Patent Application
20060278235
The present invention relates to tracheal tubes used during ventilation of a patient.
When a patient is unable to adequately breathe independently, an external mechanical ventilator may be used to provide temporary or permanent breathing support. The ventilator pumps air into and out of the subject's lungs such as, for example, through an endotracheal (ET) tube or other tracheal tube. In one example, a distal portion of the tracheal tube is introduced via the subject's mouth. A proximal portion of the endotracheal tube is connected to the ventilator. An inflatable cuff near the distal end of the endotracheal tube is inflated to completely occupy the intratracheal region surrounding the endotracheal tube. This creates a seal that prevents airflow through the trachea other than through the endotracheal tube that the ventilator can provide the subject with breathing support through the endotracheal tube.
Fluid accumulates below the cuff of the endotracheal tube. One technique for removing accumulated fluid from the lungs (below the cuff) includes interrupting the patient's ventilation by disconnecting the proximal end of the endotracheal tube from the ventilator. A suction tube is then inserted through the endotracheal tube beyond the cuff at its distal end. By applying an airflow-creating vacuum to the proximal end of the suction tube, fluid is removed from the lungs.
Fluid also accumulates above the cuff of the endotracheal tube. In a long term intubation subject, pathogenic bacteria multiply in the pool of secretions that accumulate above the inflated endotracheal tube cuff and can cause pneumonia. For this reason, it is desirable to construct endotracheal tubes that incorporate a device to draw fluids from above the cuff.
Tracheal tubes are described in U.S. Patent Publication No. US 2003/0145860 A1, published Aug. 7, 2003, entitled “Surface Energy Assisted Fluid Transport System”, and the contents of this application are hereby incorporated by reference herein.
The invention provides an improved tracheal tube having above the cuff drainage.
The invention provides a system comprising: an elongated member, sized and shaped to be inserted within a subject's trachea, the elongated member comprising proximal and distal ends; a seal, extending around the elongated member at or near the distal end of the elongated member; at least one wicking fluid pickup port, positioned near the distal end of the elongated member, the at least one wicking fluid pickup port located more proximal than at least a portion of the seal; and at least one lumen, coupled in fluid communication with the at least one wicking fluid pickup port and extending toward the proximal end of the elongated member, the seal comprising an inflatable cuff having a proximal surface, wherein the at least one wicking fluid pickup port is disposed near an inner tracheal wall when the distal end of the elongated member is positioned within a trachea of a person and the inflatable cuff is inflated.
The invention provides a system comprising: an elongated member, sized and shaped to be inserted within a subject's trachea, the elongated member comprising proximal and distal ends; a seal, extending around the elongated member at or near the distal end of the elongated member; at least one fluid pickup port, positioned near the distal end of the elongated member, the at least one fluid pickup port located more proximal than at least a portion of the seal; and at least one lumen, coupled in fluid communication with the at least one fluid pickup port and extending toward the proximal end of the elongated member, the seal comprising an inflatable cuff having a proximal surface, wherein the at least one wicking fluid pickup port is disposed near an inner tracheal wall when the distal end of the elongated member is positioned within a trachea of a person and the inflatable cuff is inflated.
The invention provides a system comprising: an elongated member, sized and shaped to be inserted within a subject's trachea, the elongated member comprising proximal and distal ends; a seal, extending around the elongated member at or near the distal end of the elongated member; at least one wicking fluid pickup port, positioned near the distal end of the elongated member, the at least one wicking fluid pickup port located more proximal than at least a portion of the seal; and at least one lumen, coupled in fluid communication with the at least one wicking fluid pickup port and extending toward the proximal end of the elongated member, the seal comprising an inflatable cuff having a proximal surface, the inflatable cuff being cup-shaped and oriented so that the proximal surface directs fluid toward the at least one wicking fluid pickup port.
