Patent Grant
10926009
The present invention relates generally to medical suction catheter devices, and specifically to catheter devices for aspiration of tracheobronchial secretions and/or cleaning of tracheal ventilation tubes.
Suction catheters are commonly used to aspirate tracheobronchial fluids in patients ventilated with endotracheal tube (ETT) and tracheostomy tube devices. A problematic aspect of the use of suction catheters is the presence of bacterial biofilm within the ETT lumen through which the suction catheter passes. Consequently, as the suction catheter is inserted, there is high risk of it carrying bacterial biofilm from the ETT lumen deeper into the bronchial tree where the suction catheter reaches, and thereby increasing the risk of lung infection. Moreover, buildup of substantial biofilm thickness reduces the effective free lumen of the ETT for air passage. Therefore, there is a need for maintaining cleaner ETT lumens between suction operations, and preventing buildup of significant biofilm thickness.
UK Publication GB 2482618 A to Einav et al., which is assigned to the assignee of the present application and is incorporated herein by reference, describes a multi-lumen catheter for multiple fluids conduction, including balloon inflation with air via an inflation lumen, suction via a suction lumen, and cleaning fluids delivery via a cleaning fluid-delivery lumen.
U.S. Pat. No. 8,999,074 to Zachar et al., which is assigned to the assignee of the present application and is incorporated herein by reference, describes a cleaning catheter that includes fluid-delivery and suction lumens. A flow regulator defines suction and fluid ports. A mechanical user control element is configured to mechanically and non-electrically set activation states of the flow regulator, and transition between first and third configurations via a second configuration. When the control element is in the first configuration, the flow regulator blocks fluid communication (a) between the suction port and the suction lumen and (b) between the fluid port and the fluid-delivery lumen. When the control element is in the second configuration, the flow regulator effects fluid communication between the suction port and the suction lumen, and blocks fluid communication between the fluid port and the fluid-delivery lumen. When the control element is in the third configuration, the flow regulator effects fluid communication (a) between the suction port and the suction lumen and (b) between the fluid port and the fluid-delivery lumen.
Some applications of the present invention provide a multi-lumen catheter for cleaning an inner surface of a tracheal ventilation tube. Some techniques of the present invention enable single-handed simultaneous activation of inflation of an inflatable element and suctioning in a closed suction system for use with the tracheal ventilation tube. A closed suction system allows catheters to be used repeatedly without being detached from the tube system including the ventilation air supply. Applications of the present invention generally provide simple user control of conduction of fluids under positive and negative pressure (suction).
The cleaning catheter is insertable into the tracheal ventilation tube, and is shaped so as to define one or more distal suction orifices. The cleaning catheter comprises an elongate, flexible, tubular catheter main body, and an inflatable element, which is mounted to the catheter main body, typically at a location within 3 cm of at least one of the one or more distal suction orifices. An input module is coupled to the cleaning catheter, and comprises an inflation module, which comprises an inflation chamber separate from the suction source. The input module also comprises a flow regulator, which (a) is shaped so as to define a suction port coupleable in fluid communication with the suction source, and (b) is configured to assume at least first and second fluid-control states.
The input module further comprises a mechanical user control element, which is configured (a) to mechanically and non-electrically set the fluid-control states of the flow regulator, (b) to assume at least first and second configurations, and (c) to mechanically and non-electrically increase pressure in an interior of the inflation chamber during at least a portion of a transition of the mechanical user control element from the first configuration to the second configuration. The input module is arranged such that:
As a result of this arrangement, a single mechanical user control element both (a) mechanically creates pressure to inflate the inflation element and (b) mechanically connects the suction source and the distal suction orifices in fluid communication.
In some applications of the present invention, the input module is arranged such that:
In some applications of the present invention, the fluid-control states are actuated by axial motion of a proximal portion of the catheter main body relative to an input module housing. For some of these applications, transitions between the states are caused by shifts in alignment of lumen inlets with respect to various chambers of the input module. The shifts in alignment are typically caused via axial motion of a proximal-most input portion of the catheter main body within the input module housing, along the longitudinal axes of the input portion and the input module. For some applications, the mechanical user control element comprises a user control handle, the movement of which includes a component perpendicular to the associated axial motion of the catheter main body. The mechanical user control element translates the movement of the user control handle into axial motion of the catheter main body with respect to the input module housing.
In other applications of the present invention, the fluid-control states are not actuated by axial motion of the proximal portion of the catheter main body relative to the input module housing, and the mechanical user control element does not translate the movement of the user control handle into axial motion of the catheter main body relative to the input module housing. Instead, the proximal-most input portion of the catheter main body is fixed with respect to the input module. The movement of the user control handle actuates the fluid-control states without translating the movement into axial motion of the proximal portion of the catheter main body. The input module is arranged such that the user control handle is moveable with respect to the catheter main body in two opposite directions along a movement axis that forms a fixed angle of between 45 and 135 degrees with a central longitudinal axis of the proximal-most input portion of the catheter main body, typically 90 degrees. The input module is arranged such that movement of the user control handle along the movement axis mechanically causes corresponding movement, along or alongside the movement axis, of a distal opening of the suction port, which selectively brings the distal end of the suction port into and out of fluid communication with the interior of the inflatable element and the distal suction orifices.
For some applications, the inflation chamber is disposed within the mechanical user control element; for example, the inflation chamber may be defined by one or more interior surfaces of the user control handle.
In other applications of the present invention, the input module is arranged such that when the mechanical user control element is in the first configuration and the flow regulator is in the first fluid-control state, the flow regulator connects the interior of the inflation chamber and the interior of the inflatable element in fluid communication to deflate the inflatable element.
For cleaning a ventilation tube, the cleaning action typically comprises the following steps, which are typically performed in the following order:
There is therefore provided, in accordance with an application of the present invention, apparatus for use with a tracheal ventilation tube and a suction source, the apparatus including:
(A) a cleaning catheter, which (a) is insertable into the ventilation tube, (b) is shaped so as to define one or more distal suction orifices, and (c) which includes:
(B) an input module, which is coupled to the cleaning catheter, and includes:
wherein the input module is arranged such that:
For some applications, the mechanical user control element is configured to mechanically and non-electrically increase the pressure in the interior of the inflation chamber during an entirely of the transition of the mechanical user control element from the first configuration to the second configuration.
For some applications, the input module is configured such that during the at least a portion of the transition of the mechanical user control element from the first configuration to the second configuration, before the flow regulator assumes the second fluid-control state, a volume of the interior of the inflation chamber decreases by between 10% and 90%.
For some applications, the mechanical user control element is configured to mechanically and non-electrically increase the pressure in the interior of the inflation chamber during motion of the mechanical user control element while the flow regulator is in the second fluid-control state.
