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WO2008009947A1 - Tubes de trachée - Google Patents

Tubes de trachée Download PDF

Info

Publication number
WO2008009947A1
WO2008009947A1 PCT/GB2007/002742 GB2007002742W WO2008009947A1 WO 2008009947 A1 WO2008009947 A1 WO 2008009947A1 GB 2007002742 W GB2007002742 W GB 2007002742W WO 2008009947 A1 WO2008009947 A1 WO 2008009947A1
Authority
WO
WIPO (PCT)
Prior art keywords
tube
discs
shaft
disc
suction
Prior art date
Application number
PCT/GB2007/002742
Other languages
English (en)
Inventor
Neil Adam Tookman
Original Assignee
Smiths Group Plc
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 Smiths Group Plc filed Critical Smiths Group Plc
Publication of WO2008009947A1 publication Critical patent/WO2008009947A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/04—Tracheal tubes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/04—Tracheal tubes
    • A61M16/0434—Cuffs
    • A61M16/0445—Special cuff forms, e.g. undulated
    • A61M16/0447—Bell, canopy or umbrella shaped
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/04—Tracheal tubes
    • A61M16/0434—Cuffs
    • A61M16/0454—Redundant cuffs
    • A61M16/0459—Redundant cuffs one cuff behind another
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/04—Tracheal tubes
    • A61M16/0475—Tracheal tubes having openings in the tube
    • A61M16/0477—Tracheal tubes having openings in the tube with incorporated means for delivering or removing fluids
    • A61M16/0479—Tracheal tubes having openings in the tube with incorporated means for delivering or removing fluids above the cuff, e.g. giving access to the upper trachea
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/04—Tracheal tubes
    • A61M16/0486—Multi-lumen tracheal tubes

Definitions

  • This invention relates to tracheal tubes of the kind having a tubular shaft and a plurality of outwardly-extending sealing discs mounted with the shaft one above the other towards the patient end.
  • Tracheal tubes are arranged to provide a passage for ventilation gas to and from a patient.
  • the patient end of the tube is inserted in the trachea and the other, machine end protrudes from the body, that is, from the mouth in the case of an endotracheal tube or from a stoma in the neck in the case of a tracheostomy tube.
  • the tube is provided with sealing means towards its patient end in the form of an inflatable cuff.
  • the purpose of this cuff is to seal the outside of the tube with the inside of the trachea in order to confine gas to flow along the bore of the tube and to prevent gas flow between the outside of the tube and the wall of the trachea.
  • inflatable cuffs There can be problems with inflatable cuffs.
  • the cuff may leak or be under-inflated and provide an incomplete seal.
  • the cuff may be over-inflated and cause trauma to the lining of the trachea. Over-inflation may be caused by permeation of anaesthetic gases, such as nitrous oxide, through the wall of the cuff.
  • the cuff needs to be monitored during use to ensure that the cuff pressure is optimal but this may not be easy to do.
  • the sealing cuff may crease or deform when inflated and form passages along which secretions that collect above the cuff can seep past the cuff into the lungs. Secretions that do enter the lungs can give rise to pneumonia infections.
  • a tracheal tube of the above- specified kind characterised in that the tube includes a suction lumen extending rearwardly along the shaft from an opening closely adjacent the rear side of at least one of the discs such that secretions collecting above that disc can be removed by applying suction to the lumen.
  • the disc adjacent the suction opening is the uppermost disc closest to the machine end of the tube.
  • Each disc is preferably dished to form a concave recess on its rear side.
  • the or each suction opening is preferably located within the concave recess of a respective disc.
  • the tube may include a plurality of suction openings adjacent the rear side of respective sealing discs.
  • the sealing discs are preferably arranged to fold rearwardly along the shaft during insertion of the tube into the trachea and to fold forwardly, in the opposite direction, when the tube is removed from the trachea.
  • the sealing discs may each have a radial slit extending to their outer edge to enable the discs to expand and contract.
  • the suction lumen preferably extends within the thickness of the wall of the shaft.
  • the tube may be an endotracheal tube.
  • Figure 1 is a side elevation view of the tube
  • Figure 2 is a perspective view of the patient end of the tube
  • Figure 3 is a cross-sectional view of the tube along the line III-III of Figure 1;
  • Figure 4 is a side elevation view of the patient end of the tube with the discs folded back during insertion of the tube; and Figure 5 is a side elevation view of the patient end of the tube with the discs folded forwards during removal of the tube.
  • the endotracheal tube includes a tubular shaft 1 of circular section made of a bendable plastics material such as PVC and curved along its length.
  • the shaft 1 is terminated with a coupling 3 adapted to connect with a cooperating coupling on tubing extending from a ventilation machine, resuscitator or the like. Where the patient is breathing spontaneously the machine end 2 may be left open.
  • the forward or patient end 4 is bevelled at an angle of about 45°.
  • the length and diameter of the shaft 1 differs from tube to tube according to the size and build of the patient on which the tube is to be used.
  • the tube has sealing means close to the patient end 4 in the form of four resilient, flexible discs 11 to 14.
  • the discs 11 to 14 are circular, having a central circular aperture 15 bonded to the outside of the shaft 1 so that the discs extend outwardly of the shaft.
  • the discs 11 to 14 In their natural state, the discs 11 to 14 each adopt a dished shape forming a rearwardly-facing concave recess 16.
  • the external diameter of the discs 11 to 14 is about three times the external diameter of the shaft 1.
  • Each disc 11 to 14 has a radial slit or cut 17 extending from its outer edge 18 radially inwardly to a point close to the central aperture 15. The slit 17 enables each disc to expand and retract.
  • the discs 11 to 14 are equally spaced from one another along the length of the shaft 1, the spacing between adjacent discs being less than the radial width of the discs, that is, the radial distance between the central aperture 15 and the outer edge 18 of the disc. It will be appreciated that the present invention is not confined to tubes with four discs but that any number of two or more discs could be used.
  • the tube also has a suction lumen 20 extruded within the thickness of the wall of the shaft 1 and extending along the shaft on the outside of its curve.
  • the suction lumen 20 is closed at the patient end tip 4 of the shaft 1 but opens externally via a suction opening 21 cut through the outer wall of the shaft just above the upper, or rearmost ones of the discs 11, that is, within the recess 16 formed on the upper side of the disc.
  • the rear end of the suction lumen 20 is also closed, at the machine end 2 of the shaft 1, connection being made to the lumen by a small-bore suction tube 22 joined into the suction lumen via an opening cut into the suction lumen from outside the shaft, about halfway along the length of the tube.
  • the rear end of the suction tube 22 is terminated by a closable or valved coupling 23 by which a suction source, such as a syringe (not shown), can be connected to the suction tube.
  • the tube is inserted through the mouth in the usual way.
  • the forward movement and contact with patient tissue deflects the discs 11 to 14 rearwardly so that they overlap one another in the manner shown in Figure 4.
  • the resilient nature of the discs 11 to 14 causes them to open outwardly to the configuration shown in Figure 2.
  • the outer edge 18 of each disc 11 to 14 expands to contact and seal with the tracheal wall.
  • Any secretions that form in the trachea above the discs 11 to 14 collect on the uppermost disc 11, in its recess 16.
  • These secretions are periodically removed by applying suction to the rear end 23 of the suction tube 22 so that the secretions are sucked from the recess 16, through the opening 21, along the suction lumen 20 and into the suction tube for disposal.
  • the tube could be provided with one or more additional suction openings positioned just above each of the other discs 12, 13 and 14. Each additional suction opening would preferably open into its own suction lumen.
  • Figure 2 shows, in broken lines, an example of a tube with three further suction openings 21% 21" and 21'" one above each of the other discs.
  • the suction opening of a tube having just one suction opening is located above the rear or uppermost disc 11, it is not essential since secretions could be collected via an opening above a lower one of the discs.
  • the suction lumen or lumens need not be formed within the wall of the shaft but could be provided by a separate tube or tubes attached to the outside of the shaft in some way, such as in a channel formed in the outer wall of the shaft, the suction opening being provided by an open end of the or each tube.