The invention provides a method comprising: inserting into a subject's trachea an elongated member, sized and shaped to be inserted within a subject's trachea, the elongated member comprising proximal and distal ends; a seal, extending around the elongated member at or near the distal end of the elongated member; at least one wicking fluid pickup port, positioned near the distal end of the elongated member, the at least one wicking fluid pickup port located more proximal than at least a portion of the seal; and at least one lumen, coupled in fluid communication with the at least one wicking fluid pickup port and extending toward the proximal end of the elongated member, the seal comprising an inflatable cuff having a proximal surface, wherein the at least one wicking fluid pickup port is disposed near an inner tracheal wall when the distal end of the elongated member is positioned within a trachea of a person and the inflatable cuff is inflated, and wherein the elongated member comprises an airflow lumen extending longitudinally from at or near the distal end of the elongated member to or near the proximal end of the elongated member;
inflating the inflatable cuff to obstruct airflow at a first location outside of the elongated member and inside the trachea;
ventilating at least one of the subject's lungs through the elongated member;
wicking fluid, at a location that is more proximal than the first location; and
drawing the wicked fluid out of the subject.
Additional features and advantages of the invention are set forth in the description which follows and in part will be apparent from the description. The objectives and other advantages of the invention will be realized and attained by the tracheal tube having above the cuff drainage as particularly pointed out in the written description and claims.
It is to be understood that both the foregoing general description and the following detailed description are exemplary and explanatory and are intended to provide further explanation of the invention as claimed.
The invention provides a system comprising: an elongated member, sized and shaped to be inserted within a subject's trachea, the elongated member comprising proximal and distal ends; a seal, extending around the elongated member at or near the distal end of the elongated member; at least one wicking fluid pickup port, positioned near the distal end of the elongated member, the at least one wicking fluid pickup port located more proximal than at least a portion of the seal; and at least one lumen, coupled in fluid communication with the at least one wicking fluid pickup port and extending toward the proximal end of the elongated member, the seal comprising an inflatable cuff having a proximal surface, wherein the at least one wicking fluid pickup port is disposed near an inner tracheal wall when the distal end of the elongated member is positioned within a trachea of a person and the inflatable cuff is inflated. In one embodiment, the at least one wicking fluid pickup port is disposed from 0.2 to 2 mm from the inner tracheal wall when the distal end of the elongated member is positioned within a trachea of a person and the inflatable cuff is inflated. In another embodiment, the at least one wicking fluid pickup port is disposed immediately adjacent to the inner tracheal wall when the distal end of the elongated member is positioned within a trachea of a person and the inflatable cuff is inflated.
In one embodiment, the at least one wicking fluid pickup port is disposed immediately above the proximal surface of the cuff. In another embodiment, the at least one wicking fluid pickup port is disposed on the proximal surface of the cuff. In one embodiment, at least a portion of the proximal surface is slanted relative to a longitudinal axis of the elongated member to direct fluid toward the at least one wicking fluid pickup port. In another embodiment, the entire proximal surface of the inflatable cuff is slanted relative to a longitudinal axis of the elongated member to direct fluid toward the at least one wicking fluid pickup port. In one embodiment, the entire proximal surface of the cuff and the longitudinal axis of the elongated member meet at an angle of less than 90 degrees. In another embodiment, the entire proximal surface of the cuff and the longitudinal axis of the elongated member meet at an angle of less than 80 degrees.
In one embodiment, the at least a portion of the proximal surface slanted relative to a longitudinal axis of the elongated member forms a V-shaped depression. In one embodiment, the entire proximal surface of the inflatable cuff is slanted relative to a longitudinal axis of the elongated member to direct fluid toward the at least one wicking fluid pickup port and the proximal surface comprises a V-shaped depression to direct fluid toward the at least one wicking fluid pickup port.
In one embodiment, the cuff comprises a reinforcing element. In another embodiment, the cuff comprises a semi-rigid polymer. In another embodiment, the cuff is made of a semi-rigid polymer.
In one embodiment, a portion of the inflatable cuff is made of a semi-elastic material that expands only a predetermined amount. In another embodiment, the predetermined amount of expansion places the wicking fluid pickup port a predetermined distance from the tracheal wall when the cuff is inflated. In one embodiment, the semi-elastic material is a woven or non-woven fabric.
In one embodiment, the elongated member comprises an airflow lumen extending longitudinally from at or near the distal end of the elongated member to or near the proximal end of the elongated member. In another embodiment, the airflow lumen is sized to provide adequate ventilation to at least one lung of a person when the airflow lumen is coupled, at or near the proximal end of the elongated member, to a mechanical ventilator.
