1. Technical Field
The present disclosure relates generally to devices and methods for delivering ingestible materials into a user's body and more particularly to mechanical devices and methods for delivering ingestible materials to a user's gastrointestinal tract through a feeding tube.
2. Background Art
In many applications, a patient may be unable to orally consume ingestible materials such as food products, nutritional supplements or medications and must be intubated with a feeding tube for delivery of such products. Intubation generally involves placing a feeding tube through the mouth or nose, beyond the esophagus, and extending to a position in the user's gastrointestinal tract, typically the stomach. Conventional feeding tubes typically include a tube inlet located outside the user's body and a tube outlet positioned inside the user's body. Ingestible materials injected into the feeding tube can be passed through the tube outlet directly to the stomach or other gastrointestinal location for consumption by the user.
In many applications, it is desirable to inject an ingestible material through a feeding tube into a user's body using a delivery device. One common application involves the use of a nasogastric feeding tube. A nasogastric feeding tube generally extends through the patient or user's nostril, nasopharynx, oropharynx, and esophagus into the user's stomach or intestine. Devices for delivering ingestible materials to a user through a nasogastric tube inlet using a plunger-driven delivery device, or syringe, are known in the art. However, such conventional plunger-driven feeding tube delivery devices include numerous moving parts that add complexity and cost to device manufacturing and packaging processes, as well as complicating use.
Another problem associated with conventional plunger-driven feeding tube delivery devices involves incomplete advancement of the ingestible material through the feeding tube. Generally, the feeding tube can have a length from about 10-100 cm, depending on the size of the patient and the particular application. When an ingestible material is injected into the feeding tube, the material must be pushed through the entire length of the feeding tube to the tube outlet inside the user's body. In some applications, a plunger-driven feeding tube delivery device is not capable of pushing the entire ingestible material volume completely through the entire length of the feeding tube using only one stroke of the plunger. Instead, using conventional devices and methods, some ingestible material may remain in the tube after the plunger has been fully depressed in a single stroke, thereby forming an occlusion in the tube and forcing the user to perform additional steps to completely evacuate the tube. Such additional steps add complexity to the process of administering ingestible material through the feeding tube. In many instances, users of conventional plunger-driven feeding tube delivery devices must disconnect the delivery device and attach a second device that includes a flushing liquid to push the remaining material through the feeding tube. Such disconnection and reconnection adds additional steps and requires that a sterile second flushing device be kept on hand at all times.
Another problem associated with conventional plunger-driven feeding tube delivery devices includes the growth and development of microorganisms in the feeding tube following delivery of the ingestible material through the tube. In some applications, the ingestible material includes chemical compounds that can promote the growth of bacteria in the interior of the tube. Conventional devices can leave ingestible material deposits on the interior wall of the tube following delivery, creating regions that support bacterial growth. Such bacterial growth can pose health risks to the user as subsequent injections into the tube will likely introduce the bacteria into the body. Additionally, in some applications, conventional syringe or plunger-driven devices do not fully evacuate the feeding tube following administration of the ingestible material, causing biofilm formation on the interior of the feeding tube. In many applications, a compressible multi-chamber delivery device for sequentially administering ingestible materials would be superior to existing conventional delivery devices with respect to the noted problems of conventional devices.
Thus, there is a continuing need in the art for improvements in feeding tube delivery devices and methods for introducing ingestible materials into a user's body through a feeding tube.
One aspect of the present disclosure provides an apparatus for sequentially delivering first and second ingestible materials to a user through a feeding tube. The device includes a first chamber defined in the delivery device and a second chamber co-axially aligned with the first chamber defined in the delivery device. A passage is defined between the first and second chambers, and a breakable seal is disposed across the passage. A puncture tool extends from the second chamber toward the seal. The first and second chambers are both compressible for manually forcing ingestible material from the delivery device into the feeding tube.
Yet another embodiment of the present disclosure provides an ingestible material delivery device for a feeding tube. The device includes a tube body and a first radially-compressible chamber defined in the tube body. A second radially-compressible chamber is also defined in the tube body. A first tube fitting is attached to the first chamber, and a second tube fitting is attached to the second chamber. The first tube fitting defines a first flow direction, and the second tube fitting defines a second flow direction. The first and second flow directions are substantially opposite in some embodiments.
