![]() vascular access device
专利摘要:
A vascular access device includes an antimicrobial coating that provides resistance to twisting a catheter. The antimicrobial coating can extend over a length of the catheter to provide antimicrobial protection when the catheter is inserted into the patient's vasculature. The antimicrobial coating can also increase the effective catheter diameter to minimize the likelihood of the catheter becoming twisted. 公开号:BR112017000463B1 申请号:R112017000463-1 申请日:2015-07-06 公开日:2020-11-17 发明作者:Jonathan Karl Burkholz;Siddarth K. Shevgoor;Tony Farnsworth Adams 申请人:Becton, Dickinson And Company; IPC主号:
专利说明:
BACKGROUND OF THE INVENTION [001] The present invention generally relates to vascular access devices that include an antimicrobial coating. In particular, the present invention is directed to an antimicrobial coating that forms a torsion resistant feature on a vascular access device. [002] It is increasingly common for vascular access devices, such as catheters, to include an antimicrobial coating to minimize the occurrence of infections caused by the use of the vascular access device. For example, catheters often include an antimicrobial lubricant that provides lubrication during insertion of the catheter into the patient's vasculature and then provides antimicrobial protection while the catheter is inserted. [003] A problem that exists with the use of current antimicrobial coatings is the risk of toxicity caused when excess antimicrobial agents enter the bloodstream or are distributed to a confined location. In order to obtain antimicrobial protection for a substantial period of time (for example, the entire time the catheter is inserted), a significant amount of antimicrobial lubrication must be present on the catheter. With the use of significant amounts of lubrication, there is a risk that a very high concentration of antimicrobial agents will be distributed. [004] Another problem that exists with the use of catheters is torsion. For example, when a peripheral intravenous catheter is inserted into the patient's vasculature, it will typically be folded at the point, where the catheter exits the catheter adapter (for example, due to the catheter adapter being placed flat on the patient's skin) and possibly where the catheter enters through the patient's skin or vasculature. This fold can often result in twists that limit or prevent fluid flow through the catheter. BRIEF SUMMARY OF THE INVENTION [005] The present invention extends to vascular access devices that include an antimicrobial coating that provides torsion-resistant catheter. The antimicrobial coating can extend over a length of the catheter to provide antimicrobial protection when the catheter is inserted into the patient's vasculature. The antimicrobial coating can also increase the effective catheter diameter to minimize the likelihood of the catheter becoming twisted. [006] In one embodiment, the present invention is implemented as a vascular access device. The vascular access device includes a catheter adapter, a catheter that extends distally from the catheter adapter, and an antimicrobial coating. The antimicrobial coating is applied to at least a portion of the catheter adapter and comprises a base material that releases one or more antimicrobial agents when the antimicrobial coating is inserted into a patient's skin. The base material also provides a torsion-resistant catheter. [007] In some embodiments, the antimicrobial coating may be positioned adjacent to the catheter adapter and / or may include an enlarged diameter portion. In some embodiments, the enlarged diameter portion is positioned adjacent to the catheter adapter. [008] In some embodiments, the length of the antimicrobial lining can be configured, so that the distal end of the antimicrobial lining is positioned close to an inner layer of a vein, when the catheter is inserted into the vein. In some embodiments, this length can be between 7 mm and 12 mm. [009] In some embodiments, the base material can be hydroscopic to increase the release of antimicrobial agents, when the antimicrobial coating is positioned inside the patient's skin. In some embodiments, the base material may be a UV-cured acrylate-urethane or a thermally-cured polyurethane. In some embodiments, the base material may have a hardness that slightly exceeds the hardness of the catheter. [010] In some embodiments, the vascular access device may also include an antimicrobial lubricant that is applied to the catheter. In some embodiments, the antimicrobial lubricant can be applied to a portion of the catheter that does not include the antimicrobial coating. [011] In another embodiment, the present invention is implemented as a vascular access device. The vascular access device includes a catheter adapter, a catheter that extends distally from the catheter adapter, and an antimicrobial coating. The antimicrobial coating extends from the catheter adapter