Landscapes

  • Health & Medical Sciences (AREA)
  • Pulmonology (AREA)
  • Emergency Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Anesthesiology (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Hematology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)
  • Media Introduction/Drainage Providing Device (AREA)
  • External Artificial Organs (AREA)

Abstract

L'invention concerne un tube endotrachéal qui est scellé de façon étanche à l'intérieur de la trachée au moyen de plusieurs disques d'étanchéité souples (11 à 14) espacés les uns des autres le long de l'axe du tube (1) vers son extrémité de patient (4). Les disques (11 à 14) sont chacun incurvés avec une cavité concave (16) sur leur côté arrière et ont également une fente radiale (17) pour permettre une dilatation et une contraction. Une lumière d'aspiration (20) s'étendant le long de l'axe (1) s'ouvre par l'intermédiaire d'une ouverture (21) située dans la cavité (16) du disque le plus élevé (11) de telle sorte que des sécrétions s'amassant au-dessus du disque peuvent être retirées.
PCT/GB2007/002742 2006-07-20 2007-07-19 Tubes de trachée WO2008009947A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
GB0614362.2 2006-07-20
GBGB0614362.2A GB0614362D0 (en) 2006-07-20 2006-07-20 Tracheal tubes

Publications (1)

Publication Number Publication Date
WO2008009947A1 true WO2008009947A1 (fr) 2008-01-24

Family

ID=36998363

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/GB2007/002742 WO2008009947A1 (fr) 2006-07-20 2007-07-19 Tubes de trachée

Country Status (2)

Country Link
GB (1) GB0614362D0 (fr)
WO (1) WO2008009947A1 (fr)

