EP3171924A1 - Dispositif pour voies respiratoires réversible et procédé associé permettant de ventiler un sujet - Google Patents

Dispositif pour voies respiratoires réversible et procédé associé permettant de ventiler un sujet

Info

Publication number
EP3171924A1
EP3171924A1 EP15745100.6A EP15745100A EP3171924A1 EP 3171924 A1 EP3171924 A1 EP 3171924A1 EP 15745100 A EP15745100 A EP 15745100A EP 3171924 A1 EP3171924 A1 EP 3171924A1
Authority
EP
European Patent Office
Prior art keywords
passageway
endotracheal tube
airway device
tube
laryngeal
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Withdrawn
Application number
EP15745100.6A
Other languages
German (de)
English (en)
Inventor
Rafi Avitsian
Andrew Zura
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Cleveland Clinic Foundation
Original Assignee
Cleveland Clinic Foundation
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Cleveland Clinic Foundation filed Critical Cleveland Clinic Foundation
Publication of EP3171924A1 publication Critical patent/EP3171924A1/fr
Withdrawn legal-status Critical Current

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
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/04—Tracheal tubes
    • 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
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/04—Tracheal tubes
    • A61M16/0402—Special features for tracheal tubes not otherwise provided for
    • A61M16/0404—Special features for tracheal tubes not otherwise provided for with means for selective or partial lung respiration
    • 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
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/04—Tracheal tubes
    • A61M16/0402—Special features for tracheal tubes not otherwise provided for
    • A61M16/0409—Special features for tracheal tubes not otherwise provided for with mean for closing the oesophagus
    • 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
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/04—Tracheal tubes
    • A61M16/0434—Cuffs
    • A61M16/0454—Redundant cuffs
    • A61M16/0459—Redundant cuffs one cuff behind another
    • 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
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/04—Tracheal tubes
    • A61M16/0434—Cuffs
    • 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
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/04—Tracheal tubes
    • A61M16/0486—Multi-lumen tracheal tubes