to a distal end of the catheter and has an enlarged diameter portion adjacent to the catheter adapter. [012] In another embodiment, the present invention is implemented as a catheter comprising an antimicrobial coating applied to a portion of the catheter. The antimicrobial coating has a proximal end and a distal end. The proximal end comprises a portion of increased diameter. The antimicrobial coating also comprises a base material that releases one or more antimicrobial agents, when the antimicrobial coating is positioned within a patient's skin. [013] This Summary is provided to introduce a selection of concepts in a simplified form which is further described below in the Detailed Description. This Summary is not intended to identify the main characteristics or essential characteristics of the claimed subject. [014] The additional features and advantages of the invention will be presented in the description that follows, and in part will be obvious from the description, or can be learned by practicing the invention. The characteristics and advantages of the invention can be realized and obtained by means of the instruments and combinations particularly highlighted in the appended claims. These and other features of the present invention will become more fully apparent from the following description and the appended claims, or can be learned from the practice of the invention as set out below. BRIEF DESCRIPTION OF THE DRAWINGS [015] In order to describe the manner in which the above and other advantages and features of the invention can be obtained, a more particular description of the invention briefly described above will be made with reference to specific embodiments thereof which are illustrated in the attached drawings. Understanding that these drawings describe only typical modalities of the invention and should therefore not be considered as limiting its scope, the invention will be described and explained with additional specificity and detail through the use of the attached drawings in which: [016] Figure 1 is a perspective view of a vascular access device that includes an antimicrobial coating that functions as a torsion resistant feature on the catheter. [017] Figure 1A is a perspective view of the vascular access device of Figure 1 showing the antimicrobial coating along a length of the catheter. [018] Figure 2 illustrates a cross-sectional view of a portion of a vascular access device. [019] Figure 3 illustrates a cross-sectional view of the vascular access device of Figure 2, when it was inserted into a patient's vasculature. [020] Figure 3A is a detailed cross-sectional view of the antimicrobial coating in contact with dermal layers of the skin, the primary source of resident bacteria. [021] Figure 4 is a cross-sectional view of a vascular access device with the addition of an antimicrobial lubricant over a distal portion of the catheter. [022] Figure 5 is a cross-sectional view of a vascular access device, when the antimicrobial coating extends along the entire length of the catheter. DETAILED DESCRIPTION OF THE INVENTION [023] Figure 1 illustrates an example of the vascular access device 100 that includes an antimicrobial coating 103 according to one or more embodiments of the invention. The vascular access device 100 includes a catheter adapter 102 and a catheter 101 that extend distally from the catheter adapter. Although the vascular access device 100 is shown to include an extension tube, a vascular access device according to the present invention need not include extension tubes. In addition, the vascular access device 100 is an example of a peripheral intravenous catheter. However, an antimicrobial coating according to the present invention can be applied to other types of catheters including central venous catheters and peripherally inserted central catheters. In summary, any device that includes a flexible component that is inserted into a patient's vasculature can include an antimicrobial coating on the component, according to one or more embodiments of the present invention. [024] The antimicrobial coating can comprise any material that has antipathogenic properties that can be applied to the surface of a catheter and that is sufficiently rigid to minimize the likelihood of the catheter becoming twisted when it is bent. For example, in some embodiments, the antimicrobial coating may comprise a matrix of base material and one or more antimicrobial agents. In some embodiments, the base material matrix may be a hydrophilic, UV-curable material that contains an antimicrobial agent with controlled release characteristics (elution). Alternatively, a base material can be coated with an antimicrobial coating from which an antimicrobial agent will elute when subjected to a fluid. [025] For example, the base material, in some embodiments, can be a UV curing matrix of decalcified water, such as UV cured acrylate-urethanes, or thermally cured