Cuff for use with medical tubing and method and apparatus for making the same

Information

  • Patent Grant
  • 8590534
  • Patent Number
    8,590,534
  • Date Filed
    Monday, June 22, 2009
    15 years ago
  • Date Issued
    Tuesday, November 26, 2013
    11 years ago
Abstract
A method of manufacturing more than one inflatable cuff per blow molding operation is provided. The method includes using two or more molds arranged in series and/or in parallel to simultaneously form two or more cuffs. The two or more cuffs may then be used in the manufacture of two or more respective endotracheal tubes. Apparatuses and systems for simultaneously forming the two or more cuffs are also provided.
Description
BACKGROUND

The present disclosure relates to medical devices, and more particularly, to tracheal tubes and other tubes designed to form a seal against a surrounding passage.


This section is intended to introduce the reader to various aspects of art that may be related to various aspects of the present invention, which are described and/or claimed below. This discussion is believed to be helpful in providing the reader with background information to facilitate a better understanding of the various aspects of the present invention. Accordingly, it should be understood that these statements are to be read in this light, and not as admissions of prior art.


Within the course of medical treatment, a tube or other medical device may sometimes be used to control the flow of air, food, fluids, or other substances into a patient. For example, medical devices (such as various types of tubes and catheters) may be used to control the flow of one or more substances into or out of a patient. In many instances it is desirable to provide a seal between the outside of the tube or device and the interior of the passage in which the tube or device is inserted. In this way, substances can only flow through the passage via the tube or other medical device, allowing a medical practitioner to maintain control over the type and amount of substances flowing into and out of the patient.


For example, tracheal tubes may be used to control the flow of air or other gases through a patient's trachea. Such tracheal tubes may include endotracheal tubes or tracheostomy tubes. To create a seal between such tubes and the tracheal wall, an inflatable cuff is typically employed. When inflated, the cuff may prevent air from flowing into or out of the patient's lungs except via the tube. In this manner, major air leaks during positive pressure ventilation, i.e., when air is being pushed into the lungs, and gas leaks during anesthesia procedures may be prevented.


The cuffs employed on devices such as endotracheal tubes or tracheostomy tubes may be manufactured from a variety of polymeric compositions, such as polyurethane (PU) or polyvinyl chloride (PVC). It may be desirable to manufacture such cuffs while wasting as little of the polymeric composition as possible and/or to improve the efficiency of the manufacturing process.





BRIEF DESCRIPTION OF THE DRAWINGS

Advantages of the invention may become apparent upon reading the following detailed description and upon reference to the drawings in which:



FIG. 1 illustrates a tracheal tube, in accordance with aspects of the present disclosure;



FIG. 2 illustrates a tracheal tube deployed within a trachea, in accordance with aspects of the present disclosure;



FIG. 3 illustrates a blow molding machine, in accordance with aspects of the present disclosure;



FIG. 4 is a flow chart depicting acts for manufacturing inflatable cuffs, in accordance with aspects of the present disclosure;



FIG. 5 depicts an embodiment of molds arranged in series in accordance with aspects of the present disclosure;



FIG. 6 depicts a further embodiment of molds arranged in series in accordance with aspects of the present disclosure;



FIG. 7 depicts an additional embodiment of molds arranged in series in accordance with aspects of the present disclosure;



FIG. 8 depicts a further embodiment of molds arranged in series with a gap spacing the molds apart, in accordance with aspects of the present disclosure;



FIG. 9 depicts an additional embodiment of molds arranged in series with an additional clamp disposed between the molds, in accordance with aspects of the present disclosure;



FIG. 10 depicts an embodiment of cuff molds arranged in parallel in accordance with aspects of the present disclosure; and



FIG. 11 depicts an embodiment of cuff molds arranged in series and in parallel in accordance with aspects of the present disclosure.





DETAILED DESCRIPTION OF SPECIFIC EMBODIMENTS

One or more specific embodiments of the present invention will be described below. In an effort to provide a concise description of these embodiments, not all features of an actual implementation are described in the specification. It should be appreciated that in the development of any such actual implementation, as in any engineering or design project, numerous implementation-specific decisions must be made to achieve the developers' specific goals, such as compliance with system-related and business-related constraints, which may vary from one implementation to another. Moreover, it should be appreciated that such a development effort might be complex and time consuming, but would nevertheless be a routine undertaking of design, fabrication, and manufacture for those of ordinary skill having the benefit of this disclosure.


A variety of medical devices are designed to be inserted within cavities or passages of the human body. Examples of such medical devices include catheters, stents, feeding tubes, intravenous tubes, breathing tubes, and so forth. In many instances it is desirable that the device be provided with an inflatable cuff that can be used to form a seal between the medical device and the surrounding passage or cavity. In accordance with aspects of the present disclosure, such a cuff may be manufactured using more than one mold (either in series or in parallel) and/or using molds having more than one cuff-shaped cavity such that more than one cuff may be formed in each molding operation. In addition to increasing the number of cuffs formed in each operation, such an approach may also increase the number of cuffs that can be produced using a given length of tubing material. In this manner, the number of cuffs produced per molding operation may be increased and/or the amount of tubing material wasted (i.e., not being used to form a cuff) may be decreased.


With the foregoing in mind, an example of a medical device that may include a cuff is an endotracheal tube 10, as depicted in FIG. 1. The endotracheal tube 10 includes an inflatable cuff 12 that may be inflated at low pressure (approximately 25 cm H2O or less) to form a seal against the trachea wall 14 (see FIG. 2). Typically the inflatable cuff 12 is inflated and deflated via a tube 16 in communication with the inflatable cuff 12.


For simplicity, the present example describes the use of an inflatable cuff 12 in the context of an endotracheal tube. However, an inflatable cuff 12 may be used with other medical devices, such as those listed above, or with other devices in which it is desirable to form a seal between the device and a surrounding passage or pathway. Therefore, it should be understood that the present examples and descriptions are merely exemplary and are not intended to limit the scope of the present disclosure.


Returning now to FIG. 1, in accordance with the one embodiment, the wall of the inflatable cuff 12 is about 0.00086 inches (0.022 mm) thick or less. In addition, the walls of the inflatable cuff 12 are made of a material having suitable mechanical properties (such as puncture resistance, tear resistance, pin hole resistance, tensile strength), chemical properties (such as forming a suitable bond to the main tube body 18), and biocompatibility.


