This invention is generally related to endotracheal or intubation devices and the use of endotracheal or intubation devices, for example, in operating rooms, emergency rooms, and by first responders. Specifically, aspects of the invention include endotracheal devices having an external conduit, an internal conduit within the external conduit, and a rod that can be used to move the internal conduit within the external conduit to treat patients.
Endotracheal tubes (or ETTs) are conventional supra-glottic (that is, above the glottic or laryngeal opening) devices used, for example, during surgery, to—among other things—maintain access to the trachea of the patient. Endotracheal tubes are also conventional tubes specially designed with inflatable cuffs to seal airways and effectively support oxygenation and ventilation, for example, during surgery.
In the existing art, especially during thoracic surgery, endotracheal tubes may be used to isolate one lung from the other. For example, a thoracic surgeon may require that the lungs be isolated and a single lung be ventilated when performing certain procedures, for instance, lobectomy, bronchopulmonary lavage, and esophagogastrectomy, among other procedures.
One device that is may be used to isolate the lungs is a relatively rigid tubular device referred to as “double-lumen endotracheal tube” (DLT). When using a DLT, the user, for example, an anesthesiologist, inserts a tube having two lumens into the trachea through which to ventilate the lungs. One of the two lumens is positioned in the left or right bronchial main stem and the other lumen remains in the trachea. However, though DLTs can provide an effective means for isolating a lung, DLTs can be bulky and thus cumbersome to manipulate by the user, such as, an anesthesiologist. In addition, DLTs typically must be left in place in the patient for a few days after surgery if the patient is transferred to intensive care after surgery.
However, it is well recognized in the art that in the use of ETTs the manipulation and positioning of the tube in the airway, for example, in a bronchus, can be difficult without undo diligence and care. Of course, these prior art devices and practices are being performed on patients, where misstep or error can be harmful, if not life threatening.
Aspects of the invention address these and other disadvantages of the prior art by providing a unique ETT that not only avoids the inconveniences and complications of the prior art, but also can provide unique opportunities for improved techniques and improved patient treatment and outcome.
Aspects of the present invention may, for example, be used for lung isolation, among other procedures, and may facilitate the positioning and/or orienting of tubes within the trachea and bronchi. In addition, according to aspects of the invention, once the, for example, thoracic surgery is completed, the inner conduit or tube of the present invention can be withdrawn from the patient. In other aspects, the inner conduit or tube of the present invention may be left in place within the patient. Aspects of the present invention may also be less bulky and less cumbersome to handle and position within the patient compared to existing devices. In short, aspects of the present invention may be easier to use by the anesthesiologist and thus easier to isolate a lung of a patent than existing devices.
In the following discussion, aspects of the invention may be referred to as “endotracheal devices”; however, aspects of the invention may be referred to as “intubation devices” or “endobronchial devices,” for example, depending upon the use, function, and/or positioning of the aspect disclosed.
Aspects of the present invention address the disadvantages of the existing art by providing endotracheal devices having two cooperating conduits or tubes, an external conduit and an internal conduit positioned within the external conduit, and a manipulation rod or wire mounted to the internal conduit which may be used to move the internal conduit, for example, telescopically, within the external conduit to treat patients. Embodiments of the invention and the many aspects the embodiments are summarized in the following descriptions.
One embodiment of the invention is an endotracheal device comprising or including: a first elongated conduit having an internal dimension, a proximal end, and an open distal end; a second elongated conduit having an external dimension less than the internal dimension of the first conduit, an open proximal end in fluid communication with the first elongated conduit, and an open distal end; and a manipulation rod operatively mounted to the second conduit, the manipulation rod adapted to allow an operator to move the second conduit within the first conduit. In one aspect, the manipulation rod may be adapted to allow the operator to translate the second conduit within the first conduit and/or rotate the second conduit within the first conduit.
In one aspect, the first conduit further comprises an opening through which the manipulation rod accesses the second conduit, wherein movement of the manipulation rod moves the second conduit within the first conduit. In one aspect, the opening may be an elongated slot, in another aspect, the opening may include a fluid-sealing element.
