• 专利附录
  • 专利说明
  • 权利要求
  • 类似技术
  • 同族专利
  • 引用文献
  • 法律状态
  • 优先权
    • 专利摘要:
    Endotracheal dilatation and ventilation device, comprising a tube composed of a first section of constant caliber and a second section of progressive caliber, and the second section being in continuity with the first section, the second section being of a decreasing caliber from its contact with the first section, the free end of the tube corresponding to the first section being open and with an opening and enabled for the incorporation of a breathing means, and the other free end being opposite the tube corresponding to the second section also open with an opening and presenting an external geometry as a tip with blunt edges. (Machine-translation by Google Translate, not legally binding)
    公开号:ES2725873A1
    申请号:ES201830301
    申请日:2018-03-27
    公开日:2019-09-30
    发明作者:San Roman Carlos Gutierrez；Gil Jorge Gutierrez
    申请人:Gil Jorge Gutierrez；
    IPC主号:
    专利说明:

    [0001]
    [0002] ENDOTRAQUEAL DILATION AND VENTILATION DEVICE
    [0003]
    [0004] OBJECT OF THE INVENTION
    [0005]
    [0006] The purpose of the present invention application is to register an endotracheal dilatation and ventilation device, which incorporates notable innovations and advantages over the techniques used so far.
    [0007]
    [0008] More specifically, the invention proposes the development of an endotracheal dilatation and ventilation device, which by its particular arrangement allows a very advantageous use against a tracheal obstruction on a patient, either through the main (oral) route or through of an artificial route such as a tracheotomy.
    [0009]
    [0010] BACKGROUND OF THE INVENTION
    [0011]
    [0012] In the known state of the art, there are several documents in some way linked, although with substantial differences with the proposed invention.
    [0013]
    [0014] For example, document ES2779934T3 refers to an effective pulser dilator for digestive use, mainly esophageal, although it refers to the fact that it can be incorporated into a bronchoscope, but it is not suitable for the airway, as it does not allow dilation and ventilation , and is not designed for introduction by narrow airway, and it is also not progressive. It assumes that it could dilate bronchi, but the act of dilating, would clearly affect the ventilation of the patient since the device would occupy the light of the trachea, making normal ventilation impossible.
    [0015]
    [0016] Other arrangements known in the state of the art, such as that disclosed in US2014277058, have generalized the use of pneumatic dilators. A balloon with controlled pressure inflation causes a narrowing of the narrow airway. However, this maneuver is accompanied by apnea, and therefore is improvable, because it is detrimental to the correct oxygenation of the patient.
    [0017] In this regard, the provision referred to in document MX2014001145A1 uses the inflation balloon around a ventilatory tube, managing to dilate and ventilate the patient at the same time. This arrangement has proven effective, but it is improved since the precise channel to inflate the balloon occupies ventilatory light in the device and would impede the correct ventilation in small calibres such as some severe stenosis. Therefore, this provision could be useful, but it does not have the necessary conicity to be applied in certain serious situations, which require immediate action, such as a severe subglottic stenosis of a newborn, although this need could be complementary to the present invention. , so that both devices could act together.
    [0018]
    [0019] Additionally, this previous provision would also not allow intubation and emergency ventilation in serious situations, and is much less intuitive than the proposed invention, as well as substantially more expensive, due to the different more complex elements that it incorporates, and therefore, would not solve the problem of being used in emergency situations and / or in medical facilities with precarious conditions, where the device of the proposed invention could be used.
    [0020]
    [0021] EP3135332A1 corresponds to a tracheal catheter to infuse gases once the patient has been intubated with a classic tube. It is a very soft and thin catheter that has nothing to do with the present invention, although it has a slightly conical tip to facilitate the introduction into the tracheal tube. It cannot dilate, nor can it intubate, nor can it contain any optics.