In one embodiment, the walls of the inflatable cuff 12 are made of a polyurethane or polyurethane-based composition having suitable mechanical and chemical properties. An example of one suitable polyurethane is Dow Pellethane® 2363-90AE. In other embodiments, the walls of the inflatable cuff 12 are made of other suitable compositions, such as compositions having suitable mechanical properties at the desired wall thickness of the cuff 12. Examples of suitable polymeric compositions may include polymethylmethacrylate (PMMA), polyacrylonitrile (PAN), polyamide (such as nylon) (PA), polycarbonate (PC), polyesters (such as polyethylene terephthalate (PET)), polyolefins (such as polyethylenes (PE) and polypropylenes (PP)), polystyrene (PS) or vinyls (such as polyvinyl chloride (PVC) and polyvinylacetate). Other polymers and/or polymer admixtures having suitable mechanical, chemical, and biocompatibility properties may also be used to form the cuff 12.


In the embodiment depicted in FIG. 1, the cuff 12 is shaped as being generally tapered, being wider at one end when inflated. As will be appreciated by those of ordinary skill in the art, the degree of taper, curvature and/or linearity at different parts of the cuff 12 may vary. As depicted in the embodiment of FIG. 1, the cuff 12 may be secured at the proximate end 20 and distal end 22 to the main tube body 18, such as by collar regions 24 adhered, fused, or otherwise attached to the main tube body 18. However, the cuff body 26 between the proximate end 20 and the distal end 22 forms an expanded structure between these ends when partially or completely inflated. As depicted in FIG. 2, when inflated in the trachea, portions of the inflated cuff 12 may be partially flattened against the trachea wall to form a seal against the tracheal wall 14.


While the cuff 12 in FIG. 1 is depicted as tapered when inflated, in various exemplary embodiments the inflatable cuff 12 may be shaped differently when inflated. For example, the cuff may be tapered differently or opposite to what is depicted in FIG. 1, or may be generally symmetrical, without a substantial taper from one end to the other. Likewise, other cuff shapes having straight walls, curved walls, or combinations of straight and curved walls are possible and are within the scope of the present disclosure. The collar regions 24 adhering or otherwise attaching the various cuffs to the respective main tube bodies 18 are typically the same or about the same diameter as the main tube body 18.


The inflatable cuffs 12 discussed herein may be formed by various techniques. In one implementation, the inflatable cuff 12 is formed by blow-molding. For example, in one such implementation a preformed tubular polyurethane extrusion is blow-molded to form the cuff 12. The tubular extrusion has a suitable internal diameter and wall thickness such that, when the extrusion is blown, the resulting cuff 12 has a sufficient internal diameter to fit onto an endotracheal tube 10 and has the desired wall thickness.


For example, a tube, such as a preformed extruded polyurethane tube, may be loaded into a mold assembly 40 of a blow molding machine 38, as depicted in FIG. 3. A suitable blow molding machine 38, such as an angioplasty balloon blowing machine, may allow process parameters such as the stretch of the preformed tube, blow pressure, and temperature to be controlled. In one embodiment, the blow molding machine 38 may be a model 2210 computerized balloon forming machine, available from Interface Associates, which is configured to run at 1-2 bars of gas pressure.


In an embodiment, the mold assembly 40 may include two or more molds 42 (FIGS. 5-11) housed (serially and/or parallel to one another) within common or separate heating/cooling jackets 44. In one embodiment, the molds 42 may be manufactured from beryllium copper and may be split horizontally to allow opening and closing of the mold 42 when not in the respective jacket 44. The heating/cooling jackets 44 may house one or more molds 42 as well as components for heating and/or cooling the molds 42. For example, the heating/cooling jackets 44 may include passages, conduits, or open areas through which coolant (such as cooled water) may flow to actively cool the molds 42. In addition, the heating/cooling jackets 44 may include one or more heating cartridges or other heating elements (such as resistive heating elements which heat when a current is passed through the element) which may be used to actively heat the molds 42. For example, in one embodiment, the heating/cooling jacket 44 includes a series of ten electrical heating elements used to heat the molds 42. In this manner, the heating/cooling jackets 44 may actively regulate the temperature of the molds 42 contained within.


The mold assembly 40 may be bracketed on either side by clamp structures 50 that secure respective ends of the tube 46 when placed within the mold assembly 40. One or both of the clamp structures 50 may include nozzles which are secured within the end of the tube 46 when clamped and which allow a gas (such as nitrogen) to be injected at pressure into the secured tube 46. In one embodiment, the clamp structures 50 may move outward with respect to the mold assembly 40 such that a secured tube 46 may be placed under tension.


In one implementation, a length of tube 46 which is inserted into the mold assembly 40 and secured by the clamps 50 may be approximately 12 inches (30.48 cm) in length prior to being placed under tension. In general, the tube 46 may be between about 10 to about 12 inches (i.e., approximately 25 cm to 30 cm) in length when inserted into the mold assembly 40 and secured by the clamp structures 50 prior to application of tension. In one embodiment, the end-portions of the extruded tube 46 that project out from the mold 42 are constrained to the shape and thickness of the original extruded tube by non-heat transferable plastic holders at the ends of the mold 42.


As depicted, the blow molding machine 38 may include a control station 54, which may include a user interface and/or controls, a monitor, and so forth. The control station 54 may display current status information for a blow molding operation and/or may display a user interface with which a user can interact to select, initiate, and/or control one or more programs or operations to be performed by the blow molding machine 38. Such programs or operations may coordinate operation of the clamps 50 in applying tension to a tube 46, may control heating and cooling of the jackets 44 such that a particular temperature profile is achieved with respect to the mold 42 over time, and may control injection of pressurized gas into the tube 46 as part of a blow molding process.


In one embodiment, the control station 54 may include a touch sensitive screen by which the user interacts with the interface, though in other embodiments, a keyboard and mouse or other similar interface may contain buttons or keys by which the user interacts with the displayed user interface. In one embodiment, the control station 54 may be a programmed computer configured to display a user interface and status information, to receive user commands, and to control operation of other components of the blow molding machine 38. In other embodiments, the control station 54 may be any suitable processor based system or components configured to perform some or all of these functions. Such computers or other processor based systems may include one or more processors as well as memory and storage components suitable for storing and executing routines and/or programs as discussed above for controlling operation of different components of the blow molding machine 38.


