The COVID-19 pandemic continues to rage on, but quite often, we don’t think of the consequences for those people that contract it. Often we hear of friends who have a few weeks of symptoms while at home, but for many, the situation is life-threatening.
In severe cases, coronavirus has people fighting for their lives. Alone, sedated, and without friends and family by their side. Patients connected to a life support machine will need to receive nutrition through an enteral feeding tube. And here’s the problem.
According to multiple studies, placing feeding tubes blindly leads to several complications, including the patient’s death. In one review of 9,931 insertions, 187 ended up in the tracheobronchial tree (which transports air into the lungs) instead of the stomach, with at least five of these misplacements caused patient death.
Intending to change this situation forever, ENvizion has created what can be described, since the company was founded in Israel, as the “Waze of feeding tubes.”
To get an idea of how it works, Doron Besser, CEO at ENvizion, demonstrated the ENvue solution to me (via Zoom, of course). Of course, the demonstration was not on a real patient, but using a highly sophisticated model that allowed me to see the inner workings of the body.
Before Besser started inserting tubes into our plastic and rubber test dummy, we discussed the problem’s size.
“We’re talking about 27 million feeding tubes which are inserted around the world every year,” Besser said. “The growth rates are estimated to be between 5.5 to 6.5 percent per year. And just in the United States, more or less 9 million feeding tubes are being inserted every twelve months. In the UK, we’re talking approximately 1 million tubes.”
Based on the misplacement rates we know about from various studies, one million feeding tubes are being placed in the lungs every year worldwide.
So why not just stick with the “gold standard,” and use X-rays to help determine the right positioning?
“One issue is that an X-ray is done after the procedure,” Besser said. “So that means one does the chest X-ray after the feeding tube may have been already placed in the lungs. So if there was any damage, it was done.”
The other issue, is time.
“One study says that you have to deliver nutrition as quickly as possible, certainly within 24 to 48 hours,” Besser said. “It is also recommended that this be placed deeper in the small intestine, which increases safety issues. So, if you have an X-ray performed two to four times to determine proper placement, it could be more than 48 hours for confirmation while waiting on confirmation from the radiologist.”
ENvizion’s solution is elegant, and impressive.
Besser begins by placing electrodes on the plastic patient’s body. The feeding tube has a small sensor in the tip, and on placing it into the mouth, you can see exactly where the tube is going on the computer. As the tube is moved further down into the patient, you see both the view from above, and from the side, with images showing where the body’s major organs are.
But that’s not everything in ENvizion’s bag of tricks.
The system also uses machine learning and AI to guide the process.
“As I push, look what happens when I begin to enter into the lung,” Besser said. “The algorithm identifies that, and it will then provide the user with an immediate, preemptive warning. So the moment that happens, the user can then manipulate it out of the windpipe as quickly as possible, and then try and manipulate it to get into the food pipe.”
The system is impressive, and Besser continues to show me a successful entry, guided by the sensors, the monitor, and the associated AI. While there are several different systems in use for the aid and assistance of feeding tube placement, this is by far the slickest and easiest to understand I’ve seen.
And that’s important in a post-COVID world.
“We’ve seen significant use of feeding tubes during these troubling times of COVID, because of mechanically ventilated patients, and patients who are very sick,” Besser said. “We see about a 30-40% increase in the sales and use of feeding tubes.
ENvizion’s ENvue system could become critical in treating and preventing further adverse health outcomes from COVID-19 infections within the first 24 hours. To help broaden its use, ENvizion recently announced its partnership with one of the largest private hospital networks in the U.S.
“The Waze of feeding tubes?” Yes, and it is a GPS that will have a much more significant impact as it becomes adopted by more hospitals and regions.