A variety of different circumstances exist in which a person may be required to have a catheter inserted into their body for a medical procedure. Once such use for a catheter exists when a person needs to have an artificial airway, such as an endotracheal tube, placed in his or her respiratory system. During surgery, for instance, the artificial airway's primary function is to keep the patient's airway open so that adequate lung ventilation can be maintained during the surgical procedure. Alternatively, with many patients the endotracheal tube will remain in place to sustain mechanical ventilation for a prolonged period.
If an endotracheal tube is to be left in place for any substantial amount of time, it is critical that respiratory secretions be periodically removed. This is usually accomplished with the use of a respiratory suction catheter. As the suction catheter is withdrawn, a negative pressure may be applied to the interior of the catheter to draw mucus and other secretions from the respiratory system.
With conventional closed suction catheter assemblies, for example as the one set forth in U.S. Pat. No. 4,569,344 issued to Palmer, which is incorporated by reference herein in its entirety for all purposes, the catheter tube is enveloped by a protective sleeve. The catheter assembly includes a valve mechanism in communication with a vacuum source to control the suctioning process. At its distal or patient end, the closed suction catheter assembly is permanently attached to a manifold, connector, adaptor, or the like.
After the application of negative pressure, the catheter tube may be withdrawn from the artificial airway and, as the catheter tube is pulled back into the protective sleeve, a wiper or seal strips or scrapes a substantial portion of any mucus or secretions from the outside of the catheter tube. However, the distal tip portion of the catheter tube may not pass through the seal or wiper and thus any secretions or mucus on the distal end must be removed by other means. It is desirable to remove these secretions from the catheter tube in order to prevent contamination from infectious agents that may be present in the respiratory secretions. Patients using artificial airways often have compromised immune systems and are more susceptible to infectious agents.
Several mechanisms exist by which a catheter may be cleaned. For example, a lavage port may be included which enables the clinician to inject liquid into the area surrounding the tip of the catheter after it has been withdrawn from the patient's airway. When liquid is injected and suction is applied, the liquid helps to loosen and remove the secretions from the exterior of the catheter.
One significant problem with simply injecting liquid and applying suction is that the suction also causes a volume of respiratory air to be removed through the catheter. In a closed system, the air that is evacuated potentially disrupts the carefully controlled ventilation cycle and the amount of respiratory air available to the patient may be decreased as a result of catheter cleaning.
Prior respiratory suction catheter apparatuses have been developed in order to allow for cleaning of the distal tip of the catheter without substantially interrupting the airflow to the patient from the ventilator. U.S. Pat. No. 6,227,200 B1 issued to Crump et al., which is incorporated by reference herein in its entirety for all purposes, provides in one exemplary embodiment a flap valve that may be used to substantially isolate the distal end of the catheter from the patient's airway during cleaning. The flap valve also has an open position in which the catheter may be inserted through the manifold into the airway of the patient. Prior respiratory suction catheter apparatuses incorporate the flap valve and related structure such that these parts are permanently bonded to the manifold.
Although respiratory suction catheter apparatuses are provided with a cleaning mechanism in order to remove mucus and other infectious agents, it is often the case that the catheter itself needs to be regularly replaced in order to insure a more sterile respiratory circuit. Some manufacturers recommend replacement of the suction catheter every 24 hours with a new suction catheter. In the instance when the suction catheter needs to be replaced, the artificial airway structure, often a manifold, into which the flap valve and related parts are contained, and onto which the suction catheter is attached, is detached from the respiratory circuit. This detachment necessarily interferes with the supply of air to the patient, and increases the chance of ventilator associated complications. The new manifold having the catheter and valve is then attached to the ventilator circuit.
Therefore, there is a need in the art for a closed suction respiratory system that is capable of effectively cleaning the tip of a suction catheter without a resulting drop of ventilation air to the patient. Additionally, a need in the art exists in replacing a respiratory suction catheter apparatus with a new respiratory suction catheter apparatus without disconnecting the artificial airway structure from the ventilation circuit in order to prevent air loss to the patient and to lower the chance of imparting illness to the patient during the replacement procedure.
Various features and advantages of the invention will be set forth in part in the following description, or may be apparent from the description, or may be learned from practice of the invention.
