EP1786500A2 - Systeme d'alarme en cas d'embolie gazeuse lors d'interventions par catheter - Google Patents
Systeme d'alarme en cas d'embolie gazeuse lors d'interventions par catheterInfo
- Publication number
- EP1786500A2 EP1786500A2 EP05787066A EP05787066A EP1786500A2 EP 1786500 A2 EP1786500 A2 EP 1786500A2 EP 05787066 A EP05787066 A EP 05787066A EP 05787066 A EP05787066 A EP 05787066A EP 1786500 A2 EP1786500 A2 EP 1786500A2
- Authority
- EP
- European Patent Office
- Prior art keywords
- catheter
- infusion tube
- lumen
- transparent
- colored
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Withdrawn
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M5/00—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
- A61M5/14—Infusion devices, e.g. infusing by gravity; Blood infusion; Accessories therefor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L29/00—Materials for catheters, medical tubing, cannulae, or endoscopes or for coating catheters
- A61L29/14—Materials characterised by their function or physical properties, e.g. lubricating compositions
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M5/00—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
- A61M5/14—Infusion devices, e.g. infusing by gravity; Blood infusion; Accessories therefor
- A61M2005/1401—Functional features
- A61M2005/1402—Priming
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2205/00—General characteristics of the apparatus
- A61M2205/33—Controlling, regulating or measuring
- A61M2205/3317—Electromagnetic, inductive or dielectric measuring means
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M5/00—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
- A61M5/36—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests with means for eliminating or preventing injection or infusion of air into body
- A61M5/365—Air detectors
Definitions
- the invention relates to a signaling device which warns against the use of a not yet flushed catheter lumen or the connection of not yet flushed infusion tubes to the catheter according to the preamble of patent claim 1.
- Cardiac catheters usually consist of a thin, flexible plastic tube, which is passed through an artery through the aorta against the bloodstream to the heart.
- X-ray contrast agents can be injected directly into the coronary artery via the catheter lumen so that the course of the coronary arteries and possible bottlenecks are displayed on an X-ray screen.
- a guidewire can be positioned over the catheter lumen to guide additional catheters, such as balloon catheters, to the target.
- a thicker catheter is first led to the occluded coronary artery, through the lumen of which smaller catheters can be advanced into the coronary artery to reopen the constriction with a balloon, a drill head (rotablation), or a laser source.
- a balloon catheter With the aid of a balloon catheter, a dilated constriction can be stabilized by a wire mesh (stent).
- Each catheter lumen must be flushed with physiological saline solution prior to use and ventilated to prevent air from entering the patient's vasculature and there trigger an air embolism. Even during a catheter procedure, it may be necessary to flush the catheter lumen with saline solution over and over again. If pressure infusions or pumps are used to flush the catheter, make sure that all infusion tubes are flushed and vented. Otherwise, the air contained in the tube lumen could pass through the catheter into the vascular system of the patient and trigger an air embolism there.
- One problem is that the proper flushing and venting of catheters and tubing is difficult to control, especially in darkened rooms such as catheter labs. Usually, pressure infusions are prepared by the assisting nurse and then connected to the catheter by the doctor.
- a tube flushed with physiological saline solution or another aqueous solution looks just like a non-flushed tube still filled with air.
- the doctor on the basis of the liquid level in the drip chamber below the infusion bottle or the infusion bag can get an indication of the flushing done.
- the infusions in the darkened labs usually hang in the shadows and are therefore difficult to assess clearly.
- the assessment is even more difficult due to the lack of drip chamber. The risk despite the routine of the employees and strict procedures for incorrectly flushed and vented catheters and pressure infusion hoses is currently accepted.
- the object of the present invention is to indicate to the doctor a defective or not carried out irrigation of a catheter lumen or attached infusion tube or to warn him before using the improperly prepared catheter.
- the invention can be seen in the fact that an objective technical warning device in the catheter, the catheter directly upstream or in pressure infusion hose allows direct control of the correct preparation.
- a physical approach is implemented in which a coating of the inner surface of a transparent portion of the catheter or infusion tube is provided with a soluble, non-toxic and non-allergenic dye, for example red-colored saline.
- a soluble, non-toxic and non-allergenic dye for example red-colored saline.