With the foregoing in mind, and turning now to FIG. 4, a flowchart is depicted setting forth a method 60 for forming cuffs for a medical device in accordance with one embodiment of the present disclosure. In this method 60, two or more molds 42 (FIG. 3) are loaded and secured (block 62) within one or more respective heating/cooling jackets 44. For example, the molds 42 may be loaded into the respective jacket or jackets 44 and pneumatically locked into place once loaded. In one embodiment, the molds 42 may be loaded in series (i.e., end-to-end) within a common jacket 44 or in separate respective jackets 44. In other embodiments, the molds 42 may be loaded in parallel (i.e., side-by-side) within a common jacket 44 or in separate respective jackets 44. In another embodiment, four or more molds 42 may be employed and may be loaded and secured in a common jacket 44 or in separate respective jackets 44 in both series and parallel configurations, i.e., some of the molds 42 may be situated end-to-end while also being side-by-side with other molds 42.


In the depicted method 60, a blow molding program is loaded (block 64) to a blow molding machine 38, such as via operation of the control station 54. The blow molding program may control a cycle of operation of the blow molding machine 38 during which two or more cuffs will be formed using the loaded molds 42. For example, in one embodiment, the loaded program may control the extent to which one or more preformed tubes are stretched, the temperature profile to which the tubes are subjected, and/or the pressure at which gas, such as nitrogen, is injected into the tubes, as well as the timing of such actions.


The blow molding machine 38 may also be calibrated (block 66) or zeroed out prior to beginning a blow molding operation. For example, the molds 42, jackets 44, and/or clamps 50 may be positioned at a start location, the temperature of the jackets may be set at an initial temperature or measured for use as a start point, and so forth. One or more tubes 46 may then be loaded (block 68) into each set of molds 42 (e.g., into the collet/mandrel system of the respective molds) provided in series. In one embodiment, a 12 inch (30.48 cm) long preformed tube 46 of polyurethane is loaded into two molds 42 placed end-to-end. For example, in one embodiment, a commercially available pre-formed extrusion of Dow Pellethane® 2363-90AE having an inner diameter between 0.1708 inches and 0.296 inches (4.34 mm to 7.52 mm) and a wall thickness of about 0.20 inches±0.05 inches (5.08 mm±1.27 mm) may be loaded into the molds 42 and blown to form cuffs 12 suitable for use with a 7.5 mm internal diameter (ID) endotracheal tube. In certain embodiments where molds 42 are loaded in parallel, more than one tube 46 may be loaded into the respective molds 42, i.e., each set of parallel molds 42 may be loaded with a separate tube 46.


An operator may initiate (block 70) a blow molding operation on the blow molding machine 38, such as by actuating one or more buttons or switches, or by interacting with an initiation option at the control station 54. As will be appreciated, the foregoing steps may be performed in the described order or in a different order, depending on the implementation. For example, the blow molding program may be loaded (block 64) prior to loading and securing (block 62) the molds 42, and so forth.


In the depicted example, the loaded tube 46 is clamped on the ends of the tube 46 by the clamps 50. At least one end of the tube 46 is clamped around a nozzle inserted into the tube end. In one implementation, the clamps 50 are initially spaced apart from the ends of the tube 46 and move inward, such as 50 mm, to reach the tube ends and to clamp the tube ends. Once clamped to the tube ends, the clamps 50 may move outward from the respective molds 42 to linearly stretch (block 74) the clamped tube 46. In one embodiment, the clamps 50 each move outward 100 mm to 120 mm (for a total stretch of 200 mm to 240 mm) and hold the tube 46 under tension at this position. In one implementation, the operator initiates the stretch operation by actuating one or more buttons or switches or by interacting with an initiation option at the control station 54.


In the depicted example, the tube 46 is pressurized (block 76), such as with pressurized nitrogen. For example, pressurized nitrogen (or other gas) may be blown into the tube via a nozzle or nozzles inserted into the ends of the tube 46 such that the clamps 50 hold the respective end or ends of the tube 46 around the respective nozzle or nozzles. The nozzle may be connected to a source of pressurized air, such as an air pump or pre-pressurized source, to achieve a desired positive pressure within the tube 46 and to blow out the cuff walls to the shape of the mold 42. In one embodiment, nitrogen is blown into the tube 46 to produce a pressure of about 1.2 bar to about 1.6 bar within the tube 46. In one implementation, the pressure may be increased to 1.6 bar and then decreased to 1.4 bar after the initial pressure is reached.


As the pressure is increased, the molds 42 may be heated (block 78), such as by activating the heater cartridges within the heating/cooling jacket(s) 44. In one embodiment, the temperature of the mold 42 is quickly raised from an initial temperature of 50° C. to 80° C. and may continue to rise to 120° C. In one implementation, at the pressure/temperature changeover point the pressure in the tube 46 may be reduced to 1.3 bar while the temperature rises to 120° C. Once a desired temperature and pressure is reached, the tube 46 may be held at this temperature and pressure for a set time interval, such as between 60 and 90 seconds. Tension on the tube 46 may be relaxed during the heating process (e.g., moving the clamps 50 inward to 50 mm from 120 mm of pull) or the tube 46 may be maintained under full tension throughout the heating process.


In the depicted example, the active heating of the mold is discontinued, i.e., turned off (block 80) after a desired temperature is reached and/or a set time has elapsed. For example, in one implementation heater cartridges in the heating/cooling jackets 44 are turned off when the molds 42 reach 120° C. However, the temperature of the molds 42 may continue to rise after the heating cartridges are turned off. In one such example, the heater cartridges may be turned off and, over a dwell time of approximately 8 seconds, the temperature of the molds 42 may continue to rise to approximately 130° C.