The present invention provides for a respiratory suction catheter apparatus that allows for a suction catheter to be removed from a ventilation circuit of a patient and replaced without having to disconnect an artificial airway structure from the ventilation circuit. The suction catheter may be adapted for removing fluid from a patient by insertion of a tubular portion into an artificial airway of the patient and application of negative pressure to a lumen of the tubular portion. A catheter attachment section may be present and has a passageway therethrough that allows for passage of the tubular portion. The catheter attachment section may have a proximal end that is attached to the suction catheter. A distal end of the catheter attachment section may be configured for releasable attachment with an artificial airway structure that is attached to the patient. Further, a valve may be located in the catheter attachment section. When closed, the valve at least substantially blocks the tubular portion of the suction catheter from the artificial airway of the patient. The valve also has an open position that allows the tubular portion of the suction catheter to be advanced through the catheter attachment section and into the artificial airway of the patient.
Also provided according to the present invention is a respiratory suction catheter apparatus that has a suction catheter with a tubular portion, lumen and distal end. The suction catheter may be adapted for removing fluids from a patient by insertion of the tubular portion into an artificial airway of the patient and application of negative pressure to the lumen. A catheter attachment section is present and has a passageway therethrough that allows for passage of the tubular portion of the suction catheter. A proximal end of the catheter attachment section may be attached to the suction catheter. A distal end of the catheter attachment section may be configured for releasable attachment with an artificial airway structure. A valve is located in the catheter attachment section and may be capable of at least substantially blocking the passageway when in a closed position. The valve has an open position that allows the tubular portion of the suction catheter to be advanced through the catheter attachment section. The catheter attachment section also has a cleaning section that is proximal from the valve when the valve is in the closed position. An irrigation port may be in communication with the cleaning section. The irrigation port may be configured for allowing fluid to be transferred therethrough into the cleaning section.
The present invention also provides for a respiratory suction catheter apparatus that has a suction catheter having a tubular portion with a lumen and distal end. The suction catheter may be adapted for removing fluids from a patient by insertion of the tubular portion into an artificial airway of the patient and application of negative pressure to the lumen. A sleeve is also present in the suction catheter and completely surrounds the tubular portion along at least a portion of the length of the tubular portion. A catheter attachment section is also provided and may have a passageway therethrough that allows for passage of the tubular portion of the suction catheter. The catheter attachment section may also have a proximal end that is attached to the suction catheter. Also, a distal end of the catheter attachment section may be configured for releasable attachment by a friction fit arrangement with an artificial airway structure that is attached to the patient. A valve is located in the catheter attachment section. The valve has a closed position in which the tubular portion of the suction catheter may be at least substantially blocked from the artificial airway of the patient. The valve has an open position that allows the tubular portion of the suction catheter to be advanced through the catheter attachment section and into the artificial airway of the patient. A cleaning section may be present and is located in the catheter attachment section proximal from the valve. Further, a wiper seal may be located in the catheter attachment section, proximal from the cleaning section.
Other exemplary embodiments of the present invention may exist in a respiratory suction catheter apparatus as described above where the valve is a single flap. In yet other exemplary embodiments, a wiper seal may be located in the catheter attachment section proximal from the valve.
In other exemplary embodiments of the present invention, the valve may be biased towards the closed position. Further, other exemplary embodiments of the present invention may include a respiratory suction catheter apparatus as described above where the single flap has an aperture therethrough. The single flap may be opened by insertion of the tubular portion through the catheter attachment section.
Other exemplary embodiments of the present invention may include a respiratory suction catheter apparatus as described above where the distal end of the catheter attachment section is releasably attachable to the artificial airway structure by a variety of mechanisms. For instance, the attachment may be effected through a friction fit arrangement, a threaded engagement, a barb structure, or a clamping ring. Additionally, the artificial airway structure onto which the respiratory suction catheter apparatus is attached may be a rotatable manifold, an elbow manifold, an elbow manifold with swiveling ports, a T-manifold, or Y-manifold in different exemplary embodiments according to the present invention.
Reference will now be made in detail to embodiments of the invention, one or more examples of which are illustrated in the drawings. Each example is provided by way of explanation of the invention, and is not meant as a limitation of the invention. For example, features illustrated or described as part of one embodiment can be used with another embodiment to yield still a third embodiment. It is intended that the present invention include these and other modifications and variations.
As used herein, proximal refers generally to the direction towards a medical caregiver. Also, distal refers generally to the direction towards a patient.
The present invention provides for a respiratory suction catheter apparatus 10 that allows for a suction catheter 12 to be removed from the ventilation circuit of a patient 18 and replaced without having to disconnect an artificial airway structure 30 from the ventilation circuit. Referring to the drawings,
If the artificial airway 34 is left in the patient 18 for any substantial amount of time, respiratory secretions may build up in the lungs of the patient 18. As such, these secretions need to be removed in order to ensure adequate lung ventilation of the patient 18 is maintained. These secretions may be removed through the use of a suction catheter 12. The suction catheter 12 has a tubular portion 14 that may be extended through the artificial airway 34 into the lungs of the patient 18. A vacuum source 78 may be in communication with the ventilation circuit, and more specifically in communication with the suction catheter 12. A medical caregiver may actuate a suction valve 74 thereby applying a vacuum pressure to the tubular portion 14. Upon doing so, respiratory secretions in the patient 18 and in the artificial airway 34 may be removed.