For some applications, the suction port is coupled in fluid communication with the suction source.
For some applications, the input module further includes a user signal generator, which is configured to generate a user signal during or upon deflation of the inflatable element.
For some applications, the inflation chamber has a volume of between 1 and 10 cc when the mechanical user control element is in the first configuration.
For some applications, when the mechanical user control element is in the second configuration, the inflation chamber has a volume of at least 1 cc less than when the mechanical user control element is in the first configuration.
For some applications, the mechanical user control element is biased toward the first configuration.
For some applications, the cleaning catheter further includes one or more suction lumens arranged along the catheter main body, and the flow regulator, when in the second fluid-control state, connects in fluid communication the suction source and the distal suction orifices via the one or more suction lumens.
For some applications, the inflatable element includes a balloon.
For some applications, the inflatable element is mounted to the catheter main body is within 5 cm of a distal end of the catheter main body.
For some applications, the inflatable element has a greatest outer diameter of between 6 and 12 mm when inflated at 1 bar above atmospheric pressure and unconstrained.
For some applications, the apparatus is for use with a ventilator, and the apparatus further includes a tube-connector assembly, which is configured to couple the ventilation tube in fluid communication with the ventilator, in a substantially air-tight manner.
For some applications, the first and the second configurations are first and second spatial positions, respectively, and the mechanical user control element is configured to assume at least the first and the second spatial positions.
For some applications, the mechanical user control element is arranged to move between first and second spatial end-points, and the first and the second spatial positions correspond with the first and the second spatial end-points, respectively.
For some applications:
For some applications, the one-way air inlet valve is configured to generate a sound signal during at least a portion of a period of fluid flow into the inflation chamber.
For any of the applications described hereinabove, the mechanical user control element may be configured to increase the pressure in the interior of the inflation chamber by mechanically and non-electrically compressing the inflation chamber during the at least a portion of the transition of the mechanical user control element from the first configuration to the second configuration.
For some applications, the inflation chamber transitions from a lower level of compression to a higher level of compression during the at least a portion of the transition of the mechanical user control element from the first configuration to the second configuration, and the input module is configured to elastically bias the inflation chamber toward the lower level of compression.
For some applications, the inflation module is elastically biased toward the lower level of compression.
For some applications, at least one wall of the inflation chamber is elastically biased toward the lower level of compression.
For some applications, the at least one wall of the inflation chamber is accordion-shaped.
For some applications, the inflation module includes an elastic element that is arranged to bias the inflation chamber toward the lower level of compression.
For some applications, the mechanical user control element is elastically biased toward the lower level of compression.
For any of the applications described hereinabove, the catheter main body may include a proximal-most input portion, which is disposed within and axially slidable with respect to the input module.
For some applications, the input module is arranged such that changes in configuration of the mechanical user control element cause corresponding changes in axial position of the input portion of the catheter main body with respect to the input module.
For some applications, the input module is arranged such that the input portion assumes first and second axial positions with respect to the input module, corresponding to the first and the second configurations of the mechanical user control element.
For any of the applications described hereinabove, the catheter main body may include a proximal-most input portion, which is disposed within and fixed with respect to the input module.
For some applications:
the mechanical user control element includes a user control handle,
the input module is arranged such that the user control handle is moveable with respect to the catheter main body in two opposite directions along a movement axis that forms a fixed angle of between 45 and 135 degrees with a central longitudinal axis of the proximal-most input portion of the catheter main body, and
the input module is arranged such that movement of the user control handle along the movement axis mechanically causes corresponding movement, along or alongside the movement axis, of a distal opening of the suction port, which selectively brings the distal end of the suction port into and out of fluid communication with the interior of the inflatable element and the distal suction orifices.
For some applications:
the inflation chamber is shaped so as to define an outlet, and
the input module is arranged such that movement of the user control handle along the movement axis mechanically causes corresponding movement of the outlet of the inflation chamber along or alongside the movement axis, which selectively brings the interior of the inflation chamber into and out of fluid communication with the interior of the inflatable element.
For any of the applications described hereinabove, the inflation chamber may be disposed within the mechanical user control element.
For some applications, the mechanical user control element includes a user control handle, and the inflation chamber is defined by one or more interior surfaces of the user control handle.
For some applications, the input module includes exactly one mechanical user control element configured (a) to mechanically and non-electrically set the fluid-control states of the flow regulator, (b) to assume the at least first and second configurations, and (c) to mechanically and non-electrically increase the pressure in the interior of the inflation chamber during the at least a portion of the transition of the mechanical user control element from the first configuration to the second configuration.
There is further provided, in accordance with an application of the present invention, apparatus for use with a tracheal ventilation tube and a suction source, the apparatus including:
(A) a cleaning catheter, which (a) is insertable into the ventilation tube, (b) is shaped so as to define one or more distal suction orifices, and (c) which includes:
(B) an input module, which is fixed to the proximal-most input portion of the catheter main body of the cleaning catheter, and includes:
wherein the input module is arranged such that:
For some applications, the suction port is coupled in fluid communication with the suction source.
For some applications, the mechanical user control element is biased toward the first spatial positions.
For some applications, the inflatable element includes a balloon.
For any of the applications described hereinabove:
the input module may further include an inflation module, which includes an inflation chamber separate from the suction source, and
the mechanical user control element may be configured to mechanically and non-electrically increase pressure in an interior of the inflation chamber during at least a portion of a transition of the mechanical user control element from the first spatial position to the second spatial position.
For some applications, the inflation chamber is disposed within the mechanical user control element.
For some applications, the inflation chamber is defined by one or more interior surfaces of the user control handle.
For some applications:
the inflation chamber is shaped so as to define an outlet, and
the input module is arranged such that movement of the user control handle along the movement axis mechanically causes corresponding movement of the outlet of the inflation chamber along or alongside the movement axis, which selectively brings the interior of the inflation chamber into and out of fluid communication with the interior of the inflatable element.
For some applications, the input module is arranged such that:
when the mechanical user control element is in the first spatial position, the flow regulator is in the first fluid-control state, in which the flow regulator blocks fluid communication between the suction source and the distal suction orifices, and
when the mechanical user control element is in the second spatial position, the flow regulator is in the second fluid-control state, in which the flow regulator (A) connects the suction source and the distal suction orifices in fluid communication, and (B) connects the interior of the inflation chamber and an interior of the inflatable element in fluid communication to inflate the inflatable element.
For some applications:
the flow regulator is configured to assume a third, intermediate fluid-control state, between the first and the second fluid-control states, in which (a) the suction source and the distal suction orifices are in fluid communication with one another, and (b) the interior of the inflation chamber and the interior of the inflatable element are not in fluid communication with one another, and
the flow regulator is configured to assume the third, intermediate fluid-control state when the mechanical user control element is in a third, intermediate spatial position between the first configuration and the second configuration.