A further embodiment of the present disclosure provides a method of sequentially administering first and second ingestible materials to a user through a feeding tube. The method includes the steps of: (a) providing an ingestible material delivery device including first and second chambers, each filled with an ingestible material, the delivery device including a seal between the first and second chambers and a puncture tool positioned in the second chamber extending toward the seal; (b) attaching a feeding tube to the first chamber; (c) compressing the first chamber; and (d) compressing the second chamber, causing the puncture tool to disrupt the seal.
Yet another embodiment of the present disclosure provides a method of manufacturing a dual-chamber delivery device for sequentially delivering first and second ingestible materials to a user through a feeding tube. The method includes the steps of: (a) blow molding a tube body having first and second axially consecutive chambers and a passage defined between the chambers; (b) filling the second chamber with a second ingestible material; (c) applying a breakable seal across the passage; and (d) filling the first chamber with a first ingestible material.
Numerous other objects, features and advantages of the present disclosure will be readily apparent to those skilled in the art upon a reading of the following description when taken in conjunction with the accompanying drawings.
Referring now to the drawings and particularly to
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First and second chambers 12, 14 are interconnected by a bridge member 36. In some embodiments, a passage 37 is defined between first and second chambers 12, 14 such that material can flow from second chamber 14 into first chamber 12.
A seal 30 is disposed between first and second chambers 12, 14 across passage 37. Seal 30 can include an integral portion of a longitudinal end wall of first chamber 12 in some embodiments. In other embodiments, seal 30 can include a dissimilar material spanning a hole defined in a longitudinal end wall of first chamber 30 adjacent bridge member 36. Seal 30 functions to prevent material stored in first chamber 12 from mixing with material stored in second chamber 14 prior to breakage of the seal 30. Seal 30 can be referred to as a friable seal 30 in some applications because seal 30 can be broken by the application of force.
A first ingestible material 16 can be disposed in first chamber 12, and a second ingestible material 18 is disposed in second chamber 14. In some embodiments, one or both ingestible materials 16, 18 include a food product, a nutritional supplement and/or a pharmaceutical compound. In other embodiments, one or both ingestible materials 16, 18 form a solid. In other embodiments, ingestible materials 16, 18 can include a powder or particulate material that is intended to be mixed with the material stored in the other chamber. Ingestible materials 16, 18 can include an amorphous solid such as a gel or a paste. One or more prebiotic materials that promote the growth and development of bacteria in the digestive tract, such as but not limited to a galactooligosaccharide (GOS) or a fructooligosaccharide (FOS), can be included in first or second ingestible materials 16, 18. Other suitable prebiotic or probiotic materials and mixtures known in the art or hereinafter developed can be included in ingestible materials 16, 18 in some embodiments.
In a preferred embodiment, first ingestible material 16 stored in first chamber 12 includes a food product, a nutritional supplement and/or a pharmaceutical compound, and second ingestible material 18 stored in second chamber 14 includes a flushing liquid for advancing first ingestible material 16 through a feeding tube. First ingestible material 16 can include an active product, and second ingestible material 18 can include a sterile, non-active flush.
The presence of first ingestible material 16 in a feeding tube 50 can contribute to the growth and development of bacteria on the inner wall of the feeding tube. Such bacterial growth and development presents a threat of contamination to the user and is generally undesirable. Additionally, after one or more uses, feeding tube 50 may develop a biofilm on the interior tube wall. Such a biofilm may include one or more types of bacteria and can pose a health hazard to the user. Bacteria and biofilm growth and development can be prevented by sequentially forcing a second ingestible material 18 including a flushing liquid through feeding tube 50 after passage of first ingestible material 16 through feeding tube 50. Second ingestible material 18 including a flushing liquid contained in second chamber 14 can perform one or more functions when injected into the feeding tube 50. First, the flushing liquid can push first ingestible material 16 through feeding tube 50 into the user's stomach 56. Second, the flushing liquid can disinfect the interior feeding tube wall to inhibit bacterial growth and development. Third, the flushing liquid can prevent biofilm growth and development on the interior feeding tube wall. It is understood that the flushing liquid can perform as few as one or as many as all of these functions in various embodiments.