Definitions

  • the present disclosure relates generally to the field of airway
  • a reversible airway device and related method for ventilating a subject using the airway device that can convert supraglottic and infraglottic ventilation interchangeably and does not risk disconnection or loss of the patient's airway during ventilation.
  • Airway devices are widely used in hospital surgical environments to provide respiratory assistance and ventilate patents during medical procedures. While there are a multitude of airway devices currently on the market, one popular airway device is an endotracheal tube and another is a supra-glottic support device, such as a laryngeal tube. While the use of these devices is widespread, there are disadvantages associated with each of these devices.
  • Endotracheal tubes for example, are used to ventilate patients requiring anesthesia and/or respiratory assistance.
  • endotracheal tube is a plastic tube, which is inserted into a subject's mouth, passed down the trachea through the vocal cords, and lodged in the trachea proximal (or above) the lungs.
  • the endotracheal tube may have a cuff or balloon portion surrounding the circumference of the endotracheal tube near the distal end that rests in the subject's trachea. After the endotracheal tube has been inserted properly, the cuff may be inflated to seal against the wall of the trachea. Once sealed, positive pressure ventilation may be used to provide respiratory assistance and, if desired, anesthesia or other gas, gas mix, etc., to the patient though the endotracheal tube via a ventilator.
  • the cuff provides a seal that tends to block liquids and solids from passing along the outside of the endotracheal tube between the tube and the trachea wall and entering the subject's lungs.
  • the supraglottic laryngeal tube is made up of a tube with a larger balloon cuff in the middle (oropharyngeal cuff) and a smaller balloon cuff at the end (esophageal cuff).
  • the tube is kinked at an angle of 30-45° in the middle, with the kink being located in the larger cuff.
  • Both cuffs are inflated through a single small lumen line and pilot balloon.
  • the cuffs are high-volume, low-pressure cuffs with inflating volume ranging from 10 ml (size 0) to 90 ml (size 5).
  • the present disclosure relates generally to the field of airway
  • a reversible airway device and related method for ventilating a subject using the airway device that can convert supraglottic and infraglottic ventilation interchangeably and does not risk disconnection or loss of the patient's airway during ventilation.
  • the airway device can comprise a laryngeal tube, an endotracheal tube, and a sealing mechanism.
  • the laryngeal tube can include a tubular guide having a distal end portion, a proximal end portion, and a first passageway extending between the distal and proximal end portions.
  • the laryngeal tube can further include axially spaced apart distal and proximal cuffs coupled thereto.
  • the endotracheal tube can be slidably disposed within the first passageway.
  • the endotracheal tube can have a second passageway that is disposed within the first passageway.
  • the sealing mechanism can be disposed within the first passageway and configured to occlude the flow of gas through the first passageway.
  • the reversible airway device can comprise a laryngeal tube, an endotracheal tube, and a sealing mechanism.
  • the laryngeal tube can include a tubular guide having a distal end portion, a proximal end portion, and a first passageway extending between the distal and proximal end portions.
  • the laryngeal tube can further include axially spaced apart distal and proximal cuffs coupled thereto.
  • the endotracheal tube can be slidably disposed within the first
  • the endotracheal tube can have a second passageway that is disposed within the first passageway.
  • the sealing mechanism can be disposed within the first passageway and configured to occlude the flow of gas through the first passageway.
  • the laryngeal tube can be inserted into the subject so that a first airtight seal is formed between the distal cuff and the proximal esophagus, and a second airtight seal is formed between the proximal cuff and the oropharynx.
  • the endotracheal tube can then be deployed so that a distal end of the endotracheal tube is positioned below the vocal cords of the subject.
  • the endotracheal tube can be retracted so that the distal end of the endotracheal tube is positioned above the vocal cords.
  • a flow of gas through the second passageway can be uninterrupted during the inserting and deploying steps.
  • FIG. 1 is a perspective view of a reversible airway device constructed in accordance with one aspect of the present disclosure
  • Fig. 2 is a cross-sectional view taken along Line 2-2 in Fig. 1 ;
  • Fig. 3A is a cross-sectional view taken along Line 3A-3A in Fig. 1 ;
  • Fig. 3B is a cross-sectional view taken along Line 3B-3B in Fig. 1 ;
  • FIG. 4 is a perspective view of a reversible airway device constructed in accordance with another aspect of the present disclosure.
  • Fig. 5 is a cross-sectional view taken along Line 5-5 in Fig. 4;
  • Fig. 6A is a cross-sectional view showing a distal end of the airway device in Fig. 1 ;
  • Fig. 6B is a cross-sectional view showing a guide member attached to the distal end of the airway device in Fig. 6A;
  • FIG. 7 is a process flow diagram illustrating a method for ventilating a subject according to another aspect of the present disclosure.
  • FIG. 8 is a schematic illustration showing the airway device in Fig. 1 inserted in the airway of a subject
  • FIG. 9 is a schematic illustration showing an endotracheal tube of the airway device in Fig. 8 being deployed across the vocal cords of the subject;
  • Fig. 10 is a schematic illustration showing the endotracheal tube in Fig. 9 being retracted from the trachea of the subject.