For some applications, the input module is arranged such that:
when the mechanical user control element is in the first spatial position and the flow regulator is in the first fluid-control state, the flow regulator connects the suction source and the interior of the inflatable element in fluid communication to deflate the inflatable element, and
when the mechanical user control element is in the second spatial position and the flow regulator is in the second fluid-control state, the flow regulator does not connect the suction source and the interior of the inflatable element in fluid communication.
For some applications, the inflation module includes a one-way air inlet valve, which is arranged to allow air to flow into the inflation chamber during at least a portion of a transition of the mechanical user control element from the second spatial position to the first spatial position.
For some applications, the one-way air inlet valve is configured to generate a sound signal during at least a portion of a period of fluid flow into the inflation chamber.
For some applications, the input module is arranged such that when the mechanical user control element is in the first spatial position and the flow regulator is in the first fluid-control state, the flow regulator connects the interior of the inflation chamber and the interior of the inflatable element in fluid communication to deflate the inflatable element.
For some applications, the mechanical user control element is configured to increase the pressure in the interior of the inflation chamber by mechanically and non-electrically compressing the inflation chamber during the at least a portion of the transition of the mechanical user control element from the first spatial position to the second spatial position.
For some applications, the inflation chamber transitions from a lower level of compression to a higher level of compression during the at least a portion of the transition of the mechanical user control element from the first spatial position to the second spatial position, and the input module is configured to elastically bias the inflation chamber toward the lower level of compression.
For some applications, the inflation module is elastically biased toward the lower level of compression.
For some applications, at least one wall of the inflation chamber is elastically biased toward the lower level of compression.
For some applications, the at least one wall of the inflation chamber is accordion-shaped.
For some applications, the inflation module includes an elastic element that is arranged to bias the inflation chamber toward the lower level of compression.
For some applications, the mechanical user control element is elastically biased toward the lower level of compression.
There is still further provided, in accordance with an application of the present invention, apparatus for use with a tracheal ventilation tube and a suction source, the apparatus including:
(A) a cleaning catheter, which (a) is insertable into the ventilation tube, (b) is shaped so as to define one or more distal suction orifices, and (c) which includes:
(B) an input module, which is coupled to the cleaning catheter, and includes:
For some applications, the mechanical user control element includes a user control handle, and the inflation chamber is defined by one or more interior surfaces of the user control handle.
For some applications, the input module is arranged such that:
when the mechanical user control element is in the first configuration, the flow regulator is in the first fluid-control state, in which the flow regulator blocks fluid communication between the suction source and the distal suction orifices, and
when the mechanical user control element is in the second configuration, the flow regulator is in the second fluid-control state, in which the flow regulator (A) connects the suction source and the distal suction orifices in fluid communication, and (B) connects the interior of the inflation chamber and an interior of the inflatable element in fluid communication to inflate the inflatable element.
For some applications, the suction port is coupled in fluid communication with the suction source.
For any of the applications described hereinabove, the catheter main body may include a proximal-most input portion, which is disposed within and fixed with respect to the input module.
For some applications:
the mechanical user control element includes a user control handle,
the input module is arranged such that the user control handle is moveable with respect to the catheter main body in two opposite directions along a movement axis that forms a fixed angle of between 45 and 135 degrees with a central longitudinal axis of the proximal-most input portion of the catheter main body, and
the input module is arranged such that movement of the user control handle along the movement axis mechanically causes corresponding movement, along or alongside the movement axis, of a distal end of the suction port, which selectively brings the distal end of the suction port into and out of fluid communication with the interior of the inflatable element and the distal suction orifices.
For some applications:
the inflation chamber is shaped so as to define an outlet, and
the input module is arranged such that movement of the user control handle along the movement axis mechanically causes corresponding movement of the outlet of the inflation chamber along or alongside the movement axis, which selectively brings the interior of the inflation chamber into and out of fluid communication with the interior of the inflatable element.
There is additionally provided, in accordance with an application of the present invention, apparatus for use with a tracheal ventilation tube and a suction source, the apparatus including:
(A) a cleaning catheter, which (a) is insertable into the ventilation tube, (b) is shaped so as to define one or more distal suction orifices, and (c) which includes:
(B) an input module, which is coupled to the cleaning catheter, and includes:
wherein the input module is arranged such that:
For some applications, the first and the second mechanical user control buttons are arranged such that a portion of one of the first and the second mechanical user control buttons at least partially surrounds the other of the first and the second mechanical user control buttons.
For some applications, the first and the second mechanical user control buttons are arranged such that a closest distance between the first and the second mechanical user control buttons is between 0.1 mm and 2 mm.
For some applications, the input module is configured such that during the at least a portion of the transition of the first mechanical user control button from its first configuration to its second configuration, before the flow regulator assumes the second fluid-control state, a volume of the interior of the inflation chamber decreases by between 10% and 90%.
For some applications, the second mechanical user control button is configured to mechanically and non-electrically increase the pressure in the interior of the inflation chamber during motion of the second mechanical user control button while the flow regulator is in the second fluid-control state.
For some applications, the suction port is coupled in fluid communication with the suction source.
For some applications, the input module further includes a user signal generator, which is configured to generate a user signal during or upon deflation of the inflatable element.
For some applications, the inflation chamber has a volume of between 1 and 10 cc when the mechanical user control element is in the first configuration.
For some applications, when the second mechanical user control button is in the second configuration, the inflation chamber has a volume of at least 1 cc less than when the second mechanical user control button is in the first configuration.
For some applications, the first mechanical user control button is biased toward its first configuration.
For some applications, the second mechanical user control button is biased toward its first configuration.
For some applications, the first and the second configurations of the first mechanical user control button are first and second spatial positions, respectively, and the first mechanical user control button is configured to assume at least the first and the second spatial positions.
For some applications, the first and the second configurations of the second mechanical user control button are first and second spatial positions, respectively, and the second mechanical user control button is configured to assume at least the first and the second spatial positions.
For some applications:
the flow regulator is configured to assume a third, intermediate fluid-control state, between the first and the second fluid-control states, in which (a) the suction source and the distal suction orifices are in fluid communication with one another, and (b) the interior of the inflation chamber and the interior of the inflatable element are not in fluid communication with one another, and
the flow regulator is configured to assume the third, intermediate fluid-control state when the first mechanical user control button is in a third, intermediate configuration between its first configuration and its second configuration.
For any of the applications described hereinabove, the inflation module may include a one-way air inlet valve, which is arranged to allow air to flow into the inflation chamber during at least a portion of a transition of the second mechanical user control button from its second configuration to its first configuration.