The respiratory suction catheter apparatus 10 is shown with a flexible plastic sleeve 44. The sleeve 44 may be present in order to contain and isolate respiratory secretions that accumulate on the tubular portion 14 of the suction catheter 12 as the tubular portion 14 is withdrawn from the ventilation circuit. The sleeve 44 may be provided on either end with sealing connections 45 and 47 that attach the sleeve 44 to the suction catheter 12.
Respiratory secretions may sometimes remain on the tubular portion 14 of the suction catheter 12 or transfer onto other portions of the ventilation circuit. These respiratory secretions are undesirable in that they provide a breeding ground for pathogens and other harmful agents that may harm the patient 18. It is therefore the case that the suction catheter 12 and/or other components of the ventilation circuit may be cleaned in order to remove any residual respiratory secretions. However, in order to ensure a lower risk of contamination to the patient 18, it may be common practice to remove and replace the suction catheter 12 and/or other components in the ventilation circuit after some amount of set time has passed, for instance after 24 or 72 hours of use.
As was previous practice, the artificial airway structure 30 was detached from the artificial airway 34 so that a new artificial airway structure 30 could be incorporated into the ventilation circuit. This break in the ventilation circuit interrupted the flow of air to the patient 18 and increased the chances of ventilator associated complications. In the present invention the respiratory suction catheter apparatus 10 may be removably attached to the artificial airway structure 30. In this instance, upon removing the respiratory suction catheter apparatus 10, the artificial airway structure 30 may remain in place and allow for communication between the ventilator 76 and the artificial airway 34. As such, air may still be provided to the patient 18 during removal of the respiratory suction catheter apparatus 10. A new respiratory suction catheter apparatus 10 may be reattached to the same artificial airway structure 30.
The respiratory suction catheter apparatus 10 in accordance with the present invention may be used in combination with a variety of artificial airway structures 30. For instance, in one exemplary embodiment of the present invention as shown in
The respiratory suction catheter apparatus 10 is shown in greater detail in
The catheter attachment section 22 may also be provided with a cleaning section 38. In one exemplary embodiment, the cleaning section 38 may be defined by a cleaning section member 86. Additionally or alternatively, the cleaning section 38 may be defined on one end by a valve 32. Further, the cleaning section 38 may alternatively be defined by any portion of the catheter attachment section 22. The valve 32 shown in
The tubular portion 14 of the suction catheter 12 may have a distal end 16 with a distal opening 82. A lumen 20 may extend through the tubular portion 14 and allows for respiratory secretions and other fluids to be transferred through the distal opening 82 and into the lumen 20 by the vacuum source 78 (
Although described as contacting the distal end 16 of the suction catheter 12 in certain exemplary embodiments of the present invention the valve 32 need not contact the distal end 16 of the tubular portion 14 in order to effectively clean the tubular portion 14. For instance, the valve 32 may be urged against the cleaning section member 86 during cleaning of the tubular portion 14 of the suction catheter 12.
The tubular portion 14 may also be provided with at least one side opening 84. This arrangement allows for turbulent flow to be established within the cleaning section 38 causing the lavage solution to break up and remove any respiratory secretions present on the tubular portion 14. Respiratory secretions may be removed through the side opening 84 and/or the distal opening 82. The valve 32 may be provided with an aperture 42 therethrough. The presence of the aperture 42 may help to establish a more desirable turbulent fluid flow within the cleaning section 38. In one exemplary embodiment of the present invention, the aperture 42 is about 0.03 inches in diameter.
An irrigation port 40 may be attached to the catheter attachment section 22 in order to allow for the injection of the lavage solution. A container (not shown) holding the lavage solution may have an outlet inserted into the irrigation port 40. Lavage may then be dispensed from this container into the irrigation port 40 which may be in communication with the cleaning section 38. The irrigation port 40 may also be provided with an irrigation cap 70 that may be connected to the irrigation port 40 by way of a tether 72. The irrigation cap 70 may be placed onto the irrigation port 40 in order to close the irrigation port 40 when not in use.