Cited By (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2009132043A1 (fr) * 2008-04-22 2009-10-29 Abnousi, Freddy Tube endotrachéal
WO2014191594A1 (fr) * 2013-05-27 2014-12-04 Servicio Andaluz De Salud Tube endotrachéal amélioré
WO2015107318A1 (fr) 2014-01-14 2015-07-23 Smiths Medical International Limited Tube médico-chirurgical comportant un agencement d'étanchéité
CN104874079A (zh) * 2015-05-29 2015-09-02 四川大学华西医院 声门下吸引气管导管
WO2015147769A1 (fr) * 2014-03-25 2015-10-01 Demi̇rci̇ Mehmet Fatih Sonde endotrachéale sans ballonnet
US9750910B2 (en) 2014-08-14 2017-09-05 Coeo Labs Private Limited Systems for automatically removing fluid from multiple regions of a respiratory tract
DE102016120819A1 (de) * 2016-11-02 2018-05-03 Tracoe Medical Gmbh Trachealkanüle mit einer Abdichteinrichtung
WO2018203073A1 (fr) * 2017-05-03 2018-11-08 Lancashire Teaching Hospitals NHS Foundation Trust Dispositif de trachéotomie amélioré
US20200030557A1 (en) * 2018-07-27 2020-01-30 Guillermo L. Pol Medical tubes for selective mechanical ventilation of the lungs

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3659611A (en) * 1969-12-15 1972-05-02 Dow Corning Tracheal tube seal
DE3523663A1 (de) * 1985-06-28 1987-01-08 Zdsislaw Forycki Endotrachealkanuele bzw. -tubus
WO1993004725A1 (fr) * 1991-09-12 1993-03-18 UNITED STATES GOVERNMENT as represented by SECRETARY DEPARTMENT OF HEALTH AND HUMAN SERVICES Organes d'etancheite pour tubes endotracheens
US5322062A (en) * 1993-04-08 1994-06-21 Servas Francis M Non-inflatable sealing cuff for tracheal tube and other cannula
US5520175A (en) * 1995-05-22 1996-05-28 Fry; William R. Endotracheal tube with suctioning means
DE19734821A1 (de) * 1997-08-12 1999-02-18 Tracoe Medizine Ges Fuer Endotracheal- oder Tracheotomietubus

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3659611A (en) * 1969-12-15 1972-05-02 Dow Corning Tracheal tube seal
DE3523663A1 (de) * 1985-06-28 1987-01-08 Zdsislaw Forycki Endotrachealkanuele bzw. -tubus
WO1993004725A1 (fr) * 1991-09-12 1993-03-18 UNITED STATES GOVERNMENT as represented by SECRETARY DEPARTMENT OF HEALTH AND HUMAN SERVICES Organes d'etancheite pour tubes endotracheens
US5322062A (en) * 1993-04-08 1994-06-21 Servas Francis M Non-inflatable sealing cuff for tracheal tube and other cannula
US5520175A (en) * 1995-05-22 1996-05-28 Fry; William R. Endotracheal tube with suctioning means
DE19734821A1 (de) * 1997-08-12 1999-02-18 Tracoe Medizine Ges Fuer Endotracheal- oder Tracheotomietubus

Cited By (12)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2009132043A1 (fr) * 2008-04-22 2009-10-29 Abnousi, Freddy Tube endotrachéal
WO2014191594A1 (fr) * 2013-05-27 2014-12-04 Servicio Andaluz De Salud Tube endotrachéal amélioré
WO2015107318A1 (fr) 2014-01-14 2015-07-23 Smiths Medical International Limited Tube médico-chirurgical comportant un agencement d'étanchéité
WO2015147769A1 (fr) * 2014-03-25 2015-10-01 Demi̇rci̇ Mehmet Fatih Sonde endotrachéale sans ballonnet
US9750910B2 (en) 2014-08-14 2017-09-05 Coeo Labs Private Limited Systems for automatically removing fluid from multiple regions of a respiratory tract
US10695516B2 (en) 2014-08-14 2020-06-30 Jagdish Chaturvedi Systems for automatically removing fluid from multiple regions of a respiratory tract
US11684738B2 (en) 2014-08-14 2023-06-27 InnAccell Technologies Private Limited Systems for automatically removing fluid from multiple regions of a respiratory tract
CN104874079A (zh) * 2015-05-29 2015-09-02 四川大学华西医院 声门下吸引气管导管
DE102016120819A1 (de) * 2016-11-02 2018-05-03 Tracoe Medical Gmbh Trachealkanüle mit einer Abdichteinrichtung
WO2018082981A1 (fr) * 2016-11-02 2018-05-11 Tracoe Medical Gmbh Canule trachéale dotée d'un dispositif d'étanchéité
WO2018203073A1 (fr) * 2017-05-03 2018-11-08 Lancashire Teaching Hospitals NHS Foundation Trust Dispositif de trachéotomie amélioré
US20200030557A1 (en) * 2018-07-27 2020-01-30 Guillermo L. Pol Medical tubes for selective mechanical ventilation of the lungs

Also Published As

Publication number Publication date
GB0614362D0 (en) 2006-08-30

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