Endotracheal Catheter and Manifold Assembly with Improved Valve

专利摘要:
A manifold 204 for attaching to the distal hub of the endotracheal tube to form a venting circuit, a catheter tube 208 displaceable into the endotracheal tube through the manifold to draw secretions from the tube and lungs; An improved respiratory inhalation device catheter 200 comprising a valve mechanism disposed adjacent to the ventilation circuit to minimize intake of air from the patient's ventilation circuit when the catheter is cleaned. In a preferred embodiment of the present invention, the catheter 208 is washed more thoroughly than in the prior art with little or no inhalation of air from the patient's venting circuit.
公开号:KR20030016209A
申请号:KR1020027007481
申请日:2000-12-04
公开日:2003-02-26
发明作者:크럼프쳇엠.；매드센에드워드비.
申请人:발라드 메디컬 프로덕츠；
IPC主号:

专利说明:

Endotracheal Catheter and Manifold Assembly with Improved Valve}
[2] There are a variety of other cases where it is necessary to install an artificial airway, such as an endotracheal tube, in a human respiratory system. In some cases, such as surgery, the function of the artificial airway is to keep the patient's airways open so that adequate lung ventilation is maintained during the surgical procedure. In many other cases, however, the endotracheal tube will remain in the patient for a longer period of time. For example, for many patients, the endotracheal tube will remain in place to maintain mechanical ventilation for the patient's life.
[3] If the endotracheal tube remains in place for any sufficient time, it is essential that the respiratory secretions be removed periodically. This mainly consists of the use of a respiratory inhalation catheter that is advanced into the endotracheal tube. When the inhalation catheter is retracted, a negative pressure is applied inside the catheter to inhale mucus and other secretions from the patient's respiratory system. As large amounts of mucus and other secretions retreat through the catheter, some mucus and other secretions remain on the exterior of the catheter.
[4] It is important to protect the clinician from contact with the catheter because the patient's secretions may contain infectious agents such as streptococci, Pseudomonas aeruginosa, Staphylococcus aureus, and even HIV. Similarly, it is important to protect patients from infectious pathogens and bacteria that may be delivered by clinicians in the atmosphere. This is especially important for patients who rely on mechanical aeration because their immune systems are often compromised.
[5] In addition to the concerns of mutual infection, inhaling the patient's artificial airways potentially interferes with proper breathing. The most common group of patients who have an indwelling endotracheal tube for longer periods of time is those who must mechanically ventilate. Mechanically ventilated patients will typically have a device or manifold attached to the distal end of the endotracheal tube (ie, the end extending out of the patient) at the endotracheal tube hub. The pair of vent tubes extend from the mechanical vents and are typically attached to the manifold by an adapter. One tube provides inhalation air to the patient for inspiration. The other tube is for exhaled air or exhaled air flowing out of the system.
[6] Until the 1980s, it was common to remove a manifold and vent tube from a patient whenever the patient needed suction. Interruptions in the air supply to the patient, even for a few seconds, often suffered unnecessarily for the patient. This problem was initially overcome in the invention disclosed in US Pat. No. 3,991,762 to "Radford." Radford has developed what is commonly called a closed inhalation catheter system. In a closed suction catheter system, the catheter was held in a protective sleeve attached to the manifold. If traction is needed, the catheter advances through the manifold into the artificial airway. A negative pressure is then applied to the catheter and the discharge in the patient's respiratory system is discharged. This system was improved by the invention disclosed in US Pat. No. 4,569,344 to "Palmer." Palmer improved the invention by reducing the risk of cross-infection between medical personnel and patients using the device. Since then, there has been a significant shift towards using a closed catheter system. The advantage of a closed suction catheter is that during the open rotation procedure, the vent circuit is not disconnected from the patient during the suction procedure. Since the catheter is reused several times over 24 hours, it is important to wash the mucus and other secretions from the catheter before it is not used. If secretions are not removed, the risk of auto contamination is increased. In addition, it is important to clean the catheter to maintain suction efficiency.
[7] There are several mechanisms by which the catheter can be washed. First, US Pat. No. 4,569,344 discloses a cleaning port that allows a user to inject liquid into an area surrounding the distal end of the catheter after the catheter withdraws from the patient. When the liquid is injected into a closed inhalation catheter device and inhalation is applied, the liquid helps the discharge to come out of the catheter.
[8] One major problem with simply injecting liquid and inhaling to remove it is that inhalation also causes large amounts of respiratory air to be removed through the catheter. In a "closed system," the air released potentially disrupts a carefully controlled aeration cycle. Thus, the amount of respiratory air available to the patient is potentially reduced as a result of catheter washing. If the clinician has trouble flushing the secretions from the catheter, cessation may be made through the catheter several times to repeatedly inhale air from the venting circuit. Other closed suction catheters have been developed to have a cleaning or cleaning chamber that is physically isolated from the vent circuit. For example, US Pat. No. 5,487,381 to "Jinotti" discloses a closed suction catheter having a cleaning chamber configured to receive the distal tip of the catheter when the catheter is retracted from the manifold. At this time, the wall slides from the open position to the closed position to isolate the distal end of the catheter from the manifold and vent circuit. Ports are generally provided for injecting the cleaning solution into the cleaning chamber.
[9] One problem with this structure is the lack of air flow that allows the intake catheter to be properly cleaned. When negative pressure is applied in the catheter, there is not enough air flow into the chamber and a vacuum may be formed in the chamber. Thus, isolating the chamber limits the free discharge of the cleaning solution. In addition, the movement of the wall will require an extra step from the clinician's point of view. Moreover, in currently available products, the wash solution usually remains in the catheter due to the lack of air flow. Thus, infected liquid remaining in the catheter can be reintroduced to the patient when the cleaning chamber is opened.
[10] In addition to the above concerns, currently available closed suction catheters have the problem that the catheter tip cannot be cleaned to the most desirable degree. If pathogens or other infecting bacteria stay on the catheter too long, they can auto-infect the patient. In addition, if mucus and other secretions dries on the catheter, they can interfere with inhalation efficiency, exhibit poor appearance, and lead to early replacement of a closed inhalation catheter device. Therefore, there is a need for a catheter device having a mechanism for more efficiently cleaning the catheter end without substantially breathing breathing air in the venting circuit.
[1] The present invention relates to a breathable inhalation catheter system having an improved mechanism for cleaning the catheter tip without inhaling excessive amounts of air from an endotracheal catheter attached breathing circuit. More specifically, the present invention relates primarily to closed inhaled endotracheal catheter systems that improve catheter cleaning while eliminating or minimizing air that is drawn from the patient's venting circuit.
[15] The above and other objects, features and advantages of the present invention will become apparent from the following detailed description presented with reference to the accompanying drawings.
[16] 1 is a cross-sectional view of a manifold and catheter cleaning mechanism in accordance with the teachings of the prior art.
[17] 2 is a cross-sectional view of a manifold and catheter cleaning mechanism according to another teaching of the prior art.
[18] 3A is a cross-sectional view of the catheter distal end and manifold of the improved respiratory inhalation catheter device with the valve member in an open position in accordance with the principles of the present invention.
[19] FIG. 3B shows a cross-sectional view of the manifold and catheter portion shown in FIG. 3A with the valve in the second closed position.
[20] FIG. 3C is a partially enlarged cross-sectional view of one embodiment of the improved respiratory inhalation catheter device shown in FIG. 3A.
[21] 3D is a partially enlarged cross-sectional view of another embodiment of the improved respiratory inhalation catheter device shown in FIG. 3A.
[22] FIG. 3E is a cross sectional view similar to that shown in FIGS. 3A-3D of another embodiment in which a flap is engaged with a collar.
[23] 4A is a partial cross-sectional view of another embodiment of an improved breathing catheter device with the valve in an open position in accordance with the principles of the present invention.
[24] 4B is a partial cross-sectional view of the embodiment of FIG. 4A with the valve in a closed position to isolate the catheter from the vent circuit.
[25] 4C is a partial cross-sectional view of the embodiment of FIGS. 4A and 4B with the air replenishment mechanism in an open position to facilitate inhalation of mucus and the like.
[26] 5A is a partial cross-sectional view of another embodiment of an improved respiratory inhalation catheter device with the valve in an open position in accordance with the principles of the present invention.
[27] 5B is a partial cross-sectional view of the embodiment shown in FIG. 5A with the valve in the closed position.
[28] 5C is a partial cross-sectional view of the valve of the embodiment shown in FIGS. 5A and 5B.
[29] 6A is a partial cross-sectional view of another embodiment of an improved respiratory inhalation catheter device made in accordance with the principles of the present invention.
[30] FIG. 6B is a partial cross-sectional view of the embodiment shown in FIG. 6A in a closed configuration.
[31] 6C and 6D are end views of the valve mechanism of the embodiment shown in FIGS. 6A and 6B, respectively, in a relaxed position with a catheter extending therethrough.
[32] 7A is a partial cross-sectional view of another embodiment of an improved respiratory inhalation catheter device made in accordance with the principles of the present invention.
[33] FIG. 7B is a partial end view of the improved respiratory inhalation catheter device of FIG. 7A in a closed position.
[34] 8A is a partial cross-sectional view of another embodiment of an improved respiratory inhalation catheter device made in accordance with the principles of the present invention.
[35] FIG. 8B is a partial cross-sectional view of the improved endotracheal catheter of FIG. 8A with the valve mechanism closed. FIG.
[36] 9A is a partial cross-sectional view of an improved endotracheal catheter with the valve mechanism locked in the closed position.
[37] 9B is an enlarged view of the locking valve mechanism and associated structure of FIG. 9A.
[38] 10A is a partial cross-sectional view of another embodiment of an improved endotracheal catheter with a locking valve mechanism.
[39] 10B is an enlarged view of the locking valve mechanism and associated structure of FIG. 10A.
[40] 11A is a partial cross-sectional view of another embodiment of an improved endotracheal catheter with a locking valve mechanism disposed thereon.
[41] FIG. 11B is an enlarged view of the locking valve mechanism and associated structure of FIG. 11A.
[42] FIG. 11C is an enlarged end view of the locking valve mechanism of FIGS. 11A and 11B.
[43] FIG. 11D is an enlarged end view of another embodiment of the flap shown in FIG. 11C.
[44] 12A is a partial cross-sectional view of another embodiment of an improved endotracheal catheter with a locking mechanism disposed thereon.