polyurethanes. Softened water materials can be preferred in many implementations over non-softened materials, such as materials that become more flexible when inserted into the patient and exposed to the fluid. Catheters are often formed from such softened water materials. Therefore, using an antimicrobial coating that also consists of a softened water material can match the properties of the coating to the catheter to minimize any negative impact that the coating may have on the performance of the catheter and on patient comfort. For example, in some embodiments, the hardness of the antimicrobial coating may only slightly exceed that of the catheter. This increased hardness minimizes the probability of the catheter being twisted, while minimally affecting patient comfort during catheter use because the catheter remains substantially elastic. [026] Examples of materials that could be used to form the antimicrobial coating of the present invention include those described in U.S. Patent No. 8,512,294 entitled Vascular Access Device Antimicrobial Materials and Solutions; U.S. Patent Application No .: 12 / 397,760 entitled Antimicrobial Compositions; U.S. Patent Application No .: 12 / 476,997 entitled Antimicrobial Coating Compositions; U.S. Patent Application No .: 12 / 490,235 entitled Systems and Methods for Applying an Antimicrobial Coating to a Medical Device; and U.S. Patent Application No .: 12 / 831,880 entitled Antimicrobial Coating for Dermally Invasive Devices. Each of these patent documents is incorporated herein by reference. [027] In a particular embodiment, the antimicrobial agent used to form the antimicrobial coating can be chlorhexidine including chlorhexidine diacetate (CHA) and / or chlorhexidine gluconate (CHG). However, any other antimicrobial agent that elutes from a base material or a coating on a base material could be used. [028] Figure 1A illustrates a detailed view of catheter 101 and antimicrobial lining 103. As shown, antimicrobial lining 103 can extend from catheter adapter 102 along a portion of catheter 101. In this example, the antimicrobial lining 103 extends over about half the length of catheter 101. However, in some embodiments, the antimicrobial coating 103 may extend over a greater or lesser length of catheter 101, including the extension to the distal tip. [029] As best seen in Figure 1A, the proximal end of the antimicrobial lining 103 may have a diameter that increases for catheter adapter 102. Catheter 101 is more susceptible to twisting as it exits from the catheter adapter. catheter 102. Consequently, increasing the diameter of the antimicrobial coating 103 for catheter adapter 102 provides additional torsion resistance where otherwise torsions would be more likely to occur. In some embodiments, as shown in Figure 1A, the increase in the diameter of the antimicrobial coating 103 can be gradually increased to the point where the antimicrobial coating has the same diameter as the nose of the catheter adapter 102. [030] Although in Figures 1 and 1A the antimicrobial coating 103 is shown to extend only to the catheter adapter 102, in some embodiments, the antimicrobial coating may extend proximally over a portion of the catheter adapter. In addition, in some embodiments, the diameter of the antimicrobial coating at the point where it meets the catheter adapter can be configured to be smaller than the diameter of the catheter adapter at that point. In addition, in some embodiments, instead of having a diameter gradually increasing, the diameter may increase from a smaller diameter to a larger diameter some distance from the catheter adapter. In this way, the present invention encompasses many different types of increases in the diameter of the antimicrobial coating as the coating approaches the catheter adapter. [031] Figure 1A also shows that the diameter of the antimicrobial coating 103 decreases to a minimum amount at the distal end of the coating. Having a minimum diameter at the distal end of the lining can minimize any discomfort caused to the patient when catheter 101 is inserted. [032] Figure 1A also illustrates that, in some embodiments, an antimicrobial lubricant 104 can be applied to any portion of the catheter that does not include the antimicrobial coating. However, the present invention encompasses modalities, where only one antimicrobial coating is applied to a catheter regardless of whether the antimicrobial coating extends only over a portion of the length of the catheter. [033] Figure 2 provides a cross-sectional view of the vascular access device 100 to better illustrate the increase in the diameter of the antimicrobial coating 103. As shown, for a distal end of the antimicrobial coating 103, the diameter of the coating is minimal. In some embodiments, the diameter at this distal end can be between 10 and 100 microns. Then, as the antimicrobial coating 103 approaches the catheter adapter 102, the diameter gradually