In one embodiment, the system further comprises a cuff lumen, coupled in fluid communication with the inflatable bladder, the cuff lumen extending longitudinally to or near the proximal end of the elongated member. In another embodiment, the elongated member comprises a hollow tube including a ventilation airflow lumen extending between the distal end of the elongated member and the proximal end of the elongated member, and in which at least a portion of the cuff lumen extends longitudinally through a sidewall portion of the hollow tube. In one embodiment, the elongated member comprises a hollow tube including a ventilation airflow lumen extending between the distal end of the elongated member and the proximal end of the elongated member, and in which at least a portion of the cuff lumen extends longitudinally within the ventilation airflow center lumen. In another embodiment, the elongated member comprises a hollow tube including a ventilation airflow lumen extending between the distal end of the elongated member and the proximal end of the elongated member, and in which at least a portion of the cuff lumen extends longitudinally outside the hollow tube.
In one embodiment, the inflatable cuff comprises a single inflatable bladder. In another embodiment, the inflatable cuff comprises two inflatable bladders. In one embodiment, the two inflatable bladders are coupled in fluid communication to first and second cuff lumens, the first and second cuff lumens extending longitudinally to or near the proximal end of the elongated member. In another embodiment, a first inflatable bladder is coupled in fluid communication to a cuff lumens, the lumen extending longitudinally to or near the proximal end of the elongated member, and the second inflatable bladder is coupled in fluid communication with the first inflatable bladder by one or more pressure relief valves that open when the pressure in the first inflatable bladder exceeds a certain pressure.
In one embodiment, the at least one wicking fluid pickup port includes at least one of a size, shape, and material characteristic that obtains a surface energy capable of assisting in introducing mucus into the at least one wicking fluid pickup port. In another embodiment, the system further includes a pump coupled in fluid communication with the at least one lumen that is in fluid communication with the at least one wicking fluid pickup port. In another embodiment, at least one lumen that is in fluid communication with the at least one wicking fluid pickup port comprises a portion that extends within an interior portion of the inflatable cuff. In one embodiment, a portion of the at least one lumen that is in fluid communication with the at least one wicking fluid pickup extends distally past the at least one wicking fluid pickup port. In another embodiment, the pump comprises a peristalsis pump.
In one embodiment, the system further includes a holding receptacle coupled in fluid communication with the at least one lumen that is in fluid communication with the at least one wicking fluid port. In another embodiment, the elongated member is sized and shaped to be inserted through an airflow passage of a tracheal tube assembly to a desired bronchial tube of the subject. In one embodiment, the wicking fluid pickup port has a rounded tip. In another embodiment, the elongated member comprises a reference mark to assist in proper placement of the elongated member.
In one embodiment, the system comprises two or more wicking fluid pickup ports. In another embodiment, the lumen coupled to the at least one wicking fluid pickup port exits the inflatable cuff distal of the proximal surface of the inflatable cuff. In one embodiment, the at least one wicking fluid pickup port is disposed immediately above or on the proximal surface of the cuff and an area of the cuff surrounding the at least one wicking fluid pickup port is hydrophilic. In another embodiment, an area of the cuff distant from the at least one wicking fluid pickup port is hydrophobic.
The invention provides a system comprising: an elongated member, sized and shaped to be inserted within a subject's trachea, the elongated member comprising proximal and distal ends; a seal, extending around the elongated member at or near the distal end of the elongated member; at least one fluid pickup port, positioned near the distal end of the elongated member, the at least one fluid pickup port located more proximal than at least a portion of the seal; and at least one lumen, coupled in fluid communication with the at least one fluid pickup port and extending toward the proximal end of the elongated member, the seal comprising an inflatable cuff having a proximal surface, wherein the at least one wicking fluid pickup port is disposed near an inner tracheal wall when the distal end of the elongated member is positioned within a trachea of a person and the inflatable cuff is inflated. In one embodiment, the system further comprises a vacuum pump coupled in fluid communication with the at least one lumen that is in fluid communication with the at least one wicking fluid pickup port.
The invention provides a system comprising: an elongated member, sized and shaped to be inserted within a subject's trachea, the elongated member comprising proximal and distal ends; a seal, extending around the elongated member at or near the distal end of the elongated member; at least one wicking fluid pickup port, positioned near the distal end of the elongated member, the at least one wicking fluid pickup port located more proximal than at least a portion of the seal; and at least one lumen, coupled in fluid communication with the at least one wicking fluid pickup port and extending toward the proximal end of the elongated member, the seal comprising an inflatable cuff having a proximal surface, the inflatable cuff being cup-shaped and oriented so that the proximal surface directs fluid toward the at least one wicking fluid pickup port.