[45] 12B is an enlarged view of the associated structure and locking valve mechanism of FIG. 12A.
[46] 12C is an enlarged end view of the locking valve mechanism of FIGS. 12A and 12B.
[47] 13A is a partial cross-sectional view of another embodiment of an improved endotracheal catheter having a locking valve mechanism.
[48] Fig. 13B is an enlarged view of the related structure and locking valve mechanism of Fig. 13A.
[49] 14A is a partial cross-sectional view of another embodiment of an improved endotracheal catheter having a locking valve mechanism.
[50] 14B is an enlarged view of the associated structure and locking valve mechanism of FIG. 14A.
[51] Fig. 14C is a perspective view of the flap shown in Figs. 14A and 14B.
[52] 14D is a side view of the flap shown in FIGS. 14A-14C.
[53] 15A is a partial cross-sectional view of another embodiment of an improved endotracheal catheter in which a pair of wiper seals are used to enhance distal cleaning of the catheter tube.
[54] Fig. 15B is a cross sectional view similar to Fig. 15A with the catheter tube pulled into the base end position.
[11] The present invention provides an improved respiratory inhalation catheter device that minimizes the amount of air drawn in from the venting circuit while cleaning the distal end of the catheter. This includes a respiratory inhalation catheter device that improves the removal of mucus and other secretions from the catheter end. In a preferred embodiment, the respiratory inhalation catheter device includes a mechanism for improving the cleaning function that automatically at least partially divides the cleaning area from the vent circuit. Respiratory inhalation catheters may also be configured such that washing occurs in turbulent flow.
[12] These and other various objects of the present invention are realized in specific embodiments of the improved respiratory inhalation catheter device claimed and described below. An improved respiratory inhalation catheter device is typically displaced through a manifold for attaching to an artificial airway, such as an endotracheal tube, to form a venting circuit, and through the manifold to inhale secretions from the artificial airway and lungs. Possible catheter and valve mechanism disposed adjacent the venting circuit to minimize air drawn from the patient's venting circuit while cleaning the catheter.
[13] In a preferred embodiment, the valve mechanism is configured to automatically engage the catheter tip after minimizing the amount of air drawn into the catheter during catheter retreat through the manifold and cleaning. In addition, the valve mechanism may be configured to lock in the closed position when pulled toward the retracted catheter to maintain isolation between the airway and the catheter tip through the manifold. The valve mechanism may also include air replenishment to supply replenishment air into the catheter to ensure proper discharge of any liquids and secretions used to clean the catheter.
[14] In addition, the turbulence enhancing mechanism may also increase turbulent flow around the catheter end to enhance secretion removal from the catheter. An air replenishment mechanism may also be arranged to provide replenishment air at the distal end of the catheter that is not inhaled from the venting circuit. Finally, other embodiments may include a pair of wiper seals used to more effectively clean the distal end of the catheter tube.
[55] Reference will now be made to the drawings, in which various elements of the invention are designated with the same reference numerals to designate the same materials. These reference signs are associated with various aspects of the preferred embodiments, but are not intended to limit the scope of the invention as disclosed and claimed herein. It is to be understood that the following detailed description is merely illustrative of the present invention and is not intended to narrow the claims. Those skilled in the art will appreciate that aspects of the various embodiments discussed can be interchanged and modified without departing from the spirit and scope of the invention. In addition, the use of different reference numerals for corresponding elements in the lower drawings is merely for clarity and is not intended to limit the scope of the present invention.
[56] Referring to Figure 1, a cross-sectional view of manifold 10 and catheter cleaning mechanism 14 in accordance with the teachings of the prior art is shown. The manifold has a valve mechanism in the form of a rotatable rod 18 for selectively isolating the cleaning chamber 20 from the vent circuit 26. When the distal end of the catheter 22 is disposed in the cleaning chamber 20, a cleaning solution may be injected through the side port 30 to help clean the mucus and other secretions from the outside of the catheter 22. have.
[57] However, because of the relative size and dimensions of the cleaning chamber 20, there is no means to force a vigorous interaction between the secretion on the exterior of the catheter and the cleaning solution. In addition, since the cleaning chamber is not configured to enter supplemental air when the rotatable rod 18 is closed, a vacuum may be formed in the cleaning chamber 20 that prevents effective suction. Another disadvantage of the embodiment shown in FIG. 1 is that the closing mechanism for such a device typically must be manually operated. If the user fails to close the rotatable rod 18, the suction operation through the catheter will suck air from the vent circuit 26.
[58] Referring now to FIG. 2, there is shown a cross-sectional view of another embodiment of the prior art. Manifold 100 is provided with a plurality of ports 104. The first port 104a is attached to the hub of the endotracheal tube of the patient such that breathing air is delivered to and from the endotracheal tube. Thus, the manifold forms part of the vent circuit. Air is typically removed from and provided to the manifold through a second port 104b attached to a pair of vent tubes via a connector (not shown). The vent tube is connected to a mechanical vent (not shown) in a manner well known to those skilled in the art.
[59] The third port 104c may be located opposite the second port 104b. The third port is typically covered with a cap 108 that is removed when "blow-by" is required to remove forced aeration from the patient, as discussed in more detail below. The manifold may include a fourth port 104d.
[60] The coupling 112 is adapted to form an interference fit coupling with the fourth port 104d and effectively connects the catheter 116 and the protective sleeve 120 to the manifold 100. A cleaning port 124 is disposed adjacent the proximal end of the coupling 112, wherein the cleaning solution may be injected to rinse the outside of the catheter 116 through this cleaning port. This configuration is advantageous because the cleaning port 124 is positioned adjacent the seal 128 configured to wipe the mucus and other secretions from the catheter 116 when the catheter is pulled through the seal 128. Thus, the user will typically retract the catheter 116 until the distal end 116a of the catheter is positioned slightly distal from the seal 128, and then the wash port (eg, the wash solution) to help remove secretions. 124). Although this method of removing secretions is generally effective, it can draw more air from the venting circuit 132 than is necessary to effectively clean the distal end 116a of the catheter 116. Also, it is common for respiratory therapists or other clinicians to maintain inhalation through the catheter 116 while retracting the catheter 116 from the first port 104a to a position immediately adjacent to the seal 128. .
[61] Referring now to FIG. 3A, there is shown a partial cross-sectional view of an improved endotracheal catheter, indicated generally at 200. Endotracheal catheter generally includes a manifold and catheter 208, indicated as 204. Manifold 204 includes a plurality of ports 212a-212d. The first port 212a is structured for attachment to the proximal end of the artificial airway, such as the hub of the endotracheal tube. The second port 212b is typically connected to a pair of vent tubes (not shown) by an adapter (not shown) in accordance with conventional practice in the prior art.
[62] As used herein, the distal end generally points in the direction of the patient while the base points in the direction of the user. Unless otherwise indicated, in each figure the distal (patient) portion faces the top of the page, while the base (clinical) portion faces the bottom of the page.
[63] During normal use, the regulated breathing air is forced to move into the patient's lungs through either of the vent tubes, through the second port 212b and the first port 212a, and through the artificial airway. The exhalation is delivered to the outside through the first port 212a, then the second port 212b and other vent tubes. Thus, the manifold 204 forms part of the vent circuit 214 through which the breathing air is circulated.
[64] Also forming part of the manifold 204 is the third port 212c of this embodiment. Whenever mechanical ventilation is used, the ultimate goal is to return the patient to spontaneous or involuntary breathing. In order to achieve this, the patient usually has to escape from mechanical ventilation and become involuntary breathing.
[65] To this end, the cap 216 may be removed from the third port 212c such that oxygen passes through the endotracheal tube of the patient but respiratory air is not forced into the patient's lungs by a fully closed circuit. This situation, commonly referred to as "blobby", allows the patient to resume gradually natural or involuntary breathing.
[66] Manifold 204 may include fourth port 212d. The fourth port 212d is generally disposed opposite the first port 212a and configured to slide the catheter 208 into and through the first port to allow for patient slack. Upon completion of the rupture, the catheter 208 is pulled back into the fourth port 212d to prevent obstruction of the venting circuit 214.
[67] A coupling or adapter 220 is disposed between the fourth port 212d and the wall forming the catheter 208. At the outermost end, adapter 220 engages the wall that forms fourth port 220. At the innermost end, the adapter 220 engages the collar 224 closely surrounding the catheter 208 to leave a small cylindrical space 226 around the catheter 208. Ideally, the space between catheter 208 and collar 224 is between about 0.127 mm (0.005 inches) and about 0.381 mm (0.015 inches).
[68] This approximation offers two important advantages. First, if it is necessary to clean the lungs of a patient, a sterile saline solution or wash solution is injected through the wash port 228 and into the cylindrical space 226 so that the flow of the wash solution flows through the first port 212a. It is led out of the distal end 224a of the collar. If the space between the catheter 208 and the collar 224 is too large (as in the art discussed above), no cleaning solution can be induced. Second, when the catheter 208 is pulled back into the collar 224 after use, the collar helps to wipe off a thick layer of mucus or other secretion from the outside of the catheter.
[69] Injecting a sterile saline solution through the cleaning port 228 also removes secretions from the exterior of the catheter 208 and improves discharge by suction in the catheter. This structure also minimizes the amount of cleaning solution and air required to clean.
[70] Although the collar 224 structure shown in FIG. 3A is beneficial, it is still common for the secretion to accumulate on the distal end 208a of the catheter 208. If this accumulation is not removed immediately, it may interfere with the catheter's ability to inhale the patient properly. It can also function as a culture medium for pathogens in a closed inhalation catheter system.
[71] According to one of the principles of the present invention, selective blocking of air flow into the catheter 208 distal end 208a is known to significantly improve catheter cleaning. In addition, such mechanisms for improving cleaning are also known to minimize the withdrawal of air from the vent circuit 214.
[72] As shown in FIG. 3A, the flap 232 is hinged to an annular ring 236 disposed in the fourth port 212d to pivot about the ring forming the self-closing valve member. Of course, flap 232 may be attached directly to the wall of manifold 204 or adapter 220 forming fourth port 212d. Hinged attachment 240 allows flaps 232 to move selectively while maintaining alignment with the catheter tip, creating a self-closing flap valve.