- the catheter or the tube could be filled prior to its packaging with a sterile, colored saline solution, which leaves a colored, visible from the outside salt layer in Katheter ⁇ or tubular lumen when drying. If such a catheter or infusion tube is rinsed correctly with physiological saline solution before use, the dye is dissolved and washed out. In this way, the doctor is warned by a color-coded catheter or a color-coded infusion system prior to its use.
- any readily soluble, non-toxic dye can be used. As described, it can be introduced in dissolved form, blown into the catheter or tube lumen or introduced in solid or crystalline form. Catheters without a transparent section can be described in Way color-coded, transparent piece of tubing are connected upstream to meet the warning function in the context of the invention.
- the mark should be as close as possible to the end of the infusion tube facing the patient to indicate complete flushing of the tubing.
- this section of the infusion system is located in the direct field of view of the physician, which is also illuminated in the darkened catheter laboratory.
- a warning device according to the invention is also present if the marking is not mounted in the infusion tube itself but in an extension connected downstream.
- a further embodiment uses a different physical approach, which is implemented by laying a colored material in a transparent section of the catheter or in the patient-facing end of the infusion tube, a material that is intransparent in a dry state, which becomes transparent when wet that the colored marking becomes visible.
- a material that is intransparent in a dry state which becomes transparent when wet that the colored marking becomes visible.
- This may be, for example, a green plastic tube mounted in an enlarged, transparent portion of the catheter or an extended portion of the transparent infusion tube. Between the plastic tube and the outer wall of the catheter / infusion tube is a layer of pulp, which becomes transparent on contact with a liquid.
- the filling of an infusion system with an oily infusion solution would also be reliably indicated here, as used, for example, in parenteral nutrition via central venous catheters.
- the colored tube consists of a fine, water-permeable mesh, which at the same time ensures that no pulp particles can be flushed into the catheter lumen.
- any other form of colored marking may be chosen which does not restrict the lumen of the catheter and safely retain any dissolved pulp particles.
- any other non-toxic material can be used, which becomes transparent when wet or even changes the color (for aqueous solutions eg orange gel from orange to white).
- the marker should be placed as close as possible to the end of the infusion system facing the patient to ensure complete coverage Indicate flushing of the hose.
- this section of the infusion system is located in the direct field of view of the physician, which is also illuminated in the darkened catheter laboratory.
- a warning device according to the invention is also present if the marking is not mounted in the infusion tube itself but in an extension connected downstream.
- the warning device is attached from the outside to the infusion tube.
- a region of the infusion tube which lies in the field of view of the doctor, stained from the outside and coaxially surrounded by a tube which is connected at both ends liquid-tight with the hose.
- a material is applied between the tube and the surrounding tube, which is non-transparent in the dry state and transparent in the moistened state (for example, pulp or orange gel).
- the area of the tube surrounded by the tube is perforated beforehand so that the liquid passing through the tube can escape to the outside and moisturize the material surrounding the tube, but this material can not be flushed into the tube lumen.
- a warning device according to the invention is also present when the warning device is not attached to the infusion tube itself but at an extension connected downstream.
- a warning device can also be realized according to a further exemplary embodiment as a movable mechanism.
- the pressure of the rinsing liquid triggers a mechanical display device in the catheter or in the pressure infusion system.
- a display device may for example consist of a movable flap or a red ball, which is displaced by the pressure of the rinsing liquid from a transparent part of the catheter or infusion system into a non-transparent part.
- the attending physician can recognize the operational capability of the catheter or the infusion system on the basis of the invisible red ball.
- a ball or another movable part can also be flushed by the rinsing liquid into the transparent section of the catheter or infusion system.
- a visible green ball signal that the catheter or pressure infusion system has been flushed.
- An accidental release of the mechanism for example, by vigorous shaking or falling can be achieved by a water-soluble barrier, which is solved immediately when rinsing the lumen and releases the mechanics. The higher the flushing pressure required for triggering the mechanical warning device, the safer it can be assumed that the lumen has completely flushed.
- a mechanical warning device according to the invention is independent of the shape, color and attachment of the movable part and is also present when the mechanism is not included in the catheter or pressure infusion system itself but is switched between the two.
- a warning device in the sense of a fifth exemplary embodiment of the invention can also represent an optical solution in which a light barrier or a laser path monitors a transparent part of the catheter or a section of the pressure infusion tube and signals a change in the refractive index or the transparency.
