DE202010001611U1 - tracheostomy - Google Patents

Abstract

Tracheostomy tube with balloon (1) for aspiration of secretion (16) in the region of the trachea (17), characterized in that between inner cannula (5) and outer cannula (2) a suction lumen (10) is formed, which with the perforations and a suction tube ( 6) is connected and secretion (16) is aspirated by applying a vacuum (12) on the suction hose (6).

Description

The The invention relates to a tracheotomy cannula with balloon and Suction device for percutaneous tracheostomy.

State of the art

The Tracheostomy is one of the oldest operative Techniques in the history of medicine. The origins This technique goes back to antiquity. In the classic tracheotomy is surgically performed below the larynx, typically between 1st and 2nd or 2nd and 3rd tracheal ring, an artificial one Access to the trachea created. To this artificial opening in order to maintain ventilation, becomes a so-called tracheostomy tube used. Medical indications, such as B. the need a long-term ventilation, make this technique necessary today. Alternatively to the surgical technique have been within the last few decades also minimally invasive puncture techniques developed. So find in particular percutaneous dilatation tracheotomy according to Ciaglia, dilatation tracheotomy According to Griggs and the translaryngeal tracheotomy after Fantonie wide Application.

at The percutaneous dilatation tracheotomy according to Ciaglia becomes the trachea at a suitable place first with a steel cannula punctured. So that the delicate tracheal back wall is not injured, this process typically takes place under bronchoscopic surveillance instead of. The correct position of the cannula tip can be achieved by air aspiration in a patch, filled with liquid Syringe to be checked. When the situation is correct a Teflon catheter located above the steel cannula 1 to 2 cm distal to the trachea. After removal the steel cannula becomes a J-shaped guidewire (about 1.3 mm in diameter) through this Teflon catheter into the trachea advanced. Thereafter, the Teflon catheter can be removed. Instead will now be a tubular plastic catheter with safety stop pushed over the guidewire for reinforcement. about The armored guidewire will now be one or sequentially several dilators to dilate the puncture opening pushed into the tracheal lumen with the help of a rotating movement. Due to the conical shape of the dilators, the tissue expands so that the tracheal cannula wetted with lubricant with the help of a special insertion aid (obturator) the guide wire can be used. The correct one Location is checked with the bronchoscope. Subsequently The guide wire can be removed and attached to the tracheostomy tube located balloon for sealing the trachea with air be filled.

The font DE 101 09 935.5-09 discloses, for example, a tracheostoma prosthesis, which consists of a speaking valve with a flap, an outer cannula, which is connected to a ring-shaped surrounding sealing balloon, which is connected via an air passage, which runs within the outer cannula, with a pressure balloon, and with perforations, the is located between the sealing balloon and the speaking valve near the sealing balloon, is provided, an inner cannula with a recess which is offset from the perforations, located near the speaking valve, a seal which is sealingly disposed between the inner cannula and the outer cannula near the sealing balloon, and a suction device connected to a suction duct above the speaking valve.

From the Scriptures DE 195 14 433 C1 a tracheostomy cannula for use in a tracheostoma is known, which consists of a tubular outer cannula with a cannula shield and a tubular inner cannula, wherein the inner cannula is insertable into the outer cannula and can be locked with the latter at the proximal part.

From the Scriptures DE 196 36 050.1 a tracheostomy spacer is known, which consists of a tubular tracheostomy leg, which terminates unilaterally in an integrally formed and in a first dimension (y) arched trained tracheal limb, the tracheal limb in a direction perpendicular to the first dimension dimension ( z) amittig to the tracheostomy leg axis (XX) is connected such that it has different lengths of overhang areas and the tracheostomy leg locking means are assigned to the recording and fixation of a shield in a variably adjustable distance to the contact surface of the trachea thigh to the trachea guarantee. In this case, the locking means in the form of introduced into the tracheostomy legs grooves or in the form of applied to the tracheostomy thighs beads are formed.

The font DE 20 2004 007 251 U1 discloses a tracheostomy tube, consisting of an inner cannula and an outer cannula, wherein the inner cannula at its distal end n locking means which do not form a continuous circular cross-section of the distal end of the inner tube, but protrude from the distal end of the inner tube in a pin or barb-like manner and form fit engage in corresponding recesses / profiles of the outer cannula, where n ≥ 3, so that rotation of the inner cannula to the outer cannula is prevented.