The invention provides a method comprising:
inserting into a subject's trachea an elongated member, sized and shaped to be inserted within a subject's trachea, the elongated member comprising proximal and distal ends; a seal, extending around the elongated member at or near the distal end of the elongated member; at least one wicking fluid pickup port, positioned near the distal end of the elongated member, the at least one wicking fluid pickup port located more proximal than at least a portion of the seal; and at least one lumen, coupled in fluid communication with the at least one wicking fluid pickup port and extending toward the proximal end of the elongated member, the seal comprising an inflatable cuff having a proximal surface, wherein the at least one wicking fluid pickup port is disposed near an inner tracheal wall when the distal end of the elongated member is positioned within a trachea of a person and the inflatable cuff is inflated, and wherein the elongated member comprises an airflow lumen extending longitudinally from at or near the distal end of the elongated member to or near the proximal end of the elongated member;
inflating the inflatable cuff to obstruct airflow at a first location outside of the elongated member and inside the trachea;
ventilating at least one of the subjects lungs through the elongated member;
wicking fluid, at a location that is more proximal than the first location; and
drawing the wicked fluid out of the subject. In one embodiment, the drawing the wicked fluid out of the subject includes using a peristalsis pump to provide a pressure for drawing the wicked fluid out of the subject. In one embodiment, the drawing the wicked fluid out of the subject includes matching a flow rate at which the wicked fluid is drawn out of the subject to a mucus generation rate of the subject.
In one embodiment of the invention, the area immediately surrounding the fluid pickup port is made of a material that attracts fluids or is treated to attract fluids (i.e., the area is hydrophilic). Polymers that attract tracheal secretions include polyphenylene oxide, polyethylene terephthalate, polyamide, polyimide, and polyether block amide. In another embodiment of the invention, the area immediately surrounding the fluid pickup port is made of a material that attracts fluids or is treated to attract fluids (i.e., the area is hydrophilic) and the rest of the cuff is treated to repel fluids (i.e., the rest of the cuff is hydrophobic).
In this example, at the proximal end portion of endotracheal tube assembly 102, cuff lumen 135 is coupled in fluid communication with external cuff tube 114, which extends outwardly therefrom toward cuff pressure bladder 116 and inflation port 118, or similar pump device for inflating cuff 110. Cuff 110 is capable of being inflated when endotracheal tube assembly 102 is disposed within a lumen (e.g., within a patient's trachea). Inflating cuff 110 provides a seal that ensures that airflow occurs within air passage 108, rather than through the trachea outside endotracheal tube assembly 102. In one example, cuff 110 is inflated by introducing air into inflation port 118 by using a syringe, and by then compressing cuff pressure bladder 116 to force the air through external cuff tube 114 and cuff lumen 135 into cuff 110.
The proximal end of endotracheal tube assembly 102 terminates at an end connector 124. In this example, end connector 124 is sized and shaped to allow coupling to a ventilator tube 122, which, in turn, is coupled to a mechanical lung ventilator. End connector 124 provides fluid communication between ventilator tube 122 and air passage 108 of endotracheal tube assembly 102.
In the example of
In this example, the fluid pickup port 130 wicks fluid into the port 130. That is, the fluid pickup port 130 is sized, shaped, made of a particularly selected material, and/or otherwise configured to use interfacial surface energy (also referred to as surface tension) to introduce a bodily or other fluid (such as mucus or the like) into the wicking fluid pickup port 130. Interfacial surface energies cause a resulting “skin” to form (or, conversely, a repulsion to occur) at an air/liquid interface boundary. Similarly, an attraction or repulsion between a liquid fluid and its interface boundary with a solid may result because of its interfacial surface energy. This interfacial edge effect can provide a capillary action whereby a liquid is pulled into a small pipe, i.e., a capillary. The relative value of the surface energy of the solid wall and that of the liquid determines whether the liquid is more attracted to the wall (in which case a “wicking” occurs which pulls the fluid to the wall) or to itself (in which case it avoids “wetting” the wall). In the present case, the relative value of the surface energy will be affected by, among other things, the size of the fluid pickup port 130, the shape of the fluid pickup port 130, and the material characteristics of the endotracheal tube assembly 102 in which the fluid pickup port 130 is formed, and the characteristics of the air/fluid interface.