In anther aspect, the device may further include a rod receiver mounted to the first conduit, and the rod receiver may have an opening to receive the manipulation rod. The opening in the rod receiver may include a fluid sealing element. The opening in the rod receiver may a circumferentially directed slot.
In one aspect, the device may further include a projection, tab, or bar connecting the manipulation rod to the second conduit.
In another aspect, the device may further include at least one inflatable cuff mounted to one of the first conduit and the second conduit.
Another embodiment of the invention is a method for treating a patient. The method may comprise or include: introducing to a cavity within the patient a device comprising: a first elongated conduit having an internal dimension, a proximal end, and an open distal end; a second elongated conduit having an external dimension less than the internal dimension of the first conduit, an open proximal end in fluid communication with the first elongated conduit, and an open distal end; and a manipulation rod operatively mounted to the second conduit; and moving the second conduit within the first conduit with the manipulation rod to position the distal end of the second conduit within the patient. The step of moving the second conduit within the first conduit may comprise translating and/or rotating the second conduit within the first conduit.
In one aspect, the cavity within the patient being treated may be an airway, such as, a trachea or bronchus.
In another aspect, the method may further include introducing and/or extracting a fluid from the cavity.
In another aspect, the method may further include inflating at least one inflatable cuff on the first conduit and/or the second conduit to obstruct fluid flow passed the cuff.
These and other aspects, features, and advantages of this invention will become apparent from the following detailed description of the various aspects of the invention taken in conjunction with the accompanying drawings
The subject matter, which is regarded as the invention, is particularly pointed out and distinctly claimed in the claims at the conclusion of the specification. The foregoing and other objects, features, and advantages of the invention will be readily understood from the following detailed description of aspects of the invention taken in conjunction with the accompanying drawings in which:
In one aspect, an endotracheal device 10 may be referred to as “an endotracheal tube (ETT)” or “an endotracheal tube device.” In another aspect, each of first elongated conduit 12 and second elongated conduit 14 may be referred to as “an endotracheal tube.” For example, in one aspect, device 10 may be referred to as “an endotracheal tube within an endotracheal tube” or “an ETT within an ETT.” It is envisioned that the inventors and/or others may conceive of other appropriate designations for aspects of the invention.
In one aspect, the first elongated conduit 12 typically has an internal dimension 18, for example, an inside diameter or inside width; a proximal end 20; and an open distal end 22; and second elongated conduit 14 typically has an external dimension 24, for example, an outside diameter or outside width, less than the internal dimension 18 of the first conduit 12; an open proximal end 26; and an open distal end 28. Typically, open proximal end 26 of second elongated conduit 14 may be in fluid communication with the interior of the first elongated conduit 12.
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Rod receiver 38 may typically comprise a structure or housing positioned and adapted to receive rod 16 and allow rod 16 to access and move conduit 14 within conduit 12. In one aspect, rod receiver 38 may be adapted to receive rod i6 and allow rod 16 to access and move conduit 14 while minimizing or preventing the passage of fluid from device 10, for example, from rod receiver 38 and/or conduit 12. As shown in
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Though one specific airway that may be accessed by aspects of the invention is shown in
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As shown, inflation lumen 104 associated with cuff 130 may be mounted to or within and extend along conduit 112.
According to aspects of the invention shown in
According to one aspect of the invention, as shown in
In one aspect of the invention, device 100 may include one or more other ancillary lumens or conduits no having a proximal end 111 and a distal end 113. For example, in one aspect, one or more lumens or conduits 110 may include one or more open ends, holes, or orifices 115 adjacent to distal end 113. According to aspects of the invention, the one or more orifices or holes 115 may be provided in or on conduit 112 (for example, evenly distributed in, about and/or along the distal end of conduit 112). In one aspect, one or more lumens or conduits 110 may communicate via proximal end in with one or more external fluid sources (not shown) and/or one or more external fluid receivers (not shown). According to aspects of the invention, the one or more lumens or conduits 110 may be used to introduce one or more fluids to or extract one or more fluids from an internal cavity or passage, such as, a trachea, a bronchus, an esophagus, or another cavity or passage into which device 110 is placed. The proximal ends in of one or more lumens or conduits 110 may communicate with external sources, for example, sources of medication, or treatments, for example, vacuum or fluid pressure, by conventional means. In one aspect, lumens or conduits 110 may be used to inflate or deflate an internal cavity, for example, a lung.