For some applications, the one-way air inlet valve is configured to generate a sound signal during at least a portion of a period of fluid flow into the inflation chamber.
For any of the applications described hereinabove, the second mechanical user control button may be configured to increase the pressure in the interior of the inflation chamber by mechanically and non-electrically compressing the inflation chamber during the at least a portion of the transition of the second mechanical user control button from its first configuration to its second configuration.
For some applications, the inflation chamber transitions from a lower level of compression to a higher level of compression during the at least a portion of the transition of the second mechanical user control button from its first configuration to its second configuration, and the input module is configured to elastically bias the inflation chamber toward the lower level of compression.
For some applications, the inflation module is elastically biased toward the lower level of compression.
For some applications, at least one wall of the inflation chamber is elastically biased toward the lower level of compression.
For some applications, the at least one wall of the inflation chamber is accordion-shaped.
For some applications, the inflation module includes an elastic element that is arranged to bias the inflation chamber toward the lower level of compression.
For some applications, the second mechanical user control button is elastically biased toward the lower level of compression.
There is further provided, in accordance with an application of the present invention, a method for use with a tracheal ventilation tube and a suction source, the method including:
coupling, in fluid communication with the suction source, a suction port of a flow regulator of an input module that (a) is configured to assume at least first and second fluid-control states, and (b) includes (i) an inflation module, which includes an inflation chamber separate from the suction source, and (ii) a mechanical user control element, which is configured to mechanically and non-electrically set the fluid-control states of the flow regulator;
setting the mechanical user control element in a first configuration, in which the flow regulator is in a first fluid-control state, in which the flow regulator blocks fluid communication between the suction source and one or more distal suction orifices defined by a cleaning catheter that (a) is coupled to the input module and (b) includes (i) an elongate, flexible, tubular catheter main body, and (ii) an inflatable element, which is mounted to the catheter main body at a location within 3 cm of at least one of the one or more distal suction orifices, wherein at least when the mechanical user control element is in the first configuration, the flow regulator is in the first fluid-control state, in which the flow regulator connects the suction source and an interior of the inflatable element in fluid communication to deflate the inflatable element;
while the mechanical user control element is in the first configuration, inserting the cleaning catheter, in a proximal to distal direction, into the ventilation tube inserted in a trachea of a patient, and advancing the cleaning catheter until a distal end of the catheter main body is axially disposed in the ventilation tube at a location more distal than an axial mid-point of the ventilation tube; and
while the cleaning catheter is thus disposed, transitioning the mechanical user control element from the first configuration to a second configuration, in which the flow regulator is in a second fluid-control state, in which the flow regulator (a) connects the suction source and the distal suction orifices in fluid communication, and (b) connects an interior of the inflation chamber and an interior of the inflatable element in fluid communication to inflate the inflatable element,
wherein the mechanical user control element is configured to mechanically and non-electrically increase pressure in an interior of the inflation chamber during at least a portion of the transitioning of the mechanical user control element from the first configuration to the second configuration.
For some applications, the input module is configured such that during the at least a portion of the transition of the mechanical user control element from the first configuration to the second configuration, before the flow regulator assumes the second fluid-control state, a volume of the interior of the inflation chamber decreases by between 10% and 90%.
For some applications, the inflation chamber includes a one-way air inlet valve, which is arranged to allow air to flow into the inflation chamber during at least a portion of a transition of the mechanical user control element from the second configuration to the first configuration.
The present invention will be more fully understood from the following detailed description of embodiments thereof, taken together with the drawings, in which:
As used in the present application, including in the claims, a “tracheal ventilation tube” comprises an endotracheal tube (ETT) or a tracheostomy tube. Suction source 601 provides a pressure less than one atm. As used in the present application, including in the claims, a “fluid” comprises liquid and/or gas, for example, a liquid-gas mixture that is predominantly liquid, such as a liquid with gas bubbles. The liquid may comprise water, such as saline solution or a disinfectant solution.
Cleaning system 100 comprises a distal ventilation tube-connector assembly 158, a cleaning catheter 200, and an input module 156. Cleaning catheter 200 comprises an elongate, flexible, tubular catheter main body 210. As shown in
As used in the present application, including in the claims, “axial” and “axially” mean along an axis, and do not mean around or about an axis. For example: (a) “axial motion” means motion along an axis, and (b) “axially aligned” means aligned along an axis.
Ventilation tube-connector assembly 158 comprises: (a) a ventilator port 664, configured to be coupled in fluid communication with ventilator 170 via a ventilator connection tube 910, (b) a ventilation tube port, configured to be coupled in fluid communication with a proximal end of ventilation tube 160, and (c) a main body inlet, which is configured to allow passage therethrough of catheter main body 210.
In some applications of the present invention, cleaning system 100 is operative to clean an interior of ventilation tube 160 when ventilation tube-connector assembly 158 is directly or indirectly connected to both ventilation tube 160 and ventilator 170 so as to mediate a substantially air-tight connection (e.g., via an interior chamber(s) and/or conduit(s) of ventilation tube-connector assembly 158) between the ventilator and an interior of the ventilation tube.
Cleaning catheter 200 further comprises an inflatable element 588, such as a balloon, which is mounted to catheter main body 210 near a distal end of catheter main body 210. e.g., within 3 cm, such as within 1 cm, of the distal end, and/or in a distal half of distal portion 212 of cleaning catheter 200, such as a distal third, a distal fifth, or a distal tenth of distal portion 212. Alternatively or additionally, inflatable element 588 is mounted to catheter main body 210 within 3 cm, e.g., within 1 cm, of at least one of the one or more distal suction orifices 440, described hereinbelow. Inflatable element 588 is inflatable into contact with an inner surface of ventilation tube 160. For some applications, inflatable element 588 has a greatest outer diameter of at least 6 mm, no more than 12 mm, and/or between 6 and 12 mm when inflated at 1 bar above atmospheric pressure and unconstrained (i.e., not constrained by the ventilation tube or anything else), which is typically slightly greater than an inner diameter of ventilation tube 160, in order to provide sealing contact with the inner surface of the ventilation tube. For some applications, inflatable element 588 has a volume of at least 0.5 cc, no more than 2 cc, and/or between 0.5 and 2 cc when inflated at 1 bar above atmospheric pressure and unconstrained. For some applications, inflatable element 588 is elastic, while for other applications inflatable element 588 is not elastic. For some applications, inflatable element 588 comprises a thin pliable material, such that the inflatable element crumples when deflated.
For some applications, catheter main body 210 has an outer diameter of at least 6 mm, no more than 12 mm, and/or between 6 and 12 mm. For some applications, the greatest outer diameter of inflatable element 588 when fully inflated and unconstrained (i.e., not constrained by the ventilation tube or anything else) equals at least 60%, no more than 120%, and/or between 60% and 120% of the outer diameter of catheter main body 210.