    [0022]
    [0023] The same document EP3135332A1 and document US3880168A present another similarity with the proposed invention only apparent in the conical shape of the design, being able to reach the bronchi in a classical intubation and in large airways. However, it is not possible to dilate with these devices, for example, a severe stenosis of a newborn.
    [0024]
    [0025] The present invention contributes to solve and solve the present problem, since it allows its use in a very advantageous way against a tracheal obstruction on a patient, either through the main (oral) route or through an artificial route such as a tracheotomy
    [0026] DESCRIPTION OF THE INVENTION
    [0027]
    [0028] The present invention has been developed in order to provide an endotracheal dilatation and ventilation device, which is essentially characterized by the fact that it comprises a tube composed of a first section of constant caliber and a second section of progressive caliber, and the latter being second section in continuity with the first section, the second section being of a decreasing caliber from its contact with the first section, the free end of the tube corresponding to the first section open and enabled for the incorporation of a breathing medium, and the other opposite free end of the tube corresponding to the second section also being open, and presenting an external geometry as a tip with the blunt edges.
    [0029]
    [0030] Preferably, in the endotracheal dilatation and ventilation device, the free end of the tube that corresponds to the first section also incorporates an endoscopy means that is enabled for its passage through the inside of the tube both by the first section and by the second section and for its passage through the opening of the free end of the tube that corresponds to the second section.
    [0031]
    [0032] Additionally, in the endotracheal dilatation and ventilation device, the outer surface of the tube has notches or recesses in the total or partial longitudinal extension of the tube.
    [0033]
    [0034] Alternatively, in the endotracheal dilatation and ventilation device, the tube is made entirely or partially of biocompatible plastic material, silicone or the like.
    [0035]
    [0036] Preferably, in the endotracheal dilatation and ventilation device, the region of the tube where the opening corresponding to the second section is, has less rigid properties than the rest of the same tube.
    [0037]
    [0038] Alternatively, in the dilatation and endotracheal ventilation device, the tube has a straight geometry.
    [0039]
    [0040] Alternatively, in the dilatation and endotracheal ventilation device, the tube has a curved geometry.
    [0041] Preferably, in the endotracheal dilatation and ventilation device, the free end of the tube that corresponds to the first section has a groove inside it adapted for the adaptation of a rigid optical lens that serves as a guide for the correct insertion of the endoscopic means.
    [0042]
    [0043] Additionally, the endotracheal dilatation and ventilation device incorporates an element of radiopaque properties.
    [0044]
    [0045] Preferably, in the endotracheal dilatation and ventilation device, the radiopaque feature element comprises a metal piece as a ring and embedded in the tube.
    [0046]
    [0047] Preferably, in the endotracheal dilatation and ventilation device, the ring-shaped metal part is arranged in the region of the contact tube of the first section with the second section.
    [0048]
    [0049] Thanks to the present invention, a very advantageous use is achieved against a tracheal obstruction on a patient, either through the main (oral) route or through an artificial route such as a tracheotomy.
    [0050]
    [0051] Other features and advantages of the dilatation and endotracheal ventilation device will be apparent from the description of a preferred but not exclusive embodiment, which is illustrated by way of non-limiting example in the accompanying drawings, in which:
    [0052]
    [0053] BRIEF DESCRIPTION OF THE DRAWINGS
    [0054]
    [0055] Figure 1.- It is a schematic view of a preferred embodiment of the dilatation and endotracheal ventilation device of the present invention.
    [0056] Figures 2 and 3.- They are schematic views of a preferred embodiment of the endotracheal dilatation and ventilation device of the present invention with a built-in endoscopic means.
    [0057] Figure 4.- It is a schematic view of a preferred embodiment of the endotracheal dilatation and ventilation device of the present invention, and with a curved geometry.
    [0058] DESCRIPTION OF A PREFERRED EMBODIMENT
    [0059]
    [0060] As shown schematically in Figure 1, the endotracheal dilatation and ventilation device comprises a tube 1 composed of a first section 11 of constant caliber and a second section 12 of progressive caliber, and the second section 12 being in continuity with the first section 11.