In one aspect of the invention, lumen or conduit 110 and hole 115 and/or conduit 117 and hole 119 may be associated with an image-capturing device 140, shown in phantom in
In another aspect, one or more lumens or conduits 117 (only a representative portion of which is shown in phantom in
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In one aspect of the invention, in order to allow the translation and/or rotation of internal conduit 214 within external conduit 216 by means of rod 246, the external conduit 212 may be omitted within the extents of the housing of rod receiver 238 allowing rod 216 and, for example, projection 246 unencumbered access to internal conduit 214 to translate and/or rotate internal conduit 214. According to this aspect, the housing of rod receiver 238 may provide a chamber for accessing internal conduit 214 with rod 216 and allowing rod 216 and one or more projections 246 unencumbered access to conduit 214, while providing appropriate sealing devices or elements about any penetrations into the housing of rod receiver 238.
According to aspect of the invention, the arc length of slot 250 may range from 5 degrees to 360 degrees, for example, from 15 degrees to 270 degrees, or from 5 degrees to 180 degrees, as suggested by the aspect shown in
The use of any one of the endotracheal devices disclosed herein may be practiced with or without the use of a guidance device, that is, a device used to assist the user in guiding the insertion and placement of the endotracheal devices disclosed herein. According to aspects of the invention, any conventional guidance device may be used, including a thin surgical instrument, or “bougie,” as known in the art, that is, a “hard bougie” or a “soft bougie”; a bronchoscope, for example, a fiber optic bronchoscope; or any elongated rod, tube, wire, conduit, or structure that can be used to assist the user in guiding the insertion and placement of the endotracheal devices disclosed herein. According to one aspect of the invention, the guidance device may be placed within the passage or airway of the patient, and, while in place, any one of the endotracheal devices disclosed herein may be inserted into the airway while threading the guidance device through, for example, the internal conduit of an endotracheal device disclosed herein. Guidance devices that may be used when practicing aspects of the invention may include an Eschmann-style tracheal tube introducer or bougie provided by various manufactures, such as, Teleflex Inc. Insertion of aspects of the invention into a passage or an airway may be facilitated by lubricating the endotracheal device prior to insertion.
Though many different aspects of the present invention have been presented disclosed individually or in combination herein for the sake of facilitating disclosure, it is envisioned that any one or more of the aspects or features disclosed herein may be combined with any one or more other aspects of features disclosed herein.
The endotracheal devices and their subcomponents disclosed herein may be fabricated from any conventional material, for example, any conventional plastic material, elastomeric material, and even wood or metal. In one aspect, the materials from which the components of the invention, for example, the first conduit, the second conduit, and/or the manipulation rod, are made may provide for at least some flexibility, deformability, and/or malleability to the components. That is, in some aspects, the components, such as, the first conduit, the second conduit, and/or the manipulation rod, may be bent, deformed, or otherwise manipulated during handling by an operator, such as, an anesthesiologist, to introduce, position, and/or orient the devices as desired within a cavity or passage of a patient, for example, in an airway. In one aspect, the components disclosed herein may be fabricated from a polyamide (PA), for example, nylon; a polyethylene (PE), both high-density polyethylene (HDPE) and low-density polyethylene (LDPE); a polyethylene terephthalate (PET); a polypropylene (PP); a polyester (PE); a polytetrafluoroethylene (PTFE); a polystyrene (PS); an acrylonitrile butadiene styrene (ABS); a polycarbonate (PC); or a polyvinylchloride (PVC); among other plastics.