[73] As shown in FIG. 3B, the flap 232 is positioned to align with the distal end 208a of the catheter 208 when the catheter is nearly fully retracted into the collar 224. Hinged attachment 240 has sufficient flexibility so suction through distal end 208a of catheter 208 will pull flap 232 from the first distal position to the second base position as the base, and the flap Contacts the distal end of the catheter. Thus, forming the self-closing valve together with the flap 232 and associated structure does not require any additional external manipulation of the catheter system to close the valve.
[74] For most closed inhalation catheters, the catheter 208 is formed such that a major hole 244 is formed in the one or more lateral holes 248 and the distal end 208a positioned slightly towards the base from the distal end 208a. do. As the flap 232 moves to the base and contacts the distal end 208a of the catheter 208, suction through the catheter tip hole 244 is reduced or eliminated. The cover of the hole 244 increases the suction flow in the lateral hole 248, thereby increasing the discharge of secretions contained between the inside of the collar 224 and the outside of the catheter 208 through the hole 248. Since each lateral hole 248 is generally smaller than the distal hole 244 and the collar 224 restricts air flow to the lateral hole 248, the cleaning of the catheter 208 is improved. At the same time, less air is drawn from the venting circuit.
[75] As shown in Figures 3A and 3B, the base side 232a of the flap 232 (ie, the opposite side of the vent circuit 214) is generally planar. In this structure, the base side 232a of the flap 232 typically forms a substantially complete seal with the distal end 208a of the catheter 208.
[76] Referring now to FIG. 3C, there is shown an enlarged cross-sectional view of the embodiment shown in FIGS. 3A and 3B with slight modifications to flap 232. Unlike the flap 232 shown in FIGS. 3A and 3B, which are substantially planar, the flap 232a shown in FIG. 3C has a channel 252 formed on the base end 232a. This channel 252 prevents the flap 232 from forming an airtight bond with the distal end 208a of the catheter 208. In other words, the channel 252 ensures that the measured amount of air is sucked into the hole 244 at the distal end 208 of the catheter.
[77] The measured amount of air sucked through channel 252 can have a significant effect. Specifically, air forms turbulent flow within and immediately outside of catheter 208. Turbulent flow helps to break down lumps of mucus and secretions that cannot be broken down by sterile saline solution alone. Thus, turbulent flow helps to improve cleaning of the distal end 208a of the catheter 208. This is in sharp contrast with many prior art devices that have supported the use of cleaning / cleaning chambers to clean the exterior of the catheter. Since the cleaning / cleaning chamber is usually substantially larger than the catheter or no supplementary air is specifically provided, it is difficult to create turbulence in the chamber. Without turbulence, it is more difficult to remove mucus and other secretions from the outside of the catheter.
[78] Referring now to FIG. 3D, another variation of the flap 232 shown in FIGS. 3A and 3B is shown. Rather than having a channel formed at the base side, flap 232b has a hole 260 formed therein to allow a relatively small amount of air to pass through flap 232b. Small holes create turbulence at the distal end 208a of the catheter 208, thereby improving cleaning. It is presently believed that the diameter of the hole 260 in the flap 232b is about 0.76 mm (0.03 inches).
[79] Although FIGS. 3A-3D show engagement with the distal end 208a of the catheter 208, the flap 232 forming the flap valve need not engage the catheter. Thus, for example, FIG. 3E illustrates FIGS. 3A-3A except that the flap 232 is arranged to engage the distal end 224a of the collar 224 rather than the distal end 208a of the catheter 208. An embodiment similar to that shown in 3d is shown. In this configuration, suction flow can still be achieved through the aperture 244 at the distal end 208a of the catheter 208.
[80] Preferably, a source of make-up air will be provided. This can be accomplished using either of the flap structures shown in Figures 3C and 3D. In another example, small holes may be formed in the collar 224 so that small amounts of supplemental air are readily present to enhance intake flow and increase turbulence.
[81] Regardless of which of the structures shown in FIGS. 3A-3E is used, the end portion 208a of the catheter 208 can be washed at the same time as a result significantly reducing the amount of air retracted from the venting circuit 214. Improve their ability Thus, consistent ventilation is provided to the patient and the clinician can also more easily clean the catheter 208.
[82] Referring now to FIG. 4A, another embodiment of an improved respiratory inhalation catheter device, represented generally 300, is made in accordance with the principles of the present invention. The improved respiratory inhalation catheter device 300 includes a manifold 304 and a catheter 308. In the previous embodiment, the manifold 304 includes a first port 312a, a second port 312b, a third port 312c and a fourth port 312d.
[83] Adapter 320 is disposed within fourth port 312d in such a manner as to make manifold 304 and catheter 308 a functionally integrated unit. Adapter 320 may be attached to manifold 304 or may simply be interference fit.
[84] Unlike the embodiment discussed in FIGS. 3A-3D, the annular ring is not disposed in manifold 304 independent of adapter 320. Rather, the annular ring 326 extends inward from the distal end 320a of the adapter 320. The annular ring 326 defines a hole or opening 330, which can extend through the catheter 308. Thus, the opening 330 is slightly larger than the outside of the catheter 308.
[85] Flap 336 also extends inward from adapter 320. The flap 336 is preferably attached directly to the adapter or by either hinge to the annular ring 326. If no suction to the catheter 308 is made or if the distal end 308a of the catheter is disposed distal from the flap 336, the flap will generally extend distal from the annular ring and the It provides virtually no resistance to advancement.
[86] As shown in FIG. 4B, when suction is taken and the distal end 308a of the catheter 308 retracts through the annular ring 326, a vacuum is created that pulls the flap 336 over the opening 330, This isolates the distal end 308a of the catheter 308 from the vent circuit 340 and prevents the catheter from inhaling air away from the patient to which the manifold is attached. Flap 336 may be configured in the manner shown in FIGS. 3C and 3D, which does not require the use of supplemental air from vent circuit 340.
[87] If the catheter 308 is simply left in the chamber 348 behind the flap 336 / annular ring 326 and a cleaning liquid is injected into the chamber, a substantial negative pressure is created in the chamber. In addition, since no relief is provided, it is difficult to inhale mucus and similar substances from the chamber once the cleaning liquid source is suction dried. In order to overcome this problem of the prior art, the embodiment of Figures 4A-4C has a supplemental air inlet, generally denoted 350, which connects the adapter 320 and the fourth port 312d of the manifold. It is formed within a portion of the wall to form. The supplemental air inlet 350 preferably includes a filter 354 that is selected to substantially prevent cross-infection between the environment / clinical and the patient. Adjacent to the filter material is a flexible barrier 358 that forms a one-way valve 360.
[88] As shown in Figures 4B and 4C, the one-way valve 358 will generally close when the catheter 308 is in the extended position, and the catheter is through the opening 330 in the annular ring 326. Is extended. However, once the distal end 308a of the catheter 308 is retracted through the opening 330 in the annular ring 326 and the flap 336 is pulled and closed, the vacuum is flap 336 opposite the vent circuit 340. Will develop rapidly in terms of perspective. The vacuum causes the one-way valve 358 to open and supplemental air is supplied to the chamber. The supplemental air flowing past the flexible one-way valve member 358 helps to create turbulence and to facilitate the removal of any respiratory secretions on the catheter 308. This is preferably accomplished at about the same time as the user uses the cleaning port 370 to inject sterile saline solution through the space 372 between the collar 374 and the catheter 308. It will be appreciated that the one-way valve 358 may be configured to provide little resistance to air ingress, or may be configured such that substantial vacuum needs to be present before supplemental air is supplied into the base region of the flap 336.
[89] Referring now to FIG. 5A, there is shown a partial cross-sectional view of another embodiment of an improved respiratory inhalation catheter device, generally indicated at 400. The respiratory inhalation catheter device includes a catheter 408 and a manifold 404 that are movable through the manifold to inhale secretions from the patient's lungs. In the previously discussed embodiment, the manifold has a first port 412a for attaching to an endotracheal tube or other artificial airway, a second port 412b for attaching to a vent tube of a mechanical vent, and a cap 416 An optional third port 412c covered by the cover and an optional fourth port 412d for receiving the connector or adapter 420.
[90] At the distal end 420a of the adapter 420, a valve 424 is constructed which is commonly referred to as a duckbill valve. The valve 424 is formed by an elastomeric component that opens when the catheter 408 advances and closes when the catheter retreats. Valve 424 is attached to adapter 420 by flexible base 428.
[91] Also disposed within the adapter 420 is an air inlet 432 comprising a filter material 436 and an elastic member 440 configured to form a one-way valve 444 similar to that discussed in the previous embodiment. Although duckbill valves have been used in endotracheal catheter systems in the past, the valve 424 shown in FIGS. 5A-5C is advanced substantially in several directions. First, as shown in FIGS. 5A and 5C, the interior of the valve 424 has a helical groove 450 formed therein. The helical groove 450 helps to create turbulence around the distal end 408a of the catheter 408. In addition, the flexible base 428 is configured such that the valve 420 is pulled towards the collar 460, thereby reducing the space and improving the removal of secretions from the exterior of the catheter 408.
[92] Referring now specifically to FIG. 5B, there is shown a cross-sectional view similar to that shown in FIG. 5A with the distal end 408a of the catheter 408 in the retracted position. Once the distal end 408a of the catheter 408 is retracted from the valve 424 to the base, suction through the catheter acts against the flexible base 428 of the valve and pulls the valve toward the collar 460. A pair of air inlets 470 are disposed at the base 428 of the valve 424 and allow air to enter the valve.
[93] Inhaling valve 424 through air inlet 470 as shown in FIG. 5B creates a vacuum between adapter 420 and flexible base 428, thereby opening one-way valve 444 and causing collar Air enters air inlet 470 at the top of 460. This air is mixed with water injected through the cleaning port 480 and flows turbulent along the distal end 408a of the catheter 408. Turbulent motion of the air / sterile salt mixture is enhanced by the helical groove 450.
[94] Once suction through the catheter 408 is stopped, there is no longer a negative pressure from the catheter to keep the one-way flap valve 444 open or to keep the valve 424 close to the distal end of the collar. I never do that. Accordingly, the valve 424 may be returned to the position shown in FIG. 5A except when the valve is closed when the catheter 408 remains substantially in the collar until the next use.
[95] Referring now to FIG. 6A, there is shown a cross-sectional view of another embodiment of an improved endotracheal catheter made in accordance with the principles of the present invention. Endotracheal catheter 500 includes a manifold 504 and a catheter 508. Manifold 504 has a first port 512a for attaching to a hub of an artificial airway of a patient and a second port for attaching to a vent tube (not shown) of a mechanical vent to form a vent circuit 516. 512b.