After the dwell time and/or after a desired maximum temperature is reached, the pressure within the tube 46 may be reduced (block 82). For example, in one embodiment, nitrogen pressure may be reduced to 1 bar. In one embodiment, coolant, such as cooled water, may be flushed through conduits in the heating/cooling jacket 44 to actively cool (block 84) the mold 42 once the dwell time is finished and the pressure has been reduced. For example, the mold 42 may be cooled to approximately 55° C. in 10 to 15 seconds by active cooling. In one implementation, active cooling of the mold 42 may be stopped at 60° C., allowing the mold 42 to continue cooling to 55° C. without active cooling. In one embodiment, at 60° C. active cooling is stopped and a vacuum is applied to the heating/cooling jacket 44 to remove coolant. In such an embodiment, the temperature of the mold 42 may continue to drop to 55° C. Pressure applied to the interior of the tube 46 may also be reduced to 0 bar at this time in one such embodiment.


In the depicted embodiment, the tension may be removed (block 86) from the tube 46. For example, the clamps 50 holding the tube 46 may retract inwards relative to the mold assembly 40 such that the tube 46 is no longer under tension. In one such implementation, the clamps 50 may retract inwards to 50 mm on both sides and may release (block 88) the tube 46. Once released by the clamps 50, the tube 46 (which now includes two or more cuffs 12 in an implementation where molds 42 are arranged serially) may be removed (block 92) from the mold assembly 40. The tube 46 may then be cut (block 94) to produce the cuffs 12. In one embodiment, the cuffs 12 may have a wall thickness of approximately 30μ or less. Each cuff 12 may then be applied (block 96) to a respective endotracheal tube 10, as depicted in FIGS. 1 and 2. As will be appreciated, though the preceding discussion has been provided in the context of processing a preformed tube 46, in other embodiments the cuffs may be formed from a molten parison of extruded material (such as polyurethane) that is dropped into two or more mold apparatuses as discussed herein to undergo a blow molding process to form more than one cuff at a time.


With the foregoing discussion in mind, FIGS. 5-11 depict in cross-section various embodiments of mold assemblies 40 suitable for use in a blow molding machine 38 and for producing two or more cuffs per blow molding operation. Turning to FIG. 5, two molds 42 are depicted in series, i.e., in an end-to-end arrangement. The molds have cavities 100 in the shape of the inflated cuff 12. In the depicted embodiment, the serially arranged molds 42 are disposed in a common heating/cooling jacket 44. In the depicted embodiment, the heating/cooling jacket 44 includes conduits 102 through which coolant, e.g., cooled water, may flow and electrical heating elements 104 which allow, respectively, active cooling and heating of the molds 42.


As will be appreciated, the depicted arrangement of conduits 102 and heating elements 104 is merely one possible arrangement. Other suitable arrangements of the conduits 102 and heating elements 104 may also be employed. For example, in one embodiment the heating elements 104 may be cylindrical in nature (as opposed to circular) and may run in the direction of the main axis of the heating/cooling jacket 44, i.e., in the direction the tube 46 is loaded. In such an embodiment, two or more such heating elements 104 may be spaced axially about the bore of the molds 42 to provide even heating. Likewise, the cooling conduits 102, may instead be provided as an open space or cavity surrounding some or all of the molds 42, such as an open cavity within the jacket 44. In such an embodiment, cooled water or other coolant may simply fill the cavity or be flushed through the cavity to achieve active cooling of the molds 42.


In the arrangement depicted in FIG. 5, a preformed tube 46 may be loaded into the mold assembly 40, allowing two cuffs 12 to be formed in the tube 46 during a single blow molding operation. For example, after being loaded into the mold assembly 40, the tube 46 may be clamped and placed under tension by the clamps 50, i.e., the clamps 50 may be moved outward from the mold assembly 40. An air nozzle inserted into one end of the tube 46 may blow nitrogen or other gases into the tube 46 under pressure such that the portions of the tube 46 in the cavities 100 blow out to contact the cavity walls. During or after the increase of pressure within the tube 46 the temperature of the molds 42 may be increased by activation of the heating elements 104 in the heating/cooling jacket 44. The heating elements 104 may be deactivated before or after the desired temperature and/or pressure are achieved. Once the desired temperature and/or pressure are achieved and maintained for a desired interval, the molds 42 may be cooled, such as by flushing coolant through the conduits 102 or a cavity of the heating/cooling jacket 44 and the pressure within the tube may be reduced. In addition, tension in the tube may be reduced or removed, such as by moving the clamps 50 inward toward the mold assembly. Upon release by the clamps 50, the tube 46 (including the newly formed cuff regions) may be removed from the mold assembly 40 for further processing.


Thus, in this manner, two (or more) cuffs 12 may be formed in a preformed tube 46 in a single blow molding operation. For example, for a 12 inch (30.48 cm) length of tube 46, two cuffs may be formed from the tube 46 in a single blow molding operation as opposed to a single cuff. In this manner, the number of cuffs produced in a given number of blow molding operations or in a given time period may be increased, e.g., doubled or more than doubled.


In one embodiment, the outside diameter of the tooling of the mold 42 may be reduced where the molds 42 are joined, such as at locations 98 of FIG. 5. For example, the outer diameter of the passage through the mold 42 at the locations 98 may be reduced relative to the outer diameter at locations 106 near the outside of the mold assembly. In such an embodiment, it may be desirable to have a reduced tooling outer diameter at locations 98 relative to locations 106 due to the tube 46 having a larger inner diameter/outer diameter at the locations 98 as a result of the temperature and pressure exerted on the tube 46 during a blow molding operation. In addition, in one embodiment the mold 42 may have cut-out regions 108 which may help prevent heat transfer between the molds 42, thereby resulting in a controllable internal diameter/outer diameter parameter.


Turning to FIG. 6, another serial arrangement of molds 42 is depicted. In this embodiment, instead of a common or shared heating/cooling jacket 44, separate heating/cooling jackets 44 are provided for each mold 42. Thus, the embodiment of FIG. 6 may be implemented using heating/cooling jackets 44 that are only configured to hold a single mold 42. In this manner, two (or more) cuffs 12 may be formed in a preformed tube 46 in a single blow molding operation using heating/cooling jackets 44 that are configured to hold only a single mold 42.