increases to form an enlarged diameter portion 103a. The increased diameter portion 103a can provide an increased torsion resistance to a catheter as it exits catheter adapter 102. For example, due to the increased diameter of portion 103a, the catheter is unlikely to bend sufficiently at the point where it it comes out of catheter adapter 102 to cause a twist. In other words, the enlarged diameter portion 103a will tend to cause the catheter 101 to bend more gradually as it exits the catheter adapter 102, instead of bending sharply at the exit point. Similarly, the other portions (smaller diameter) of the antimicrobial coating 103 can provide additional stiffness to catheter 101 to minimize the likelihood of any sharp folds that may result in twisting. [034] Figure 3 illustrates how the antimicrobial coating 103 can provide resistance to torsion to a catheter 101. As shown, catheter adapter 102 is generally positioned flat on the patient's skin 300. Because of this, catheter 101 will be tilted down from the point where it exits the catheter adapter 102, at the point where it enters through the patient's skin 300. The antimicrobial coating 103 and, more particularly, the enlarged diameter portion 103a causes the catheter 101 bend more gradually between the insertion point and the catheter adapter 102 thereby minimizing the likelihood of twisting. [035] Figure 3 also illustrates an example where the length of the antimicrobial lining 103 is configured, so that the lining extends through the dermal layers of the skin 300 and into the vein 301. In this way, antimicrobial agents can be released from the antimicrobial coating 103 directly to the dermal layers and at the insertion points on the skin 300 and vein 301. These sites, and particularly the dermal layers, are the primary source of bacteria that can enter the vein 301. For this reason, the length of the antimicrobial coating 103 can be configured to ensure that the antimicrobial agents are directed to these locations. [036] Figure 3A provides a detailed view of a portion of Figure 3 to illustrate the dermal layers 302 of skin 300 where catheter 101 is inserted. As shown, antimicrobial coating 103 is of sufficient length to ensure that the coating is in contact with the dermal layers. Using an antimicrobial coating that elutes antimicrobial agents (for example, a coating that is hydroscopic), antimicrobial agents can be delivered to dermal layers (and surrounding areas) in a controlled manner to minimize the possibility of toxicity from the agents. [037] As noted above, when an antimicrobial lubricant is used to provide antimicrobial protection to these dermal layers, there is an increased risk of toxicity because it is difficult to guarantee that antimicrobial agents will be located in the dermal layers and not introduced into the patient's vasculature in toxic levels. In contrast, by using an antimicrobial coating comprising a base material that elutes antimicrobial agents, antimicrobial agents can be accurately distributed to dermal layers 302 and released at a rate that provides long-term antimicrobial protection. In other words, the antimicrobial coating 103 can limit the total amount of a particular antimicrobial agent that elutes over the life of the device, and concentrate the agent in the area of maximum benefit. [038] To ensure proper positioning of the antimicrobial coating 103 when the vascular access device 100 is used, the antimicrobial coating 103 can be configured to an appropriate length. For example, the depth of the tissue between the outer layers of the skin and the inner layers of the vein is usually between 3 mm and 6 mm. In addition, it is typical for 4 mm to 6 mm of the catheter to remain outside the skin. Therefore, in some embodiments, the length of the antimicrobial coating 103 can extend from 7 mm to 12 mm from the catheter adapter to ensure that the distal end of the coating is positioned at least, if not beyond, the inner layers of the vein. [039] Of course, other lengths of antimicrobial coating can be used in other modalities. In summary, the length of the antimicrobial coating can be selected for a particular vascular access device based, at least partially, on the typical length of the catheter that remains outside the skin when the particular vascular access device is used. For example, many catheters include a line or other indication that identifies how the catheter depth should be inserted. In some embodiments, the length of the antimicrobial coating 103 may be based on the length of the catheter between the catheter adapter and this type of indication. Similarly, the length of the antimicrobial coating can also be based on distance, from the outer layers of the skin and the inner layers of a vein where the catheter will be inserted (that is, the length can be based on the intended location where the catheter will typically be inserted). [040] The antimicrobial coating of the