    [0061]
    [0062] The second section 12 of the tube 1 is of a decreasing caliber from its contact with the first section 11 of the same tube 1.
    [0063]
    [0064] The free end 2 of the tube 1 corresponding to the first section 11 is open and with an opening 21, and is enabled for the incorporation of a breathing means, either manual or mechanical.
    [0065]
    [0066] The other free end 3 opposite the same tube 1 and corresponding to the second section 12 is also open and with an opening 31, and has a tip-like exterior geometry with blunt edges.
    [0067]
    [0068] The free end 2 of the tube 1 corresponding to the first section 11 also incorporates an endoscopy means 4 that is enabled for its passage through the interior of the tube 1, both by the first section 11 and by the second section 12, and for its passage through the opening 31 of the free end 3 of the tube 1 corresponding to the second section 12, as can be seen in figure 2 and in the enlarged detail of figure 1.
    [0069]
    [0070] The outer surface of the tube 1 has notches 5 or recesses in the total or partial longitudinal extension of the tube 1, as can be seen in the enlarged details of Figures 1 and 2.
    [0071]
    [0072] The tube 1 is made of biocompatible plastic material, silicone or similar. In addition, the region of the tube 1 where the opening 31 is has less rigid properties than the rest of the same tube 1, or with semi-rigid properties, even also of silicone or the like, in order to avoid and prevent injuries at the time of its patient insertion
    [0073] The dilatation and endotracheal ventilation device of the invention allows the dilation of narrows in the patient's airway due to its impulsion and advancement. It manages to break the granulation tissue that presents the mucosa of the narrowness and establish a new caliber. At the same time and once the optics of the endoscopic medium 4 have been removed, it allows the correct ventilation of the patient since its design in its proximal part adapts to the breathing medium, either the anesthetic tower respirator or a manual ventilator, for example.
    [0074]
    [0075] The length, diameter and calipers of tube 1 are variable to adapt to the different ages and characteristics of the patient.
    [0076]
    [0077] The notches 5 or external recesses facilitate the rupture of the narrow ring of the patient.
    [0078]
    [0079] The end 2 of the tube 1 corresponding to the first section 11, has a groove 6 inside it for the adaptation of a rigid optical lens that serves as a guide for the correct insertion of the endoscopic means 4 adapted for this purpose, as It can be seen in figure 3 in its enlarged details. A metal guide can also be used in this regard.
    [0080]
    [0081] The tube 1 can have a straight geometry, as can be seen in Figures 1, 2 and 3, thus allowing the initial introduction of a rigid endoscopic means 4, useful especially when the patient is with the neck extended, and in Consequently, the straight airway.
    [0082]
    [0083] The tube 1 can also have a curved geometry, as shown in Figure 4, to thus allow a flexible endoscopic means 4, useful when the patient has a flexed neck.
    [0084]
    [0085] In the use of the endotracheal dilatation and ventilation device of the invention, once the stricture has been diagnosed by rigid or flexible endoscopy, tube 1 of the endotracheal dilatation and ventilation device of the invention is introduced into the patient's trachea and progressed by its inside until stenosis is reached. With direct vision, the narrowness is progressed, the endoscopic means 4 and its optics are removed, connected to the breathing medium and by dilation the dilation is achieved.
    [0086] The tube 1 of the endotracheal dilatation and ventilation device of the invention can remain dilating for as long as it is necessary since the patient is perfectly ventilated from the beginning of the procedure.
    [0087]
    [0088] The dilatation and endotracheal ventilation device of the invention is designed for tracheal use both in the subglottic region and in the trachea and main bronchi, modifying its length.
    [0089]
    [0090] The smaller 1-gauge tubes will be used in newborn children with subglottic stenosis and the larger 1-gauge tubes are useful for older children and adults.