  • phrases such as "between about X and Y” can mean “between about X and about Y.”
  • phrases such as “from about X to Y” can mean “from about X to about Y.”
  • spatially relative terms such as “under,” “below,” “lower,” “over,” “upper” and the like, may be used herein for ease of description to describe one element or feature's relationship to another element(s) or feature(s) as illustrated in the figures. It will be understood that the spatially relative terms can encompass different orientations of the apparatus in use or operation in addition to the orientation depicted in the figures. For example, if the apparatus in the figures is inverted, elements described as “under” or “beneath” other elements or features would then be oriented “over” the other elements or features.
  • ventilating can refer to providing breathable air or oxygen, for example, and removing gas, etc., e.g., exhalant exhaled by a subject, and providing anesthesia and/or other materials to and/or from the lungs of a subject.
  • gases e.g., oxygen, air, anesthesia, etc.
  • the various gases e.g., oxygen, air, anesthesia, etc., alone or in combination sometimes are referred to below collectively as a gas mixture.
  • any warm-blooded organism including, but not limited to, human beings, pigs, rats, mice, dogs, goats, sheep, horses, monkeys, apes, rabbits, cattle, etc.
  • the present disclosure relates generally to the field of airway
  • Fig. 1 illustrates a reversible airway device 1 0 for establishing an artificial airway and providing continuous ventilation in a subject when needed.
  • Existing airway devices and associated methods for ventilating subjects involve the introduction of an endotracheal tube through a supra-glottic airway support device. This is time consuming, involves multiple devices, entails ventilation stoppage, and requires a high level of medical expertise.
  • the present disclosure integrates both sub-glottic and supra-glottic support components that can easily and automatically provide intubation and, when needed, be quickly changed to function as a supra-glottic airway support while not compromising ventilation.
  • the reversible airway device 1 0 can generally include a supra-glottic airway support 1 2 (e.g., a laryngeal tube), an endotracheal tube 14, and a sealing mechanism 16.
  • a supra-glottic airway support 1 2 e.g., a laryngeal tube
  • an endotracheal tube 14 e.g., a laryngeal tube
  • a sealing mechanism 16 e.g., a laryngeal tube
  • reversible it is meant that an artificial airway provided by the supra-glottic airway support 1 2 can be readily exchanged for an artificial airway provided by the endotracheal tube 14 without removing or disconnecting any component(s) of the airway device 1 0, and while maintaining continuous,
  • the term "reversible” can refer to the ability of the airway device 1 0 to be automatically changed from a supra-glottic airway support 1 2 to an endotracheal tube 14, and then back to a supra-glottic airway support, without compromising ventilation.
  • the airway device 10 of the present disclosure can be used for all indications of a supra- glottic airway support device where there is a possibility that endotracheal intubation may be necessitated ⁇ e.g., in trauma or critically ill patients).
  • one component of the airway device 10 includes a supra-glottic airway support 12, such as a laryngeal tube.
  • the supraglottic laryngeal tube 12 can comprise a tubular guide 18 ⁇ e.g., a hollow tube) having a distal end portion 20, a proximal end portion 22, and a first
  • the first passageway 24 of the tubular guide 18 is sized and dimensioned to receive the endotracheal tube 14.
  • a healthcare provider e.g., physician, nurse or other individual.
  • the proximal end portion 22 of the tubular guide 18 may be conveniently of any size and shape to secure a variety of attachments (not shown) to the tubular guide ⁇ e.g., a syringe, an endoscope probe, a gas mix supply connection to receive a gas mix for ventilating, anesthetizing, etc., a patient, a drainage tube, etc.).
  • the laryngeal tube 12 can include a longitudinal slot 27 that partially extends between the distal and proximal end portions 20 and 22 of the tubular guide 18.
  • the longitudinal slot 27 can serve as a rapid and convenient means for introducing the endotracheal tube 14 into the tubular guide 18. It will be appreciated that the longitudinal slot can be located on either the anterior or posterior portion of the tubular guide 18.
  • the entire tubular guide 18 can have a tubular or cylindrical configuration. In other words, the tubular guide 18 can be free of a longitudinal slot 27.
  • the size and shape of the tubular guide 18 can be selected so that the distal end portion 20 can be readily inserted into a subject's mouth and upper airway.
  • the tubular guide 18 is generally J-shaped to follow the profile of a typical subject's airway through the mouth, over the tongue, and into the
  • the tubular guide 18 can be made from one or a combination of materials, such as plastic, with sufficient strength and rigidity to keep the subject's teeth apart and to prevent the subject from biting down and collapsing the tubular guide.
  • the tubular guide 18 can also be sized to
  • the tubular guide 1 8 further includes an inflatable proximal cuff 26 that is axially spaced apart from an inflatable distal cuff 28.
  • the proximal cuff 26 when inflated, functions to hold the entire airway device 1 0 in place (i.e., in a patient's airway) during use. Consequently, this avoids slippage of the airway device 1 0 and potential loss of a patent airway.
  • first and second air valves 30 and 32 can be in fluid communication (e.g., via tubing) with each of proximal and distal cuffs 26 and 28, respectively.
  • the proximal and distal cuffs 26 and 28 can be selectively inflated and deflated during use of the airway device 1 0.