present invention can be particularly beneficial over a vascular access device that is used to draw blood. It is becoming more and more common to take blood samples through vascular access devices that were previously used mainly to inject fluids into the patient's vasculature. When fluids are being injected, there is less concern about torsion, because fluid pressure tends to open up any torsions that may otherwise occur in the catheter. However, when these same devices are used to draw blood, torsion is more likely due to the reduced pressures and flow rates used when drawing blood. The antimicrobial coating of the present invention can therefore be particularly beneficial in preventing sprains during blood withdrawal. [041] Figure 4 illustrates an alternative embodiment of the vascular access device illustrated in Figure 3. Figure 4 differs from Figure 3, in which an antimicrobial lubricant 310 was applied to the portion of catheter 101 that does not include antimicrobial coating 103.0 antimicrobial lubricant 310, in some embodiments, may also extend at least partially over the antimicrobial lining 103. Antimicrobial lubricant 310 can provide lubrication to catheter 101 to assist insertion and may also provide additional antimicrobial protection along the insertion site. For example, as catheter 101 is inserted, antimicrobial lubricant 310 can rub over the dermal layers of the skin to provide immediate and concentrated antimicrobial protection. Then, the antimicrobial coating 103, once positioned within the dermal layers, can continue to provide antimicrobial protection in a controlled release and targeted manner. Antimicrobial lubricant 310 can also assist in preventing the formation of clots on and in catheter 101 and, in particular, in the distal opening or catheter openings 101. [042] Figure 5 illustrates another alternative modality of the vascular access device illustrated in Figure 3. Figure 5 differs from Figure 3 in that the antimicrobial coating 103 extends to the distal end of the catheter 101. In these cases, an antimicrobial lubricant , although it is not represented, it can also be used. [043] According to one or more embodiments of the invention, an antimicrobial coating can be applied to a vascular access device by delivering an uncured base material to the catheter adjacent to the catheter adapter. This base material can be applied while rotating the catheter slowly (for example, between 20 and 120 rpm). The catheter can continue to be rotated, while a dye is used to draw the base material over the desired length of the catheter. In some embodiments, a sample dye can be used. Then the coating can be cured. In some embodiments, the catheter can continue to be rotated while the coating is cured. [044] The present invention can be realized in other specific forms without departing from its scope or essential characteristics. The described modalities should be considered in all aspects only as illustrative and not restrictive. The scope of the invention is therefore indicated by the appended claims instead of the previous description. All changes that are within the meaning and equivalence range of the claims must be included within its scope.
权利要求:
Claims (19) [0001] 1.Vascular access device, CHARACTERIZED by the fact that it comprises: a catheter adapter; a catheter extending distally from the catheter adapter and comprising a material; and an antimicrobial coating applied to at least a portion of the catheter, the antimicrobial coating comprising a base material that releases one or more antimicrobial agents, when the antimicrobial coating is inserted into a patient's skin, where the material is cured by UV and has a greater hardness than the hardness of the catheter material to provide resistance to torsion to the catheter, where antimicrobial coating is uniform in thickness over a first portion of the catheter, where the antimicrobial coating increases in thickness over of a second portion of the catheter adjacent to the catheter adapter, where when the catheter is inserted into a patient's vein, the first portion is configured to be positioned at least on an inner layer of the vein and the second portion is configured to be arranged out of a patient's body at least close to the outer layers of the skin. [0002] 2. Vascular access device according to claim 1, CHARACTERIZED by the fact that a distal end of the antimicrobial coating is positioned proximal to a distal end of the catheter. [0003] 3.Vascular access device according to claim 1, CHARACTERIZED by the fact that the length of the antimicrobial coating is between 7 mm and 12 mm. [0004] 4.Vascular access device, according to claim 1, CHARACTERIZED by the fact that the base material is hydroscopic. [0005] 5.Vascular access device according to claim 1, CHARACTERIZED by the fact that the base material is UV-cured acrylate-urethane. [0006] 6.Vascular access device according to claim 1, CHARACTERIZED