Likewise, FIG. 7 depicts a serial arrangement of molds 42 positioned within separate heating cooling jackets 44. Unlike the depicted embodiment of FIG. 6, the embodiment of FIG. 7 depicts the respective molds 42 in a symmetric, i.e., mirror image, relationship to one another. As will be appreciated, and as depicted in FIGS. 6 and 7, the relative orientation of the two or more molds 42 may or may not be symmetric, depending on a given implementation.


Unlike the embodiments depicted in FIGS. 5-7, the molds 42 may be spaced apart from one another, i.e., there is a gap 110 separating the molds 42, as depicted in the embodiment of FIG. 8. In such an embodiment, the separation of the molds 42 may prevent heat transfer between the molds 42, i.e., the gap 110 may thermally insulate the molds 42 from one another. Such thermal separation and/or independence of the molds 42 may be desirable. For example, in embodiments where different temperature profiles are applied to the molds 42 (e.g., where one mold 42 is heated to a different temperature and/or for a different interval than the other), the absence of heat transfer between the molds 42 may be desirable.


Turning to FIG. 9, in a further embodiment, an additional clamp 112 may be provided between the molds 42. The additional clamp 112 may prevent the flow of nitrogen or other gas between the molds 42. For example, in one embodiment each clamp 50 may be associated with a respective nozzle (as opposed to a single nozzle being employed to blow gas into the tube 46). Additional clamp 112 and the respective nozzle associated with each clamp 50 may allow a different pressure profile to be employed with each mold 42 (e.g., one mold 42 may be pressurized to a different pressure and/or for a different interval than the other). Such pressure independence may be desirable in certain implementations.


Turning to FIG. 10, a parallel arrangement of molds 42 in a common or shared heating/cooling jacket 44 is depicted. In such an arrangement, each mold 42 may be loaded with a different respective tube 46. Likewise, different respective sets of clamps 50, i.e., one set for each tube 46, may be employed. In this manner, in one embodiment the different respective tubes 46 may be subjected to different amount of tension and/or the duration of the tension may be different for each tube 46. In such an embodiment, the blow molding machine 38 may be provided with separate servo motors to control movement of the respective clamps 50 so that the respective tubes 42 may be stretched independent of one another.


Turning to FIG. 11, a combination parallel and serial arrangement of molds 42 is depicted. In this arrangement, two pairs of serially arranged molds are provided in parallel, allowing production of four cuffs (two cuffs in each tube 46) for each blow molding operation. In the depicted embodiment, the molds 42 are loaded into a common or shared heating cooling jacket 44, though in other embodiments each mold 42, each serial combination of molds, and/or each parallel combination of molds may be loaded into separate respective heating/cooling jackets 44. Likewise, in the depicted embodiment, the serially arranged molds 42 are in contact with one another. In other embodiments, the serially arranged molds 42 may be spaced apart to reduce or eliminate heat transfer between molds 42.


While the invention may be susceptible to various modifications and alternative forms, specific embodiments have been shown by way of example in the drawings and have been described in detail herein. However, it should be understood that the invention is not intended to be limited to the particular forms disclosed. Rather, the invention is to cover all modifications, equivalents, and alternatives falling within the spirit and scope of the invention as defined by the following appended claims. Indeed, the present techniques may not only be applied to forming cuffs for tracheal tubes but for any type of device designed for insertion into a human or animal body for which a tight seal is desired.