    [0091]
    [0092] In other preferred embodiments of the endotracheal dilatation and ventilation device of the invention, an element of radiopaque properties may be incorporated, so that in an X-ray patient examination, a real position of the dilatation device can be obtained and endotracheal ventilation of the invention.
    [0093]
    [0094] Said element of radiopaque properties may comprise a metal part 7 as a ring, which by its metallic nature has radiopaque properties, and that is embedded in the tube 1 and that covers a large part of the circular perimeter of the tube 1, and which is arranged in the region of the contact tube 1 of the first section 11 with the second section 12.
    [0095]
    [0096] The endotracheal dilatation and ventilation device of the invention could also be used to dilate stenosis of the pharynx, tracheostomas and esophagus.
    [0097]
    [0098] More specifically, subglottic stenosis is known as one of the most problematic incidents in the areas of intensive neonatal and pediatric treatment.
    [0099]
    [0100] These patients often require long periods of assisted ventilation with a respirator, which injures their subglottic region. Ventilatory failures may occur that require a new urgent intubation, in this case with a caliber lower than the previous one of the newborn, due to the presence of inflammatory tissue caused by the tube.
    [0101]
    [0102] There are also situations that require the use of a very small caliber to secure the airway and prevent an emergency tracheotomy. In these situations, the endotracheal dilatation and ventilation device of the proposed invention may be of very useful, ensuring ventilation, on the one hand, and on the other hand dilating the granulation tissue and avoiding an emergency tracheotomy.
    [0103]
    [0104] In the known state of the art, the trachea is usually dilated with pneumatic dilators, but it is necessary to have low-cost devices, which can be substitutes for small, or complementary, calipers of pneumatic dilation, as is the case with the device of dilatation and endotracheal ventilation of the proposed invention.
    [0105]
    [0106] Another point of interest of the dilatation and endotracheal ventilation device of the present invention is its possibility of use in the management of the difficult airway (VAD), which is defined as that clinical situation in which a trained professional experiences difficulty with ventilation. with facial mask, with tracheal intubation, or with both. Even these difficulties can lead to the inability to ventilate a patient and cause his death.
    [0107]
    [0108] It is known that an accidental rupture of the trachea (0.4% of accidents) can occur in obese, pregnant and craniofacial patients. 34% of anesthetic demands are linked to VAD. The frequency is important since in a proportion of 1/50000 patients are not intubable, and intubation failures occur in a proportion of 1/2000 patients with scheduled anesthesia and 1/200 in urgent patients.
    [0109]
    [0110] The dilatation and endotracheal ventilation device of the present invention can be especially useful in VAD. Currently, the VAD is approached with intubation by means of an endoscope, but with the same intubation tubes as in the non-problematic airway. It is reported in the state of the art that this method is accompanied by 8.5% of vocal cord injuries (Anestesiology 2007, 107: 585-90), which could be avoided with the use of a tube with progressive caliber with the endoscope on the tip, as it is referred to in the dilatation and endotracheal ventilation device of the proposed invention.
    [0111]
    [0112] In situations where an endoscope is not available, such as ambulances and centers in geographic areas without financial resources, the use of the endotracheal dilatation and ventilation device of the present invention is possible in the working channel mode. The narrow airway is visualized, a thin metal guide with soft tip is passed and then the present dilatation and ventilation device is placed endotracheal of the proposed invention, capable of solving urgent ventilation with very small calibrations of useful aerial light and with low cost equipment.
    [0113]
    [0114] When a reduced caliber is used and it is not sufficient to properly ventilate the patient, as it has been dilated it is possible to use an immediately larger size, keeping the guide until adequate ventilation is achieved.
    [0115]
    [0116] The dilatation and endotracheal ventilation device of the proposed invention provides three important improvements to the state of the known art.
    [0117]
    [0118] First of all, both in surgery and other medical applications, and in emergency situations, in which advanced means are not available, with the dilatation and endotracheal ventilation device of the present invention an advanced technical solution is proposed, since it is obtained airway communication (tracheal dilation) and instant ventilation is provided to the patient.
