleeding, tumors, or inflammation. Specimens may be taken from inside the lungs.
  • Phototherapy has been shown to alleviate the symptoms of respiratory diseases (such as acute respiratory distress syndrome (ARDS) and COVID) and to increase blood oxygen levels. While effective, reaching the lungs with an effective dose of light is difficult due to overlying tissues.
  • respiratory diseases such as acute respiratory distress syndrome (ARDS) and COVID
  • COVID chronic respiratory distress syndrome
  • the present disclosure provides a phototherapy system for illuminating the lungs using a bronchoscope or tracheal tube including a light guide for delivering light into the body, and light-extracting features for directing the light from the light guide to illuminate the lungs.
  • FIG. l is a schematic view of a phototherapy system including a tracheal tube as an instrument for delivering light.
  • FIG. 2 is a schematic view of an elongated body of the instrument including a light guide.
  • FIG. 3 is a cross sectional view of the elongated body of FIG. 2 showing lightextracting features.
  • FIG. 4 is a top schematic view of a light source including light emitters.
  • FIG. 5 is a cross sectional view of an elongated body including light emitters located near the distal end of the elongated body.
  • FIG. 6 is a block diagram of the phototherapy system including processor circuitry.
  • FIG. 7 is a schematic view of a phototherapy system including a bronchoscope as the instrument for delivering light.
  • each element with a reference number is similar to other elements with the same reference number independent of any letter designation following the reference number.
  • a reference number with a specific letter designation following the reference number refers to the specific element with the number and letter designation and a reference number without a specific letter designation refers to all elements with the same reference number independent of any letter designation following the reference number in the drawings.
  • the present disclosure provides a phototherapy system including an instrument comprising a bronchoscope or tracheal tube having an elongated (e.g., tubular) body.
  • the elongated body includes a light guide configured to receive and conduct light along the elongated body.
  • the elongated body also includes light-extracting features for causing the conducted light to be emitted from a light emitting surface to illuminate the lung of a patient.
  • a phototherapy system 10 for illuminating a lung 12 of a patient with electromagnetic radiation 14 emitted by a light source 16.
  • the phototherapy system 10 includes an instrument 18 that is either a bronchoscope or a tracheal tube.
  • the instrument 18 has an elongated body 20 having a proximal end 22 and a distal end 24.
  • the instrument 18 also has a light guide 26 extending from the proximal end 22 towards the distal end 24 of the elongated body 20.
  • the light guide 26 includes a light emitting surface 28 and light-extracting features 30.
  • the light guide 26 is configured to receive the emitted electromagnetic radiation 14 at the proximal end 22 and to conduct the received electromagnetic radiation 14 from the proximal end 22 towards the distal end 24 via total internal reflection.
  • the light-extracting features 30 cause the conducted electromagnetic radiation 14 to be emitted from the light emitting surface 28, such that the emitted electromagnetic radiation 14 illuminates the lung 12 when the instrument 18 is inserted into an airway 32 or esophagus of the patient.
  • the elongated body 20 may be formed by a tubular wall 34 forming a lumen.
  • the light guide 26 may be located at least partially within the tubular wall, such that the light guide 26 extends longitudinally along the elongated body 20.
  • the light guide 26 may include waveguides 36 for directing the electromagnetic radiation 14 in a specific direction from the elongated body 20.
  • the waveguides on one side of the elongated body 20 may direct the electromagnetic radiation 14 in a direction towards the left lung while the waveguides on the other side of the elongated body 20 direct the electromagnetic radiation 14 in a direction towards the right lung.
  • the light guide 26 may include any suitable number of waveguides 36 taking any suitable shape.
  • the waveguides 36 may be optically connected and/or isolated.
  • the waveguides 36 may be optically separated and extend longitudinally as shown in FIG. 2.
  • at least one of the waveguides 36 may extend at an angle such that the waveguide 36 at least partially spirals around the elongated body 20.
  • the light guide 26 may be integral to the tubular wall 34. That is, the light guide 26 may be embedded partially or wholly into the tubular wall 34.
  • an entirety of the light guide 26 may be contained within the tubular wall 34 or only a portion of the light guide 26 may be within the tubular wall 34.
  • the light guide 26 may be affixed to an exterior surface of the tubular wall 34.
  • the light-extracting features 30 may be any suitable structure for extracting light from the light guide (e.g., to target a specific light output distribution).
  • the lightextracting 30 features may include at least one of surface aberrations, micro-lenses, reflective spots, partial reflective planes, or diffraction gratings.
  • a diffuser sheet or a 2-D lensing sheet may be placed on an emission surface of the light guide.
  • the surface aberrations include at least one of a contour of the surface, surface depositions, or surface etchings.
  • the light emitting surface 28 may be located at any suitable location along the light guide 26.