The font DE 20 2004 007 252 U1 discloses a tracheostomy tube, consisting of an inner cannula and an outer cannula, wherein the inner cannula has locking means on its outer wall, which give the inner cannula an N-shaped cross-section, where n ≥ 3, and the form fit into the inside grab wall of the outer cannula, so that rotation of the inner cannula to the outer cannula is prevented.

From the Scriptures DE 35 23 663 A1 An endotracheal cannula (tube) is known, at one end of which a connection for a respirator and at the other end an opening for the inlet and outlet of the respiration medium is provided.

From the Scriptures DE 20 2004 013 323 U1 is a tracheostomy-placeholder, consisting of a tubular tracheostomy-leg, which is formed on one side with a molded and arched tracheal limb and one on the tracheostomy-leg molded, glued or sliding and lockable flange with a multi-part clamping sleeve for positive or cohesive connections with a receiving ring for mounting of speaking valves and artificial noses, known.

Farther are known from different leaflets cannulas, at those above the low-pressure cuff or the cuff for removal the Flüssigkeitsssees a suction through the cannula wall is provided.

The GB 091 036 Shows a system in which the inner suction cannula with spacers, formed by the outer cannula, is spaced and is sucked through perforations in the inner cannula from the inner lumen of the inner cannula by means of vacuum secretions.

Of the Disadvantage of all known tracheostomy tubes with low pressure cuff and suction channel is that the suction channels to are kept small and in the suction of thicker secretions blockages enter. Furthermore, the suction channels are mounted so that the suction hole must be placed in the wrong place, which is not the optimal secretariat. A suction of Secretion is usually through a suction with a suction hole possible, which is prepared on the outside. A Discharge of secretion in the inner lumen of the tracheostomy tube is not possible.

Of the Invention is therefore based on the object, a device for to seek intensive suction of secretions or saliva from the trachea. This should be around the low pressure cuff or the balloon of the tracheostomy tube respectively. For patients with low pressure cuff or The balloon secretion or saliva needs to be aspirated behind the low pressure cuff or behind the balloon perforations around the entire tracheostomy tube diameter to the lumen between Inner wall of outer cannula and outer wall the inner cannula and through the Trachealkanülenschild derived from the trachea.

The The object of the invention is using a known per se Blocked tracheostomy tube by the features of the claim 1 solved. Advantageous embodiments are the subject the subordinate claims.

The Essence of the invention is that a blocked tracheostomy tube is used, which with a inner cannula a larger Absaugvolumen has. The suction hoses are through the Trachealkanülenschild or flange or by the cohesive assembled universal cone from the lumen between the cannulas directed to the outside.

The Invention will be described below with reference to an embodiment and schematic drawings explained in more detail become.

It demonstrate:

1 A possible first embodiment of the invention with a sealed inner cannula and end seal

2 a second embodiment of the invention with a sealed inner cannula and sealing ring.

