Disruptive solution of medical endoscopy in emergency and critical care diagnosis and treatment

1、 Life-saving techniques for acute gastrointestinal bleeding

(1) Endoscopic Immediate Hemostasis System

Hemospray hemostatic powder spray:

Technical principle: Titanate particles form a mechanical barrier on the bleeding surface, stopping bleeding within 30 seconds.

Clinical data: The control rate of Forrest Ia grade jet bleeding is 92%, which is three times faster than traditional titanium clips.

Over The Scope Clip (OTSC):

Bear Claw Design: Close ulcer perforation with a diameter of 3cm (such as Dieulafoy lesion), with a rebleeding rate of less than 5%.

(2) AI bleeding risk prediction

Real time visual algorithm:

Like Cosmo AI's BLEED Score, Rockall score is automatically calculated in endoscopic images to guide treatment priority.

2、 Minimally invasive treatment of airway emergencies

(1) ECMO combined with bronchoscopy

Technological breakthrough:

Portable ECMO (such as Cardiohelp) is used to maintain oxygenation and perform bronchoalveolar lavage (BAL) to remove COVID-19 mucus plugs.

Clinical value: Validation of operational safety in patients with PaO ₂/FiO ₂<100mmHg (Lancet Respir Med 2023).

(2) Cryoprobe airway recanalization

Rapid freezing technology:

-40 ℃ low-temperature probe (such as ERBE CRYO2) is used to freeze airway tumors, with a bleeding volume of<10ml (compared to electrocautery>200ml).

3、 Endoscopic intervention for severe pancreatitis

(1) Endoscopic guided debridement of necrotic tissue (EUS-NEC)

Technological innovation:

(2) Continuous peritoneal lavage system

Endoscopic placement of irrigation catheter:

Under the guidance of dual channel endoscopy, the amylase level in the lavage fluid is monitored in real-time.

4、 Endoscopic application in trauma emergency treatment

(1) Emergency hemostasis through thoracoscopy

Single hole rigid thoracoscopy:

Explore the chest cavity with a 5mm incision, use electrocoagulation to stop bleeding, and avoid thoracotomy (such as Storz 26003BA).

Military medical application: battlefield penetration injury bleeding control time reduced to 15 minutes.

(2) Duodenoscopy for the treatment of biliary tract injury

ERCP emergency stone removal+stent:

The placement of a fully covered metal stent during the surgery for common bile duct rupture has a success rate of 98%.

5、 Disruptive solution for ICU bedside monitoring

(1) Transnasal endoscopic placement of gastric emptying tube

Electromagnetic navigation technology:

Cortrak ® The system displays the catheter path in real-time, and the rate of accidentally entering the airway is reset to zero.

Comparison of X-ray positioning: The operation time has been reduced from 2 hours to 20 minutes.

(2) Micro cystoscopy for monitoring renal function

10Fr electronic cystoscope:

Continuously monitor the renal papillary ischemia status of critically ill patients (such as sepsis related AKI).

6、 Future technological directions

(1) Nano hemostatic endoscope:

Magnetic nanoparticles carrying thrombin, magnetic field guided precise embolization (animal experiment hemostasis time<10 seconds).

(2) Holographic AR navigation:

Microsoft HoloLens 2 projects the three-dimensional coordinates of the point of vascular rupture.

(3) Degradable airway stent:

The polycaprolactone material scaffold should be absorbed within 4 weeks to avoid secondary removal.

Clinical Benefit Comparison Table

Implementation strategy suggestions

Emergency department: Comes standard with the Hemofray+OTSC "Hemostasis Kit".

Trauma Center: Construct a hybrid operating room (CT+endoscopic integration).

Research focus: Developing a trauma bio adhesive endoscopic spraying system.

These technologies are pushing emergency endoscopy to the core position of "golden hour" treatment through three major breakthroughs: "minute level response, zero additional damage, and physiological function preservation". It is expected that by 2027, 50% of emergency open abdominal/thoracic surgeries will be replaced by endoscopy.