Patent Application
20110265798
The present disclosure relates to tracheal tubes used in medical applications, and more particularly, to tracheal tubes having spaced lumens and associated ported adapters for connecting the tracheal tubes to cooperative devices, such as evacuation systems, ventilators, and so forth.
This section is intended to introduce the reader to various aspects of art that may be related to various aspects of the present disclosure, 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 disclosure. Accordingly, it should be understood that these statements are to be read in this light, and not as admissions of prior art.
In the course of treating a patient, a tube or other medical device may be used to control the flow of air, food, fluids, or other substances into and out of the patient. For example, medical devices, such as tracheal tubes, may be used to control the flow of air or other gases through a trachea of a patient. Such tracheal tubes may include endotracheal tubes (ETTs), tracheostomy tubes, or transtracheal tubes. 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, such as the trachea. In this way, substances can only flow through the passage via the tube or other medical device inserted in the tube, allowing a medical practitioner to maintain control over the type and amount of substances flowing into and out of the patient. In addition, a high-quality seal against the tracheal passageway allows a ventilator to perform efficiently.
In many instances, it is also desirable to manage the accumulation of subglottic secretions (e.g., mucus) around the seal (e.g., a cuff) or elsewhere via removal through external suctioning. It may also be desirable to provide for administration of antibiotics and other medicaments in the same region. These subglottic secretions are undesirable as they may contain bacteria that may cause infection if left to grow. In some cases, these subglottic secretions may cause ventilator-associated pneumonia (VAP) due to bacterial colonization of the lower respiratory airways.
As such, the tracheal tubes may include one or more lumens extending axially through walls of the tracheal tubes. These lumens enable various auxiliary applications (e.g., tubes for enabling suctioning and blowing, cameras, devices for monitoring pressure, temperature, and other parameters, and so forth) to be introduced at various locations along the tracheal tubes. However, conventional tracheal tubes may not be configured to adapt to changes in patient orientation. More specifically, for example, the lumens of the tracheal tubes may only be aligned with locations requiring suctioning or blowing when the patient is oriented in a specific manner. As such, these tracheal tubes may only work efficiently if the patient is immobile and inclined at a certain attitude. Moreover, conventional evacuation and other lines may require piercing the tube wall to link a small external tube to the lumen. This can be time consuming, and where two or more lumens are present, can lead to a relatively confusing set of tubes and fittings.
Advantages of the disclosed techniques may become apparent upon reading the following detailed description and upon reference to the drawings in which:
One or more specific embodiments of the present techniques 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.
As discussed in detail below, various embodiments are provided of a tracheal tube having equally spaced lumens and an associated ported adapter. The lumens of the tracheal tube may be spaced around the circumference of the tracheal tube to facilitate evacuation (e.g., suctioning and blowing) and other applications at various locations around the circumference of the tracheal tube. The ported adapter includes lumen extensions that may be inserted into the lumens of the tracheal tube, thereby forming a connection between the ported adapter and the tracheal tube lumens. More specifically, hollow ports extending through the lumen extensions and the body of the ported adapter facilitate connection of the lumens of the tracheal tube with external equipment such as, for example, evacuation equipment for suctioning and blowing into and out of the lumens of the tracheal tube.
The devices and techniques provided herein enable evacuation (e.g., suctioning and blowing) and other applications to be performed at various locations around the circumference of the tracheal tube. As such, problems associated with patient orientation and blockage of certain lumens will be reduced. In addition, using a removable ported adapter to connect the spaced lumens of the tracheal tube with external equipment enables different ported adapters to be used with the tracheal tube. For example, certain ported adapters may include ports for each of the lumens of the tracheal tube, whereas other ported adapters may only include ports for a few (or even one) of the lumens of the tracheal tube.
Turning now to the drawings,
As illustrated, an inflation cuff 28 that may be inflated to seal against the walls of a body cavity (e.g., a trachea) may be attached along and above the distal end 22 of the endotracheal tube 12. The inflation cuff 28 may be inflated via an inflation lumen 30 connected to a fixture 32. A shoulder 34 of the inflation cuff 28 may secure the inflation cuff 28 to the endotracheal tube 12. In certain embodiments, the shoulder 34 may be folded up inside a lower end of the inflation cuff 28, although various alternative structures are common in the art. As illustrated, the endotracheal tube 12 also includes a plurality of lumens 36 that extend from locations on the endotracheal tube 12 above the inflation cuff 28. For example, each of the lumens 36 may be associated with notches on a proximal side of the inflation cuff 28. The lumens 36 illustrated in this embodiment are equally spaced around the circumference of the endotracheal tube 12. As described in greater detail below, the lumens 36 may be connected with corresponding ports 38 of the ported adapter 14. It should be noted, however, that the lumens 36 need not be equally spaced in all applications, and indeed may be provided for different purposes than evacuation.