  • the light emitting surface 28 may include multiple separate regions on the light guide 26 where electromagnetic radiation 14 is emitted from. Each of these regions may include light-extracting features 30 configured to illuminate different regions of the lungs.
  • the light emitting surface 28 may also include a tip of the elongated body 20, such that electromagnetic radiation 14 is emitted from the distal end 24 of the elongated body 20.
  • the light source 16 may include light emitters 38 configured to emit the electromagnetic radiation 14.
  • Each of the light emitters 38 may be associated with at least one of the waveguides 36, such that the electromagnetic radiation 14 emitted by a light emitter 38 is received by the associated at least one waveguide 36.
  • the light source 16 may be shaped to direct the electromagnetic radiation 14 into the light guide 26 without interfering with a lumen 76 of the elongated body 20.
  • the light source 16 may be at least a partial ring matching a size and shape of the proximal end of the elongated body.
  • the light source 16 may be coupled to the light guide 26 to improve the uptake of electromagnetic radiation 14 by the light guide 26.
  • the coupling may include optical components for adjusting the incident beam's angle, position, and intensity profile to improve coupling efficiency of light (e.g., into the light guide 26 acting as a single mode optical fiber).
  • the light guide 26 may include optical fibers having an end face that is planar and perpendicular to the fiber's long axis.
  • coupling efficiency may be optimized for beams meeting the following criteria: Gaussian intensity profile; normal incidence on the fiber's end face; beam waist in the plane of the end face; beam waist centered on the fiber's core; and/or diameter of the beam waist equal to the mode field diameter (MFD) of the fiber.
  • Gaussian intensity profile normal incidence on the fiber's end face
  • beam waist in the plane of the end face
  • beam waist centered on the fiber's core
  • diameter of the beam waist equal to the mode field diameter (MFD) of the fiber.
  • the light emitters 38 may be mechanically supported by the instrument 18 at a location closer to the distal end 24 of the elongated body 20 than then proximal end 22 of the elongated body 20.
  • the light emitters 38 may be mechanically attached to an outer surface or an inner surface of the tubular wall 34.
  • the light emitters 38 may be located at least partially within the tubular wall 38 as shown in FIG. 5.
  • the light emitters 38 may be configured to emit the electromagnetic radiation 14, such that the emitted electromagnetic radiation 14 illuminates the lung when the instrument is inserted into an airway or an esophagus of the patient.
  • the instrument 18 may be a medical device intended for short term insertion into the airway or esophagus, such as a tracheal tube or bronchoscope.
  • the tracheal tube may be connected to a ventilator for intubating a patient.
  • the instrument 18 may be a bronchoscope used for assessing the lungs for foreign obstructions.
  • the phototherapy system 10 may additionally include processor circuitry 40 for selectively controlling the emission of the electromagnetic radiation 14 by the light emitters 38, such that a region of the lung illuminated by the electromagnetic radiation 14 emitted from the elongated body 20 is controlled.
  • the processor circuitry 40 may receive a location for a tissue target and selectively control the emission of the electromagnetic radiation by the light emitters 38, such that the received location of the tissue target is illuminated by the emitted electromagnetic radiation 14.
  • the phototherapy system 10 may also include a photosensor 42 for sending a view from a perspective of the elongated body 20 and a user interface 44 for selecting the location for the tissue target within the sent view.
  • the processor circuitry 40 may receive the selected location for the tissue target and selectively control the emission of the electromagnetic radiation 14 by the light emitters 38, such that the selected region of the lung is illuminated by the electromagnetic radiation emitted from the elongated body.
  • the processor circuitry 40 may receive a location identifying a central portion of the left lung. Based on a relative location of the received location to the elongated body 20, the processor circuitry 40 may determine the light emitter(s) 38 that will illuminate this location.
  • the processor circuitry 40 may then cause only these determined light emitter(s) 38 to emit the electromagnetic radiation 14.
  • the photosensor 42 may be any suitable device for generating a view from a perspective of the elongated body.
  • the photosensor 42 may be a camera (also referred to as a camera system) configured to provide images to the processor circuitry 40.
  • the phototherapy system 10 may include a thermal feedback sensor 46 for sensing a temperature of at least one of the light guide 26 or a tissue adjacent the thermal feedback sensor 46 (e.g., lung tissue, airway tissue, etc.).
  • the processor circuitry 40 receives the temperature sensed by the feedback sensor 46 and modulates a dose of the electromagnetic radiation 14 emitted by the light guide 26 based on the received temperature. For example, the processor circuitry 40 may decrease the optical dose of the electromagnetic radiation 14 when the sensed temperature increases beyond an upper temperature threshold. In this example, the electromagnetic radiation 14 may increase a temperature of the light guide 26, elongated body 20, and/or surrounding tissue.
  • the thermal feedback sensor 26 may be used as a safety control to ensure that the temperature does not increase beyond a threshold value.
  • the processor circuitry 40 may increase the optical dose of the electromagnetic radiation 14 when the sensed temperature decreases below a lower temperature threshold.