- a change of media in the catheter lumen or in the infusion tube can be detected, as it exists when flushing a previously air-filled catheter or tube.
- this method has the disadvantage that only the media change is displayed in the controlled section itself. The complete flushing is thus not guaranteed beyond doubt, a small residual risk remains.
- infusion pumps Infusomat®
- there is visual control of air in the infusion system which, however, relies on a special infusion tube and is not universally applicable.
- Another solution in the sense of a sixth exemplary embodiment of the invention is the electrical monitoring of the catheter lumen and / or the pressure infusion system.
- the electrical resistance between two electrodes in the catheter lumen or in the infusion tube is measured, one of which at the outlet of the catheter lumen in the catheter tip or is mounted just behind the catheter tip and the other in the Hose connection at the other end of the catheter or in a section of the flushing line upstream of the catheter or both electrodes in as large a distance as possible in the pressure infusion hose. Since air conducts no electric current, but physiological saline solution by the contained sodium and chloride ions is a good conductor, the electrical resistance between the two electrodes very reliably indicates the correct filling of the catheter lumen or infusion system.
- each bubble which is at least as large as the tube diameter, acts as an insulator and thus drastically increases the electrical resistance between the electrodes.
- This parameter can be fed into the catheter monitor monitoring monitors so that the physician can assess the correct filling status of all catheter lumens and pressure infusion systems at a glance.
- a simple electronic circuit can also be attached directly to the end of the infusion hose facing the patient and put into operation when the hose connection is screwed in so that an alarm signal (red flashing light / buzzer sound) is triggered when an infusion hose is filled with air.
- the correct function of the warning device is indicated by a green light, which lights up when the electronic circuit is activated by screwing the screw connection.
- the electrodes mounted in the infusion tube can alternatively also be connected to the monitoring monitors of a catheter measuring station or an intensive care monitoring unit, so that the correct filling state of all infusion tubes can be checked at a glance.
- a warning device according to the invention is also present when one or both electrodes are not mounted in the infusion system itself but in an extension connected downstream of it. In the case of an extension or an intermediary canine bank, the filling of the entire length of the infusion line can be monitored when the near-patient electrode (34) of the extension tube is used with the patient remote electrode (33) in the drip chamber (25) of the infusion system. Of the The microswitch (32) should be mounted in the near-patient screw connection (27) of the extension.
- Figure 1 is a schematic view of a preferred embodiment of a catheter according to the invention using a soluble dye; for a better overview, the shape of the catheter was simplified to a tube with a lumen,
- Figure 2 is a schematic view of a transparent according to the invention
- FIG. 3 shows a schematic, partially sectioned view of a further preferred embodiment using a material which becomes transparent upon wetting, such as pulp; for a better overview, the shape of the catheter was simplified to a single-lumen tube,
- Figure 4 is a schematic, partially sectioned view of another preferred embodiment using a pulp cushion
- Figure 5 is a schematic, partially sectioned view of another
- Figure 6 is a schematic, transparent view of another preferred embodiment
- FIG. 7 shows a schematic view of a preferred embodiment of an infusion tube according to the invention using a soluble dye
- 8 shows a schematic, partially sectioned view of a further preferred embodiment using a material which becomes transparent upon wetting, such as pulp
- FIG. 9 shows a schematic, partially sectioned view of a further preferred embodiment in which a cellulose cushion is used, which becomes transparent when wet,
- Figure 10 is a schematic, transparent view of a fourth preferred embodiment, which allows the measurement of electrical resistance between two electrodes in the infusion tube.
- a catheter lumen 10 with a signaling device according to the invention has a transparent section 11 which is coated from the inside with red-colored, crystalline sodium chloride.
- the function is as follows: When a pressure infusion is connected to port 12 and the catheter lumen is flushed with physiological saline, the stained saline crystals are dissolved in the transparent portion of the catheter and rinsed out of the catheter. In this way, the red warning color disappears from the transparent portion of the catheter lumen, signaling to the physician the usefulness of the catheter.
- each catheter lumen 10 to be flushed is first preceded by an extension according to the invention in accordance with a second exemplary embodiment.
- a transparent portion 11 is screwed to the connection coupling 12 by means of the connecting piece 13, which is coated from the inside with red-colored, crystalline common salt.
- non-transparent catheters can be retrofitted with the signaling device according to the invention.
- the function is analogous to FIG. 1.