One or more of the ports 38 may be connected to an external evacuation tube 40 and an evacuation system 42 used for the removal and introduction of suctioned and blown fluids. Where the lumens 36 are at spaced locations around the circumference of the endotracheal tube 12, the lumens 36 facilitate evacuation at various possible orientations of the patient (e.g., sitting, reclined, and lying on the back, chest, or side). In certain embodiments, to prevent suctioning or blowing from lumens 36 not requiring suctioning or blowing, a method of sequential bi-directional flow through the lumens 36 may be employed. The bi-directional flow may allow any blockage to be expelled from the affected lumen 36. This method of sequential bi-directional flow may employ a powered valve (or manual valve) allowing alternating bi-directional flow to each lumen 36 in turn. Moreover, in certain embodiments, a more complex method may use feedback sensors to, for example, identify when a specific lumen 36 is producing suctionable secretions and, when appropriate, commence suctioning of the corresponding port 38 of the ported adapter 14. As such, only lumens 36 that are ideally placed for suctioning or blowing will be subject to evacuation. Similarly, pressure sensors may be used to detect pressure changes due to blockages, and to instigate a suction/blow cycle until normal pressures resume.
Furthermore, the plurality of lumens 36 and ports 38 may be used for various other applications of the endotracheal tube 12. For example, in addition to being used for evacuation purposes, the lumens 36 and ports 38 may be used to introduce other devices and/or fluids (e.g., cameras, sensors, medicaments, and so forth) into the patient's trachea.
As noted above, the spaced lumens 36 may be used for various applications of the endotracheal tube 12. For example, the lumens 36 may be used for suctioning, blowing, introducing cameras, introducing sensors, introducing medicaments, and so forth. Indeed, the lumens 36 are multifunctional, facilitating any number of suitable functions of the endotracheal tube 12. As described above, in the illustrated embodiment, because the lumens 36 are spaced around the circumference of the endotracheal tube 12, the lumens 36 facilitate better suctioning and blowing in all patient orientations, while also facilitating removal of blockages.
In addition to the spaced, multifunctional lumens 36, in certain embodiments, the endotracheal tube 12 may include the inflation lumen 30 for inflating the inflation cuff 28, and an X-ray lumen 46, which may be filled with a fluid such as barium to render the structure visible in X-ray images. In general, the inflation lumen 30 and the X-ray lumen 46 may be smaller than the lumens 36. For example, the lumens 36 may be approximately 1.5-3.0 mm in diameter, whereas the inflation lumen 30 and the X-ray lumen 46 may be approximately 0.8-1.2 mm and 0.3-0.8 millimeter in diameter, respectively. By way of comparison, in certain embodiments, the wall 44 of the endotracheal tube 12 may have a width of approximately 2.0-4.0 mm, depending upon the particular application. It should be noted that certain of the conventional lumens, such as the inflation lumen 30, may also be ported though the ported adapter 14.
In certain embodiments, both the inflation lumen 30 and the X-ray lumen 46 may be offset from the equally spaced, multifunctional lumens 36 around the circumference of the wall 44 of the endotracheal tube 12. For example, as illustrated in
The endotracheal tube 12 may be manufactured using extrusion techniques and may be made from any material suitable for use in tracheal tubes. For example, in certain embodiments, the endotracheal tube 12 may be made of polyurethane, polyvinyl chloride (PVC), polyethylene teraphthalate (PETP), low-density polyethylene (LDPE), polypropylene, silicone, neoprene, polytetrafluoroethylene (PTFE), or polyisoprene. Moreover, the lumens 36 may be specifically dedicated to certain types of applications (e.g., inflation, evacuation, etc.), or the tubes may be designed with a number of “multi-purpose” lumens, as set forth in U.S. patent application Ser. No. 12/750,789, filed on Mar. 31, 2010, and entitled “Tracheal Tube with Scaffolding-Supported Wall,” which is hereby incorporated by reference.