  • the distal and proximal cuffs 28 and 26 can be inflated when the airway device 1 0 is inserted into the upper airway of a patient to form first and second airtight seals between the distal and proximal cuffs and the proximal esophagus and oropharynx of a subject (respectively).
  • the interior volume of the proximal cuff 26, when inflated can be greater than the interior volume of the distal cuff 28 (when inflated). In other instances, the interior volume of the proximal cuff 26, when inflated, can be equal to, about equal to, or less than the interior volume of the distal cuff 28 (when inflated).
  • the distal end portion 20 of the tubular guide 1 8 can include an opening 34 in fluid communication with the first passageway 24.
  • the opening 34 can be beveled to substantially match the angle of the subject's laryngeal inlet after insertion of the airway device 1 0 into the subject's airway.
  • the laryngeal tube 12 can include a guide member 36 (Fig. 4B) for directing the endotracheal tube 14 at a desired angle (e.g., to substantially match the angle of the subject's laryngeal inlet).
  • the guide member 36 can comprise a piece of plastic, for example, disposed on a surface of the laryngeal tube 1 2 adjacent the opening 34.
  • the guide member 36 can have a rectangular shape and include a U-shaped cross-sectional profile. As shown in Fig. 4B, the guide member 36 can be disposed within the distal end portion 20 of the tubular guide 1 8 and extend partially outward therefrom.
  • An angle A 2 formed by virtue of the guide member 36 can be customized depending upon the construction (e.g., length, width, thickness, etc.) of the guide member so that the angle A 2 is different from an angle Ai (Fig. 4A), which is naturally formed by the bevel associated with the opening 34.
  • the airway device 1 0 includes an endotracheal tube 14 (Fig. 2) that is slidably disposed within the first passageway 24 of the tubular guide 1 8.
  • slidably disposed it is meant that the endotracheal tube 14 is not fixed within the first passageway 24 so that it is incapable of telescoping through the tubular guide 1 8. Rather, the term “slidably disposed” can mean that the
  • endotracheal tube 14 is translatable along a longitudinal axis of the first passageway 24 (e.g., using tactile force). In some instances, substantially the entire length of the endotracheal tube 14 can extend through the first passageway 24.
  • endotracheal tube 14 can be sized and dimensioned to ventilate a patient requiring anesthesia and/or respiratory assistance.
  • the endotracheal tube 14 can comprise a plastic tube that can be passed through the laryngeal tube 12, past the vocal cords, and lodged in the trachea proximal (or above) the lungs.
  • the endotracheal tube 14 can include a distal end 38, a proximal end 40, and a second passageway 42 that extends between the distal and proximal ends. Since the laryngeal tube 1 8 is sized and dimensioned to receive the endotracheal tube 14, a diameter associated with the first passageway 24 can be greater than a diameter associated with the second passageway 42. In some instances, when the laryngeal tube 1 8 is sized and dimensioned to receive the endotracheal tube 14, a diameter associated with the first passageway 24 can be greater than a diameter associated with the second passageway 42. In some instances, when the
  • endotracheal tube 14 is disposed in the first passageway 24, the second
  • the passageway 42 and the first passage way are concentric or coaxial with one another.
  • the first passageway 24 is not concentric with the second passageway 42 when the endotracheal tube 14 is disposed within the tubular guide 1 8.
  • the tubular guide 1 8 has a non-circular cross- sectional profile ⁇ e.g., an oblong cross-sectional profile
  • the endotracheal tube 14 can be axially offset from, or non-concentric with, the first passageway 24.
  • the endotracheal tube 14 can include a cuff 44 or balloon portion surrounding the circumference of the endotracheal tube near the distal end 38 that rests in the patient's trachea.
  • the cuff 38 can be inflated to seal against the wall of the trachea after the endotracheal tube 14 has been properly inserted into a subject. Once sealed, positive pressure ventilation may be used to provide respiratory assistance and, if desired, anesthesia or other gas, gas mix, etc., to the patient though the endotracheal tube 14 via a ventilator (not shown).
  • the cuff 38 provides a seal that tends to block liquids and solids from passing along the outside of the endotracheal tube 14 between the tube and trachea wall and entering the patient's lungs.
  • the endotracheal tube 14 can further include an inflation tube (not shown) and an air valve (not shown) for inflating and deflating the cuff 44.
  • the airway device 1 0 includes a sealing mechanism 16 (Fig. 3A) configured to occlude the flow of a gas, gas mix, etc., through the first passageway 24.
  • the sealing mechanism 1 6 is disposed within a portion of the first passageway 24 (e.g., at any one or more points along the entire length of the tubular guide 1 8).
  • the sealing mechanism 1 6 is configured to permit the endotracheal tube 14 to translate along the longitudinal axis of the tubular guide 1 8, while
  • the sealing mechanism 1 6 is configured to form a fluid-tight seal between an inner surface 46 (Fig. 3B) of the first passageway 24 and an outer surface 48 of the endotracheal tube 14.
  • the sealing mechanism 1 6 (Fig. 3A) imparts the airway device 1 0 with the ability to change from the laryngeal tube 12 to an endotracheal tube 14 (and back again) by providing a single, common airway (i.e., the second
  • the sealing mechanism 1 6 can include one or more sealing members 50 (Fig. 3A) configured to directly contact, and encircle, a portion of the outer surface 48 of the endotracheal tube 14.
  • a sealing member 50 can include an O-ring, a gasket, an inflatable cuff or cushion, or the like.