In some embodiments, the flushing liquid included in second ingestible material 18 comprises water. In further embodiments, the flushing liquid includes a disinfectant material or an antimicrobial agent for killing and/or preventing the growth of microorganisms such as bacteria in feeding tube 50.
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In further embodiments, cap 22 is attached to first chamber 18 using one or more frangible bridges 25, illustrated in
In additional embodiments, an annular tamper-evident ring or band can be disposed between cap 22 and first chamber 12 to visually indicate to a user whether cap 22 has previously been removed. Each frangible bridge 25a, 25b, etc. can extend from the tamper-evident ring to the cap 22 in some embodiments. A retaining structure can be positioned on the first chamber 18 to retain the tamper-evident ring on the first chamber 12 when the cap 22 is rotated relative to the first chamber 12.
Referring now to
In some embodiments, after first chamber 18 has been radially compressed, a volume of first ingestible material 16 may remain in feeding tube 16, forming an occlusion in the tube. Thus, second ingestible material 18 must be forced into the feeding tube 50 to push the occlusion of first ingestible material 16 into the user's stomach 56.
Second ingestible material 18 is generally prevented from entering first chamber 12 and feeding tube 50 by seal 30. In some embodiments, such as those illustrated in
A puncture tool 32 is disposed between first and second chambers 12, 14. Puncture tool 32 in some embodiments is positioned on a tool wall 35. Tool wall 35 can span second chamber 14 substantially transverse to chamber axis 70. Puncture tool 32 includes a sharpened point axially projecting toward seal 30. A gap 34 is defined between puncture tool 32 and seal 30, as seen in
A second radial force 62b can be applied to second chamber 14. When second radial force 62b is applied to second chamber 14, puncture tool 32 advances axially toward seal 30. When a sufficient level of second radial force 62b is applied to second chamber 14, puncture tool 32 advances fully across gap 34 and punctures seal 30. Once seal 30 is punctures, second ingestible material 18 passes through first chamber 12, through exit nozzle 24 and into feeding tube 50. Once in feeding tube 50, first ingestible material 18 can interact or mix with first ingestible material in some embodiments. Additionally, second ingestible material 18 in some embodiments can mechanically push, or flush, first ingestible material through feeding tube 50 into the user's stomach. In some embodiments, an increased internal chamber pressure is developed in second chamber 14 due to the application of radial force 62 up until the moment when the seal 30 is disrupted. When the seal is disrupted, the increased internal chamber pressure is released through the first chamber, and the sudden release of the internal chamber pressure due to the seal breakage can cause second ingestible material 18 to be forcefully ejected from exit orifice 26 into feeding tube 50. Such forceful ejection due to the sudden disruption of seal 30 can further enhance the flushing function of second ingestible material 18 to push first ingestible material 16 through the feeding tube 50.
Referring now to
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A cross-sectional view of this embodiment of a delivery device 10 is illustrated generally in
Next, an axial force 64 is applied to base 48 of second chamber 14. Axial force 64 applied to second chamber 14 causes the bellows 78a, 78b, etc. to compress toward first chamber and simultaneously causes puncture tool 32 to advance toward seal 30. Puncture tool 32 engages seal 30, creating an opening through which second ingestible material 18 can advance into first chamber 12 and on into the feeding tube.
In some embodiments, as puncture tool 32 travels axially across gap 34, an increasing internal chamber pressure is developed in second chamber 14 resulting from a decrease in the volume of second chamber 14 due to the application of axial force 64. The increasing internal chamber pressure is suddenly released seal 30 is disrupted. Such sudden release of the internal chamber pressure in second chamber 14 can cause second ingestible material 18 to be forcefully ejected from second chamber 14, through first chamber 12, out exit orifice 26 and through feeding tube 50, thereby driving first ingestible material 16 into the user's stomach. In other embodiments, the sudden release of internal chamber pressure is negligible, and the driving force associated with advancing second ingestible material is due solely to the controlled deformation of second chamber 14. The gap 34 distance is a control parameter that can be used to determine whether a second chamber pressure is developed prior to seal breakage.