Reference is now made to
Inflation lumen 520 typically has a cross-sectional area smaller than that of suction lumen 530, e.g., less than 50%, less than 30%, or less than 20% of the cross-sectional area of suction lumen 530.
Reference is still made to
During one state of operation, cleaning system 100 cleans the inner surface of ventilation tube 160 when ventilation tube-connector assembly 158 mediates a substantially air-tight seal between (i) ventilator 170 and/or an interior of ventilator port 664 and (ii) an interior of ventilation tube 160 and/or an interior of the ventilation tube port.
Concurrently with maintaining of this ventilation machine-ventilator tube seal, inflatable element 588 may be positioned within ventilation tube 160 (e.g., in a distal portion of ventilation tube 160), for example by moving a distal end of catheter main body 210 in a distal direction towards a distal end of ventilation tube 160. For example, inflatable element 588 may be distally advanced when inflatable element 588 is in a non-contact state (i.e., not in contact with the inner surface of ventilation tube 160). After inflatable element 588 is thus positioned, inflation of the inflatable element induces contact between an outer surface of inflatable element 588 and the inner surface of ventilation tube 160 and/or obstructs (i.e., significant hinders) longitudinal flow between proximal and distal portions of the interior of ventilation tube 160.
Upon inflation of inflatable element 588 when the inflatable element is positioned within ventilation tube 160, the inflated inflatable element forms a sliding boundary which obstructs (i.e., significantly hinders) fluid flow to between: (a) a more proximal portion of an interstitial region outside of catheter main body 210 and within ventilation tube 160 and (b) locations within the ventilation tube 160 that are distal to the slidable boundary formed and delineated by inflatable element 588. This slidable boundary between the proximal and distal portions may be useful for facilitating the cleaning of the inner surface of ventilation tube 160 (by wiping), for example for substantially confining locations of negative pressure and/or fluid (e.g., pressurized fluid) introduced into an interstitial region outside of catheter main body 210 and within ventilation tube 160 so that the suction is introduced predominantly in the proximal portion of ventilation tube 160.
Distal portion 212 of cleaning catheter 200 (labeled in
Distal suction orifices 440 are supplied with negative pressure by suction source 601 and facilitate cleaning of the inner surface of ventilation tube 160. For some applications, material within the interior of ventilation tube 160 may be suctioned into distal suction orifices 440 and proximally transported out of ventilation tube 160, e.g., to a location that is proximal to ventilation tube-connector assembly 158. As described below in detail, fluid communication between suction source 601 and distal suction orifices 440 may be provided by one or more connecting lumens within or along catheter main body 210. As used in the present application, including in the claims, “fluid communication” includes both positive and negative pressure fluid communication, and thus includes, for example, communication of a positive pressure or of a suction force.
For some applications, cleaning system 100 comprises a substantially impermeable and/or pliable sleeve 610 for protecting an outer surface of catheter main body 210. In some embodiments, sleeve 610 envelops, surrounds, and/or protects at least some (e.g., at least a majority or at least a substantial majority, e.g., at least 75% or substantially all of (e.g., at least 90%)) of an outer surface of a ventilation-tube-connector-assembly-proximal portion 214 of catheter main body 210, typically in locations proximal to tube-connector assembly 158 and distal to suction port 830 (described hereinbelow), and typically to inhibit contamination. For some applications, sleeve 610 provides this enveloping and/or protection functionality when a length of the ventilation-tube-connector-assembly-proximal portion 214 (labeled in
For some applications, a length of proximal portion 214 may be modified by sliding, in a proximal or distal direction, catheter main body 210 through ventilation tube-connector assembly 158.
For some applications, a distal end of sleeve 610 is (i) directly or indirectly attached to and/or (ii) has a location that is fixed and/or longitudinally fixed relative to ventilation tube-connector assembly 158. For some applications, a longitudinal position of a location of the distal end of sleeve 610 corresponds to a location on ventilation tube-connector assembly 158 (e.g., at or near the main body inlet) and/or is longitudinally displaced from a proximal end (e.g., corresponding to the main body inlet) of ventilation tube-connector assembly 158 by at most 5 cm, e.g., at most 3 cm, at most 2 cm, or at most 1 cm, and/or at most 50%, e.g., at most 30%, at most 20%, at most 10% of a length of ventilation-tube-connector-assembly-proximal portion 214 of catheter main body 210.
For some applications, a location of the distal end of sleeve 610 is not fixed relative to catheter main body 210. For example, catheter main body 210 may be longitudinally slidable within the sleeve 610 at or near a location of the distal end. Alternatively or additionally, for some applications, a location of a proximal end of sleeve 610 is fixed and/or longitudinally fixed relative to a proximal end of catheter main body 210. For some applications, sleeve 610 forms a substantially air-tight seal between the external environment and an outer surface of ventilation-tube-connector-assembly-proximal portion 214 of catheter main body 210 and/or between the external environment and region of space outside of an outer surface of ventilation-tube-connector-assembly-proximal portion 214 of catheter main body 210 and within sleeve 610.
Reference is now made to
As mentioned above, in some configurations input portion 216 of proximal portion of catheter main body 210 is configured to be inserted into or is disposed within, and axially slidable with respect to, input module 156. Input module 156 has at least one port for connection with a fluid source, including at least suction source 601. Input module 156 is coupled to cleaning catheter 200, and comprises:
For some applications, the first and second configurations of mechanical user control element 320 are first and second spatial positions, respectively. Mechanical user control element 320 is configured to assume at least the first and the second spatial positions.
For some applications, input module 156 comprises exactly one mechanical user control element 320 having the properties described herein, and/or system 100 comprises exactly one mechanical user control element 320 having the properties described herein.
Input module 156 and/or system 100 may comprise further user control elements that perform control functions in addition to those performed by mechanical user control element 320.
Input module 156 is arranged such that:
Typically, mechanical user control element 320 is able to assume an infinite number of intermediate configurations (e.g., spatial positions) between the first configuration and the second configuration, as mechanical user control element 320 transitions between the first configuration and the second configuration and vice versa. For some applications, mechanical user control element 320 is arranged to move between first and second spatial end-points, and the first and the second spatial positions correspond with the first and the second spatial end-points, respectively, as shown. Alternatively, the first and the second spatial positions do not correspond with the first and the second spatial end-points, respectively (configuration not shown), but instead the first spatial position and/or the second spatial position are between the first and the second spatial end-points. For some applications, the above-mentioned intermediate configurations include the third intermediate configuration (e.g., spatial position) described hereinbelow with reference to
Input module 156 is typically arranged such that flow regulator 700 is in the first fluid-control state not only when mechanical user control element 320 is in the first configuration (e.g., spatial position), as shown in
As mentioned above, mechanical user control element 320 is configured to mechanically and non-electrically increase pressure in an interior of inflation chamber 335 during at least a portion of the transition of mechanical user control element 320 from the first configuration to the second configuration. For some applications, mechanical user control element 320 is configured to mechanically and non-electrically increase the pressure in the interior of inflation chamber 335 during an entirety of the transition of mechanical user control element 320 from the first configuration to the second configuration.
