WO2015107319A1 - Tubes trachéaux - Google Patents

Tubes trachéaux Download PDF

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Publication number
WO2015107319A1
WO2015107319A1 PCT/GB2014/000511 GB2014000511W WO2015107319A1 WO 2015107319 A1 WO2015107319 A1 WO 2015107319A1 GB 2014000511 W GB2014000511 W GB 2014000511W WO 2015107319 A1 WO2015107319 A1 WO 2015107319A1
Authority
WO
WIPO (PCT)
Prior art keywords
cuff
shaft
tracheal tube
tube according
attached
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/GB2014/000511
Other languages
English (en)
Inventor
Timothy Bateman
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Smiths Medical International Ltd
Original Assignee
Smiths Medical International Ltd
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Smiths Medical International Ltd filed Critical Smiths Medical International Ltd
Publication of WO2015107319A1 publication Critical patent/WO2015107319A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/04—Tracheal tubes
    • A61M16/0434—Cuffs
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/04—Tracheal tubes
    • A61M16/0465—Tracheostomy tubes; Devices for performing a tracheostomy; Accessories therefor, e.g. masks, filters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/04—Tracheal tubes
    • A61M16/0475—Tracheal tubes having openings in the tube
    • A61M16/0477—Tracheal tubes having openings in the tube with incorporated means for delivering or removing fluids
    • A61M16/0479—Tracheal tubes having openings in the tube with incorporated means for delivering or removing fluids above the cuff, e.g. giving access to the upper trachea
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/04—Tracheal tubes
    • A61M16/0486—Multi-lumen tracheal tubes