[96] The manifold also includes a third port 512c adapted to receive the catheter 508. Within the third port 512c is a pair of floating flexible disks or membranes 520, 524. Each disc forms holes or openings 528, 532, respectively, and the catheter 508 may slide through it. End views of discs 520 and 524 through which the catheter slides are shown in FIG. 6D.
[97] When the catheter 508 is retracted through the openings 528, 532 in the disk, a vacuum is created at the base of the disk 520, 524. The vacuum pulls both disks toward the end of the catheter 508, as shown in FIG. 6B. This substantially seals the two disks together in an arrangement without overlapping openings as shown in Figures 6B and 6C. This structure minimizes or eliminates air flow from the vent circuit (depending on the seal) when the cleaning solution is injected through the cleaning port 540 and the distal end 508a of the catheter 508 is cleaned.
[98] If desired, a second cleaning port 550 can be added at the end from the disk, since the cleaning port 540 is disposed behind the disks 520 and 524 which impede significant disruption to the cleaning flow. The second cleaning port 550 is typically not used for cleaning the catheter 508.
[99] Referring now to FIG. 7A, there is shown a cross-sectional view of another embodiment of an improved endotracheal catheter made in accordance with the principles of the present invention. Most of the endotracheal catheters shown in FIG. 7A are the same as those discussed with respect to FIGS. 6A-6D, and accordingly reference numerals are indicated. One major difference between the embodiments of FIGS. 6A-6D and 7A is that the disks 520, 524 of the previous embodiment have one end 570a attached to the manifold 504 and the opposite end 570b of the catheters. Is replaced by an elastically closed membrane 570 that is attached to an adapter 572 having a terminator 508. The adapter 572 or manifold 504 can be rotated to twist the membrane 570, thereby reducing or enlarging the size of the hole 580 (see FIG. 7B) formed by the material. Twisting the elastic material 570 to close the hole 580 can reduce or even eliminate the intake of air from the vent circuit 516.
[100] If traction of the patient is desired, the elastic material 570 is rotated to allow the catheter to penetrate. Since the swivel 574 is disposed on the first and second ports 512a, 512b, the rotation of the elastic material to inflate or deflate the hole provides virtually no inconvenience to the patient, and the catheter 508 It is possible to effectively control the amount of air sucked in from the venting circuit 516 when the distal end 508a of the head) is cleaned.
[101] 7B shows an end view of the elastic membrane 570. By rotating the elastic membrane 570 in one direction, the hole 580 is enlarged. By rotating the elastic material in the opposite direction, the size of the hole 580 is reduced.
[102] Referring now to FIGS. 8A and 8B, another intratracheal catheter is shown that embodies the principles of the present invention. The respiratory inhalation catheter device 600 includes a catheter 608 and a manifold 604 that are movable through the manifold. In many other embodiments previously discussed, the manifold 604 has a first port 612a for connecting to the hub of the endotracheal tube and a second port for connecting (via the vent tube) to the mechanical vent. 612b, cap 616 and optional third port 612c that can be used for blow-by.
[103] The fourth port 612d differs from those previously discussed because a shroud 620 is placed therein. The shroud 620 is attached to the plunger 624 to allow the user to move the shroud between the second position (see FIG. 8) and the first position adjacent the sidewall of the fourth port 612d (FIG. 8A), and the shroud It is disposed approximately in the center of the port 612d.
[104] While using the respiratory inhalation catheter device 600, the shroud 620 will typically be moved into the first position so as not to interfere with the advancement of the catheter 608 through the manifold 604. Once inhalation is complete, catheter 608 is retracted into collar 634.
[105] The plunger 624 is then pressed to move the shroud 620 over the distal end 634a of the collar 634 to cover the distal end 608a of the catheter 608. Typically, catheter 608 will be advanced toward distal end 620a of shroud 620. Subsequently, a cleaning / cleaning solution will be applied through the cleaning port 640 during the inhalation.
[106] If desired, a small gap may be formed between the shroud 620 and the collar 634 to ensure turbulent flow into the catheter 608 distal end 608a. Similarly, grooves or other patterns may be formed in the shroud to promote turbulence. In addition, a valve member may be included to hold supplemental air in a manner similar to that discussed in some of the above embodiments. Referring now to FIG. 9A, there is shown a partial cross-sectional view of another embodiment of an improved endotracheal catheter system, indicated generally at 700, in conjunction with aspects of the present invention. The endotracheal catheter system generally includes a manifold and a catheter 708, represented by 704. In some previous embodiments, manifold 704 includes a plurality of ports 712a-712d. The first port 712a is adapted to be attached to the proximal end of an artificial airway, such as a hub of an endotracheal tube. Second port 712b is typically connected to a pair of vent tubes (not shown) by an adapter (not shown) in accordance with conventional practice in the art. During normal use, the regulated breathing air is forced into the patient's lungs through one of the vent tubes, through the second port 712b and the first port 712a and through the artificial airway. The exhaled air is delivered to the outside through the first port 712a and then through the second port 712b and through another vent tube. Thus, the manifold 704 forms part of the vent circuit 714 through which the breathing air is circulated.
[107] Also forming part of manifold 704 is third port 712c. The third port 712c is typically covered with a cap 716 that may be removed to facilitate "blowby" so that the patient can resume progressively involuntary breathing. Those skilled in the art will understand that although it is preferred to provide a third port for blow-by, it is not necessary in practice of the principles of the present invention. Thus, a manifold or other manifold structure similar to that shown in FIGS. 6A and 7A can be used.
[108] Manifold 704 also has a fourth port 712d. The fourth port 712d is generally disposed opposite the first port 712a and configured to slide the catheter 708 into and through the first port to allow for inhalation of the patient. Upon completion of the suction, the catheter 708 is pulled back into the fourth port 712d to prevent obstruction of the vent circuit 714 and to facilitate cleaning.
[109] A coupling or adapter 720 is disposed between the catheter 708 and the wall that forms the fourth port 712d. On the outermost end, adapter 720 engages the wall that forms fourth port 712d. On the innermost end, adapter 720 engages with catheter 708. If desired, the collar shown at 224 in FIG. 3A can be used between the catheter 708 and the adapter 720.
[110] The adapter 720 preferably has a cylindrical hollow forming a first portion 720a disposed towards the base end and a second portion 720b disposed towards the distal end. In the first portion 720a, the diameter of the cylindrical hollow is substantially the same as the outer diameter of the catheter 708 so that the first portion 720a of the adapter 720 closely surrounds the catheter.
[111] The cylindrical hollow second portion 720b of the adapter 720 has a larger diameter than the first portion 720a. This larger diameter forms a collecting area where mucus and other secretions can collect when the catheter 708 is pulled to the base through the adapter 720.
[112] As mentioned previously, according to one of the principles of the present invention, it is known that selectively blocking the air flow into the distal end 708a of the catheter 708 can significantly improve catheter cleaning. In addition, such mechanisms for improving cleaning are also known to minimize the withdrawal of air from the vent circuit 714.
[113] As shown in FIG. 9A, the flap 732 is hinged to an annular ring 736 disposed in the fourth port 712d to pivot about the ring. Of course, the flap 732 may be attached directly to the adapter 720 or to the wall of the manifold 704 forming the fourth port 712d. Hinged attachment 740 allows the flap 732 to selectively move while maintaining alignment with the distal end 708a of the catheter 708, thereby creating a flap valve.
[114] Within the flap 732 is a hole 760 positioned to provide a small amount of air into the distal end 708a of the catheter 708. In the previous embodiment, the aperture 760 provides a small amount of air into the catheter 708 to facilitate cleaning without excessively inhaling air from the patient's intake circuit.
[115] Due to the flap 732 blocking the flow of air into the distal end 708a of the catheter 708, increased suction is applied to the lateral opening 738 formed in the catheter from the distal end to the base. Increased inhalation improves cleaning of the catheter 708.
[116] One notable difference between the flaps 732 and those shown in the previous embodiment is the way the flaps engage the ring 736. On one end, the flap 732 is pivotally attached to the ring 736 to allow the same movement as the flap valve discussed above. On the opposite end, the flap 732 is configured to engage a flange 764 extending inwardly from the ring 736. More specifically, the ends of the flange 764 and flap 732 are configured to overlap one another or to complement one another to form a locking engagement. Thus, as shown more clearly in FIG. 9B, the end 764a of the flange 764 is provided with a V-shaped groove and the complementary end 732a of the flap 732 protrudes in a V-shape.
[117] When the catheter 708 is retracted through the adapter 720 to the point behind the ring 736 where the distal end 708a of the catheter is placed, the suction of air through the tube pulls the flap 732 to pull the catheter ( Contacting the distal end 708a of 708, thereby improving the cleaning of the catheter 708 as discussed in the previous embodiment. Once the catheter 708 has been fully retracted through the adapter 720, the distal end 732a of the flap 732 will be nested in a groove in the end 764a of the flange 764, whereby the flap is in the closed position. Is locked. By closing and locking flap 732, the risk of slime or other material returning into vent circuit 714 is significantly reduced.
[118] Thus, the engagement between the flap 732 and the flange 764 prevents the flap 732 from moving from the closed position as shown in FIG. 9B to an open position that does not interfere with the distal movement of the catheter 708. To provide. In some previous embodiments, the only mechanism for holding flap 732 in the closed position is through suction. In contrast, this embodiment securely holds the flap 732 in the closed position.
[119] If the following suction procedure is required, the flap 732 can be opened by advancing the distal end 708a of the catheter 708 and forcibly separating the flap end 732a from engagement with the flange 764. . This requires a minimum amount of force above the force normally applied to advancing the catheter for inhalation.
[120] Although not shown in FIGS. 9A and 9B, a cleaning port may be used with the adapter 720 to enhance cleaning of the catheter 708. The cleaning port may be placed adjacent to the first or second portion 720a, 720b depending on its tolerance.
[121] Referring now to FIG. 10A, there is shown a partial cross-sectional view of another embodiment of an improved endotracheal catheter system, indicated generally at 800. In the previous embodiment, the endotracheal catheter system comprises a locking valve mechanism, indicated generally at 810.
[122] Endotracheal catheter 800 includes a catheter 808 and a manifold, generally designated 804. The manifold includes the first, second, third and fourth ports 812a through 812d forming the venting circuit 814 and otherwise in the same manner as the first through fourth ports 712a through 712d discussed above. Function as.