For some applications, input module 156 is configured such that during the at least a portion of the transition of mechanical user control element 320 from the first configuration to the second configuration, before flow regulator 700 assumes the second fluid-control state, a volume of the interior of inflation chamber 335 decreases by at least 10%, such as at least 20%, 30%, 40%, or 50%, and/or no more than 90%, such as no more than 80% or 70%, e.g., by between 10% and 90%. In other words, the pressure in inflation chamber 335 increases substantially before fluid communication is established between the interior of inflation chamber 335 and the interior of inflatable element 588.
For some applications, the mechanical user control element 320 is configured to mechanically and non-electrically increase the pressure in the interior of inflation chamber 335 during motion of mechanical user control element 320 while flow regulator 700 is in the second fluid-control state. For example, the pressure may (a) continue to increase while flow regulator 700 is in the second fluid-control state, (b) increase only while flow regulator 700 is in the second fluid-control state, or (c) increase only while flow regulator 700 is in the second and the third fluid-control states.
As mentioned above, mechanical user control element 320 is configured to mechanically and non-electrically increase pressure in the interior of inflation chamber 335 during at least a portion of the transition of mechanical user control element 320 from the first configuration to the second configuration. For some applications, as labeled in
Typically, flow regulator 700:
Optionally, seals 342 and 343 are provided to seal around outlet 337.
For some applications, such as shown in
In these applications, typically flow regulator 700, when in the second fluid-control state, connects in fluid communication suction source 601 and distal suction orifices 440 via the one or more suction lumens 530.
Typically, each of the first and the second configurations of mechanical user control element 320 includes a range of spatial positions, such that each of the first and the second fluid-control states of flow regulator 700 is stably activated over the respective range of spatial positions, rather than only at single respective spatial positions of mechanical user control element 320. Providing these ranges of spatial positions obviates the need for the user to precisely position mechanical user control element 320 in order to achieve the different fluid-control states.
For some of these applications, inflation module 330 comprises a one-way air inlet valve 331, which is arranged to allow air to flow into inflation chamber 335 during at least a portion of a transition of mechanical user control element 320 from the second configuration to the first configuration. One-way air inlet valve 331 allows ambient air 199 to enter (be sucked into) inflation chamber 335 as inflation chamber 335 expands during at least a portion of a transition between the second fluid-control state to the first fluid-control state. For some applications, one-way air inlet valve 331 is configured to generate a sound signal during at least a portion of a period of fluid flow into inflation chamber 335 and/or during deflation of inflatable element 588; for example, one-way air inlet valve 331 may be shaped so as to define a whistle.
In the configuration illustrated in
Typically, suction port 830 is shaped as a conventional suction port in accordance with hospital standards for coupling to standard hospital suctions sources. For example, suction port 830 may have a male conical interface, such as shown in
Reference is now made to
For some applications, flow regulator 700 is configured to assume the third, intermediate fluid-control state when mechanical user control element 320 is in a third, intermediate configuration (e.g., spatial position), as shown in
For some applications, when mechanical user control element 320 is in the third, intermediate configuration and flow regulator 700 is in the third, intermediate fluid-control state:
Typically, as described above regarding the first and the second configurations of mechanical user control element 320, the third configuration of mechanical user control element 320 includes a range of spatial positions, such that the third fluid-control state of flow regulator 700 is stably activated over the range of spatial positions, rather than only at a single spatial position of mechanical user control element 320. Providing this range of spatial positions obviates the need for the user to precisely position mechanical user control element 320 in order to achieve the third fluid-control states.
As mentioned above, for some of these applications, when mechanical user control element 320 is in the third, intermediate configuration and flow regulator 700 is in the third, intermediate fluid-control state, inflation inlet 521 is in fluid communication with suction port 830, as shown in
For some applications, during a transition of mechanical user control element 320 between the first configuration and the second configuration, mechanical user control element 320 assumes a transient position in which inflation inlet 521 is neither in fluid communication with suction port 830 nor in fluid communication with outlet 337 of inflation chamber 335. Typically, the transient position has a shorter range of spatial positions than do the first, the second, and the third configurations of mechanical user control element 320, as described above.
For some applications, the distal end of catheter main body 210 is closed (such as shown). In these applications, tracheal suction is typically performed by advancing catheter main body 210 far enough beyond the distal end of ventilation tube 160 such that at least one of the one or more distal suction orifices 440 is in fluid communication with the interior of the trachea distally beyond the end of ventilation tube 160. For other applications, catheter main body 210 is shaped so as to define, in addition to the one or more distal suction orifices 440, a distal-most suction orifice at a distal end of distal portion 212 of cleaning catheter 200, distal to inflatable element 588, for example such as described in above-mentioned U.S. Pat. No. 8,999,074, with reference to FIGS. 21A-B and 22A-C thereof.
For some applications, input module 156 is configured such that changes in configuration (e.g., spatial position) of mechanical user control element 320 cause corresponding changes in axial position of input portion 216 of catheter main body 210 with respect to input module 156. Typically, input module 156 is configured such that input portion 216 assumes first and second axial positions with respect to input module 156 (e.g., with respect to suction port 830), corresponding to the first and the second configurations (e.g., spatial positions) of mechanical user control element 320. The first and the second axial positions of input portion 216 are typically along a single axis.
For some applications, such as shown in
For some applications, as shown in
For some applications, input module 156 further comprises a user signal generator 350, which is configured to generate a user signal (e.g., a sound) during at least a portion of a period of fluid flow into inflation chamber 335 and/or during or upon deflation of inflatable element 588. The user signal generator may be electrical and/or mechanical.
For some applications, inflation chamber 335 has a volume of at least 1 cc, no more than 10 cc, and/or between 1 and 10 cc (e.g., at least 1.5 cc, no more than 3 cc, and/or between 1.5 and 3 cc), when mechanical user control element 320 is in the first configuration (i.e., not compressed). The volume typically equals more than 1 times and less than 3 times the volume of inflatable element 588. Typically, when mechanical user control element 320 is in the second configuration (i.e., compressed), inflation chamber 335 has a volume of at least 1 cc less than when mechanical user control element 320 is in the first configuration (i.e., not compressed).