- a catheter lumen 10 with a signal device according to the invention has a green-colored porous section 14 which is surrounded by an enlarged transparent section 11.
- the portion 11 completely surrounds the catheter lumen, according to Figure 4, the section 11 only a viewing window on the top of the catheter.
- a layer of white pulp 15 Between the transparent outer wall 11 and the green-colored, porous inner wall is a layer of white pulp 15, which at Moisture becomes transparent.
- the pores of the inner wall 14 are large enough for water molecules to diffuse freely therethrough, but at the same time so small that even the smallest pulp particles are retained in each case, so that they can not be washed into the catheter lumen.
- the function is as follows: If a pressure infusion is connected to the connection coupling 12 and the catheter lumen is flushed with physiological saline solution, water molecules penetrate through the porous inner wall 14 and moisten the pulp 15, which makes it transparent. In this way, the green color of the inner wall is visible through the wet pulp, which signals the doctor readiness for use of the catheter lumen.
- a catheter lumen 10 with a signaling device according to the invention has an auxiliary lumen 19 shortly before the connection coupling 12, which contains a green plastic ball 17 fixed in crystalline salt 18 for safety. Between the ball 17 and the catheter tip, a portion 11 of the secondary lumen is transparent.
- the function is as follows: When a pressure infusion is connected to port 12 and the catheter lumen is flushed with saline, a portion of the saline solution is forced into the minor lumen and dissolves the crystalline saline surrounding the sphere, whereupon the ball is released and into the transparent Rinsed section of the extra lumen. In this way, the green ball is visible to the doctor and signals the readiness of the catheter lumen.
- a catheter lumen 10 with a signal device according to the invention has electrodes on both ends of the inside of the device
- the electrode 22 is mounted directly in front of the outlet of the catheter lumen, the electrode 21 directly behind the connection coupling 12.
- Catheter wall extending connection cables 23 are the electrodes with a
- Measuring device 20 connected outside the catheter.
- the measuring device 20 is suitable for measuring and monitoring the ohmic resistance between the electrodes 21 and 22 without danger to the patient.
- Air is an electrical current insulator. As long as there is air in the catheter lumen between the electrodes 21 and 22, the DC resistance is very high or infinite. In contrast, a saline solution is a very good conductor, since the common salt decomposes in aqueous solution into sodium ions with positive ions and chloride ions with negative charge, which transport the electric current very well.
- the infusion tube has a transparent section 28 which is coated on the inside with red-colored, crystalline saline.
- the infusion system is connected via the drip chamber 25 to an infusion bottle or an infusion bag and the tube clamp 26 is opened, the tube is flushed through with the connected infusion solution (eg physiological saline).
- the connected infusion solution eg physiological saline
- the colored saline crystals are dissolved in the section 28 and out of the screw 27 rinsed. In this way, the red warning color disappears from the transparent section
- an infusion tube 24 with a signaling device has a green-colored porous section 29, which is surrounded by an enlarged transparent section 31.
- the section 31 surrounds the tube lumen completely; according to FIG. 9, the section 31 only represents a viewing window on the top side of the infusion tube.
- a layer of white pulp 30 which becomes transparent when wet. The pores of the inner wall 29 are large enough for the liquid to diffuse freely therethrough, but at the same time so small that even the smallest pulp particles are retained in any case, so that they can not be washed into the lumen.
- the function is as follows: When the infusion system is connected to an infusion bottle or pouch via the drip chamber 25 and the tubing clamp 26 is opened, the tubing is flushed with the infusion solution (e.g., physiological saline) attached.
- the infusion solution e.g., physiological saline
- the infusion solution penetrates through the porous inner wall
- an infusion tube 24 with a signal device has two spaced-apart electrodes on the inner wall of the tube.
- the electrode 34 is mounted directly in front of the screw of the infusion system, the electrode 33 in the greatest possible distance thereof in the course of the hose between drip chamber and electrode 34.
- screw 27 Luer-Lock male
- a button 32 is mounted, the screw when screwing Infusion system, for example, with a catheter is activated.
- the Electrodes and the button connected to a measuring or warning device outside the infusion system.
- the measuring or warning device is suitable for measuring the ohmic resistance between the electrodes 33 and 34 without danger to the patient and is activated when the Luer-lock coupling 27 is screwed together.