[123] Adapter 820 is disposed within fourth port 812d in a manner similar to that discussed for the previous embodiment. The adapter 820 may include first and second portions 820a and 820b with different diameters to facilitate the collection of mucus and other secretions or to improve the action of the device.
[124] In the fourth port 812d, a flap 832 configured to engage with the distal end 808a of the catheter 808 is disposed. The flap 832 is pivotally attached to a ring 836 disposed in the fourth port 812d. Alternatively, the flap 832 may be directly connected to the wall forming the fourth port 812d. In some embodiments previously discussed, as the suction is applied through the catheter and the catheter is pulled to the base through the adapter 820, the flap 832 is pulled to contact the distal end 808a of the catheter 808. Done. Preferably, a hole 860 is formed in the flap 832 such that the flap resists air flow into the distal end 808a of the catheter 808 without completely blocking the air flow. A complete lack of air flow can limit cleaning, but reduced air flow improves cleaning. The size of the hole 860 is preferably about 0.76 mm (0.03 inches) in diameter.
[125] Also disposed on ring 836 are inwardly extending protrusions 864 forming a catch. Preferably, protrusion 864 is disposed on ring 836 opposite the position where flap 832 is attached to the ring. In the flap 832, the protrusion may also be mounted directly on the fourth port 812d.
[126] When the flap 832 is pulled to the base by suction through the catheter 808, the flap passes over the protrusion 864 extending slightly inwardly than the end 832a of the flap. Thus, once flap 832 is moved to the base beyond the innermost point of protrusion 864, the distal movement of the flap is limited by the protrusion. Thus, flap 832 is frictionally engaged behind protrusion 864 until it is forced into the base beyond the protrusion by advancing catheter 808. While discussed as requiring aspiration, those skilled in the art will appreciate that the flap 832 or the like can be configured to deflect the flap into the base or closed position.
[127] Referring specifically to Figure 10B, there is shown an enlarged view of the locking structure and locking valve mechanism discussed above. As shown, the end 832a of the flap 832 is inclined to a point 832b formed on the distal side of the flap. The protrusion 864 is inclined toward a point disposed at its base end 864a. This structure causes the end 832a of the flap 832 to slide to the base above the protrusion 864, but requires additional effort to move the flap to the base beyond the protrusion.
[128] 11A shows a cross-sectional view of another embodiment of an improved endotracheal catheter, generally indicated at 900. Catheter 900 includes a manifold 904 and a catheter 908. Manifold 904 includes first, second, third and fourth ports 912a through 912d, of which the first and fourth ports are arranged to advance the catheter through the manifold.
[129] Adapter 920 is disposed within fourth port 912d and serves as a guide for catheter 908 when the catheter is advanced and retracted. Adapter 920 preferably includes a first portion 920a having an inner diameter approximately the same size as the outer diameter of catheter 908 and a second portion 920b having a diameter larger than the diameter of the first portion. do.
[130] In addition, a pair of rings 936a and 936b are disposed in the fourth port 912d. The flap 932 is attached to the ring 936b and extends inwardly to be disposed perpendicular to the path of travel of the catheter 908 when the catheter is advanced through the manifold 904. The flap 932 preferably has a small hole 960 through which a small amount of air passes through the flap 832.
[131] More specifically referring to FIG. 11B, the flap 932 is pivotally attached to the ring 936b so that suction from the catheter is flaped when the distal end 908a of the catheter 908 is retracted through the fourth port. 932 is pulled in contact with distal end 908a. In this way, flap 932 functions as a flap valve that substantially blocks the distal end of catheter 908.
[132] Also shown in FIG. 11B is a catch 964 more clearly shown attached to the ring 936a by the arm 968. The catch 964 is configured to engage the flap 932 to lock the flap in the desired position. When the catheter 908 is retracted through the fourth port 912b, the flap 932 is pulled to the distal end 908a and pulled to the base by suction through the catheter. Alternatively, it may be deflected. The end 932a of the flap 932 opposite the attachment arm 940 between the flap and the ring 936b engages with the catch 964 and deflects (to the right of FIG. 11B) so that the catch is not obstructed. Once the end 932a of the flap 932 passes the catch 964, the catch returns to its normal position. In this position, catch 964 engages end 932a of flap 932 and locks the flap in the closed position of the base. To release the flap 932, the catheter 908 is advanced with sufficient force to deflect the catch so as not to interfere. Flap 932 may then pivot at the distal end and catheter 908 may be advanced.
[133] Referring now to FIG. 11C, an end view of the ring and associated structure shown generally at flap 932, 936 is shown. Flap 932 is attached to ring 936 by two arms 948, each forming an attachment point 940. Opposite end 932a of flap 932 engages catch 964 attached to ring 936 by arm 968. The catch 940 effectively locks the flap 932 at the base position until the user forcibly advances the catheter in the distal direction until the catch releases the flap.
[134] Those skilled in the art will understand that many variations can be used to achieve the principles of the present invention. For example, a single arm 948 can be used with the flap 932 and multiple catches 964 can be used. Similarly, a single ring rather than first and second rings 936a and 936b may be used to support the flap 932 and catch 968. Moreover, as shown in FIG. 11D, other modifications may be made to the flap 932 to provide other advantages. As shown in FIG. 11D, a pair of arms 948a attaches flap 932a to ring 936a. As mentioned above, arm 948a may be configured to deflect flap 932a to a closed position.
[135] Flap 932a is generally circular, but has two rounded projections 950a that are spaced approximately 90 degrees apart and extend outwardly. The protrusion is for two important purposes. First, although the generally circular flap 932a portion is slightly smaller than the distal opening of the endotracheal tube (not shown), the protrusion 950a prevents the flap from entering the endotracheal tube. Second, protrusion 950a aligns the flap such that air flow continues to the patient without a lying flat covering any passage that may interfere with air flow to or from the patient.
[136] Also shown in FIG. 11D is a hole 960a formed in a generally circular flap 932a portion. As shown, the aperture 960 is about 0.76 mm (0.03 inches) to about 1.02 mm (0.04 inches) in diameter. While shown in a circular or disc shape, it will be appreciated that other types of holes may be used in light of the present disclosure.
[137] Referring now to FIG. 12A, a cross-sectional side view of an improved endotracheal catheter, generally indicated at 1000, is shown. Improved endotracheal catheter 1000 includes a manifold and catheter 1008, generally designated 1004. Manifold 1004 includes first, second, third and fourth portions 1012a-1012d as described above.
[138] Adapter 1020 is disposed within fourth port 1012d and facilitates retraction and advancement of the catheter through manifold 1004. Although shown as having a first portion 1020a having a smaller diameter and a second portion 1020b having a larger diameter, the adapter 1020 can be made to have a uniform internal diameter. In another embodiment, the wall forming the fourth port 1012d may be configured to eliminate the need for an adapter. In the fourth port 1012d, a flap 1032 connected to the ring 1036 is disposed. The flap 1032 is configured to extend inwardly from the ring 1036 and to be disposed perpendicular to the long axis of the catheter 1008.
[139] As in the previous embodiment, the end 1032a of the flap 1032 engages the catch mechanism 1064 extending inwardly. As shown more clearly in FIG. 12B, the catch mechanism 1064 is formed by one or more protrusions 1068 extending inwardly and to the base from the ring 1036.
[140] When flap 1032 is pulled to the base by catheter 1008, end 1032a of flap is pulled over temporarily deflected protrusion 1068. Once flap 1032 has traveled a sufficient distance to the base, protrusion 1068 returns to its normal position, thereby locking the flap to the base position.
[141] 12C shows an end view of flap 1032 and ring 1036. Flap 1032 is attached to ring 1036 by a single arm 1048. The pair of catch mechanisms 1064 in the form of protrusions 1068 are spaced at 120 degree intervals. Spacing the catch mechanism 1064 helps to stabilize the flap 1032 in the locked position.
[142] Referring now to FIG. 13A, there is shown a partial cross-sectional view of another embodiment of an improved endotracheal catheter, indicated generally at 1100. Endotracheal catheter 1100 includes a manifold and catheter 1108, indicated generally at 1104.
[143] The adapter 1120 is disposed in the fourth port 1112d. Adapter 1120 is configured to receive catheter 1108 when the catheter is advanced and retracted through manifold 1104. The adapter 1120 includes a first portion 1120a whose inner diameter of the adapter is slightly larger than the outer diameter of the catheter and a second portion 1120b whose open area is left around the catheter 1108.
[144] In the fourth port 1112d of the manifold 1104, a flap 1132 is pivotally attached to the ring 1136. In some embodiments previously discussed, the ring can be omitted and the flap can be attached directly to the manifold. Flap 1132 pivots to selectively block distal end 1108a of catheter 1108. However, holes 1160 are formed in the flap 1132 to prevent complete blockage of air flow into the distal end 1108a of the catheter 1108.
[145] Unlike the embodiments discussed above with respect to FIGS. 9A-12B, the flap 1132 does not engage a protrusion or flange on the ring 1136. Rather, the flap 1132 is provided with a protrusion 1132a disposed on the base side 1132b of the flap.
[146] The protrusion 1132a has an outer diameter 1132b that is substantially the same as the inner diameter 1108b of the distal end 1108a of the catheter 1108.
[147] When suction is applied through the catheter 1108 and the catheter is retracted through the fourth port 1112d, the protrusion 1132a forms a friction fit between the catheter and the flap 1132. Is pulled into the distal end 1108a of.
[148] Referring now to FIG. 13B, an enlarged view of the flap / catheter coupling of FIG. 13A is shown. A protrusion 1132a extending to the base of the flap 1132 is nested within the open distal end 1108a of the catheter 1108 to limit air flow through the open distal end. Of course, the air flow continues through the lateral opening in the catheter 1108 as shown in FIGS. 3A-3D. The protrusion 1132a of the flap 1132 causes the flap 1132 to pull the protrusion 1132a from the catheter and advance the catheter through the fourth port 1112d, or until the protrusion is pulled out of the catheter. It may be removed from catheter 1108 by retreating the ter to the base.
[149] Referring now to FIG. 13C, an enlarged view of the flap / catheter coupling of FIG. 13A with the modified flap 1132 is shown. Although the diagram of FIG. 13B shows a solid protrusion except hole 1160, those skilled in the art will appreciate any structural diagram that enables frictional engagement between distal end 1108a and protrusion of catheter 1108. I will understand what is possible. Thus, in Fig. 13C, the annular flange extending from the flap 1132 to the base forms a protrusion 1132a. Other structures can also be used.
[150] Referring now to FIG. 14A, there is shown a partially cut partial cross-sectional view of another embodiment of an improved endotracheal catheter, generally indicated at 1200. Endotracheal catheter 1200 includes catheter 1208 and a manifold, generally designated 1204. Manifold 1204 includes first, second, third, and fourth ports 1212a-1212d that function in the same manner as discussed above with respect to other embodiments.
[151] Adapter 1220 is disposed within fourth port 1212d such that catheter 1208 reciprocates through the adapter as the catheter is advanced into and withdrawn from manifold 1204. In some embodiments discussed above, the adapter 1220 includes a first portion 1220a that forms a first diameter that is slightly larger than the catheter 1208 and a second portion that forms a larger region around the catheter ( 1220b).