Definitions

  • This invention relates to tracheal tubes of the kind having a shaft, a sealing cuff extending around and attached with the shaft in the region of the patient end, a suction lumen extending along the shaft and having a suction opening in the region above where the cuff is attached with the shaft.
  • Cuffed tracheal tubes in particular, tracheostomy tubes, can present a problem in that secretions produced in the trachea may collect outside the tube above the cuff, providing a site for the accumulation of bacteria and infection.
  • US 4607635 describes a tracheal tube having a channel open at various locations along its length and through which a suction catheter can be inserted to remove secretions at any desired location above the cuff.
  • US 4305392 there is described a tracheal tube with a bulbous chamber above the cuff in which secretions are collected for removal through a suction lumen extending through the wall of the tube.
  • US 4840173 describes a catheter having a suction tube projecting over the proximal collar of the cuff to increase the amount of secretions that can be collected.
  • GB 2250440 describes a tube where the upper end of the cuff is everted within the cuff so that it does not provide any obstruction to locating a suction opening as close as possible to the cuff.
  • JP-A- 10005340 describes a tube with two suction lumens linked by a gutter where they open on the side of the tube.
  • US6796309 describes a tracheal tube with a gutter extending around the tube from the suction opening.
  • a tracheal tube of the above- specified kind characterised in that the configuration of the upper end of the cuff is arranged such that secretions collecting above the cuff collect preferentially in a region around the suction opening.
  • the upper end of the cuff is preferably attached with the outside of the shaft along a line the locus that lies in a plane inclined at an angle away from the diametrical plane at right angles to the longitudinal axis of the shaft.
  • the plane including the line of locus of attachment may be inclined at an angle between 5° and 45° to the diametrical plane.
  • the cuff may be attached with the shaft at its upper end by a collar that is turned inside out to lie inside the cuff and may be attached at its lower end by a collar that is turned inside out to lie inside the cuff.
  • the shaft is preferably curved along its length, the suction opening being located towards the inside of the curve.
  • the sealing cuff may be an inflatable sealing cuff.
  • the tube may have an inflation lumen extending along the shaft and displaced from the suction lumen on an opposite side of the shaft.
  • the upper end of the cuff is preferably profiled to form a recess into which secretions can flow, the recess being located towards one side of the shaft in the region of the suction opening.
  • the tube is preferably a tracheostomy tube, its patient end being adapted to locate in the trachea and its machine end being adapted to extend through a surgically made opening in the throat.
  • Figure 1 is a side elevation view of the tube
  • Figure 2 is an enlarged sectional view of a part of the tube in the region of the upper end of the cuff;
  • the tube includes a tubular shaft 1 curved along its length and having an inflatable sealing cuff 2 towards its patient end 3, which is adapted to locate in the trachea.
  • the rear or machine end 6 of the tube is adapted to extend through a surgically made opening in the patient's throat and has a flange 4 by which the tube is secured about the neck and a coupling 5 by which gas connection can be made to the tube.
  • the shaft 1, flange 4 and coupling 5 may be integrally moulded with one another as a single piece from a plastics material, such as PVC.
  • the tube could alternatively be straight and flexible or formed in different shapes.
  • the cuff 2 is inflated by means of an inflation lumen 20 extending along the length of the shaft 1 within its wall along the outside of its curve and opening at one end into the interior of the cuff.
  • the lumen 20 is connected to a small-bore inflation tube 21 close to the machine end 6 of the tube.
  • the machine end of the inflation tube 21 is terminated by a conventional connector and inflation indicator 22.
  • the inflation lumen could, alternatively, be provided by a small-bore tube extending along the outside of the shaft and attached with it, such as in a channel along the shaft.
  • the tube On its opposite side, along the inside of the curvature of the shaft 1, the tube has a suction lumen 23 extending parallel to the inflation lumen 20.
  • the suction lumen 23 has a larger diameter than the inflation lumen 20 and extends within the wall of the shaft 1 although it could be provided by a separate tube extending in a semi-cylindrical channel moulded longitudinally along the outside surface of the shaft.
  • the suction lumen 23 is connected with a suction tube 10 that is terminated by a coupling 11.
  • the coupling 11 is connected with a suction source (not shown) such as a syringe or suction pump.
  • the cuff 2 is of a thin plastics material moulded to its desired inflated shape, which is a generally doughnut shape.
  • the cuff 2 has two collars 24 and 25 at opposite ends by which the cuff is attached to the outside of the shaft 1.
  • the collars 24 and 25 are turned inside out, in the manner described in US 5201310, so that the collars do not extend beyond the inflated part of the cuff.
  • the line of attachment of the upper collar with the shaft lies in a plane extending orthogonally to the longitudinal axis of the tube.
  • the upper end of the cuff (that is, the end away from the patient end of the tube) 2 is attached with the shaft 1 by means of its upper end collar 24 along a line lying in a plane "P" that is inclined at an angle ⁇ to the diametrical plane “D” that extends orthogonally to the longitudinal axis "L” of the tube.
  • the angle ⁇ is preferably between about 5° and 45°. The angle is such that the lowest point of attachment of the collar 24 (with the longitudinal axis "L” at the patient end 3 vertical) is on the inside of the curve of the shaft 1, in alignment with the opening 26 of the suction lumen 23.
  • the inclined line of attachment of the cuff 2 with the shaft 1 encourages secretions collecting above the cuff to flow to the lowest point and to the region of the suction lumen opening 26. In this way, even small volumes of secretions, that might in conventional tubes be insufficient to flow to the suction lumen opening, will flow to the region of the suction opening 26 and collect there in sufficient quantities to be removed freely.
  • the upper part 27 of the cuff 2 it is preferable to shape the upper part 27 of the cuff 2 so that the region of the cuff around the suction lumen opening 26 is spaced from the shaft 1 by a greater distance than other regions of the cuff, forming a small sump 28 in which the secretions can collect for suctioning.
  • the arrangement of the present invention can enable a greater proportion of secretions to be removed.
  • the sealing cuff on the tube need not be of the kind that is inflated and deflated with a gas but could, instead, for example, be of a self-expanding kind, such as including a foam material, or formed of flanges, gills or the like.

