GB2217606A - Device for preventing the aspiration of stomach contents - Google Patents

Device for preventing the aspiration of stomach contents Download PDF

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Publication number
GB2217606A
GB2217606A GB8907737A GB8907737A GB2217606A GB 2217606 A GB2217606 A GB 2217606A GB 8907737 A GB8907737 A GB 8907737A GB 8907737 A GB8907737 A GB 8907737A GB 2217606 A GB2217606 A GB 2217606A
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GB
United Kingdom
Prior art keywords
stomach
use
device according
preceding
oesophagus
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Withdrawn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
GB8907737A
Other versions
GB8907737D0 (en
Inventor
Thannippillil Narayanapil Nair
Original Assignee
Thannippillil Narayanapil Nair
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
Priority to GB888809965A priority Critical patent/GB8809965D0/en
Application filed by Thannippillil Narayanapil Nair filed Critical Thannippillil Narayanapil Nair
Publication of GB8907737D0 publication Critical patent/GB8907737D0/en
Publication of GB2217606A publication Critical patent/GB2217606A/en
Withdrawn legal-status Critical Current

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M25/00Catheters; Hollow probes
    • A61M25/10Balloon catheters
    • A61M25/1011Multiple balloon catheters

Abstract

A device 10 is for use in preventing the aspiration of stomach contents, for instance during surgery. An elongate member 12 carries inflatable portions 14, 16 and provides ducts through which the cuffs 14, 16 may be inflated. The cuffs are shaped to block the path of stomach contents from the stomach 40 to the pharynx 44 when the cuffs 14, 16 have been inflated. The elongate member 12 is sufficiently long to extend out of the patient to allow inflation to be controlled from outside the patient. In use, when vomiting is expected, the cuffs 14, 16 are inflated to prevent the contents of the stomach passing up to the pharynx 44, so that they cannot be inhaled. <IMAGE>

Description

Device for Preventing the Aspiration of Stomach Contents The present invention relates to the well known problem of the aspiration of stomach contents following vomiting or regurgitation.

The stomach contents of a patient may be predominantly liquid, predominantly solid, or mixed, and may be acidic. The aspiration of solids can cause respiratory obstruction and asphyxia. The aspiration of acidic liquids can produce acid aspiration syndrome.

Vomiting and regurgitation leading to stomach content aspiration is a particular problem during anaesthesia but can occur in other situations, such as after a head injury and during coma.

It is known to reduce the risks of aspiration associated with anaesthesia by stopping all food and drink supplies to a patient for a few hours before surgery. This solution is not available in emergency cases. Other solutions include emptying the stomach, the induction of controlled vomiting, control of the acidity and alkalinity of the stomach contents, and positioning the patient to reduce the likelihood of aspiration of stomach contents. Despite these attempts at solving the problem, a significant number of deaths attributable to anaesthesia or unconsciousness are nevertheless caused by the aspiration of stomach contents.

The present invention arises from an appreciation of this problem, and seeks to obviate or mitigate it.

The invention provides a device for preventing the aspiration of stomach contents, comprising an elongate member which carries at least one inflatable portion and provides a duct or ducts through which the inflatable portion or portions may be inflated, the inflatable portion or portions being so formed as to be able to block the path of stomach contents from the stomach to the pharynx when inflated, and the elongate member being of sufficient length to extend, in use, from the inflatable portion or portions out of the patient through the oesophagus and pharynx of the patient, to allow inflation to be controlled from outside the patient.

Preferably the or one of the inflatable portions is located, in use, in the stomach, to prevent the stomach contents entering the oesophagus. The inflatable portion located in the stomach, when inflated, preferably has a surface which generally conforms to the stomach walls around the cardiac orifice, and which is placed against that region of the stomach walls during use.

Preferably the or one of the inflatable members is located, in use, in the oesophagus. The inflatable member in the oesophagus preferably has a generally cylindrical shape, when inflated. The cylindrical inflatable member preferably locates, in use, below the crico pharyngeal sphincter.

The device preferably comprises two inflatable portions located, respectively, in the stomach and in the oesophagus, in use. The two inflatable portions are preferably about 18 centimetres apart when the device is in use. The elongate member preferably provides an inflation duct for each inflatable portion.

The or each inflation duct preferably has a releasable one-way valve operable from outside the patient when the device is in use.

Preferably the elongate member further provides a drainage duct which extends into the stomach, in use, and is in communication therewith to allow the stomach contents to be drained. The drainage duct is preferably sufficiently long to extend at least 20 centimetres into the stomach, in use. The elongate member preferably further provides a drainage duct which extends into the oesophagus, in use, and is in communication therewith, to allow material in the oesophagus to be drained.