  • the processor circuitry 40 may increase the output of electromagnetic radiation 14 by the light source 16 when the light guide 26, elongated body 20, and/or surrounding tissue are within an acceptable temperature range.
  • the phototherapy system 10 may additionally include a liquid cooling system 50.
  • the liquid cooling system 50 may include cooling tubes 52 extending from the proximal end 22 towards the distal end 24 of the elongated body 20.
  • the cooling tubes 52 may be in thermal communication with the elongated body 20, such that liquid 54 located within the cooling tubes 52 absorbs thermal energy from the elongated body 20.
  • the cooling tubes 52 may be connected to a pump for moving the liquid 54 through the cooling tubes 52 and a heat exchanger for removing thermal energy from the liquid 54 (i.e., lowering a temperature of the liquid).
  • the instrument 18 may have an elongated body 20 that is tubular and bifurcated (i.e., is a bifurcated tubular body) with a primary portion 60, a left portion 62, and a right portion 64.
  • the left portion 62 and the right portion 64 bifurcate from the primary portion 60, such that the left portion 62 is receivable in a first lung 66 of the patient and the right portion 64 is receivable separately in a second (different) lung 68 of the patient.
  • the light guide 26 includes a primary portion 70, a left portion 72, and a right portion 74.
  • the primary portion 70 of the light guide 26 is mechanically supported by the primary portion 60 of the tubular body 20.
  • the left portion 72 of the light guide 26 is optically coupled to the primary portion 70 of the light guide 26 and is mechanically supported by the left portion 62 of the tubular body 20.
  • the right portion 74 is optically coupled to the primary portion 70 of the light guide 26 and is mechanically supported by the right portion 64 of the tubular body 20. That is, the left and right portions 62, 64 of the light guide 26 are optically coupled to the primary portion 60 of the light guide 26, such that electromagnetic radiation 14 transported in the primary portion 60 may pass into and be transported by the left portion 62 or the right portion 64.
  • the left portion 62 and the right portion 64 of the tubular body 20 may be separately controllable, such that the left portion 62 of the tubular body 20 may be located in a separate lung from the right portion 64 of the tubular body 20.
  • the light source 16 may be any source of electromagnetic radiation 14 (also referred to as light).
  • the light source 16 may be an external light box mechanically separated from the instrument 18 and optically coupled to the instrument 18 via a light guide (e.g., fiber optics).
  • the light source 16 may be attached to and/or mechanically supported by the instrument 18.
  • the light source 16 may include light emitters 38.
  • the light emitters 38 may be any suitable structure for emitting electromagnetic radiation 14.
  • the light emitters 38 may include one or more light emitting diodes (LEDs), organic LEDs (OLEDs), microLEDs, laser diodes, mini-LED, quantum dot (QD)-conversion, phosphor conversion, excimer lamps, multi-photon combination, or SLM wavefront manipulation.
  • the electromagnetic radiation 14 may have any suitable properties for treating inflammatory conditions.
  • the electromagnetic radiation 14 may include any wavelength of electromagnetic radiation 14, such as infrared (e.g., 805 nm, 940 nm and/or any wavelength in the range of 800-1000 nm), red (e.g., 660nm or any wavelength in the range of 620-720 nm), and blue (e.g., 405 nm, 450 nm).
  • the light source may emit different wavelengths of light sequentially or simultaneously.
  • the electromagnetic radiation 14 includes blue light for reducing scarring, and 405 nm light or ultraviolet (UV) light to reduce infection.
  • the electromagnetic radiation 14 includes mixed wavelength to effectively activate mitochondria while controlling temperature, reducing viral load, and minimizing scarring.
  • the light guide 26 and light source 16 may be implantable.
  • the light guide 26 may be made of optical fibers that biodegrade over time.
  • the optical fibers may be optically connected to the implantable light source 16.
  • the light source 16 may be similarly biodegradable.
  • a bioluminescence material may be applied as a coating to cure over the lungs. The coating may be absorbed by the lungs.
  • the phototherapy system 10 may be used to treat any suitable inflammatory condition, such as acute respiratory distress syndrome (ARDS), COVID, etc.
  • ARDS acute respiratory distress syndrome
  • COVID COVID
  • the processor circuitry 22 may have various implementations.
  • the processor circuitry 22 may include any suitable device, such as a processor (e.g., CPU), programmable circuit, integrated circuit, memory and VO circuits, an application specific integrated circuit, microcontroller, complex programmable logic device, other programmable circuits, or the like.
  • the processor circuitry 22 may also include a non-transitory computer readable medium, such as random-access memory (RAM), a read-only memory (ROM), an erasable programmable read-only memory (EPROM or Flash memory), or any other suitable medium. Instructions for performing the method described below may be stored in the non- transitory computer readable medium and executed by the processor circuitry 22.
  • the processor circuitry 22 may be communicatively coupled to the computer readable medium and network interface through a system bus, mother board, or using any other suitable structure known in the art.
  • references to “a,” “an,” and/or “the” may include one or more than one, and that reference to an item in the singular may also include the item in the plural.