As described above, the ported adapter 14 of
As illustrated by the arrows 50 in
In certain embodiments, the hollow ports 38 may extend from a distal surface 54 of the ported adapter 14 to an outer circumferential wall 56 of the ported adapter 14. As illustrated, the distal surface 54 of the ported adapter 14 is adjacent to and orthogonal with the outer circumferential wall 56 of the ported adapter 14. A 90-degree bend 58 in each of the hollow ports 38 enable the hollow ports 38 to bend from the distal surface 54 of the ported adapter 14 to the outer circumferential wall 56 of the ported adapter 14. Although illustrated as extending from the distal surface 54 of the ported adapter 14 to the adjacent outer circumferential wall 56 of the ported adapter 14, in other embodiments, the hollow ports 38 may extend from the distal surface 54 of the ported adapter 14 to a proximal surface 60 of the ported adapter 14, as described in greater detail below. As illustrated, the proximal surface 60 of the ported adapter 14 is opposite to the distal surface 54 of the ported adapter 14. It may also be desirable to provide angled or inclined walls on the ported adapter 14, with the polls 38 terminating in that wall, to allow for easy access to the ports 38, while avoiding any sharp angles within the ported adapter 14.
As described above, each lumen 36 of the endotracheal tube 12 may have an inner diameter of known dimensions, such as approximately 1.5-3.0 mm. As such, each lumen extension 48 of the ported adapter 14 has a corresponding outer diameter dle of the same or slightly larger dimension, such that the lumen extensions 48 may be interference fit within the lumens 36, ensuring that the lumen extensions 48 remain in place when attached to the lumens 36. As illustrated, the inner diameter dp of the ports 38 have a slightly smaller diameter than the outer diameter dle of lumen extensions 48. However, as described below, in certain embodiments, the lumen extensions 48 may include a tapered wall that enables the inner diameter dp of the ports 38 to be substantially similar to the inner diameter of the lumens 36 of the endotracheal tube 12. It is presently contemplated that the ported adapter 14 may simply be fitted to the endotracheal tube 12 and may remain in place by the interference fit of the lumen extensions 48 within the lumens 36. However, where desired, adhesive or other bonding techniques may be used, particularly where differently configured lumen extensions 48 are employed that may not provide the pull-out resistance desired.
As illustrated in
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As described above, in certain embodiments, the lumen extensions 48 of the ported adapter 14 may include tapered walls. For example,
As described above, the ported adapter 14 may be configured to connect with a ventilator connector 18, which in turn may be used to connect to a ventilation system. For example,
In certain embodiments, the distal section 78 of the ventilator connector 18 may have a generally circular cross-section such that the circular distal section 78 of the ventilator connector 18 may fit within the circular interior bore 64 of the ported adapter 14. As illustrated, when inserted into the interior bore 64 of the ported adapter 14, the distal section 78 may extend beyond the lumen extensions 48 of the ported adapter 14. As such, the distal section 78 of the ventilator connector 18 may be inserted into the cannula of the endotracheal tube 12, thereby connecting the ventilator connector 18 with the cannula of the endotracheal tube 12.
Conversely, in certain embodiments, the proximal end 76 of the ventilator connector 18 may have a cross-sectional area that is larger than that of the interior bore 64 of the ported adapter 14. As illustrated, when the distal end 78 of the ventilator connector 18 is inserted into the interior bore 64 of the ported adapter 14, the proximal end 76 may abut the proximal surface 60 of the ported adapter 14. As such, the ventilator connector 18 may be prevented from sliding further into the ported adapter 14 or the endotracheal tube 12. Once the ventilator connector 18 is inserted into the ported adapter 14 and the endotracheal tube 12, the proximal end 76 of the ventilator connector 18 may be connected to an external ventilation system, enabling ventilation of the patient's trachea.
It should be noted that, in certain embodiments, the ported adapter 14 and the ventilator connector 18 may not be separate components. Rather, the ported adapter 14 and the ventilator connector 18 may be integrated into a single adapter/connector piece. In other words, the ported adapter 14 may be designed as a standard ventilator connector. In certain embodiments, the ported adapter 14 and the ventilator connector 18 (as well as the integrated adapter/connector piece) may be made using injection molding techniques, and may be made from polypropylene, polyvinyl chloride (PVC), polyethylene teraphthalate (PETP), acrylonitrile butadiene styrene (ABS), or any other suitable materials.
While the disclosure 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 embodiments provided herein are not intended to be limited to the particular forms disclosed. Rather, the various embodiments may cover all modifications, equivalents, and alternatives falling within the spirit and scope of the disclosure as defined by the following appended claims.