[152] Also within the fourth port 1212d is a flap 1232 configured to engage the distal end 1208a of the catheter. Arm 1248 typically pivotally attaches flap 1232 to ring 1236 disposed in fourth port 1212d. However, flap 1232 may be attached directly to the wall forming the fourth port, or may be secured in another manner.
[153] Referring to Fig. 14B, an enlarged view of the structure in the fourth port 1212d is shown. The pivoting function of the flap 1232 is similar to many embodiments discussed above in that the flap is pulled to contact the distal end 1208a of the catheter 1208 when the catheter is retracted through the fourth port 1212d. . However, unlike the previous embodiment, flap 1232 includes a pair of catches 1240 extending from the flap to the base.
[154] As shown in FIG. 14B, one of the catches 1240a is disposed to the right of the catheter 1208, while the other is visualized by the cutout portion 1208c of the catheter. The catch 1240 is arranged such that one catch is positioned 90 degrees from the arm and the other catch is positioned 180 degrees from the arm, but the preferred positions of the catches are arranged 180 degrees from each other, and each catch is positioned 90 degrees from the arm 1248 I will understand.
[155] The catch 1240 engages the distal end 1208a of the catheter 1208 to form a locking mechanism that is retained until the flap is forcibly removed at the distal end 1208a of the catheter 1208. Typically, this is accomplished by using a catch 1240 that is slightly inwardly biased to engage the barb 1240a; barb on the catch with the annular groove 1208b located within the outer diameter of the distal end 1208a of the catheter 1208. When suction is applied and the flap 1232 is pulled towards the distal end 1208a of the catheter 1208, each catch 1240 slides along the catheter until it engages the groove 1208b. Once engaged, the flap 1232 remains locked at the distal end of the catheter 1208 until the catheter is sufficiently moved in the direction of pulling the catch 1240 from the groove 1208b.
[156] In prior embodiments, the flap 1232 preferably has a small hole 1250 disposed therein. The aperture 1250 allows a small amount of air flow through the flap into the catheter 1208.
[157] Referring now to FIGS. 14C and 14D, side and perspective views of a presently preferred embodiment of the flap 1232 shown in FIGS. 14A and 14B are shown. The flap 1232 is attached to the ring (not shown) by the arm 1248 and extends to the base (downward as shown in the figure) to engage the catheter (not shown) and extends the flap to the catheter It has a pair of catches 1240 that lock on. Preferably, the catch has a barb 1240a configured to overlap in a groove or recess in a catheter (not shown). As mentioned above, the catches 1240 are positioned 180 degrees relative to each other, with each being 90 degrees from the arm 1248.
[158] 15A is a cross-sectional view of another embodiment of an endotracheal catheter system 1300 incorporating aspects of the present invention. Endotracheal catheter system 1300 includes a manifold, generally designated 1304, that forms a device for connecting endotracheal catheter 1300 to a patient's artificial airway (ie, endotracheal tube). Endotracheal catheter system 1300 also includes an extended catheter 1308.
[159] Manifold 1304 includes a first port 1312a, a second port 1312b, and a third port 1312c. First port 1312a is configured to engage an artificial airway, such as an endotracheal tube. Second port 1312b provides inspiratory and aerobic air flow from and to the patient. Typically, the Y-shaped adapter is attached to the second port 1312b. However, many structures are used in medical facilities and those skilled in the art will appreciate other combinations available.
[160] The third port 1312c is disposed opposite the first port 1312a and the catheter 1308 is aligned to penetrate the third port, the manifold 1304 and the first port into the artificial airway. As shown in FIG. 15A, the first and second ports 1312a and 1312b may also have a pivot structure 1314 that can pivot the manifold 1304 relative to the adjacent structure to improve patient comfort. .
[161] A coupling or adapter 1320 is connected to the third port 1312c. On the outer surface of the distal end 1320a, the adapter 1320 engages the wall that forms the third port 1312c. The inner surface of the adapter 1320 forms a chamber around the distal end 1308a of the catheter 1308. This chamber helps to clean the distal end of the catheter in a manner more fully discussed below. Adjacent to the distal end 1320a of the adapter 1320 is a collar 1324 having a truncated conical bore 1328 extending therethrough. Those skilled in the art will understand that collar 1324 may be integrally formed with adapter 1320 if desired.
[162] When the cleaning solution is injected into the truncated conical bore 1328 through the cleaning port 1330 and the side opening 1332, the collar 1324 causes the cleaning solution to pass through the first port 1312a along the catheter 1308. Helps flow into the artificial airway. The distal end 1324a of the truncated conical bore forms an orifice in the distal end of the collar 1324. The flap 1340 supported by the support ring 1344 disposed in the third port 1312c selectively engages the orifice to substantially block the orifice. In previous embodiments, the flap 1340 preferably has one or more holes 1348 formed therein to allow a small amount of air to pass through the flap. Also, as in previous embodiments, the flap 1340 may be deflected to the blocking position or may be pulled into the blocking position by suction through the catheter 1308.
[163] At the base of the collar 1324, which is opposed, a first wiper seal 1352 is disposed. Preferably, the narrow portion 1320b of the adapter 1320 supports the wiper seal 1352. However, one skilled in the art will understand that other mechanisms for receiving the wiper seal 1352 may be used. As the catheter 1308 is pulled past the first wiper seal 1352, the wiper seal removes major secretions. Although discussed here as a wiper seal, other structures with fine tolerances (ie, removing most secretions) may be used.
[164] From the wiper seal 1352, the adapter 1320 extends to the base and forms a cleaning chamber. A second wiper seal 1356 is disposed adjacent the proximal end 1320c of the adapter 1320. For the first wiper seal 1352, the purpose of the second wiper seal 1356 is to remove secretions from the exterior of the catheter 1308 when the catheter is withdrawn from the patient's artificial airway. However, the second wiper seal 1356 will typically have a smaller diameter opening such that the second wiper seal is more tightly coupled to the exterior of the catheter 1308 than the first wiper seal.
[165] Conventionally, a single wiper seal has been used. The wiper seal was placed in position of the second wiper seal 1356 to wipe the discharge from the catheter when the catheter retracted. However, the end of the catheter, approximately 12.7-25.4 mm (0.5-1 inches), was not physically wiped. Instead, the operator tried to clean this part with the solution injected through the cleaning port.
[166] Referring now to FIG. 15B, a cross-sectional side view of the endotracheal catheter 1300 is shown in which the catheter 1308 is retracted through the manifold 1304 into the wash position. When the catheter 1308 is retracted, Flap 1340 is closed to block the opening in collar 1324 due to suction or deflection through the catheter.
[167] When the catheter 1308 is retracted past the wiper seal 1352 from the collar 1324 to the base, the distal end 1308a of the catheter is wiped by the wiper seal 1352 to remove most of the discharge thereon. . The secretions removed by the wiper seal 1352 are then delivered through the catheter 1308.
[168] Once the distal end 1308a of the catheter 1308 is advanced past the first wiper seal 1352, the bottle 1360 is attached to the cleaning port 1330 and the cleaning solution (typically water) is the side opening 1332. Is supplied to the collar 1324 through. The wash solution flows around the distal end 1308a of the catheter 1308 and removes secretions that have not been removed from the distal end of the catheter by the first wiper seal 1352, as indicated by arrow 1164.
[169] At the same time, holes 1348 in flap 1340 allow a small amount of air into the catheter to facilitate removal of secretions. If desired, a supplemental air valve may be disposed on the adapter 1320 side to introduce additional air.
[170] Those skilled in the art will appreciate that internal components such as valves may be formed from a variety of other components. For example, these have high density, low density, medium density and linear low density variations, ethylene (such as ethylene propylene copolymer) Synthetic resins, such as polyurethanes, ethylene vinyl acetate copolymers, polyvinyl chlorides, poly-including olefin copolymers, polyesters, polycarbonates, acrylonitrile-butadiene-styrene copolymers, polyether-polyester copolymers Amide / polyether, polysilicon, polyamide, such as nylon, may be made of polyethylene, and polyether polyamide copolymers are preferred. Also preferred are low pressure, relatively soft or flexible polymeric materials, such as thermoplastic polymers, including thermoplastic elastomers. For such internal parts, injection molded medical synthetic resin materials are preferred. Petox, Atochem North America, Philadelphia, PA Polyamide / polyether polyesters are particularly good, including those sold commercially. Pebax Pebax such as 3533 SA 00 polymer 33 polyamide / polyether polymers are the best. These polymers include Shore D, a hardness of about 35 with ASTM D2240, Shore A, a hardness of about 85 with ASTM D2240, and a curvature coefficient of about 19995500 Pa (2,900 PSI) with ASTM D790, approximately 73 ° C (165) with ASTM D1525. ° F) and a melting point of about 109 ° C (228 ° F) to about 154 ° C (309 ° F).
[171] In addition, Shore D, a hardness of about 55 with ASTM D2240, a curvature coefficient of about 165480000 Pa (24,000 PSI) with ASTM D790, a softening point of approximately 144 ° C. (291 ° F.) and ASTM C1525 and a temperature of about 128 ° C. (262 ° F.) to about 170 ° C. Pebax, characterized by having a melting point of (338 ° F.) 5533 SA 00 polyether block amide polymers are good.
[172] Thermoplastic synthetic rubber polymers, which provide excellent results as internal components for use in the present invention, are trademarks of QST Corporation, Monprene. Monprene, including those sold as Shore A hardness ASTM D2240, having a hardness of about 70 MP-2870M, trademark Santoprene of Advanced Elastomer Systems Santoprene having a hardness of about 40, including Shore Di hardness ASTM D2240 MP-2870M, trademark of Dow Plastics Pellathane Pellathane, including polyurethane (polyether) elastomers such as those sold as, and having a hardness of about 85 to Shore A hardness ASTM D2240 2363-80AE, EI Du Pont Packaging & Industrial Polymers Trademark Elvax Ethylene Vinyl Acetate Polymers, sold as Elvax 150 (33% vinyl acetate) and Elvax 360 (25% vinyl acetate), Elvax 450 (18% vinyl acetate) or Elvax 750 (9% vinyl acetate), 3447 500 Pa (500 PSI) low density polyethylene polymer, Petrothene Trademark Petrothene of Equistar Chemicals LP, such as NA270-000 low density polyethylene polymer Low Density Polyethylene, Unichem 7811G-015 Polyvinyl Chloride Polymer, Unichem 8511G-015 Flexible Polyvinyl Chloride Polymer, Unichem Trademark Unichem from Colorite Plastics, such as 6511G-015 flexible polyvinyl chloride polymer Commercially available as polyvinyl chloride, Kraton G-7705 Shell Chemical's trademark Kraton, such as styrene ethylene butylene styrene block copolymer Commercially available styrene ethylene butylene styrene block copolymer and Tenite Trademark Tenite from Eastman Chemical, such as 1870A low density polyethylene polymer Commercially available density polyethylene polymers.
[173] By using these various structures, distal end cleaning of the catheter can be enhanced while minimizing or eliminating air drawn from the patient's venting circuit. Those skilled in the art will appreciate that variations may be made within the scope and spirit of the present invention. The appended claims are not intended to cover such modifications.