by the fact that the thickness of the antimicrobial coating at a distal end of the antimicrobial coating is between 10 microns and 100 microns. [0007] 7.Vascular access device, according to claim 1, CHARACTERIZED by the fact that it still comprises: an antimicrobial lubricant applied to the catheter. [0008] 8.Vascular access device according to claim 7, CHARACTERIZED by the fact that the antimicrobial lubricant is applied to a portion of the catheter that does not include the antimicrobial coating. [0009] 9.Vascular access device, according to claim 1, CHARACTERIZED by the fact that the length of the second portion is less than 6mm. [0010] 10.Vascular access device, according to claim 1, CHARACTERIZED by the fact that the first portion is adjacent to the second portion. [0011] 11.Vascular access device according to claim 1, CHARACTERIZED by the fact that the thickness of the antimicrobial coating gradually increases over the second portion of the catheter. [0012] 12.Vascular access device according to claim 1, CHARACTERIZED by the fact that the thickness of the antimicrobial coating increases from a smaller diameter to a larger diameter at some point along the second portion of the catheter. [0013] 13.Vascular access device according to claim 1, CHARACTERIZED by the fact that the antimicrobial coating extends beyond a distal end of the catheter adapter to only a portion of the catheter adapter. [0014] 14.Vascular access device according to claim 1, CHARACTERIZED by the fact that the diameter of the antimicrobial coating at a point where the antimicrobial coating meets the catheter adapter is smaller than a diameter of the catheter adapter at the point. [0015] 15.Vascular access device, CHARACTERIZED by the fact that it comprises: a catheter adapter; a catheter extending distally from the catheter adapter; and an antimicrobial coating on the catheter, the antimicrobial coating extending from the catheter adapter towards a distal end of the catheter, the antimicrobial coating comprising a base material that releases one or more antimicrobial agents, when the antimicrobial coating is inserted within a patient's skin, where the base material is cured in such a way that the base material provides increased catheter stiffness, the antimicrobial coating having an increased diameter portion adjacent to the catheter adapter, where the antimicrobial coating increases in thickness from a distal portion of the catheter to a proximal portion of the catheter near a distal end of the catheter adapter. [0016] 16.Vascular access device according to claim 15, CHARACTERIZED by the fact that the antimicrobial coating has an excess hardness in relation to the hardness of the catheter. [0017] 17.Vascular access device according to claim 15, CHARACTERIZED by the fact that a distal end of the antimicrobial coating is positioned at a length from the catheter adapter corresponding to a length of the catheter, which is intended to exist between an internal layer of a vein and the catheter adapter, when the catheter is inserted into the vein. [0018] 18.Vascular access device, CHARACTERIZED by the fact that it comprises: an antimicrobial coating applied to a portion of the catheter, the antimicrobial coating having a proximal end and a distal end, in which the base material is cured in such a way that the material base provides increased catheter rigidity, where the antimicrobial coating is uniform in thickness over the first catheter portion, where the antimicrobial coating increases in thickness along the second catheter portion of the catheter adjacent to the catheter adapter, where a outer diameter of the antimicrobial coating at a proximal end of the second portion is equal to an outer diameter of a distal end of the catheter adapter. [0019] 19.Vascular access device according to claim 18, CHARACTERIZED by the fact that the catheter is positioned inside the catheter adapter, so that the proximal end of the antimicrobial coating is positioned adjacent to the catheter adapter.
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法律状态:
2019-08-27| B06U| Preliminary requirement: requests with searches performed by other patent offices: procedure suspended [chapter 6.21 patent gazette]| 2020-08-18| B09A| Decision: intention to grant [chapter 9.1 patent gazette]| 2020-11-17| B16A| Patent or certificate of addition of invention granted [chapter 16.1 patent gazette]|Free format text: PRAZO DE VALIDADE: 20 (VINTE) ANOS CONTADOS A PARTIR DE 06/07/2015, OBSERVADAS AS CONDICOES LEGAIS. |
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申请号 | 申请日 | 专利标题 US14/326.036|2014-07-08| US14/326,036|US10232088B2|2014-07-08|2014-07-08|Antimicrobial coating forming kink resistant feature on a vascular access device| PCT/US2015/039261|WO2016007439A1|2014-07-08|2015-07-06|Antimicrobial coating forming kink resistant feature on a vascular access device| 相关专利
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