JPS6258263B2 - - Google Patents

Description

[Detailed description of the invention] The present invention relates to a thoracic cavity drainage device.

According to the present invention, a chamber containing air for connection to a negative pressure source is provided, the air chamber is connected to take in air from a space above the liquid level in the liquid collection chamber, and the check valve drainage of the thoracic cavity, comprising a fluid collection chamber arranged between the outlet of this space and the air chamber, through which air passes from the space to the air chamber, and reverse flow therebetween is prevented; A device is obtained.

In particular, the device has a transparent U-tube connected to receive fluid and air from the thoracic cavity to be drained and to direct them to a fluid collection chamber, into which a portion of the drained fluid is deposited. A U-tube is retained and the retained liquid forms a visible indicator of air passing therethrough.

Furthermore, this device has an upwardly expanding transparent conical tube that opens to the atmosphere at the bottom and has a hole at the top that communicates with the interior of the air chamber. A display is provided on the outside of the tube to visually indicate the negative pressure in the air chamber by the height at which the ball floats. Next, the present invention will be explained with reference to the drawings.

As shown in the figures, the thoracic drainage device 8 consists of a bottle 10 and a control subassembly 12. Subassembly 12 can be removably connected to the bottle and has a check valve 14, a positive pressure relief valve 16, and a controller 18 for regulating the negative pressure within the system. Subassembly 12 also includes a negative pressure gauge 24 opening into air chamber 20 therein.

The bottle 10 of the FIGS. 1 and 2 embodiment consists of a one-piece blow molded container having three liquid collection chambers 26A, 26B and 26C in series separated from each other by partition walls 28A and 28B. The partition walls 28A and 28B include holes 30A and 30B, respectively, near their tops, which allow thoracic drainage to overflow from the first collection chamber to the second collection chamber when the first collection chamber is full, When the first and second collection chambers are full, the second collection chamber can overflow into the third collection chamber. These partition walls 28 are shown as double walls. A one-piece molded web 32 bridges the gap between the partition walls and extends along the bottom of the bottle and beyond the top except for a notch 34 into which the subassembly 12 is inserted. A clip 36 having vertical slits at each end of the subassembly 12 slides along opposite edges 38 of the web 32 separating each side of the notch 34 such that the subassembly 12 is removably mounted within the partition of the notch 34. be done. When mounted in this manner, the air inlet pipe 40 opening to the bottom of the air chamber 20 via the check valve 14 is axially aligned with the air outlet 42 at the top of the bottle 10 and the liquid collection chamber 26
A flow path is formed from the air collection chamber 86 above the liquid level to the air suction hole 74 connected to a negative pressure source. This flow path is a second flow path connected to a first flow path described later. A short connecting hose 44 ensures a seal between the bottle 10 and the air chamber 20 of the subassembly 12.

The bottle is molded from a transparent material and each liquid collection chamber 2
You can see the liquid level inside 6. Each of the three chambers is covered on its front side by a paper label 46 with adhesive on the back or other scale support member, which has a vertical slit 48 through which the liquid level is visible. The label has a volume scale 50 printed on its surface indicating the total amount of liquid stored at the level visible through the slit 48 of the last chamber containing the liquid. For example, the illustrated bottle chambers 26A and 26B each hold up to 700 cm ³ of liquid before overflowing to the next adjacent chamber. Although the liquid level in chamber 26B is lower than that in chamber 26A, it holds the same amount because chamber 26A has a corner cut. The third chamber 26c is similarly corner cut, and the third chamber 26c is
It is designed to fill to the same height as the 6B, so it holds less than the other two, specifically 600cm ³ , giving a total liquid storage capacity of 2000cm ³ . Paper labels also allow easy recording of the liquid level in the bottle at each observation time.

The back wall of chamber 26A has a hole 56 sealed by a grommet 58 through which a needle can pass at the lowest part of its recess.
It is pointed out that the When the bottle is filled to near full capacity, a sterile needle can be introduced through the conventional resealable grommet 58 to withdraw the appropriate amount of liquid contained therein, thereby exceeding the normal bottle maximum capacity. Capacity will be expanded. If the volume of the bottle is too large, such as when draining an infant's thoracic cavity, it may be desirable to introduce sterile water or saline into one or more chambers through the grommet 58. Since the grommet is recessed, it is easy to avoid dirt and keep it clean.

The three series connected chambers 26A, B and C are 3
It is exactly the same as one narrow chamber with twice the depth. This is because both allow precise volume control that cannot be achieved with a single shallow chamber of the same volume.
This is because the advantage of space saving can also be obtained.
The three chambers 26 are used exclusively as liquid storage containers and have no other function. Bottle 10 is not a precision instrument and can be used to serve a simple purpose.