权利要求:
Claims (38)
[1" claim-type="Currently amended] An elongated catheter having a distal end,
A manifold that forms a portion of the aeration circuit disposed in communication with the catheter such that the catheter is advanced into the patient's breath through the aeration circuit of the manifold;
And a valve disposed in the manifold to selectively isolate the catheter from the vent circuit.
[2" claim-type="Currently amended] The inhalation system of claim 1, wherein the valve is movable between an open position in which the valve advances the catheter through the manifold and a closed position in which the valve selectively isolates the catheter from the venting circuit.
[3" claim-type="Currently amended] The inhalation system of claim 2, wherein the valve is closed in response to inhalation applied through the catheter when the catheter is not advanced through the manifold.
[4" claim-type="Currently amended] 3. The inhalation system of claim 2 wherein the valve includes a flap that is pivotable between an open and closed position.
[5" claim-type="Currently amended] 5. The inhalation system of claim 4 wherein the valve also includes a locking member for holding the flap in the closed position.
[6" claim-type="Currently amended] 6. The inhalation system of claim 5 wherein the locking member comprises a catch.
[7" claim-type="Currently amended] The inhalation system of claim 2 wherein the valve is biased to the closed position.
[8" claim-type="Currently amended] 8. A respiratory inhalation system according to claim 7, wherein the valve member comprises a flap movable between the open position and the closed position.
[9" claim-type="Currently amended] 9. The inhalation system of claim 8 wherein the valve also includes a locking member for holding the flap in the closed position.
[10" claim-type="Currently amended] 10. The respiratory inhalation system of claim 9, wherein the locking member comprises a catch.
[11" claim-type="Currently amended] The inhalation system of claim 2, wherein the flap contacts the distal end of the catheter when in the closed position.
[12" claim-type="Currently amended] The inhalation system of claim 1, wherein the valve also includes a collar having a bore therethrough and a flap configured to selectively engage the collar to at least partially cover the bore.
[13" claim-type="Currently amended] The respirator of claim 1, further comprising first and second wiper seals disposed to engage the catheter when the catheter is retracted through the manifold, wherein the first wiper seal is distal from the second wiper seal Suction system for
[14" claim-type="Currently amended] The inhalation system of claim 13, wherein the catheter can be retracted through the manifold such that the distal end of the catheter is disposed between the first and second wiper seals.
[15" claim-type="Currently amended] The inhalation system of claim 14, further comprising a cleaning port disposed for discharging the cleaning solution onto the catheter, wherein the cleaning port is disposed distal from the first wiper seal.
[16" claim-type="Currently amended] 5. The respiratory inhalation system of claim 4, wherein the flap has a hole formed therein.
[17" claim-type="Currently amended] The valve of claim 1, wherein the valve comprises a ring disposed within the manifold and a flap pivotally attached to the ring, wherein the flap is arranged to engage a catheter advanced through the manifold to form a flap valve. Breathing inhalation system.
[18" claim-type="Currently amended] 18. The inhalation system of claim 17 further comprising one or more protrusions attached to the ring and extending inwardly from the ring to selectively engage the flap.
[19" claim-type="Currently amended] 19. The method of claim 18, wherein each protrusion is configured to permit movement of the flap from the open distal position to the closed base position but limit movement of the flap from the closed base position to the open distal position. Breathing inhalation system.
[20" claim-type="Currently amended] 20. The inhalation system of claim 19 wherein each protrusion includes a catch configured to engage the flap to retain the flap in the closed position.
[21" claim-type="Currently amended] 6. The inhalation system of claim 5 wherein the locking member retains the flap at the distal end of the catheter in the closed position.
[22" claim-type="Currently amended] The inhalation system of claim 21 wherein the locking member also includes a protrusion extending from the flap to form an interference fit coupling with the catheter, thereby holding the flap in the closed position.
[23" claim-type="Currently amended] The protective sleeve of claim 1 further comprising a protective sleeve surrounding the longitudinal portion of the base of the catheter, wherein the manifold is connected to the protective sleeve to attach to the hub of the artificial airway in fluid communication between the patient's respiratory tract and the vent. Inhalation system for breathing, characterized in that.
[24" claim-type="Currently amended] 24. The valve of claim 23, wherein the valve comprises a pivotable flap arranged to selectively separate the distal end of the catheter from the first manifold, thereby substantially reducing fluid flow between the distal end of the catheter and the first manifold. Respiratory Inhalation System.
[25" claim-type="Currently amended] The inhalation system of claim 24, wherein the aperture is disposed in the flap.
[26" claim-type="Currently amended] The inhalation system of claim 25, further comprising means for enhancing turbulent flow of the air flow.
[27" claim-type="Currently amended] 25. The inhalation system of claim 24, further comprising a locking member disposed in communication with the flap to selectively prevent movement of the flap.
[28" claim-type="Currently amended] The cleaning chamber of claim 1, further comprising a cleaning chamber disposed adjacent the manifold, the cleaning chamber having a first wiper seal and a second wiper seal, the second wiper seal disposed at a base end of the cleaning chamber, the first The wiper seal is disposed distal from the second wiper seal.
[29" claim-type="Currently amended] 29. The catheter of claim 28, wherein the cleaning chamber also includes a valve having an open position and a closed position, wherein the valve substantially extends the distal end of the catheter from the manifold when the distal end of the catheter is disposed in the wash chamber and the valve is in the closed position. Inhalation system for breathing, characterized in that arranged to isolate.
[30" claim-type="Currently amended] 30. The inhalation system of claim 29 wherein the valve forms the distal end of the cleaning chamber.
[31" claim-type="Currently amended] The inhalation system of claim 28, further comprising a cleaning port having an opening disposed in fluid communication with the cleaning chamber, wherein the opening is disposed at the end of the first wiper seal.
[32" claim-type="Currently amended] The inhalation system of claim 28, wherein the cleaning chamber comprises a collar disposed within the manifold.
[33" claim-type="Currently amended] 33. The inhalation system of claim 32 wherein the collar has a bore extending therethrough to advance the catheter and a pivotable flap to selectively cover the bore.
[34" claim-type="Currently amended] 33. The respiratory apparatus of claim 32, wherein the first wiper seal has an opening having a first diameter, the second wiper seal has an opening having a second diameter, and wherein the first diameter is larger than the second diameter. Suction system.
[35" claim-type="Currently amended] The inhalation system of claim 1, wherein the valve comprises one or more injection molded medical synthetic resins.
[36" claim-type="Currently amended] The valve of claim 1, wherein the valve is polyurethane, ethylene vinyl acetate copolymer, polyvinylchloride, polyamide / polyether, polysilicon, polyamide, polyethylene, ethylene A breathing inhalation system, comprising an -olefin copolymer, polyester, polycarbonate, acrylonitrile-butadiene-styrene copolymer, polyether-polyester copolymer and polyether polyamide copolymer.
[37" claim-type="Currently amended] 37. The inhalation system of claim 36 wherein the valve is formed of a polyether block amide polymer.
[38" claim-type="Currently amended] 37. A breathing inhalation system according to claim 36, wherein the valve consists of ethylene vinyl acetate copolymer.