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Pathology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Radiology & Medical Imaging (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Radiation-Therapy Devices (AREA)

Abstract

L'invention concerne un système de photothérapie conçu pour éclairer les poumons pour une photobiomodulation et/ou une photothérapie pendant des interventions médicales à court terme. Le système de photothérapie comprend un instrument comprenant un bronchoscope ou un tube trachéal ayant un corps allongé. Le corps allongé comprend un guide de lumière configuré pour recevoir et conduire la lumière le long du corps allongé. Le corps allongé comprend également des éléments d'extraction de lumière pour amener la lumière conduite à être émise à partir d'une surface d'émission de lumière pour éclairer le poumon d'un patient.
PCT/US2022/080479 2022-11-28 2022-11-28 Système d'éclairage pulmonaire Ceased WO2024118091A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PCT/US2022/080479 WO2024118091A1 (fr) 2022-11-28 2022-11-28 Système d'éclairage pulmonaire

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/US2022/080479 WO2024118091A1 (fr) 2022-11-28 2022-11-28 Système d'éclairage pulmonaire

Publications (1)

Publication Number Publication Date
WO2024118091A1 true WO2024118091A1 (fr) 2024-06-06

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ID=84887496

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PCT/US2022/080479 Ceased WO2024118091A1 (fr) 2022-11-28 2022-11-28 Système d'éclairage pulmonaire

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Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20100241198A1 (en) * 2009-03-20 2010-09-23 Mark Klepper Tubular device delivering light and radiation into a patient
US20180140863A1 (en) * 2015-05-18 2018-05-24 The General Hospital Corporation System and method for phototherapy for preventing or treating carbon monoxide poisoning
US20200384287A1 (en) * 2018-02-23 2020-12-10 GlobaLaseReach, LLC Device for delivering precision phototherapy
WO2021076399A1 (fr) * 2019-10-15 2021-04-22 Cedars-Sinai Medical Center Thérapie interne par ultraviolets
US20210299467A1 (en) * 2020-03-26 2021-09-30 Oscor Inc. System and method of using endobronchial ultraviolet light therapy to treat patients infected with covid-19 coronavirus, sars, cov-2

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20100241198A1 (en) * 2009-03-20 2010-09-23 Mark Klepper Tubular device delivering light and radiation into a patient
US20180140863A1 (en) * 2015-05-18 2018-05-24 The General Hospital Corporation System and method for phototherapy for preventing or treating carbon monoxide poisoning
US20200384287A1 (en) * 2018-02-23 2020-12-10 GlobaLaseReach, LLC Device for delivering precision phototherapy
WO2021076399A1 (fr) * 2019-10-15 2021-04-22 Cedars-Sinai Medical Center Thérapie interne par ultraviolets
US20210299467A1 (en) * 2020-03-26 2021-09-30 Oscor Inc. System and method of using endobronchial ultraviolet light therapy to treat patients infected with covid-19 coronavirus, sars, cov-2

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