1

balloon

2

outer cannula

3

perforation

4

flange

5

inner cannula

6

suction hose

7

Inner cannula holder

8th

Universal cone

9

lumen connector

10

suction lumen

11

air lumens

12

vacuum

13

end seal

14

head gasket

15

output distance

16

secretion

17

trachea

18

skin

19

seal

20

oval window

21

Absaugdurchbruch

22

Sonderperforation

23

double seal

In the 1 is a blocked tracheostomy tube, essentially consisting of a curved outer cannula ( 2 ), one on the Außenka nule ( 2 ) at the entrance of the trachea ( 17 ), on the skin ( 18 ) mounted flange ( 4 ) and an inflatable, with the outer cannula ( 2 connected balloon ( 1 ). The outer cannula ( 2 ) is equipped with several perforations ( 3 ) behind the balloon ( 1 ) educated. The perforations ( 3 ) are preferably as an oval window ( 20 ), so that more and thicker secretion ( 16 ) can be sucked off. In the outer cannula ( 2 ), an inner cannula ( 5 ) with the help of the inner cannula holder ( 7 ) on the flange ( 4 ) fixed. The inner cannula ( 5 ) has a diameter that is between outer cannula ( 2 ) and inner cannula ( 5 ) a suction lumen ( 10 ). With the help of an end seal ( 13 ) and a head gasket ( 14 ) the suction lumen ( 10 ) sealed. When applying a vacuum ( 12 ) the secretion ( 16 ) in the trachea ( 17 ) through the perforations ( 3 ), the suction lumen ( 10 ), the lumen connection ( 9 ) as well as the suction hose ( 6 ) sucked off. The suction hose ( 6 ) is in the wall of the inner cannula in the lumen connection ( 9 ) connected cohesively. Through the air lumen ( 11 ) the suction hose ( 6 ) with a suction distance ( 15 ) through the universal cone ( 8th ) led to the outside. By the use of a small diameter inner cannula ( 5 ) is a large suction lumen ( 10 ) in conjunction with the oval windows ( 20 ) in the outer cannula ( 2 ) optimal secretion ( 16 ) can aspirate. By this construction, the sealing of the inner cannula ( 5 ) with an end seal ( 13 ) and a head gasket ( 14 ) can it from the outer cannula ( 2 ) are pulled out. When the suction hose ( 6 ) in the initial distance ( 15 ) from the universal cone ( 8th ), an HME can be placed without problems. The connection of the balloon ( 1 ) with the air duct and an air supply has not been shown for reasons not relevant to the invention, since it is known prior art.

In the 2 the seal of the inner cannula ( 5 ) by means of an applied sealing ring ( 19 ). The oval windows ( 20 ) in the outer cannula ( 2 ) give an optimal suction breakthrough ( 21 ) to the suction lumen ( 10 ). Only in special cases of suction of secretion ( 16 ) from the air lumen ( 11 ) of the inner cannula ( 5 ) special perforations ( 22 ) incorporated.

QUOTES INCLUDE IN THE DESCRIPTION

This list The documents listed by the applicant have been automated generated and is solely for better information recorded by the reader. The list is not part of the German Patent or utility model application. The DPMA takes over no liability for any errors or omissions.

Cited patent literature

• - DE 10109935 [0004]
• - DE 19514433 C1 [0005]
• - DE 19636050 [0006]
• - DE 202004007251 U1 [0007]
• - DE 202004007252 U1 [0008]
• - DE 3523663 A1 [0009]
• - DE 202004013323 U1 [0010]
• - GB 091036 [0012]

Claims (11)

Tracheostomy tube with balloon ( 1 ) for sucking secretion ( 16 ) in the area of the trachea ( 17 ) characterized in that between inner cannula ( 5 ) and outer cannula ( 2 ) a suction lumen ( 10 ) formed with the perforations and a suction hose ( 6 ) and secretion ( 16 ) upon application of a vacuum ( 12 ) on the suction hose ( 6 ) is sucked off. Tracheal cannula according to claim 1, characterized in that in the outer cannula ( 2 ) oval windows ( 20 ) with the suction lumen ( 10 ) get connected. Tracheal cannula according to claim 1, characterized in that the inner cannula ( 5 ) with a head gasket ( 14 ) is sealed. Tracheal cannula according to claim 1, characterized in that the inner cannula ( 5 ) with an end seal ( 13 ) is sealed. Tracheostomy tube according to claim 1, characterized in that the suction tube ( 6 ) through the lumen connection ( 9 ) to the outside through the universal cone ( 8th ). Tracheostomy tube according to claim 1, characterized in that the suction tube ( 6 ) through the universal cone ( 8th ) with a starting distance ( 15 ) to be led. Tracheal cannula according to claim 1, characterized in that the inner cannula ( 5 ) from the outer cannula ( 2 ) is removable. Tracheostomy tube according to claim 1, characterized in that a plurality of perforations ( 3 ) or oval windows ( 20 ) on the circumference of the outer cannula ( 2 ) were incorporated. Tracheostomy tube according to claim 1, characterized in that the suction tube ( 6 ), directly connected to the suction lumen ( 10 ), through the flange ( 4 ). Tracheal cannula according to claim 1, characterized in that by special perforations ( 22 ) in the inner cannula ( 5 ) Secretion ( 16 ) from the air lumen ( 11 ) can be sucked off. Tracheostomy tube according to claim 1, characterized in that by a double seal ( 23 ) the inner cannula ( 5 ) is locked.