In the example of
In this example, fluid removal lumen 120, coupling 126, and fluid removal tube 128 are each sized, shaped, made of a particularly selected material, or otherwise configured such that the surface energy of the mucus (or similar bodily fluid) causes a “skin” to bridge the entire interior cross section of the conduit formed by these components. As a result, mucus, secretions, like fluid, and/or air bubbles are pulled by pump 132 through the conduit provided by these components. By contrast, conventional airflow-based vacuum devices generally pull liquid fluid by using a large ratio of entrapping air (or other gaseous substance) to the liquid fluid being entrapped by the air. This is because such airflow-based vacuum devices typically depend on the air movement at the intake port to draw the fluid into the port, rather than using surface energy to draw fluid (i.e., “wick” the fluid) into the intake port.
Although not required, in one example, the pressure provided by pump 132 is adjusted to remove fluid at a desired steady-state rate that is selected such that the extracted material passing through the conduit provided by fluid removal lumen 120, coupling 126, and fluid removal tube 128 is almost all liquid (including, among other things, viscous liquids and liquid suspensions bearing suspended solids and/or entrapped gas bubbles), rather than a liquid in combination with a more than insubstantial amount of air or other gaseous substance. This results from the wicking of the mucus or like fluid into the fluid pickup port 130 using surface energy. Similarly, the degree of wicking provided by the fluid pickup port 130 can be adjusted to match or approximate the subject's mucus generation rate. The present systems and methods of mucus removal may (but need not) be provided concurrent to the ventilation of the patient, such as continuously.
Thus, in this example, pump 132 provides a negative pressure such that entrapment of fluid by airflow is not required to transport the fluid toward holding receptacle 133. A peristalsis pump is only one example of a constant volume (CV) pump capable of supplying a negative pressure against the fluid. Alternative embodiments may use one or more other types of low volume pumps, which need not be CV pumps, and which may be operated intermittently. Some other pump examples include, among other things, an accordion-style cavity with one-way valves for intake and discharge, such that repeated compressing of the cavity transports the fluid.
In one example, at least a portion of the conduit provided by fluid removal lumen 120, coupling 126, and fluid removal tube 128 (at least up to pump head 134) is designed in material and size such that liquid fluid being transported can span the inside diameter of said conduit. The design is such that any air bubbles introduced at the fluid pickup port 130 preserve an intact air/liquid “skin” or “bridge” that spans the inside diameter of said conduit. As a result, such air bubbles can be conceptualized as being carried along by the liquid column being transported as if they were a part of that liquid column. Therefore, entrapment by high airflow is not required or used to obtain the desired mucus removal. The components forming the conduit are sufficiently rigid to prevent their collapse under the pressures used to move the fluid up against gravity and to overcome the viscosity and holding power of any fluid bridging the fluid pickup port 130.
In one embodiment, the inner diameter of at least a portion fluid removal lumen 120 is sized so as to be small enough to permit it to be bridged by the fluid/air “skin” as a result of the interfacial surface tension. The corresponding size of the inner diameter of fluid removal lumen 120 can be conceptually approximated using the following Equation 1: h=(2·y·cos Θc)÷(r·Pe·g). Equation 1 illustrates that, to obtain the desired bridging, the inner diameter of fluid removal lumen 120 must be small enough such that a column of the liquid of interest (e.g., mucus) can be lifted by surface energy to a height just greater than the height, h, of the meniscus. In Equation 1, y is the surface tension value of the fluid, Θc is the angle at which the fluid contacts the inner circumference of the fluid removal lumen 120, r is the inner radius of the fluid removal lumen 120, Pe is the fluid density in air, and g is the acceleration due to gravity. Thus, in one example, the size of the inner diameter of fluid removal lumen 120 is increased until h equals the height of the meniscus, as illustrated in Equation 1. Similarly, the size of the inner diameter of the wicking fluid pickup port 130 is determined as described with respect to Equation 1.
In another embodiment of the invention, the fluid pickup port 130 does not exhibit significant wicking action and the fluid is removed by a vacuum pump. In this embodiment, low volume pump 132 is replaced with a vacuum pump. In another embodiment, the fluid removal lumen 120 can be a sleeve lumen in the form of an annulus.