- the electrode 34 is mounted directly in front of the screw at the patient facing end of an extension of the infusion system, while the button 32 is mounted in this screw.
- This allows the use of an extension or a tap bank for the infusion tube, wherein the entire length of the infusion system is monitored by the warning system, as long as the resistance between the electrode 34 of the extension and the electrode 33 (in or near the drip chamber 25) of the infusion system is measured.
- the warning device activating button 32 is mounted in this case in the patient-near Luer-lock coupling 27 of the extension.
- Air is an electrical current insulator. As long as there is air in the infusion tube between the electrodes 33 and 34, the DC resistance is very high or infinite.
- a saline solution is a very good conductor of electricity, since common salt in aqueous solution decomposes into sodium ions with positive charge and chloride ions with negative charge. The electrical current is transported very well by these ions, the resistance to be measured depends on the concentration of the salt solution and the distance to be bridged.
- the DC resistance is monitored by electronics, which are activated when the infusion system is screwed in via the micro-probe 32. If the infusion tube is filled with saline solution at the moment of activation, the correct flushing of the system is indicated by a green LED. If there is still insulating air between the electrodes, a red LED flashes and a warning buzzer sounds. The alarm tone and the flashing of the alarm lamp continue until the screw connection is released or the infusion system is flushed correctly.
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- Veterinary Medicine (AREA)
- Public Health (AREA)
- General Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Heart & Thoracic Surgery (AREA)
- Hematology (AREA)
- Biomedical Technology (AREA)
- Anesthesiology (AREA)
- Pulmonology (AREA)
- Biophysics (AREA)
- Epidemiology (AREA)
- Vascular Medicine (AREA)
- Infusion, Injection, And Reservoir Apparatuses (AREA)
- Media Introduction/Drainage Providing Device (AREA)
Abstract
L'invention concerne des dispositifs de signalisation qui avertissent en cas de lumière de cathéter (10) non purgée ou en cas de système de perfusion sous pression (24) ni purgé ni désaéré.
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE200410043275 DE102004043275B4 (de) | 2004-09-07 | 2004-09-07 | Katheter mit Warnsystem vor Luftembolien |
DE200410050669 DE102004050669A1 (de) | 2004-10-18 | 2004-10-18 | Warnsystem vor Luftembolien in Infusionsschläuchen |
PCT/EP2005/054395 WO2006027361A2 (fr) | 2004-09-07 | 2005-09-06 | Systeme d'alarme en cas d'embolie gazeuse lors d'interventions par catheter |
Publications (1)
Publication Number | Publication Date |
---|---|
EP1786500A2 true EP1786500A2 (fr) | 2007-05-23 |
Family
ID=36036711
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
EP05787066A Withdrawn EP1786500A2 (fr) | 2004-09-07 | 2005-09-06 | Systeme d'alarme en cas d'embolie gazeuse lors d'interventions par catheter |
Country Status (2)
Country | Link |
---|---|
EP (1) | EP1786500A2 (fr) |
WO (1) | WO2006027361A2 (fr) |
Families Citing this family (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP2198778B1 (fr) | 2008-12-19 | 2013-07-03 | F. Hoffmann-La Roche AG | Dispositif de perfuseur avec mesure d'impédance |
US8197438B2 (en) | 2009-12-23 | 2012-06-12 | Roche Diagnostics Operations, Inc. | Medicinal fluid delivery systems and methods for priming the same |
GB201507395D0 (en) * | 2015-04-30 | 2015-06-17 | Steven Gill Anaesthetic Services Ltd | Injectables |
Family Cites Families (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5103817A (en) * | 1990-07-20 | 1992-04-14 | Xomed-Treace Inc. | Automatic dye dispersant for endotracheal tubes and catheters |
AU6632600A (en) * | 1999-08-20 | 2001-03-19 | Acist Medical Systems, Inc. | Apparatus and method of detecting fluid |
-
2005
- 2005-09-06 WO PCT/EP2005/054395 patent/WO2006027361A2/fr active Application Filing
- 2005-09-06 EP EP05787066A patent/EP1786500A2/fr not_active Withdrawn
Non-Patent Citations (1)
Title |
---|
See references of WO2006027361A3 * |
Also Published As
Publication number | Publication date |
---|---|
WO2006027361A3 (fr) | 2006-11-16 |
WO2006027361A2 (fr) | 2006-03-16 |
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