Landscapes

  • Health & Medical Sciences (AREA)
  • Pulmonology (AREA)
  • Emergency Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Anesthesiology (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Hematology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • External Artificial Organs (AREA)

Abstract

La présente invention concerne un brassard d'étanchéité gonflable (2) au niveau de l'extrémité patient (3) d'un tube de trachéostomie, ledit brassard étant fixé avec la tige (1) du tube par deux bagues (24 et 25) tournées à l'envers à l'intérieur du brassard. La bague supérieure (24) est fixée avec la tige (1) le long d'une ligne de locus dans un plan P qui est incliné jusqu'au plan diamétral D à un angle compris entre 5° et 45° de manière à ce que les sécrétions soient de préférence collectées dans une région autour de l'ouverture (26) d'une lumière d'aspiration (23). La tige (1) est incurvée et l'orifice d'aspiration (26) se trouve sur l'intérieur de la courbe, l'extrémité supérieure (27) du brassard (2) étant profilée pour former une cavité (28) dans la région de l'ouverture d'aspiration dans laquelle les sécrétions peuvent s'écouler.
PCT/GB2014/000511 2014-01-16 2014-12-11 Tubes trachéaux Ceased WO2015107319A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
GBGB1400722.3A GB201400722D0 (en) 2014-01-16 2014-01-16 Tracheal tubes
GB1400722.3 2014-01-16

Publications (1)

Publication Number Publication Date
WO2015107319A1 true WO2015107319A1 (fr) 2015-07-23

Family

ID=50239032

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/GB2014/000511 Ceased WO2015107319A1 (fr) 2014-01-16 2014-12-11 Tubes trachéaux

Country Status (2)

Country Link
GB (1) GB201400722D0 (fr)
WO (1) WO2015107319A1 (fr)

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5201310A (en) * 1990-12-05 1993-04-13 Smiths Industries Public Limited Company Medico-surgical tube with sealing cuff and a suction lumen at the top of the cuff
US20040255951A1 (en) * 2003-02-07 2004-12-23 Christopher Grey Endotrachael tube with suction catheter and system
US20060278235A1 (en) * 2005-06-14 2006-12-14 White Steven C Tracheal tube with above the cuff drainage
US20080053454A1 (en) * 2006-09-01 2008-03-06 Nellcor Puritan Bennett Incorporated Endotracheal tube including a partially inverted cuff collar
WO2012087839A1 (fr) * 2010-12-21 2012-06-28 C.R. Bard, Inc. Tube endotrachéal ayant un manchon évidé et/ou une ou plusieurs ouvertures d'aspiration agencées dans un évidement de manchon et procédé de fabrication et/ou d'utilisation de celui-ci
WO2012087837A1 (fr) * 2010-12-21 2012-06-28 C. R. Bard, Inc. Tube endotrachéal ayant un manchon évidé, une ou plusieurs ouvertures d'aspiration agencées dans celui-ci, et/ou un manchon ayant des raidisseurs et procédé de fabrication et/ou d'utilisation de celui-ci

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5201310A (en) * 1990-12-05 1993-04-13 Smiths Industries Public Limited Company Medico-surgical tube with sealing cuff and a suction lumen at the top of the cuff
US20040255951A1 (en) * 2003-02-07 2004-12-23 Christopher Grey Endotrachael tube with suction catheter and system
US20060278235A1 (en) * 2005-06-14 2006-12-14 White Steven C Tracheal tube with above the cuff drainage
US20080053454A1 (en) * 2006-09-01 2008-03-06 Nellcor Puritan Bennett Incorporated Endotracheal tube including a partially inverted cuff collar
WO2012087839A1 (fr) * 2010-12-21 2012-06-28 C.R. Bard, Inc. Tube endotrachéal ayant un manchon évidé et/ou une ou plusieurs ouvertures d'aspiration agencées dans un évidement de manchon et procédé de fabrication et/ou d'utilisation de celui-ci
WO2012087837A1 (fr) * 2010-12-21 2012-06-28 C. R. Bard, Inc. Tube endotrachéal ayant un manchon évidé, une ou plusieurs ouvertures d'aspiration agencées dans celui-ci, et/ou un manchon ayant des raidisseurs et procédé de fabrication et/ou d'utilisation de celui-ci

Also Published As

Publication number Publication date
GB201400722D0 (en) 2014-03-05

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