Claims
  • 1. A tube, comprising: a forming tube comprising a tube wall; andtwo or more cuffs formed from respective blown out portions of the tube wall, wherein the two or more cuffs are mirror images of each other and are configured to be separated from one another and to be incorporated onto respective endotracheal tubes as an endotracheal tube cuff.
  • 2. The tube of claim 1, wherein the forming tube is about 12 inches (30.48 cm) in length.
  • 3. The tube of claim 1, wherein the forming tube comprises a polymeric composition.
  • 4. The tube of claim 3, wherein the polymeric composition comprises polyurethane.
  • 5. The tube of claim 1, wherein the forming tube has an inner diameter between about 0.1708 inches and 0.296 inches (4.34 mm to 7.52 mm).
  • 6. The tube of claim 1 wherein each cuff comprises wall that are 0.00086 inches (0.022 mm) thick or less.
  • 7. The tube of claim 1, wherein each cuff is tapered.
  • 8. A blow molding system, comprising: two or more molds, each comprising a cavity corresponding to a shape of a cuff, wherein the two or more molds are mirror images of each other, and wherein each cuff is configured to be separated from a forming tube and attached to a respective endotracheal tube body to form an endotracheal tube;one or more heating/cooling jackets configured to secure the two or more molds and to actively heat and cool the two or more molds; andtwo or more clamps, wherein the one or more heating/cooling jackets and the two or more molds are positioned between at least two of the clamps that are configured to move toward and away from the one or more heating/cooling jackets and the two or more molds.
  • 9. The blow molding system of claim 8, comprising a control station configured to control operation of the one or more heating/cooling jackets and the two or more clamps.
  • 10. The blow molding system of claim 8, wherein each mold is secured in a respective heating/cooling jacket.
  • 11. The blow molding system of claim 8, wherein at least two molds are secured in each heating/cooling jacket.
  • 12. The blow molding system of claim 8, wherein the two or more molds are arranged in series.
  • 13. The blow molding system of claim 8, wherein the two or more molds are arranged in parallel.
  • 14. A mold assembly, comprising: two or more molds, each comprising a cavity corresponding to a shape of a cuff, wherein the two or more molds are minor images of each other, and wherein each cuff is configured to be separated from a forming tube and attached to a respective endotracheal tube body to form an endotracheal tube; andone or more heating/cooling jackets configured to secure the two or more molds and to actively heat and cool the two or more molds.
  • 15. The mold assembly of claim 14, wherein the two or more molds comprise beryllium copper.
  • 16. The mold assembly of claim 14, wherein the two or more molds are arranged in series in a heating/cooling jacket or in separate respective heating/cooling jackets.
  • 17. The mold assembly of claim 14, wherein the two or more molds are arranged in parallel in a heating/cooling jacket or in separate respective heating/cooling jackets.
  • 18. The mold assembly of claim 14, wherein four or more molds are arranged in series and in parallel in the one or more heating/cooling jackets such that a first subset of the molds are situated end-to-end with respect to one another but side-by-side with respect to a second subset of the molds.
  • 19. A method of manufacturing two or more inflatable cuffs in a single operation comprising: clamping each end of a forming tube, wherein portions of the forming tube are positioned within two or more molds, wherein the two or more molds are minor images of each other;stretching the forming tube by pulling the ends of the forming tube away from the two or more molds;increasing the pressure within the forming tube such that the portions of the forming tube within the two or more molds are blown outward to conform to the shape of the molds to form two or more cuffs, wherein each cuff is configured to be separated from the forming tube and attached to a respective endotracheal tube body to form an endotracheal tube;heating the molds for an interval of time;cooling the molds;decreasing the pressure within the tube;removing tension on the tube by moving the ends of the tube toward the two or more molds; andreleasing the ends of the tube.
  • 20. A method of manufacturing two or more inflatable cuffs in a single operation comprising: loading one or more tubes into a mold assembly comprising two or more molds, wherein the two or more molds are mirror images of each other;initiating a blow molding program on a blow molding machine, wherein the blow molding program initiates and controls stretching, heating, pressurizing, and cooling operations performed by the blow molding machine such that a cuff is formed in a respective portion of tube disposed within each of the two or more molds;removing the one or more tubes from the mold assembly, wherein each tube comprises at least two cuff regions; andcutting the cuff regions from the one or more tubes to form two or more cuffs.
  • 21. The method of claim 20, comprising attaching each of the two or more cuffs to a respective endotracheal tube body to form respective endotracheal tubes.
  • 22. A mold assembly, comprising: two molds, each comprising a cavity corresponding to a shape of a cuff having a distal end and a proximal end, and wherein the two molds are arranged end to end such that the distal end of one cavity is adjacent to the proximal end of the other cavity, and wherein each cuff is configured to be separated from a forming tube and attached to a respective endotracheal tube body to form an endotracheal tube; andone or more heating/cooling jackets configured to secure the two molds and to actively heat and cool the two molds.