In some embodiments, puncture tool 32 defines an axial tool length 67. First chamber generally defines a first chamber axial length 68 between seal 30 and exit orifice 26. In some embodiments, first chamber axial length 68 is greater than axial tool length 67 such that puncture tool 32 does not protrude beyond exit orifice 26 when second chamber 14 is in the fully compressed position. This dimensional relationship between axial tool length 67 and first chamber axial length 68 in some embodiments prevents possible user injury that could be caused by a sharp point protruding from exit orifice 26. Similarly, in some embodiments, delivery device 10 includes a total compressed length 66 defined after both first and second chambers 12, 14 have been compressed in their respective compression directions. In some embodiments, total compressed length 66 is greater than axial tool length 67.
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Referring now to
First and second chambers 12, 14 are connected by a rigid linkage 72. Rigid linkage 72 does not include any internal passage for material to pass between first and second chambers 12, 14. In some embodiments, rigid linkage 72 is a separate member that is attached to both first and second chambers 12, 14 on opposite sides. In other embodiments, rigid linkage 72 is integrally formed, or integrally molded, in tube body 20 between first and second chambers 12, 14.
In this embodiment, a first exit nozzle 24a extends axially from the first chamber 12, and a second exit nozzle 24b extends axially from second chamber 14 opposite first exit nozzle 24a. First exit nozzle 24a includes a first tube fitting 28a and a first exit orifice 26a. Second exit nozzle 24b includes a second tube fitting 28b and a second exit orifice 26b. A first removable cap 22a is attached to first chamber 12, and a second removable cap 22b is attached to second chamber 14.
During use, first removable cap 22a is removed from delivery device 10, and first exit nozzle 24a is mechanically attached to a feeding tube via first tube fitting 28a. A radial force is then applied against first chamber 12, and first ingestible product 16 is ejected from first chamber 12 into the feeding tube. Subsequently, first tube fitting 28a is disengaged from the feeding tube. The second cap 22b can be removed from the second chamber 14 before or after the first ingestible material 16 is evacuated into the feeding tube. The user can manually flip the delivery device 10 one-hundred-eighty degrees such that second exit nozzle 24b is oriented toward the feeding tube. Second exit nozzle 24b can be mechanically attached to the feeding tube via second tube fitting 28b after the first exit nozzle 24a has been disconnected. Next, a second radial force can be applied against second chamber 14, causing second ingestible material 18 to be ejected from second chamber 14, through second exit nozzle 24b and into the feeding tube.
Dual-chamber delivery device 10 illustrated in
In many applications, a delivery device in accordance with the various embodiments disclosed herein can be provided being pre-filled with metered doses of first and second ingestible materials contained in first and second chambers.
It will be readily understood by those of skill in the art that the principles of the present disclosure can be applied to delivery devices in embodiments having more than two chambers.
The present disclosure further provides methods of sequentially delivering ingestible materials to a user through a feeding tube. One embodiment of a method of sequentially administering first and second ingestible materials to a user through a feeding tube includes the steps of: (a) providing an ingestible material delivery device including first and second chambers, each filled with an ingestible material, the delivery device including a seal between the first and second chambers and a puncture tool positioned in the second chamber extending toward the seal; (b) attaching a feeding tube to the first chamber; (c) compressing the first chamber; and (d) compressing the second chamber, causing the puncture tool to disrupt the seal. In some embodiments, step (c) further comprises radially compressing the first chamber. In additional embodiments, step (d) further comprises axially compressing the second chamber.
A further embodiment of the present disclosure provides a method of manufacturing a dual-chamber delivery device for sequentially delivering first and second ingestible materials to a user through a feeding tube. The method includes the steps of: (a) blow molding a tube body having first and second axially consecutive chambers and a passage defined between the chambers; (b) filling the second chamber with a second ingestible material; (c) applying a breakable seal across the passage; and (d) filling the first chamber with a first ingestible material. In some embodiments, the method of manufacturing a dual-chamber delivery device further comprises the step of (e) positioning a puncture tool in the second chamber projecting toward the first chamber, the puncture tool defining a gap between the puncture tool and the seal.
Thus, although there have been described particular embodiments of the present disclosure of a new and useful Compressible Multi-Chamber Feeding Tube Delivery Device and Methods, it is not intended that such references be construed as limitations upon the scope of the disclosure except as set forth in the following claims.