A different number of fluid removal lumens 120 may be provided, for example, corresponding to a different number of fluid pickup ports 130. This increases the number of surface energy assisted mucus collection sites. Such fluid pickup ports may be located in many different possible configurations. In one such example, system 100 includes a single fluid pickup port 130 and a corresponding single fluid removal lumen 120.
In one example, one or more of fluid pickup ports 130 is designed to allow it to act as a safety vent for another of fluid pickup ports 130. In an alternative example, a separate safety vent port is provided, rather than using one of the fluid pickup ports 130 as a safety vent port. This may be advantageous in tailoring the safety pressure value of the safety vent port.
In one operational variation, the direction of fluid transport through the conduit is reversed, such as for introducing medicine and/or irrigation fluid or the like through the conduit and out of the fluid pickup port 130. For example, delivery of irrigation fluid to the pickup area within trachea 150 may aid in softening hardened mucus, or even in dissolving mucus castings. Therefore, system 100 is adapted to accommodate mucus of different consistencies.
In one example, the medicine, irrigation fluid, or the like is introduced by swapping in a different holding receptacle 133 (carrying the drug, irrigation fluid, or the like) and reversing the direction of pump 132. In another example, a different holding receptacle and/or pump is used for fluid delivery to the patient.
In one example, the medicine and/or irrigation fluid or the like has a different surface energy characteristic from the mucus for which the fluid transport conduit and pickup port 130 were designed. Under certain such circumstances, therefore, the medicine and/or irrigation fluid or the like is not retained within the conduit by the wicking. Therefore, such medicine and/or irrigation fluid may be delivered out of the same pickup port 130 that wicks-in mucus.
In another variation, in which the patient's lungs are irrigated by a medicinal or other irrigation fluid (either using system 100, or otherwise), system 100 is used to remove excess irrigation fluid using one or more fluid pickup ports 130 that are particularly designed to wick in the irrigation fluid. In one such example, the irrigation fluid is introduced and removed through different ports, which are tailored to provide these different functions.
In another example, the surface energy characteristics of the at least one pickup port 130 and/or the conduit are changed during the introduction of the medicine and/or irrigation fluid or the like. In one example, a temporary modulation of the surface energy at a particular location (e.g., within at least one pickup port 130 or within one or more portions of the fluid transport conduit) may be obtained by introducing a surfactant. In another example, at least one electrode (e.g., at or near the at least one pickup port 130) modulates a local surface energy characteristic and/or provides an electric field that assists in expelling a drug or other fluid out of the at least one pickup port 130. In a further example, an electric field is applied to the electrode to adjust the rate at which the drug is introduced into the patient. In one example, the electrode is located at or near the at least one pickup port 130, and is connected to a wire that extends longitudinally through endotracheal tube assembly 102, from at or near its distal end to at or near its proximal end, for coupling the electrode to an external electrical energy source.
Modifying the surface energy characteristic at the at least one pickup port 130 and/or within the fluid transport conduit is not restricted to the above example of introducing a drug, fluid, or the like into a patient. In one example, the surface energy characteristics varies at one or more different locations of the at least one pickup port 130 and along the fluid transport conduit. Such variations are obtained, in one example, by varying the size, shape, and/or material characteristics at these one or more different locations. Moreover, a needed change in lumen size at a particular location in the at least one pickup port 130 or the fluid transport conduit may be offset, if needed, by a corresponding change in another surface tension affecting characteristic (e.g., material property, embedded electrode, etc.) at that location to preserve the bridging or sealing action, at that location, of the fluid being transported. In another example, a change in a surface tension affecting characteristic is used to preserve a spanning fluid/air interface bridge or to otherwise accommodate a branching or other junction of fluid transportation lumens, such as wherein an increased diameter is desired.
The distal portion of fluid removal lumen 120 exits the wall 208 of the endotracheal tube 140 above the inflatable cuff 110a (the distal portion of the fluid removal lumen that extends from the wall 208 of the trachea tube is designated 120a) and terminates in fluid pickup port 130, which is located immediately above the proximal portion of the inflatable cuff 110a. The fluid pickup port 130 is adjacent to the wall of the trachea 150 (when the inflatable cuff 110 is inflated as shown). The inner wall 152 of the patient's trachea 150 is coated with mucus 154.