  • 23. The mold assembly of claim 22, wherein each cavity is tapered.
US Referenced Citations (295)
Number Name Date Kind
2927584 Wallace Mar 1960 A
3625793 Sheridan et al. Dec 1971 A
3627282 Kinslow, Jr. Dec 1971 A
3769983 Merav Nov 1973 A
3810474 Cross May 1974 A
3822238 Blair et al. Jul 1974 A
3901246 Wallace Aug 1975 A
3913565 Kawahara Oct 1975 A
3971385 Corbett Jul 1976 A
3975350 Hudgin et al. Aug 1976 A
3995643 Merav Dec 1976 A
4022217 Rowean May 1977 A
4096223 Krall Jun 1978 A
4130617 Wallace Dec 1978 A
4230108 Young Oct 1980 A
4231365 Scarberry Nov 1980 A
4235239 Elam Nov 1980 A
4328056 Snooks May 1982 A
4340046 Cox Jul 1982 A
4357288 Oas et al. Nov 1982 A
4417576 Baran Nov 1983 A
4423725 Baran et al. Jan 1984 A
4456000 Schjeldahl et al. Jun 1984 A
4569344 Palmer Feb 1986 A
4638539 Palmer Jan 1987 A
4649913 Watson Mar 1987 A
4696296 Palmer Sep 1987 A
4700700 Eliachar Oct 1987 A
4791920 Fauza Dec 1988 A
4825859 Lambert May 1989 A
4825861 Koss May 1989 A
4834726 Lambert May 1989 A
4836199 Palmer Jun 1989 A
4838255 Lambert Jun 1989 A
4850348 Pell et al. Jul 1989 A
4867153 Lorenzen et al. Sep 1989 A
4872579 Palmer Oct 1989 A
4886059 Weber Dec 1989 A
4913642 Weber Apr 1990 A
4927412 Menasche May 1990 A
4938741 Lambert Jul 1990 A
4963313 Noddin et al. Oct 1990 A
4967743 Lambert Nov 1990 A
4979505 Cox Dec 1990 A
5020534 Pell et al. Jun 1991 A
5021045 Buckberg et al. Jun 1991 A
5025806 Palmer et al. Jun 1991 A
5029580 Radford et al. Jul 1991 A
5033466 Weymuller, Jr. Jul 1991 A
5060646 Page Oct 1991 A
5065754 Jensen Nov 1991 A
5074840 Yoon Dec 1991 A
5076268 Weber Dec 1991 A
5098379 Conway et al. Mar 1992 A
5103816 Krischbaum et al. Apr 1992 A
5107829 Lambert Apr 1992 A
5120322 Davis et al. Jun 1992 A
5122122 Allgood Jun 1992 A
5133345 Lambert Jul 1992 A
5135516 Sahatjian et al. Aug 1992 A
5137671 Conway et al. Aug 1992 A
5158569 Strickland et al. Oct 1992 A
5165420 Strickland Nov 1992 A
5176638 Don Michael Jan 1993 A
5190810 Kirschbaum et al. Mar 1993 A
5199427 Strickland Apr 1993 A
5201310 Turnbull et al. Apr 1993 A
5207643 Davis May 1993 A
5215522 Page et al. Jun 1993 A
5218957 Strickland Jun 1993 A
5230332 Strickland Jul 1993 A
5233979 Strickland Aug 1993 A
5246012 Strickland Sep 1993 A
5250070 Parodi Oct 1993 A
5251619 Lee Oct 1993 A
5261896 Conway et al. Nov 1993 A
5263478 Davis Nov 1993 A
5269770 Conway et al. Dec 1993 A
5277177 Page et al. Jan 1994 A
5290585 Elton Mar 1994 A
5304121 Sahatjian Apr 1994 A
5305740 Kolobow Apr 1994 A
5331027 Whitbourne Jul 1994 A
5337745 Benaron Aug 1994 A
5360402 Conway et al. Nov 1994 A
5370656 Shevel Dec 1994 A
5370899 Conway et al. Dec 1994 A
5374261 Yoon Dec 1994 A
5392787 Yoon Feb 1995 A
5397302 Weaver et al. Mar 1995 A
5407423 Yoon Apr 1995 A
5417671 Jackson May 1995 A
5423745 Todd et al. Jun 1995 A
5429127 Kolobow Jul 1995 A
5439457 Yoon Aug 1995 A
5443063 Greenberg Aug 1995 A
5447505 Valentine et al. Sep 1995 A
5451204 Yoon Sep 1995 A
5452715 Boussignac Sep 1995 A
5466231 Cercone et al. Nov 1995 A
5469864 Rosenblatt Nov 1995 A
5482740 Conway et al. Jan 1996 A
5484426 Yoon Jan 1996 A
5487730 Marcadis et al. Jan 1996 A
5490839 Wang et al. Feb 1996 A
5494029 Lane et al. Feb 1996 A
5496276 Wang et al. Mar 1996 A
5501669 Conway et al. Mar 1996 A
5507284 Daneshvar Apr 1996 A
5509899 Fan et al. Apr 1996 A
5524642 Rosenblatt Jun 1996 A
5545132 Fagan et al. Aug 1996 A
5556391 Cercone et al. Sep 1996 A
5593718 Conway et al. Jan 1997 A
5599292 Yoon Feb 1997 A
5599299 Weaver et al. Feb 1997 A
5599321 Conway et al. Feb 1997 A
5611336 Page et al. Mar 1997 A
5613950 Yoon Mar 1997 A
5649902 Yoon Jul 1997 A
5653229 Greenberg Aug 1997 A
5670111 Conway et al. Sep 1997 A
5674192 Sahatjian et al. Oct 1997 A
5693014 Abele et al. Dec 1997 A
5694922 Palmer Dec 1997 A
5697365 Pell Dec 1997 A
5700239 Yoon Dec 1997 A
5714110 Wang et al. Feb 1998 A
5715815 Lorenzen et al. Feb 1998 A
5720726 Marcadis et al. Feb 1998 A
5722931 Heaven Mar 1998 A
5730123 Lorenzen Mar 1998 A
5733252 Yoon Mar 1998 A
5735271 Lorenzen et al. Apr 1998 A
5738901 Wang et al. Apr 1998 A
5765559 Kim Jun 1998 A
5769882 Fogarty et al. Jun 1998 A
5803908 Steuer et al. Sep 1998 A
5810786 Jackson et al. Sep 1998 A
5819733 Bertram Oct 1998 A
5827215 Yoon Oct 1998 A
5843017 Yoon Dec 1998 A
5843028 Weaver et al. Dec 1998 A
5843060 Cercone Dec 1998 A
5843089 Sahatjian et al. Dec 1998 A
5868719 Tsukernik Feb 1999 A
5908406 Ostapchenko et al. Jun 1999 A
5951597 Westlund et al. Sep 1999 A
5954706 Sahatjian Sep 1999 A
5954740 Ravenscroft et al. Sep 1999 A
5971954 Conway et al. Oct 1999 A
5976072 Greenberg Nov 1999 A
5997503 Willis et al. Dec 1999 A
5997546 Foster et al. Dec 1999 A
6010480 Abele et al. Jan 2000 A
6012451 Palmer Jan 2000 A
6048332 Duffy et al. Apr 2000 A
6110192 Ravenscroft et al. Aug 2000 A
6129547 Cise Oct 2000 A
6132824 Hamlin Oct 2000 A
6152136 Pagan Nov 2000 A
6169123 Cercone Jan 2001 B1
6210364 Anderson Apr 2001 B1
6213975 Laksin Apr 2001 B1
6214895 Cercone Apr 2001 B1
6227200 Crump et al. May 2001 B1
6240321 Janke et al. May 2001 B1
6248088 Yoon Jun 2001 B1
6264631 Willis et al. Jul 2001 B1
6264633 Knorig Jul 2001 B1
6277089 Yoon Aug 2001 B1
6312421 Boock Nov 2001 B1
6322586 Monroe et al. Nov 2001 B1
6328710 Wang et al. Dec 2001 B1
6364856 Ding et al. Apr 2002 B1
6378521 Van Den Berg Apr 2002 B1
6394093 Lethi May 2002 B1
6395012 Yoon et al. May 2002 B1
6398266 Crump Jun 2002 B1
6409716 Sahatjian et al. Jun 2002 B1
6481436 Neame Nov 2002 B1
