The invention relates generally to catheters used in medical applications. More specifically, the invention relates to a multilumen central venous catheter (CVC) having an integral biosensor for detecting a physiological parameter.
In medical applications, patients in intensive care units (ICUs) or other emergency situations are often fitted with invasive appliances such as catheters so that vital fluids or medicine may be administered intravenously. A physician determining a fluid dosage to be provided to a patient intravenously may need to know symptoms as quickly as possible that can only be determined through blood tests. Just how quickly the information is needed depends on the gravity of the situation. In some cases, the speed with which a physiological parameter can be determined may be the difference between life and death. In those situations, the practice of drawing a blood sample and sending it off for laboratory analysis may be entirely too slow.
A more timely method for measuring blood chemistry to ascertain a physiological parameter of interest may eventually be perfected. One promising area in this field is amperometry, or intravenous amperometric sensing, in which the concentration of a material present in a patient's bloodstream may be determined by locating, within the circulatory system, an enzyme electrode that produces an electrical current proportional to the material concentration. If successfully engineered, this type of sensor, or biosensor, could be monitored continuously over many hours, or perhaps even days, using analytical electronics coupled to the biosensor through a conductive interface.
Among many problems impeding the development of a practical intravenous amperometric biosensor is the spatial design constraint posed by the circulatory system. The biosensor needs to be small enough to be suspended within a blood vessel, and still have sufficient mechanical integrity to withstand the rigors of installation. In addition, an attending physician needs to be able to quickly position the biosensor in a location that will provide accurate measurements.
One approach to solving the positioning problem has been proposed in U.S. Patent Application Publication 2004/0064086, which is directed to a multilumen catheter fitted with a sensing element. This publication, however, provides little or no guidance regarding how to install the sensing element within the catheter.
Installing a biosensor within a catheter raises a number of other problems. Any shielding system employed to protect the biosensor from damage during installation may still expose the biosensor to a continuous flow of venous blood when in use. The system may also discourage blood from clotting around the exposed portion of the biosensor, and allows for a reliable electrical connection to external instrumentation to be maintained. In short, a reliable system for in situ positioning of an intravenous biosensor has yet to be developed.
The invention discloses a single lumen or multilumen intravenous catheter assembly that includes an integral biosensor. The biosensor may be an amperometric sensor formed on a flex circuit and having an active portion containing an enzyme electrode that reacts with a substance in blood, such as glucose, to measure a physiological parameter such as glucose concentration. The biosensor may be positioned on the insertion or distal end of the catheter within or adjacent to a lumen for exposure to blood when the catheter is installed in a blood vessel. Electrical wires secured to the flex circuit may energize the electrode and may carry signals indicative of the physiological parameter to an electrical connector disposed on the proximal end of the catheter. One or more infusion ports also located on the proximal end of the catheter may be provided to inject infusate through another lumen into a patient.
In one embodiment, the catheter may include an elongated tube that forms the insertion portion of the assembly. The biosensor may be exposed to blood through a sensing port perforating an outer wall of the catheter tube between its proximal and distal ends. A lumen may extend through the tube and connect to the sensing port. The biosensor may be mounted to a support member or probe that displaces the active portion from an inner wall of the catheter for protection from friction during installation of the biosensor through the lumen. The support member or probe may position the biosensor concentrically within the lumen or against an inner diameter of the outer wall, so that the active portion is protectively displaced from an inner wall of the catheter. The biosensor may be sealed about the sensing port to prevent passage of fluid therethrough, or a proximal end of the sensing port may remain open to allow flushing of the biosensor with saline infused through the lumen. Alternatively, the biosensor may be mounted in a recessed area formed in the outer wall. The sensing port or recessed area may be placed proximally to fluid ejection ports to prevent infusate from affecting intravenous biosensor measurements.
The features, objects, and advantages of the invention will become more apparent from the detailed description set forth below when taken in conjunction with the drawings, wherein:
The invention provides a reliable system for in situ positioning of an intravenous biosensor. A catheter such as multilumen catheter, a central venous catheter (CVC), a peripherally inserted central catheter (PICC), or other commonly used peripheral intravenous (IV) line may provide a suitable platform for effective intravenous positioning of a biosensor. Although the invention may be employed using any of these types of devices, for purposes of illustration only, the invention is presented with reference to use with a multilumen CVC. One advantage of using a CVC as a platform for installing an intravenous biosensor may be its ability to reach the largest blood vessels of the body where a biosensor may be exposed to an abundant flow of blood. Further, certain embodiments of the invention may be economically employed for use with multilumen catheters. Thus, the invention is intended to have universal application to catheters.
The invention attaches, or integrates, a biosensor within a catheter. More specifically, the invention provides a system for reliably mounting a biosensor to the catheter or within a lumen of a catheter without increasing the catheter outer diameter. The invention provides for secure mounting and displacement of the biosensor from an inner wall of the catheter so that it may withstand mechanical stress during installation, and after installation receive an unimpeded flow of blood for sustained measurement accuracy.
One embodiment of the invention may employ an amperometric biosensor manufactured using flex circuit technology. Flex circuits have been used in medical devices as microelectrode substrates for in vivo applications. For example, one flex circuit design uses a laminate of a conductive foil (e.g., copper) on a flexible dielectric substrate (e.g., polyamide). The flex circuit may be formed on the conductive foil using masking and photolithography techniques. Flex circuits are desirable due to their small size, low manufacturing cost, ease in design integration, and physical flexibility during transport in applications such as CVC insertion. In one embodiment, the invention may employ a flex circuit having a length between about 1.00 inches and about 3.00 inches, and having a width between about 0.020 inches and about 0.040 inches.