A cuff lumen 135a extends through endotracheal tube assembly 102 from cuff 110a to the proximal portion of endotracheal tube assembly 102. A cuff lumen 135b extends through endotracheal tube assembly 102 from cuff 110b to the proximal portion of endotracheal tube assembly 102.
In this example, the fluid port 130 is connected to fluid removal lumen 120, which, in this example, extends longitudinally within the wall 208 of endotracheal tube 140 toward its proximal end.
A different number of fluid removal lumens 120 may be provided, for example, corresponding to a different number of fluid pickup ports 130. This increases the number of surface energy assisted mucus collection sites. Such fluid pickup ports may be located in many different possible configurations.
In the example of
The distal portion of fluid removal lumen 120 exits the wall 208 of the endotracheal tube 140 above the inflatable cuff 110a (the distal portion of the fluid removal lumen that extends from the wall 208 of the trachea tube is designated 120a) and terminates in fluid pickup port 130, which is located immediately above the proximal portion of the inflatable cuff 110a. The fluid pickup port 130 is adjacent to the wall of the trachea 150 (when the inflatable cuff 110 is inflated as shown). The inner wall 152 of the patient's trachea 150 is coated with mucus 154. A cuff lumen 135 extends through endotracheal tube assembly 102 from cuff 110a to the proximal portion of endotracheal tube assembly 102.
In the example of
The distal portion of fluid removal lumen 120 exits the wall 208 of the endotracheal tube 140 above the inflatable cuff 110 (the distal portion of the fluid removal lumen that extends from the wall 208 of the trachea tube is designated 120a) and terminates in fluid pickup port 130, which is located immediately above the proximal portion of the inflatable cuff 110. The fluid pickup port 130 is adjacent to the wall of the trachea 150 (when the inflatable cuff 110 is inflated as shown). The inner wall 152 of the patient's trachea 150 is coated with mucus 154. A cuff lumen 135 extends through endotracheal tube assembly 102 from cuff 110 to the proximal portion of endotracheal tube assembly 102. The cuff lumen and the fluid removal lumen can also be inside the air passage 108 or outside of the wall 208 of the tracheal tube.
In this example, the fluid pickup port 130 wicks fluid into the port 130. In another embodiment of the invention, the fluid pickup port 130 does not exhibit significant wicking action and the fluid is removed by a vacuum pump. In this embodiment, low volume pump 132 is replaced with a vacuum pump.
In an alternative embodiment, the same effect of the reinforcing element could be achieved by making the entire inflatable cuff 110 out of a semi-rigid polymer such as DACRON-reinforced silicone rubber. Such an embodiment can be illustrated as shown in
In another embodiment, a portion of the inflatable cuff could be made of a semi-elastic material that expands only a predetermined distance from the wall 208 of the tracheal tube 102. The predetermined distance is chosen so that when the cuff is inflated, the fluid pickup port is a predetermined distance from the tracheal wall. Appropriate materials for the semi-elastic portion of the cuff include woven and nonwoven fabrics. Nonwoven nylon can be used. As the cuff is inflated, the semi-elastic portion reaches its limit of expansion early. Then the non-reinforced elastic portion of the cuff continues to expand to fill the trachea. The fluid pickup port is always located at the same position relative to the tracheal wall and the endotracheal tube.
Fluid pickup ports 330a, 330b are disposed above the inflatable cuff 310 and transport fluid through fluid removal lumens 335a and 335b. A different number of fluid removal lumens 335 may be provided, for example, corresponding to a different number of fluid pickup ports 330. This increases the number of surface energy assisted mucus collection sites. Such fluid pickup ports may be located in many different possible configurations. In this example, the fluid pickup port 330a, 330b wicks fluid into the ports 330a, 330b. In another embodiment of the invention, the fluid pickup ports 330a, 330b do not exhibit significant wicking action and the fluid is removed by a vacuum pump. In this embodiment, a low volume pump is replaced with a vacuum pump.
The above descriptions are provided for the purpose of describing embodiments of the invention and are not intended to limit the scope of the invention in any way. It will be apparent to those skilled in the art that various modifications and variations can be made in the endotracheal tube having above the cuff drainage without departing from the spirit or scope of the invention. Thus, it is intended that the present invention cover the modifications and variations of this invention provided they come within the scope of the appended claims and their equivalents.