6494203 Palmer Dec 2002 B1
6501945 Chien Dec 2002 B1
6524274 Rosenthal et al. Feb 2003 B1
6526977 Göbel Mar 2003 B1
6543451 Crump et al. Apr 2003 B1
6551272 Gobel Apr 2003 B2
6572813 Zhang et al. Jun 2003 B1
6584970 Crump et al. Jul 2003 B1
6588425 Rouns et al. Jul 2003 B2
6588427 Carlsen et al. Jul 2003 B1
6602218 Yoon Aug 2003 B2
6602219 Madsen et al. Aug 2003 B2
6609520 Carlsen et al. Aug 2003 B1
6612304 Cise et al. Sep 2003 B1
6612305 Fauza Sep 2003 B2
6613025 Palasis Sep 2003 B1
6615835 Cise et al. Sep 2003 B1
6620128 Simhambhatla Sep 2003 B1
6623450 Dutta Sep 2003 B1
6629530 Cise Oct 2003 B2
6632091 Cise et al. Oct 2003 B1
6651664 Lomholt Nov 2003 B1
6687519 Steuer et al. Feb 2004 B2
6688306 Cise et al. Feb 2004 B1
6698424 Madsen et al. Mar 2004 B2
6705320 Anderson Mar 2004 B1
6722368 Shaikh Apr 2004 B1
6726696 Houser et al. Apr 2004 B1
6745773 Gobel Jun 2004 B1
6767340 Willis et al. Jul 2004 B2
6769430 Carlsen et al. Aug 2004 B1
6770066 Weaver et al. Aug 2004 B1
6786876 Cox Sep 2004 B2
6790221 Monroe et al. Sep 2004 B2
6796309 Nash et al. Sep 2004 B2
6802317 Göbel Oct 2004 B2
6805125 Crump et al. Oct 2004 B1
6808521 McMichael Oct 2004 B1
6814730 Li Nov 2004 B2
6890339 Sahatjian et al. May 2005 B2
6908449 Willis et al. Jun 2005 B2
6916307 Willis et al. Jul 2005 B2
6923786 Rouns et al. Aug 2005 B2
6979420 Weber Dec 2005 B2
6997909 Goldberg Feb 2006 B2
6997918 Soltesz et al. Feb 2006 B2
7040321 Gobel May 2006 B2
7040322 Fortuna May 2006 B2
7056466 Wang et al. Jun 2006 B2
7066905 Squire et al. Jun 2006 B2
7073503 Lomholt Jul 2006 B2
7096868 Tateo et al. Aug 2006 B2
7147252 Teuscher et al. Dec 2006 B2
7258120 Melker Aug 2007 B2
8196584 Maguire et al. Jun 2012 B2
20010041861 Gobel Nov 2001 A1
20020077603 Willis et al. Jun 2002 A1
20020077604 Willis et al. Jun 2002 A1
20020078960 Cise Jun 2002 A1
20020078963 Rouns et al. Jun 2002 A1
20020082552 Ding et al. Jun 2002 A1
20020091375 Sahatjian et al. Jul 2002 A1
20020110657 Wang et al. Aug 2002 A1
20020150707 Wilkons Oct 2002 A1
20020193753 Rouns et al. Dec 2002 A1
20020195110 Watton Dec 2002 A1
20030000526 Gobel Jan 2003 A1
20030032407 Mages Feb 2003 A1
20030066532 Gobel Apr 2003 A1
20030069620 Li Apr 2003 A1
20030111077 Hooser et al. Jun 2003 A1
20030116162 Madsen et al. Jun 2003 A1
20030116963 Teuscher et al. Jun 2003 A1
20030225369 McMichael et al. Dec 2003 A1
20030225392 McMichael et al. Dec 2003 A1
20030225393 McMichael et al. Dec 2003 A1
20040024363 Goldberg Feb 2004 A1
20040079376 Melker Apr 2004 A1
20040092870 Squire et al. May 2004 A1
20040106899 McMichael et al. Jun 2004 A1
20040106900 Triebes et al. Jun 2004 A1
20040106901 Letson et al. Jun 2004 A1
20040116898 Hawk Jun 2004 A1
20040122110 MacCabee et al. Jun 2004 A1
20040154623 Schaeffer et al. Aug 2004 A1
20040193100 Van Hooser et al. Sep 2004 A1
20040193101 Van Hooser et al. Sep 2004 A1
20040215142 Matheis et al. Oct 2004 A1
20040220534 Martens et al. Nov 2004 A1
20040221853 Miller Nov 2004 A1
20040255952 Carlsen et al. Dec 2004 A1
20050004560 Cox Jan 2005 A1
20050033267 Decaria Feb 2005 A1
20050033268 Decaria Feb 2005 A1
20050033269 Decaria Feb 2005 A1
20050038381 McMichael Feb 2005 A1
20050065468 Goebel Mar 2005 A1
20050124932 Foster et al. Jun 2005 A1
20050124935 McMichael Jun 2005 A1
20050137619 Schewe et al. Jun 2005 A1
20050166924 Thomas et al. Aug 2005 A1
20060118121 Martens et al. Jun 2006 A1
20060118122 Martens et al. Jun 2006 A1
20070095351 Gobel May 2007 A1
20070289596 Campbell et al. Dec 2007 A1
20070295336 Nelson et al. Dec 2007 A1
20070295337 Nelson et al. Dec 2007 A1
20070296125 Colburn et al. Dec 2007 A1
20080064839 Hadba et al. Mar 2008 A1
20080072911 Flagler et al. Mar 2008 A1
20080078400 Martens et al. Apr 2008 A1
20080078403 Clayton Apr 2008 A1
20080078405 Crumback et al. Apr 2008 A1
20080125711 Alpini et al. May 2008 A1
Foreign Referenced Citations (27)
Number Date Country
2353007 Jun 2000 CA
2208421 Sep 1995 CN
2540984 Mar 2003 CN
19500550 Nov 1994 DE
19500550 Jul 1996 DE
19855521 Jun 2000 DE
0214721 Mar 1987 EP
0884061 Jun 1998 EP
0 884 061 Dec 1998 EP
1005877 Jun 2000 EP
1135184 Jun 2000 EP
1267981 Jan 2003 EP
1313347 Apr 1973 GB
2168256 Nov 1985 GB
2168256 Jun 1986 GB
WO 9522367 Aug 1995 WO
WO 9522367 Aug 1995 WO
WO 0027461 May 2000 WO
WO 0032262 Jun 2000 WO
WO 0032263 Jun 2000 WO
WO 03045487 Jun 2003 WO
WO 2004067262 Aug 2004 WO
WO 2004067262 Aug 2004 WO
WO 2004101046 Nov 2004 WO
WO 2006023486 Mar 2006 WO
WO 2007140262 Jun 2007 WO
WO 2007149202 Dec 2007 WO
Non-Patent Literature Citations (7)
Entry
International Search Report and Written Opinion for PCT Application No. PCT/US2010/03877 dated Sep. 4, 2011; 17 pgs.
Aye Gönen Karake{dot over (i)}l{dot over (i)} et al.; “Comparison of Bacterial and Tissue Cell Initial Adhesion on Hydrophilic/Hydrophobic Biomaterials,” J Biomater. Sci. Polymer Edn, vol. 13, No. 2, pp. 185-196 (2002).
Blunt et al.; “Gel Lubrication of the Tracheal Tube Cuff Reduces Pulmonary Aspiration,” 2001 American Society of Anesthesiologists, Inc. Lippincott Williams & Wilkins, Inc.; Anesthesiology, V. 95, No. 2, Aug. 2001.
Dullenkopf, et al., “Fluid leakage past tracheal tube cuffs: evaluation on the new Microcuff endotracheal tube,” Intensive Care Medicine, (2003) vol. 29, pp. 1849-1853.
Sartomer Application Bulletin; “Functional Acrylic Monomers as Modifiers for PVC Plastisol Formulations,” pp. 1-6.
Shintani; “Modification of Medical Device Surface to Attain Anti-Infection,” National Institute of Health Sciences; Trends Biomater. Artif. Organs, vol. 18(1), pp. 1-8 (2004).
Tecogel brochure page, Noveon Thermedics Polymer Products, Oct. 2003.
Related Publications (1)
Number Date Country
20100323048 A1 Dec 2010 US