  • the sealing member 50 can comprise an O-ring having outer and inner circumferential surfaces 52 and 54 that are configured to directly contact the inner surface 46 of the first passageway 24 and the outer surface 48 of the endotracheal tube 14, respectively.
  • sealing member 50 is shown and described as being located at the distal end portion 20 of the tubular guide 1 8, it will be appreciated that the sealing member can be located at any point within the tubular guide, such as at the proximal end portion 22. Additionally, it will be appreciated that two, three, or more sealing members 50 can be used to form the sealing mechanism 1 6.
  • FIG. 5 Another aspect of the present disclosure includes a method 56 (Fig. 5) for providing an artificial airway in a subject.
  • supra-glottic airway devices such as laryngeal tubes
  • rescue devices that are easy to use in less trained hands
  • such devices are not a definite airway.
  • Current methods for changing a supra-glottic airway support device to an endotracheal tube involve using different devices; however, such methods risk the danger of disconnection and/or loss of the airway.
  • the method 56 of the present disclosure are described below.
  • a high level of skill is not required to perform the method 56, which makes the present disclosure ideal for first responders, EMS personnel, etc., that may need to quickly change from a supra- glottic airway support device to an endotracheal tube (and back) without the requisite level of skill.
  • the method 56 can generally include the steps of providing a reversible airway device 10 (Step 58), inserting a laryngeal tube 12 of the airway device into a subject (Step 60), forming first and second airtight seals between the laryngeal tube and the airway (Step 62), deploying an endotracheal tube 14 of the airway device (Step 64), and retracting the endotracheal tube (Step 66).
  • Step 58 the steps of providing a reversible airway device 10
  • Step 60 inserting a laryngeal tube 12 of the airway device into a subject
  • Step 62 forming first and second airtight seals between the laryngeal tube and the airway
  • Step 64 deploying an endotracheal tube 14 of the airway device
  • Step 66 retracting the endotracheal tube
  • a patient is shown schematically with the mouth open in cross-section and leading to the back of the throat (sometimes the mouth and/or throat are referred to as the oral cavity of the patient), and from there to the trachea via the laryngeal inlet, which provides an airway that leads to the lungs.
  • the method 56 can include providing a reversible airway device 10.
  • the reversible airway device 10 can be constructed in an identical or similar manner as shown in Fig. 1 and described above. It will be appreciated that the airway device 10 can be sized and dimensioned to accommodate a variety of patient sizes, such as adult or pediatric patients.
  • the laryngeal tube 12 can be inserted into the oral cavity (mouth) of the subject (Step 60).
  • the laryngeal tube 12 can be inserted using, for example, fiberoptic visualization or other form(s) of facilitated visualization modality to assist in confirming passage of the endotracheal tube 14.
  • the laryngeal tube 12 can be inserted under direct visualization; that is, without the use or aid of any facilitated visualization modality (or modalities). As shown in Fig.
  • the laryngeal tube 12 can be positioned so that the distal cuff 28 extends into the proximal esophagus 68 and the proximal cuff 26 is situated in the oropharynx 70 of the patient.
  • the distal and proximal cuffs 28 and 26 can be inflated to form first and second airtight seals, respectively (Step 62) (Fig. 7).
  • the first seal can substantially block the proximal esophagus 68 to minimize the risk of regurgitation of stomach contents and the passage of air into the stomach.
  • the second seal can substantially prevent air from escaping or entering the airway.
  • substantially all of the gas inhaled or exhaled by the patient passes through the second passageway 42 of the endotracheal tube 14.
  • the endotracheal tube 14 of the airway device 10 can then be deployed, if necessary, at Step 64.
  • the endotracheal tube 14 can be deployed automatically or under direct fiberoptic view (or other methods) or without fiberoptic assistance.
  • ventilation can continue during fiberoptic or other placement by an adaptor (not shown) that is configured to mate with the fiberoptic visualization tool during ventilation.
  • the proximal end 40 of the endotracheal tube 14 can be urged downward through the tubular guide 18 using, for example, tactile force.
  • the distal end 38 emerges from the opening 34 of the laryngeal tube 12 and passes through the vocal cords 72 of the patient until the cuff 44 of the endotracheal tube is positioned distal (below) the vocal cords.
  • the cuff 44 of the endotracheal tube 14 can be inflated to seal against the wall of the trachea. Once sealed, positive pressure ventilation may be used to provide respiratory assistance and, if desired, anesthesia or other gas, gas mix, etc., to the patient though the second passageway 42 of the endotracheal tube 14 via a ventilator.
  • the cuff 44 can be deflated and the distal end 38 withdrawn into the tubular guide 18 as shown in Fig. 8 (Step 66). Since an airtight seal is still maintained between the proximal cuff 26 and the oropharynx 70, ventilation of the patient can continue uninterrupted through the second passageway 42 upon discontinuing ventilation with the endotracheal tube 14. Alternatively, if there is a failure of intubation using the endotracheal tube 14, the airway device 10 can be changed to the laryngeal tube 12 without compromising ventilation since the first and second seals are maintained.
  • the laryngeal tube 12 can thus be extracted from the patient or kept in situ for later use.