The bottle also has an inlet 6 for connecting a reservoir formed by a liquid collection chamber 26 and a drain pipe 66.
4 to an air collection chamber formed above the liquid level of the liquid collection chamber 26, and a transparent U-shaped tube 62 is disposed in this flow path. The inlet 64 to this U-tube is the only inlet to the system and the drain 66
connected directly to the patient's thoracic cavity. Tube 66 is connected to bottle inlet 64 by connector 68.

FIG. 1 shows that once fluid begins to flow from the patient, a small amount of fluid 70 is trapped within U-tube 62, thereby avoiding the need to prime the bottle. The grommet 72 of the U-tube 62 can be used to aspirate or withdraw a sample from which the effluent will be cultured.

The liquid 70 contained within the U-tube 62 is not an effective water seal to avoid backflow of air into the patient.
In fact, the thoracic drainage device performs its function properly regardless of whether there is drainage in the U-tube or not, and regardless of the level of the fluid level. Nevertheless, the U-tube 62 performs two important functions: as an air leak detector and as an indicator of patient breathing, with the fluid level fluctuating and alternating between one leg of the U-tube and an indicator of patient breathing. The liquid level inside is higher than the other.

As a leak detector, the U-tube 62 provides an immediate visual indication to the observer of the effects of an air leak within the system or, most importantly, within the patient's thoracic cavity. If air bubbles are detected flowing downstream through the liquid within the U-tube, the drain tube 66 should not be clamped or removed from the patient until the source of the leak is located. Other than a system leak, the source of air entering bottle 10 is air escaping from the patient's lungs or air displaced from the thoracic cavity by drainage.

In the case of the thoracic drainage system of the present invention, although the liquid within the U-tube allows air to completely pass through in either direction, a high precision flapper type check valve 14 collects the air to prevent air from flowing back into the patient. It is located at the interface between chamber 86 and air chamber 20 of subassembly 12 .
Valve 14 is responsive to an opening pressure of about 0.5 cm H ₂ O in the illustrated embodiment and functions completely independent of the liquid present in either the liquid collection chamber or the U-tube.

The solid line position in FIG. 1 is the normal operating state of the system, assuming that a small amount of air is evacuated from the patient's thoracic cavity. Fluid, often blood, enters the system through tube 66 and is collected in chamber 26. Air entering air collection chamber 86 through the liquid in the U-tube exits directly to air chamber 20 through check valve 14. Under normal operating conditions, negative pressure prevails within chamber 20 due to the vacuum evacuated by vacuum conduit 22. The positive pressure safety valve 16 at the top of the chamber 20 normally remains closed. room 20
When the interior is maintained below atmospheric pressure, liquids and air are aspirated from the patient without the patient having to exert the necessary positive pressure to expel them.

Vacuum conduit 22 is connected directly to a vacuum source that provides a negative pressure of sufficient magnitude to exceed that normally required for thoracic drainage purposes. Therefore, the air chamber 20
The outlet 74 is equipped with a screw pressure regulator 18 for pressure control in the chamber, and the opening pressure of the check valve 16 is carefully controlled within a narrow range.

In the rare event of a positive pressure created in the air chamber 20, as shown by the bend in the vacuum conduit 22 shown in phantom in FIG. Pressure is relieved into the patient's chest cavity, which can have serious consequences. In order to completely prevent this, a positive pressure safety valve 16 is installed in the subassembly 12.
All positive pressures above a predetermined value are vented to atmosphere before re-entering the system. Valve 16 is valve 14
It is flapper-shaped, like the valve 14, and is set to open at a pressure well below that which would break the valve 14 and allow air to return to the system. The broken line position of the valve 16 indicates the above-mentioned abnormal positive pressure release state. The open positions of both valves 14 and 16 are shown exaggerated in FIG. 1 for illustrative purposes.

One feature of this thoracic drainage system is the negative pressure gauge 24 shown in FIGS. 1 and 3. The frustoconical tube 76 containing the ball 80 opens to the bottom of the air chamber 20 by a hole 78 that is partitioned so that the ball 80 cannot pass through. A second hole 82 in the narrow end of tube 76 is also smaller than ball 80. Air is drawn from the atmosphere through holes 82 at a velocity sufficient to lift ball 80. On the outside of the tube 76 is a display 8 forming a scale.
4 to directly read negative pressure measured in cmH ₂ O or other suitable value.

In this manner, the physician can constantly monitor the negative pressure within chamber 20 by means of an easily readable pressure gauge.