Reference is made to
Typically, as shown in
For some applications, as shown in
Mechanical user control element 320 translates the movement of user control handle 718 into axial motion of catheter main body 210. For example, mechanical user control element 320 may comprise a side projection element 730 attached to catheter main body 210, and an engaging element 711 that has a diagonal face which engages side projection element 730, such that when engaging element 711 moves down, it pushes side projection element 730 sideways and thus imparts axial motion to catheter main body 210.
Reference is now made to
Unlike in the other configurations described herein, in closed suction cleaning system 500, the fluid-control states are not actuated by axial motion of proximal portion 214 of catheter main body 210 relative to input module housing 310, and mechanical user control element 320 does not translate the movement of user control handle 718 into axial motion of catheter main body 210. Instead, in closed suction cleaning system 500, proximal-most input portion 216 of catheter main body 210 is fixed with respect to input module 156. The movement of user control handle 718 actuates the fluid-control states without translating the movement into axial motion of proximal portion 214 of catheter main body 210. Input module 156 is arranged such that user control handle 718 is moveable with respect to catheter main body 210 in two opposite directions along a movement axis 618 that forms a fixed angle 3 (beta) of between 45 and 135 degrees with a central longitudinal axis 620 of proximal-most input portion 216 of catheter main body 210, typically 90 degrees (as shown). Input module 156 is arranged such that movement of user control handle 718 along movement axis 618 mechanically causes corresponding movement of a distal opening 832 of suction port 830 along or alongside movement axis 618. This corresponding movement selectively brings distal opening 832 of suction port 830 into and out of fluid communication with (a) the interior of inflatable element 588 (via inflation lumen 520 of catheter main body 210), and (b) distal suction orifices 440 (via suction lumen 530 of catheter main body 210), as described hereinbelow in detail. (Typically, input module 156 is arranged such that user control handle 718 is constrained to movement with respect to catheter main body 210 only along movement axis 618, and not in other directions.)
For some applications, module 156 is arranged such that movement of user control handle 718 along movement axis 618 mechanically causes corresponding movement of suction port 830 along or alongside movement axis 618, in addition to causing corresponding movement of distal opening 832 of suction port 830. For some of these applications, a longitudinal axis of suction port 830 is perpendicular to movement axis 618, and thus the longitudinal axis of suction port 830 moves along or alongside movement axis 618.
For some applications, mechanical user control element 320 is shaped so as to define first and second fluid-connection chambers 631 and 632, which are arranged at respective different locations along or alongside movement axis 618, with first fluid-connection chamber 631 farther from catheter main body 210 than second fluid-connection chamber 632 is from catheter main body 210. For some applications, first and second fluid-connection chambers 631 and 632 are annular (as shown). For example, in order to define the chambers, mechanical user control element 320 may be shaped so as to define, or comprise, first, second, and third sealing rings 641, 642, and 643 (e.g., O-rings), arranged such that first and second sealing rings 641 and 642 define first fluid-connection chamber 631, and second and third sealing rings 642 and 643 define second fluid-connection chamber 632.
For some applications, mechanical user control element 320 is shaped so as to define:
Inflation lumen port 650 may be disposed at or near an end of inflation lumen 637 opposite the end connected to inflation inlet 521 of catheter main body 210, as shown. Suction lumen port 652 may be disposed at or near an end of suction lumen 638 opposite the end connected to proximal suction inlet 531 of catheter main body 210, as shown.
Input module 156 is arranged such that when mechanical user control element 320 (e.g., user control handle 718 thereof) is in a first configuration (e.g., spatial position) along movement axis 618, as shown in
Input module 156 is arranged such that when mechanical user control element 320 is in the second configuration (e.g., spatial position) along movement axis 618, as shown in
For some applications, input module 156 is arranged such that movement of user control handle 718 of mechanical user control element 320 along movement axis 618 mechanically causes corresponding movement along or alongside movement axis 618 of both:
For some applications, during movement of user control handle 718 of mechanical user control element 320 along movement axis 618, first and second fluid-connection chambers 631 and 632 remain stationary with respect to catheter main body 210 (as shown), while for other applications, first and second fluid-connection chambers 631 and 632 move with respect to catheter main body 210 (configuration not shown).
Reference is still made to
For some applications, flow regulator 700 is configured to assume the third, intermediate fluid-control state when mechanical user control element 320 is in a third, intermediate configuration (e.g., spatial position) along movement axis 618 between the first configuration (e.g., spatial position) and the second configuration (e.g., spatial configuration), such as shown in
For some applications, such as shown in
When flow regulator 700 is in the third, intermediate fluid-control state (shown in
When flow regulator 700 is in the third, intermediate fluid-control state, distal opening 832 of suction port 830 spans both first and second fluid-connection chambers 631 and 632 along or alongside movement axis 618 (because distal opening 832 of suction port 830 is wider than sealing ring 642, measured along or alongside movement axis 618). As a result, distal opening 832 of suction port 830 is simultaneously in fluid communication with both first and second fluid-connection chambers 631 and 632.
For some applications, as shown in
For some applications, inflation module 330 comprises a one-way air inlet valve 331, such as described hereinabove with reference to
Reference is now made to
In closed suction cleaning system 800, inflation module 330 (including inflation chamber 335) is arranged on the opposite side of input module 156 from mechanical user control element 320. Outlet 337 of inflation module 330 may be connected to chamber 335 by a tube 802. Input module 156 is arranged such that flow regulator 700 assumes the first fluid-control state when in a resting state; to this end, mechanical user control element 320 is elastically biased toward the first configuration, for example by spring 349, and inflation chamber 335 is elastically biased toward the lower level of compression, for example as described hereinabove with reference to
Simultaneous application of respective forces (labeled as first force F1 and second force F2), directed toward each other, to mechanical user control element 320 and inflation module 330 (and inflation chamber 335), simultaneously:
The respective forces are typically applied by a healthcare worker squeezing mechanical user control element 320 and inflation module 330 (and inflation chamber 335) toward each other, such as using the thumb and fingers, respectively.
Reference is now made to
In this configuration, input module 156 comprises a first mechanical user control element 320A, which is configured to mechanically and non-electrically set the fluid-control states of flow regulator 700. First mechanical user control element 320A is configured to assume at least first and second configurations, such as first and second spatial positions, respectively. For some applications, as shown, first mechanical user control element 320A comprises a first user control button 930A.
In this configuration, input module 156 further comprises a second mechanical user control element 320B, which is configured (a) to assume at least first and second configurations, such as first and second spatial positions, and (b) to mechanically and non-electrically increase pressure in the interior of inflation chamber 335 during a transition of second mechanical user control element 320B from its first configuration to its second configuration. In these applications, inflation chamber 335 functions as a compression pump. For some applications, as shown, second mechanical user control element 320B comprises a second user control button 930B.