The endotracheal devices disclosed herein may also be provided in a broad range of sizes and dimensions, for example, depending upon the size or age of the patient being treated. Aspects of the invention may be adapted for use with adults, children, infants, and neonates. In one aspect, embodiments of the invention may be used for veterinary treatment, for example, with animals. For example, the endotracheal devices may have an overall length ranging from about 2 inches to about 2 feet, but may typically range in length from about 4 inches to about 12 inches, for example, about 10 inches in length. Similarly, the endotracheal devices disclosed herein may have an overall width ranging from about 1 inch to about 6 inches, but may typically range in width from about 2 inches to about 3 inches, for example, about 2½ inches in width.
The internal conduits and the external conduits of the devices disclosed herein may have cross-sectional dimensions, for example, diameters or widths, ranging from 2 millimeters [mm] to 100 mm, but typically have cross-sectional dimensions ranging from 5 mm to 20 mm, for example, from 8 mm to 12 mm. For instance, in one aspect, the internal diameter of the external conduit (12) disclosed herein may be 9 mm, and the internal diameter of the internal conduit (14) disclosed herein may be 6 mm.
Accordingly, in one aspect of the invention, any one of the distal ends of the conduits or tubes disclosed herein may be substantially non-beveled, for example, having an exposed cross-section substantially perpendicular to the axis of the tube. In another aspect, any one of the distal ends of the tubes or conduits disclosed herein may have a bevel, directed in a predetermined direction, for example, having a bevel directed in an anterior direction of the patient. The bevel may have a bevel angle ranging from 30 degrees to 60 degrees, for example, a 45-degree bevel.
Though various aspects and embodiments of the invention are disclosed herein that can be used or adapted for endotracheal insertion or intubation during surgery, it is envisioned that aspects of the invention may be adapted for any application where patient or victim treatment or intubation is advantageous, that includes in the emergency room (ER), in the operating room (OR), or by first responders, paramedics, and emergency medical technicians (EMTs) at accidents or other calamities. It is envisioned that aspects of the invention may be particularly advantageous for neurosurgery and/or brain surgery where the prevention of coughing, which may undesirably induce intra-cranial pressure (ICP) during extubation, is desired. Other applications of aspects of the invention are bronchoscopy thoracic surgery, obstetrics, cardiac catheterization, laparoscopic procedures, and plastic surgery, among other medical procedures, and training, for example, training of anesthesiologists.
As disclosed herein, aspects of the invention include endotracheal devices and their method of use that address many of the disadvantages of prior art devices and methods.
While various embodiments have been described above, it should be understood that these embodiments and their many aspects have been presented by way of example, and not limitation. It will be apparent to persons skilled in the relevant art that various changes in form and detail can be made therein without departing from the spirit and scope of the invention. Moreover, it is to be understood that the various embodiments of the invention, although different, are not necessarily mutually exclusive. Furthermore, a particular feature, structure, or characteristic described herein in connection with one embodiment may be implemented within other embodiments without departing from the scope of the invention. In addition, it is to be understood that the location or arrangement of individual elements within each disclosed embodiment may be modified without departing from the scope of the invention. The detailed description presented herein, therefore, is not to be taken in a limiting sense, and the scope of the present invention is defined only by the appended claims, appropriately interpreted, along with the full range of equivalents to which the claims are entitled.
Although the term “at least one” may often be used in the specification, claims and drawings, the terms “a”, “an”, “the”, “said”, etc. also signify “at least one” or “the at least one” in the specification, claims and drawings.
While several aspects of the present invention have been described and depicted herein, alternative aspects may be effected by those skilled in the art to accomplish the same objectives. Accordingly, it is intended by the appended claims to cover all such alternative aspects as fall within the true spirit and scope of the invention.
This application claims priority from pending U.S. Provisional Patent Application 62/832,947, filed on Apr. 12, 2019, the disclosure of which is included by reference herein in its entirety.
Number | Date | Country | |
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62832947 | Apr 2019 | US |