A biosensor integrated with a catheter may be formed on a flex circuit substrate having electrodes mounted thereon, wherein one electrode may be an enzyme-bearing electrode. In one embodiment, the biosensor may be a glucose sensor, and the enzyme electrode may be at least partially coated with a glucose oxidase enzyme. Under proper conditions, when the enzyme electrode is energized and exposed to a flow of blood, oxygen and glucose may react with the enzyme, resulting in an output of electrical current that is proportional to the concentration of glucose in the blood. Energization of the enzyme electrode and detection of the resulting electrical signal may be achieved by connecting the electrode to external electronics via electrical wires. In addition to glucose monitoring, other biosensors may be used in the invention, such as sensors that measure electrolyte levels in blood or other analytes found in various body fluids.
The junction 19 connects the lumens 11a-11d and the conduit 17 to a narrow elongated tube 21 that forms an intravenous insertion portion of the catheter assembly 10. The tube 21 may be typically cylindrical, having a circular or somewhat oval cross section defining a longitudinal axis extending therethrough. The tube 21 may be formed from any material, including synthetic materials such as silicone, polyurethane, polyethylene, and the like. Through the junction 19, each of the lumens 11a-11d extend in separate parallel paths for some distance into the distal end of tube 21. One or more support structures 23 within the tube 21 may be disposed along the length of the catheter to provide rigidity.
The distal end of the catheter assembly 10 is shown in greater detail in
A port 25 exposing an active portion of a biosensor 29 may be referred to as a sensing port. A sensing port 25 may perforate an outer wall of catheter 10 to form a hole that opens into a lumen. In one embodiment, the sensing port 25 opens into only one lumen. The sensing port 25 as described herein may be generally oval or rectangular in shape, having a length between about 5.0 mm and about 15.0 mm, and having a maximum width between about 1.0 mm and about 3.0 mm. The sensing port 25 may be formed in a catheter, for example, by skiving an area of the outer wall of tube 21.
In one embodiment, one or more sensing ports 25 may be located on the tube 21 proximally to an end port. In another embodiment, a catheter may be configured with a single sensing port that is proximal to all other ports, such as port 25a of
The embodiment of
As shown in
After positioning the support tubing 35, to ensure that the biosensor 29 remains firmly anchored at the sensing port 25, an adhesive agent (not shown) such as an epoxy may be applied at locations 37 and 39, which correspond to the proximal and distal ends, respectively, of the sensing port 25. The adhesive may bond the biosensor 29 to support the tubing 35, and also bond support tubing 35 to the inner walls of the lumen 15. The adhesive may also beneficially seal the lumen 15 to prevent fluid or other material from entering the catheter interior through the sensing port 25. Thus, a completed catheter assembly 10 may provide an integral biosensor that is protectively centrally oriented within a lumen and exposed through a sealed sensing port in the outer catheter wall.
Prior to positioning of the biosensor 29, it may be mounted to a support member 43, which may be a tube or rod having a cylindrical or trapezoidal cross section. The support member 43 may then be inserted through the lumen 15 until the active portion 31 of the biosensor 29 is properly exposed through the sensing port 25. As shown in the cross sectional view of
One advantage to embodiment of
To biosensor may not increase the overall outer diameter of the catheter because the biosensor 29 is mounted in a recessed area of the tube 21. The side view of
A mounting port 51 may be formed through a proximal, substantially transverse wall of the recessed area 49, as indicated. A biosensor 29, such as a thin flex circuit amperometric biosensor, may extend through the mounting port 51 along the surface of the recessed area 49, such that a portion of the proximal end 37 of the biosensor 29 remains inside the lumen 15. The portion of the proximal end 37 remaining within the lumen 15 may include at least an area sufficient for coupling the wires 33 to the biosensor 29. The distal end 55 of the biosensor 29 may abut a substantially transverse distal wall of the recessed area 49. An adhesive or sealant 53 may then complete the assembly. The sealant 53 may be applied to the area in and around the mounting port 51 to provide a seal preventing passage of fluid therethrough. The sealant 53 may also be applied to the edges and bottom surface of the biosensor 29 to securely bond it to the recessed area 49.
In an alternative embodiment indicated in
As shown in
Another embodiment of a catheter with integral biosensor is depicted in
The flexibility of probe 61 allows it to be inserted into a lumen 15 at a proximal location, such as through an infusion port 11a, and moved through lumen until it reaches a sensing port 25. A plug 59 may be inserted in the distal end of lumen 15, as shown, to stop the progress of the probe 61 so that the active portion 31 may be accurately positioned at the sensing port 25. A keying configuration 63 may be formed in the inner wall of the lumen 15 to ensure proper orientation of the probe 61 within the lumen 15 so that the active portion 31 faces outward through the sensing port 25 for optimal exposure to blood flow. Thus, during installation, the key 63 guides the probe through the lumen 15 in proper orientation to exposes the active portion 31 through the sensing port 25 when a distal end of the probe 61 reaches the plug 59.
As indicated in
The invention has been disclosed in an illustrative manner. Accordingly, the terminology employed throughout should be read in an exemplary rather than a limiting manner. Although minor modifications of the invention will occur to those well versed in the art, it shall be understood that what is intended to be circumscribed within the scope of the patent warranted hereon are all such embodiments that reasonably fall within the scope of the advancement to the art hereby contributed, and that that scope shall not be restricted, except in light of the appended claims and their equivalents.
Claim of Priority under 35 U.S.C. §119 The present Application for Patent claims priority to Provisional Application No. 60/777,030 filed Feb. 27, 2006, and assigned to the assignee hereof and hereby expressly incorporated by reference herein.
Number | Date | Country | |
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60777030 | Feb 2006 | US |