For some applications, input module 156 is arranged such that:
For some applications, as labeled in
For some applications, first and second mechanical user control elements 320A and 320B (e.g., first and second user control buttons 930A and 930B) are arranged side-by-side. For some applications, first and second mechanical user control elements 320A and 320B (e.g., first and second user control buttons 930A and 930B) are arranged such that a portion of one of the mechanical user control elements (e.g., control buttons) at least partially (i.e., partially or entirely) surrounds the other user control element (e.g., control button). For example, second mechanical user control element 320B (e.g., second user control button 930B) may at least partially surround at least two sides of first mechanical user control element 320A (e.g., first user control button 930A), such as at least three sides (e.g., three entire sides) of first mechanical user control element 320A (e.g., first user control button 930A), as shown in
Providing the control elements side-by-side may enable both (a) ergonomically-convenient simultaneous pressing of both control elements, such as to transition flow regulator 700 from the first fluid-control state to the second fluid-control state, and (b) pressing of only first mechanical user control element 320A (e.g., first user control button 930A) to transition flow regulator 700 from the first fluid-control state to a third fluid-control state, such as described hereinbelow.
Reference is now made to
For some applications, flow regulator 700 is configured to assume the third, intermediate fluid-control state when:
For some applications, when first mechanical user control element 320A (e.g., first user control button 930A) is in the third, intermediate configuration and flow regulator 700 is in the third, intermediate fluid-control state:
Flow regulator 700 may have any of the features thereof described hereinabove with reference to
For other applications (configuration not shown), flow regulator 700 is configured to assume the third, intermediate fluid-control state when:
For still other applications (configuration not shown), flow regulator 700 is configured to assume the third, intermediate fluid-control state when:
For some applications, inflation chamber 335 transitions from a lower level of compression to a higher level of compression during the transition of second mechanical user control element 320B from its first configuration to its second configuration. For some of these applications, input module 156 is configured to elastically bias inflation chamber 335 toward the lower level of compression. For some applications, inflation chamber 335 (e.g., at least one wall 332 of inflation chamber 335) is elastically biased toward the lower level of compression. For example, the at least one wall of inflation chamber 335 may be accordion-shaped and/or the chamber walls comprise an elastic material, such as silicon, rubber, or polyurethane. In some embodiments, substantially no friction needs to be overcome during expansion of inflation chamber 335. Alternatively or additionally, inflation module 330 (such as inflation chamber 335) comprises a distinct elastic element 333 (e.g., a spring) that is arranged to bias inflation chamber 335 toward the lower level of compression. Alternatively or additionally, second mechanical user control element 320B is elastically biased toward the lower level of compression (and to the first configuration), for example by a spring 349. In any event, typically, when second mechanical user control element 320B is released, inflation chamber 335 expands. In other words, input module 156 is biased to assume the first configuration and first fluid-control state when in a resting state, such that inflation chamber 335 is in an expanded state when input module 156 is in the resting state.
For some applications, first mechanical user control element 320A comprises user control handle 718, the movement of which includes a component perpendicular to the associated axial motion of catheter main body 210. First mechanical user control element 320A translates the movement of user control handle 718 into axial motion of catheter main body 210. For example, first mechanical user control element 320A may comprise side projection element 730 attached to catheter main body 210, and engaging element 711 that has a diagonal face which engages side projection element 730, such that when engaging element 711 moves down, it pushes side projection element 730 sideways and thus imparts axial motion to catheter main body 210.
Although the fluid-control states of flow regulator 700 of input module 156 are sometimes characterized hereinabove as “first,” “second,” and “third,” these ordinal numbers do not necessarily imply a particular order of activation during use of cleaning system 100 unless explicitly stated. In addition, input module 156 may have activation states in addition to those described herein, which may be activated before, after, or temporarily between the states described herein. The ordinal numbers of the states recited in claims do not necessarily correspond to the ordinal numbers of the states described hereinabove in the specification.
In the description and claims of the present application, each of the verbs, “comprise,” “include” and “have,” and conjugates thereof, are used to indicate that the object or objects of the verb are not necessarily a complete listing of members, components, elements or parts of the subject or subjects of the verb. The articles “a” and “an” are used herein to refer to one or to more than one (i.e., to at least one) of the grammatical object of the article. By way of example, “an element” means one element or more than one element. The term “including” is used herein to mean, and is used interchangeably with, the phrase “including but not limited to.” The term “or” is used herein to mean, and is used interchangeably with, the term “and/or,” unless context clearly indicates otherwise. The term “such as” is used herein to mean, and is used interchangeably, with the phrase “such as but not limited to.”
All publications, patent applications, patents, and other references mentioned herein are incorporated by reference in their entirety. In case of conflict, the present patent specification, including definitions, will prevail. In addition, the materials, methods, and examples are illustrative only and not intended to be limiting.
For brevity, some explicit combinations of various features are not explicitly illustrated in the figures and/or described. It is now disclosed that any combination of the method or device features disclosed herein can be combined in any manner—including any combination of features—any combination of features can be included in any embodiment and/or omitted from any embodiments.
The scope of the present invention includes embodiments described in the following applications, which are assigned to the assignee of the present application and are incorporated herein by reference. In an embodiment, techniques and apparatus described in one or more of the following applications are combined with techniques and apparatus described herein. It is noted that the phrase “fluid-control state” used herein may, for some applications, correspond in some respects to the phrases “mode,” “activation mode,” and/or “operating mode” referred to in the following applications (although many of the configurations of these states described herein differ in at least some respects from the configurations of the modes described in the following applications). It is also noted that the phrase “mechanical user control element” used herein may, for some applications, correspond in some respects to the word “switch,” referred to in the following applications (although many of the configurations of these states described herein differ in at least some respects from the configurations of the modes described in the following applications):
It will be appreciated by persons skilled in the art that the present invention is not limited to what has been particularly shown and described hereinabove. Rather, the scope of the present invention includes both combinations and subcombinations of the various features described hereinabove, as well as variations and modifications thereof that are not in the prior art, which would occur to persons skilled in the art upon reading the foregoing description.
| Number | Date | Country | Kind |
|---|---|---|---|
| 1600233.9 | Jan 2016 | GB | national |
The present application is a continuation of U.S. patent application Ser. No. 15/363,782, filed Nov. 29, 2016, which claims the benefit of U.S. Provisional Application 62/287,223, filed Jan. 26, 2016, and U.S. Provisional Application 62/319,640, filed Apr. 7, 2016, and which claims foreign priority from UK Application 1600233.9, filed Jan. 6, 2016, all of which are incorporated herein by reference in their entirety.
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| Child | 16224231 | US |