    [0119]
    [0120] Secondly, the airway can be secured either by an endoscopic optical element (flexible or rigid) or by using an internal working channel (very thin tube) that can provide guidance of the endotracheal dilatation and ventilation device of the present invention through a very narrow airway.
    [0121]
    [0122] Third, the possibility of using a flexible endoscopy means, in the realization of the endotracheal dilatation and ventilation device of the present invention with curved geometry. The dilatation and endotracheal ventilation device of the present invention is adaptable, for difficult intubation, in cases where patients do not have an extended neck and therefore an intubation with elements of rigid or straight geometry would be less preferable.
    [0123]
    [0124] Both the rectilinear version and the curved geometry version of the dilatation and endotracheal ventilation device of the present invention coincide in the technical application of solving a joint problem, as well as, before a prior assessment by the doctor in charge of the intervention, being able to use one or the other version, depending on the patient's conditions, as well as their own experience.
    [0125] In addition to everything explained, due to the intuitive and practical of the dilatation and endotracheal ventilation device of the proposed invention, with a brief training any physician or healthcare staff can use the endotracheal dilatation and ventilation device of the invention, especially when treated patients in emergency situations, with vital risk in outdoor performances, in ambulances, in health centers where there is no operating room or intervention rooms, as well as expert personnel in anesthesia and resuscitation, always providing a safety in the air permeability of a patient.
    [0126]
    [0127] Due to the technical simplicity of the endotracheal dilatation and ventilation device of the proposed invention, it can be part of a therapeutic arsenal, as well as the emergency kit of any hospital center, of difficult airway equipment of any hospital facility, since For economic purposes, the impact is much less than in many other devices of the state of the art.
    [0128]
    [0129] The endotracheal dilatation and ventilation device of the invention further provides for the incorporation of progressive gauges, in order to provide progressive intubations depending on the section of each of them, in order to initiate airway dilation with a first caliber of reduced dimensions, and progressively using devices with multiple sections of the previous one and gradually expanding the airway lumen and therefore progressively improving patient ventilation.
    [0130]
    [0131] Quantifying the above, and by way of illustrative and non-limiting example, a series of gauges could be available for the second section 12 of decreasing caliber from its contact with the first section 11, as indicated below:
    [0132] - A first light of 2.5mm to 4mm internal diameter.
    [0133] - A first light of 3.5mm to 8mm internal diameter.
    [0134] - A first light of 7.5mm to 12mm internal diameter.
    [0135]
    [0136] The details, shapes, dimensions and other accessory elements, as well as the materials used in the manufacture of the dilatation and endotracheal ventilation device of the invention, may be conveniently replaced by others that are technically equivalent and do not depart from the essentiality of the invention or the scope defined by the claims included below.
    权利要求:
    Claims (11)
    [1]
    1. Endotracheal dilatation and ventilation device, characterized in that it comprises a tube (1) composed of a first section (11) of constant caliber and a second section (12) of progressive caliber, and the second section (12) being ) in continuity with the first section (11), the second section (12) being of a decreasing caliber from its contact with the first section (11), the free end (2) of the tube (1) corresponding to the first section (11) open and with an opening (21) and enabled for the incorporation of a breathing means, and the other free end (3) opposite the tube (1) corresponding to the second section (12) also open with an opening (31) and presenting an external geometry as a tip with blunt edges.
    [2]
    2. Endotracheal dilatation and ventilation device according to claim 1, characterized in that the free end (2) of the tube (1) corresponding to the first section (11) also incorporates an endoscopy means (4) which it is enabled for its route through the inside of the tube (1) both by the first section (11) and by the second section (12) and for its passage through the opening (31) of the free end (3) of the tube (1) which corresponds to the second section (12).
    [3]
    3. Endotracheal dilatation and ventilation device according to claim 1, characterized in that the outer surface of the tube (1) has notches (5) or recesses in the total or partial longitudinal extension of the tube (1).