类似技术:

---

公开号 | 公开日 | 专利标题

---

RU2509577C2|2014-03-20|Valve assembly for respiratory systems

---

US9480537B2|2016-11-01|Self positioning tracheal tube clearance mechanism using a collar

---

EP0875262B1|2002-01-02|Medical insertion device with hemostatic valve

---

US5058580A|1991-10-22|Percutaneous tracheostomy tube

---

ES2297244T3|2008-05-01|automatic valve.

---

JP4008813B2|2007-11-14|Method and apparatus for cleaning catheter assembly by turbulence

---

US10245401B2|2019-04-02|Subglottic suctioning system

---

JP4604039B2|2010-12-22|Respiratory suction catheter device configured to be removably attached to an artificial airway structure

---

DE19514433C1|1996-01-04|Tracheostomy cannula for insertion into tracheostoma

---

US5359998A|1994-11-01|Manual resuscitator

---

US7036509B2|2006-05-02|Multiple seal port anesthesia adapter

---

JP5575797B2|2014-08-20|Respiratory access port assembly with push button lock and method of use

---

AU734483B2|2001-06-14|Suction control valve

---

JP4029039B2|2008-01-09|Aspiration catheter device for breathing with antimicrobial chamber

---

ES2541703T3|2015-07-23|Systems and methods to provide a flow control valve for a medical device

---

CN101541257B|2012-05-23|Yankauer suction device with sleeve and wiper

---

US10016575B2|2018-07-10|Cleaning devices, systems and methods

---

US5083561A|1992-01-28|Tracheal suction catheter

---

AU755974B2|2003-01-02|Valved fenestrated tracheotomy tube

---

US5735271A|1998-04-07|Multiple access adaptors for monitoring, sampling, medicating, aspirating, and ventilating the respiratory tract of a patient

---

ES2309490T3|2008-12-16|Respiratory device that includes a configured introduction section to fix a respiratory instrument in a removable way.

---

JP4271443B2|2009-06-03|Improved closed suction catheter assembly adapter and system including the same

---

US5123840A|1992-06-23|Surgical apparatus

---

ES2366901T3|2011-10-26|Improved paracentesis device that has multiple separable components.

---

EP0112668B1|1991-10-09|Endotracheal tube assembly

同族专利:

---

公开号 | 公开日

---

BR0016279A|2003-02-25|

---

NO20022781L|2002-08-12|

---

CA2393656C|2012-09-25|

---

EP1239907A1|2002-09-18|

---

ES2291232T3|2008-03-01|

---

EP1239907B1|2007-09-12|

---

BR0016279B1|2009-05-05|

---

DE60036406D1|2007-10-25|

---

MXPA02005898A|2004-08-12|

---

JP4603751B2|2010-12-22|

---

AT372801T|2007-09-15|

---

AU2575401A|2001-06-18|

---

AU773706B2|2004-06-03|

---

DE60036406T2|2008-01-10|

---

NO20022781D0|2002-06-11|

---

CA2393656A1|2001-06-14|

---

WO2001041853A1|2001-06-14|

---

JP2003523797A|2003-08-12|

---

KR100753262B1|2007-08-29|

引用文献:

---

公开号 | 申请日 | 公开日 | 申请人 | 专利标题

---

法律状态:
1999-12-13|Priority to US46025799A

---

1999-12-13|Priority to US09/460,257

---

2000-12-04|Application filed by 발라드 메디컬 프로덕츠

---

2000-12-04|Priority to PCT/US2000/032889

---

2003-02-26|Publication of KR20030016209A

---

2007-08-29|Application granted

---

2007-08-29|Publication of KR100753262B1

优先权:

---

申请号 | 申请日 | 专利标题

---

US46025799A| true| 1999-12-13|1999-12-13|

---

US09/460,257|1999-12-13|

---

PCT/US2000/032889|WO2001041853A1|1999-12-13|2000-12-04|Endotracheal catheter and manifold assembly with improved valve|