Although excessive negative pressure is rare, if an abnormal negative pressure exists within the air chamber 20, perhaps due to so-called "milking" of the thoracic drain 66,
Such a condition immediately exists in the liquid collection chamber 26 as well. If a negative pressure condition occurs upstream in the system, fluid within the U-tube 62 will be pumped out to the drain and, absent the negative pressure safety valve 60, will eventually return to the patient's thoracic cavity.
Similarly, if high negative pressure suddenly occurs in the air chamber 20,
Safety valve 16 is closed and check valve 14 is opened, exposing liquid collection chamber 26 and everything upstream thereof, including the patient, to this abnormal condition. Liquid collection chamber 2
A safety valve 60 connected to a liquid-free air collection chamber 86 above the liquid contained within 6 responds by opening as shown to admit air from the atmosphere, and the maximum negative pressure that can exist in the system is It is limited to a predetermined level that is low enough that reflux into the patient cannot occur. The negative pressure safety valve 60 is poppet-shaped and includes a bacterial filter 88 (FIG. 3) for filtering incoming air to prevent contamination of the liquid within the liquid collection chamber. bottle net 9
The valve 60 connected by a hose 92 to 0-50 cmH ₂ O is advantageously perfectly suited for protecting the patient.
is set to open at maximum negative pressure. FIG. 3 shows a negative pressure condition in the air chamber 20, which negative pressure causes the valve element 94 of the valve 60 to be moved away from the perforated valve seat 96 against the spring 98, thus reducing the system pressure. is maintained at a maximum of −50 cmH ₂ O.

FIG. 5 illustrates the use of an inverted bottle as a container for returning previously drained pleural fluid to the patient's thoracic cavity. After drain tube 66 is closed with clamp 100, subassembly 12 is removed and liquid supply tube 102 is attached to air outlet tube 42. Valve 60 remains in its normally closed state and does not need to be removed. After inserting tube 102 into the patient's thoracic cavity,
The bottle can be inverted and the liquid stored therein fed by gravity.

An advantage of the invention is that the waterless check valve located between the fluid collection chamber and the air chamber avoids the need to introduce priming water before use, unlike known devices. Furthermore, in order to obtain a flow indicator, which according to known methods is achieved by a water-filled valve, according to the invention a transparent U-tube is provided between the inlet part of the device, i.e., the inlet and the fluid collection chamber; The passage and retention of pleural fluid has the advantage that this U-tube forms a bubble flow indicator indicating the movement of air between the patient's thoracic cavity and the fluid collection chamber.

[Brief explanation of the drawing]

1 is a longitudinal sectional view of the device of the present invention, FIG. 2 is a sectional view taken along the line 2-2 in FIG. Figure 4 is the first
FIG. 4 is a sectional view taken along line 4--4, and FIG. 5 is a side view of the device inverted. 10... Bottle, 12... Control subassembly, 14
...Check valve, 16...Positive pressure safety valve, 18...Negative pressure controller, 20...Air chamber, 22...Exhaust conduit, 24...Negative pressure gauge, 26...Liquid collection chamber, 28...Partition wall, 62
...U-shaped pipe, 64...inlet, 66...drainage pipe.

Claims (1)

[Scope of Claims] 1. An inlet connectable to the patient's thoracic cavity, a chamber for collecting fluid from the thoracic cavity, a first flow path from the inlet to an air collection chamber above the liquid level in the liquid collection chamber; A pleural fluid drainage device consisting of a pleural fluid collection bottle having a second flow path from an air collection chamber to an air suction hole that can be connected to a negative pressure source, the second flow path being an air outlet for regulating and maintaining negative pressure. a check valve that does not require water and is arranged between the air chamber and the air collection chamber to open in the direction of flow from the air collection chamber to the air suction hole;
A thoracic cavity drainage device comprising a transparent U-tube that forms a bubble flow indicator when the channel contains fluid. 2 The U-shaped tube is equipped with a discharge device at a position below the normal liquid level in the U-shaped tube, and one part of the liquid in the U-shaped tube is drained through this.
2. The apparatus according to claim 1, wherein the liquid is discharged from the apparatus. 3. The device of claim 2, wherein the evacuation device comprises a resealable plug through which a needle can pass. 4. A flow control valve is disposed between the air chamber downstream of the check valve and the negative pressure source, and the flow control valve is operated to control the level of negative pressure in the air collection chamber and the air chamber. The device according to any one of the ranges 1 to 3. 5 an upwardly expanding transparent conical tube opening to the atmosphere at the bottom and having a hole at the top leading into the interior of the air chamber, containing a ball that floats in response to the upward flow of air through the tube; Claims 1 to 4 are provided with an indication forming a scale on the outside of the tube, whereby the negative pressure in the air chamber is visibly indicated by the height at which the ball floats.
The device according to any one of the preceding paragraphs. 6. A vent opening to the atmosphere is arranged downstream of the check valve, and a positive pressure safety valve is provided which opens at a predetermined pressure exceeding atmospheric pressure and releases the air in the air chamber from the vent. Claim 1 5. The apparatus according to any one of paragraphs 5 to 5. 7. According to any one of claims 1 to 6, in which the liquid collection chamber has a drainage device near its bottom accessible from the outside for removing a portion of the liquid collected therein. The device described. 8. Any one of claims 1 to 7, wherein the liquid collection chamber is detached from the negative pressure source and inverted, forming a container for returning the collected liquid to the patient through the air suction hole. The device described in. 9. The device according to claim 1, wherein the air chamber, the check valve and the part of the device downstream of the check valve form a unit that is removable from the liquid collection chamber. Device.