    [4]
    4. Endotracheal dilatation and ventilation device according to claim 1, characterized in that the tube (1) is made totally or partially of biocompatible plastic material, silicone or the like.
    [5]
    5. Endotracheal dilatation and ventilation device according to claim 1, characterized in that the region of the tube (1) where the opening is (31) has less rigid properties than the rest of the same tube (1).
    [6]
    6. Endotracheal dilatation and ventilation device according to claim 1, characterized in that the tube (1) has a straight geometry.
    [7]
    7. Endotracheal dilatation and ventilation device according to claim 1, characterized in that the tube (1) has a curved geometry.
    [8]
    8. Endotracheal dilatation and ventilation device according to claim 1, characterized in that the free end (2) of the tube (1) corresponding to the first section (11) has a notch (6) enabled inside for the adaptation of a rigid optical lens that serves as a guide for the correct insertion of the endoscopic medium (4).
    [9]
    9. Endotracheal dilatation and ventilation device according to any one of the preceding claims, characterized in that it incorporates an element of radiopaque properties.
    [10]
    10. Endotracheal dilatation and ventilation device according to claim 9, characterized in that the element of radiopaque properties comprises a metal part (7) as a ring and embedded in the tube (1).
    [11]
    11. Endotracheal dilatation and ventilation device according to claim 10, characterized in that the ring-shaped metal part (7) is arranged in the region of the contact tube (1) of the first section (11) with the second section (12).
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    同族专利:
    公开号 | 公开日
    WO2019185956A1|2019-10-03|
    ES2725873B2|2020-07-09|
    EP3777941A1|2021-02-17|
    EP3777941A4|2021-12-29|
    引用文献:
    公开号 | 申请日 | 公开日 | 申请人 | 专利标题
    US3880168A|1973-12-21|1975-04-29|Robert A Berman|Endotracheal tube|
    ES2279934T3|2002-12-20|2007-09-01|Ethicon Endo-Surgery, Inc.|TRANSPARENT DILATOR DEVICE.|
    EP1647233A1|2004-10-15|2006-04-19|Ethicon Endo-Surgery, Inc.|Transparent dilator device|
    WO2008089424A2|2007-01-18|2008-07-24|Creighton University|Systems and techniques for endoscopic dilation|
    MX2011007038A|2008-12-29|2011-07-20|Acclarent Inc|System for dilating an airway stenosis.|
    MX2014001145A|2011-07-28|2014-02-27|Acclarent Inc|Improved device and method for dilating an airway stenosis.|
    US20140046357A1|2012-08-09|2014-02-13|Cook Medical Technologies Llc|Dilation device|
    US20140277058A1|2013-03-12|2014-09-18|Acclarent, Inc.|Airway dilation shaft with staggered adjacent internal lumens|
    EP3135332A1|2015-08-28|2017-03-01|CHIRANA Medical, a.s.|Tracheal catheter for ventilatory support of lungs by continuous flow of breath gases during nasotracheal intubation and use thereof|
    法律状态:
    2019-07-31| PC2A| Transfer of patent|Owner name: JORGE GUTIERREZ GIL Effective date: 20190725 |
    2019-09-30| BA2A| Patent application published|Ref document number: 2725873 Country of ref document: ES Kind code of ref document: A1 Effective date: 20190930 |
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    优先权:
    申请号 | 申请日 | 专利标题
    ES201830301A|ES2725873B2|2018-03-27|2018-03-27|ENDOTRACHAL DILATION AND VENTILATION DEVICE|ES201830301A| ES2725873B2|2018-03-27|2018-03-27|ENDOTRACHAL DILATION AND VENTILATION DEVICE|
    PCT/ES2019/070164| WO2019185956A1|2018-03-27|2019-03-12|Endotracheal dilation and ventilation device|
    EP19776340.2A| EP3777941A4|2018-03-27|2019-03-12|Endotracheal dilation and ventilation device|
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