Stories of Medical Innovation

New Oxygen-Delivery Device Offers Safer, More Reliable Performance

A new oxygen-delivery device with the potential to replace an apparatus that has been standard medical equipment for more than 60 years has been invented by R. Patrick Yeatts, M.D., an oculoplastic surgeon at Wake Forest Baptist Medical Center.

The new device is a single-prong nasal cannula that offers simpler, safer and more reliable performance than the dual-prong devices currently in use worldwide, with more than 50 million surgeries performed each year in the United States alone.

Nasal cannulas are used to deliver supplemental oxygen to people in need of respiratory help, frequently patients under sedation and those recovering after an operation. Most nasal cannula comprise double-channel tubes that accommodate the simultaneous monitoring of carbon dioxide in the person’s breath, which is an indicator of respiratory function. Nasal cannulas in current use consist of plastic tubes placed behind the ears and across the cheeks with two prongs that rest on the upper lip and extend into the front of the nostrils.

While dual-prong cannulas have proven generally effective since being introduced in 1949, they do present some problems. The positioning of the tubes on both sides of the face can interfere with surgery on the head and neck; oxygen flow to the front of the nostrils can be insufficient for mouth breathers and people under heavy sedation; the proximity of the oxygen-in and carbon dioxide-out ports permits oxygen “blow-by” that can distort breath monitoring; and the nasal prongs can easily be dislodged, which not only interrupts oxygen delivery but also presents a fire hazard if oxygen is blown into a surgical field where cautery (burning or searing) is used.

The new device has a double-channel tube that is inserted through one nostril to near the top of the main airway, which ensures proper oxygen delivery in all individuals while greatly reducing the possibility of unintentional dislocation and eliminating the inadvertent flow of oxygen into a surgical field. The five-centimeter separation of its oxygen and carbon dioxide ports prevents the distortion of breath monitoring, and its placement in one nostril offers greater and unimpeded access for surgeons performing operations on the head and neck.

Wake Forest Innovations, the commercialization enterprise of the Medical Center, is currently working to bring the new nasal cannula to market through a licensing agreement with a medical device manufacturer, said Dean Stell, associate director of product commercialization. The pre-production device that is being shown to potential licensees was developed by Kenneth Russell, associate director of product innovation, based on Yeatts’ original design and prototype.

The average price for the current dual-prong devices is approximately $6 each. The Wake Forest single-prong cannula is suitable for all types of surgeries and other settings in which supplemental oxygen delivery and carbon dioxide monitoring are desired, it has a vast potential market.

“The single-prong nasal cannula devised by Dr. Yeatts is noteworthy for its efficiency, its potential impact in the global health care marketplace and its ease of use,” said Eric Tomlinson, D.Sc., Ph.D., Wake Forest Baptist’s chief innovation officer. “The greatest innovations, after all, are often the simplest.”

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