In certain exemplary embodiments of the present invention, the cleaning section member 86 may be configured such that a small amount of space is present between the tubular portion 14 of the suction catheter 12 and the cleaning section member 86. In certain exemplary embodiments of the present invention, this space may be between about 0.005 and about 0.015 inches. This space provides two advantages. First, if lavage is needed to be provided to the patient 18, injection of lavage through the irrigation port 40 and then into the cleaning section 38 causes a stream of lavage solution to be directed out of the catheter attachment section 22 and into the patient 18. Second, as the tubular portion 14 is withdrawn the close proximity between the tubular portion 14 and the cleaning section member 86 may help to wipe any heavy layers of respiratory secretions from the outside of the tubular portion 14 of the suction catheter 12.
Employment of the valve 32 is advantageous in that the tubular portion 14 of the suction catheter 12 may be cleaned without causing a pressure loss to the ventilation circuit. This is because the valve 32 substantially isolates the portion of the respiratory suction catheter apparatus 10 proximal the valve 32 from the remainder of the ventilation circuit. In one exemplary embodiment of the present invention, the valve 32 may be provided with one or more projections 88.
In one exemplary embodiment of the present invention, the valve 32 is biased towards the closed position. Although shown in
In other exemplary embodiments of the present invention the valve 32 need not be a single flap, nor need the flap be attached to the annular ring 31, nor need it have the aperture 42, or the projection 88. It is to be understood that the configuration of the valve 32 shown in the drawings is only a desired embodiment, and other configurations of the valve 32 are possible in accordance with the present invention. For instance, the valve 32 may be one, two, or three flaps that are biased towards a closed position and opened by insertion of the tubular portion 14 of the suction catheter 12 through the catheter attachment section 22.
Referring back to
As shown in
Another exemplary embodiment of the present invention is shown in
Although shown (in
Yet another exemplary embodiment of the present invention is disclosed in
The artificial airway structure valve 66 may prevent air loss during removal of the respiratory suction catheter apparatus 10 by sealing off the port 46. The artificial airway structure valve 66 may take any design commonly known in the art. For instance, as disclosed in
Additionally, the artificial airway structure valve 66 may be a mechanism that does not have flaps but yet still provides for a closed port 46 during disengagement of the respiratory suction catheter apparatus 10 from the artificial airway structure 30.
Additionally, the valve 32 and the artificial airway structure valve 66 may be of other configurations in other exemplary embodiments of the present invention. For instance, configurations disclosed in commonly owned U.S. Pat. No. 6,227,200 B1 issued to Crump et al., may be employed which may be a twisting membrane, a duckbill arrangement, or a dual membrane configuration having offset apertures.
The artificial airway structure valve 66 may be configured such that it is closed during disengagement of the respiratory suction catheter apparatus 10, but opened upon insertion of the distal end 28 of the catheter attachment section 22 into the port 46. Additionally, the artificial airway structure valve 66 may be configured to be opened by insertion of the tubular portion 14 of the suction catheter 12 through the port 46 and into the artificial airway structure 30. In this instance, it may be the case that the artificial airway structure valve 66 is also in need of cleaning due to contact with respiratory secretions from the tubular portion 14. In this instance, the distal end 16 of the tubular portion 14 may be located proximate to the artificial airway structure valve 66, and lavage solution may be injected into this location through the irrigation port 40. Vacuum may be applied to the lumen 20 of the tubular portion 14 and respiratory secretions present may then be removed via a process substantially the same as the cleaning procedure with respect to the valve 32.
Additionally, other ways of releasably attaching the respiratory suction catheter apparatus 10 to the artificial airway structure 30 are possible in accordance with the present invention.
Another way of releasably attaching the respiratory suction catheter apparatus 10 to the artificial airway structure 30 is disclosed in
Yet another exemplary embodiment of the present invention is shown in
An additional exemplary embodiment of the present invention is shown in
In accordance with the present invention, the respiratory suction catheter apparatus 10 may be sized such that it may be attached to a variety of artificial airway structures 30. As such, the present invention includes various sizes of the respiratory suction catheter apparatus 10 along with various sizes and configurations of the artificial airway structure 30. The examples of which described herein are only exemplary embodiments of the present invention and do not limit the present invention. Additionally, various ways of releasably attaching the distal end 28 to the artificial airway structure 30 are possible in accordance with the present invention, the mechanisms disclosed herein are only exemplary embodiments.
The respiratory suction catheter apparatus 10 may be provided with a cap 100 as shown in
The cap 100 may be attached to the artificial airway structure 30 as shown in
It should be understood that the present invention includes various modifications that can be made to the embodiments of the respiratory suction catheter apparatus described herein as come within the scope of the appended claims and their equivalents.
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