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  • Health & Medical Sciences (AREA)
  • Pulmonology (AREA)
  • Emergency Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Anesthesiology (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Hematology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Media Introduction/Drainage Providing Device (AREA)

Abstract

L'un des aspects de la présente invention concerne un dispositif pour voies respiratoires réversible permettant de ventiler un sujet. Le dispositif pour voies respiratoires peut comprendre un tube laryngé, un tube endotrachéal, et un mécanisme d'étanchéité. Le tube laryngé peut comprendre un guide tubulaire ayant une partie d'extrémité distale, une partie d'extrémité proximale, et un premier passage s'étendant entre les parties d'extrémité distale et proximale. Le tube laryngé peut en outre comprendre, espacées axialement les uns des autres, des manchons distal et proximal couplés à celui-ci. Le tube endotrachéal peut être disposé de manière coulissante à l'intérieur du premier passage. Le tube endotrachéal peut avoir un deuxième passage qui est disposé à l'intérieur du premier passage. Le mécanisme d'étanchéité peut être disposé à l'intérieur du premier passage et configuré pour obstruer l'écoulement de gaz à travers le premier passage.
EP15745100.6A 2014-07-25 2015-07-24 Dispositif pour voies respiratoires réversible et procédé associé permettant de ventiler un sujet Withdrawn EP3171924A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US201462028886P 2014-07-25 2014-07-25
PCT/US2015/041870 WO2016014879A1 (fr) 2014-07-25 2015-07-24 Dispositif pour voies respiratoires réversible et procédé associé permettant de ventiler un sujet

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EP3171924A1 true EP3171924A1 (fr) 2017-05-31

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Country Link
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WO (1) WO2016014879A1 (fr)

Families Citing this family (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2016187108A1 (fr) * 2015-05-15 2016-11-24 The Cleveland Clinic Foundation Dispositif de gestion des voies aériennes réversible et procédé associé de ventilation d'un sujet
US10596339B2 (en) 2018-05-21 2020-03-24 Sridhar R. Musuku Intubation devices and methods of use

Citations (2)

* Cited by examiner, † Cited by third party
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