Preferably the elongate member extends, in use, at least 15 centimetres from the patient. Preferably the lowermost end of the device is weighted to assist introduction into a patient.

One embodiment of a device according to the invention will now be described in more detail, by way of example only, and with reference to the accompanying drawings in which: Fig. 1 shows the whole device; Fig. 2 is a cross-section of the elongate member of the device; Fig. 3 is an elevation of the lower end of the device; and Fig. 4 is a schematic view of the device in use in a patient.

The device 10 is for use in preventing the aspiration of stomach contents. The device comprises an elongate member 12 which carries inflatable portions 14,16 or cuffs. The elongate member 12 provides ducts 18,20 through which the cuffs 14,16 may be inflated.

The cuffs are so formed as to block the path of stomach contents from the stomach to the pharynx when inflated, and the elongate member 12 is of sufficient length to extend, in use, from the cuffs out of the patient through the oesophagus and pharynx, to allow inflation to be controlled from outside the patient.

The elongate member 12 is a generally circular tube of a suitable non-toxic, semi-rigid material such as a polymer, chosen to ensure that it will not damage delicate body tissues with which it will come into contact during use. The tube 12 has the cross-section shown in Fig. 2. A main duct 22 through the tube 12 provides a duct for draining stomach contents. In the walls of the tube 12, a second duct 24 is provided for draining the oesophagus. Finally, the ducts 18,20 for inflating the cuffs 14,16 are also provided in the walls of the tube 12.

The inflation ducts 18,20 terminate at the upper end of the device 10 in short tubes 26 to which are attached releasable one-way valves 28. The valves 28 allow air to be introduced into the tubes 26 and inflation ducts 18,20, in order to inflate the cuffs 14,16.

The cuff 14 is in communication with the duct 18, and the cuff 16 is in communication with the duct 20.

Both cuffs are made from neoprene. The lower cuff 14 has a heart shape when inflated, as shown in Fig. 1, to provide an upper surface 30 which conforms with the stomach wall around the cardiac orifice. The cuff 16 is of a generally cylindrical form when inflated. The cuffs 14,16 are separated by a distance of about 18 centimetres, in a device intended for use in adults.

The tube 12 has a tail 32 which extends beyond the cuff 14 for a distance of about 20 centimetres. In use, this portion lies within the stomach. Near the end of the tail 32, the tube 12 is perforated at 34 to provide communication between the stomach and the duct 22. The lowermost tip of the tail 32 is rounded to facilitate the introduction of the device into a patient and to further facilitate this, a metal weight 36 is embedded in the material of the tube 12. The weight 36 is preferably a non-rusting alloy.

A short way above the cuff 14, the tube 12 is again perforated, at 37, to allow communication through the tube walls 12 with the drainage channel 24. This channel finishes at the top of the device 10 in a short tube 38 which includes an appropriate adaptor 40 to allow the tube 38 to be attached to a pump or other equipment.

The method of use of the device will now be described, with particular reference to Fig. 4.

Initially, the cuffs 14, 16 are deflated, by operation of the valves 28. The tail 32 of the device is then introduced into the nose 42 of the patient and the device is inserted through the pharynx 44 and oesophagus 46 until the tail 32 has passed into the stomach 48 and the cuff 14 is located just below (after) the oesophageal sphincter at 50. The appropriate valve 28 is then used to partially inflate the cuff 14 in order to close the cardiac orifice 52 retain the device in position.

When vomiting or regurgiation is anticipated, the cuff 14 is fully inflated and the tube 12 is then pulled gently back to locate the upper surface 30 of the cuff 14 against the stomach wall around the cardiac orifice 52. The cuff 16 can then be inflated to block the oesophagus just below the crico pharyngeal sphincter, and to assist in retaining the device in place.

The use of the device is simplified if at least 15 centimetres of the tube 12 projects from the nose of the patient when the device has been correctly installed.

When the device is installed as shown in Fig. 4, the cuff 14 blocks the cardiac orifice and thereby substantially prevents the stomach contents being regurgitated into the oesophagus, even if strong stomach contractions occur. However, the compliant nature of the inflated cuff reduces the likelihood of severe damage to the tissues of the stomach. If necessary, the stomach contents can be drained through the drainage duct 22.

Any contents which do leak around the cuff 14 into the oesophagus 46 encounter the cuff 16 which provides a second defence to prevent any stomach contents reaching the pharynx, from where they could be inhaled.

Material in the oesophagus can be drained through the drainage duct 24.

Variations and modifications to the apparatus described can be made without departing from the spirit and scope of the present invention. In particular, the number and shape of inflatable cuffs can be varied.

The use of only a single cuff is envisaged, but a greater number of cuffs is preferred. The shape of the cuffs will be selected according to the intended location during use. Other arrangements of perforations and ducts for draining the oesophagus and stomach could be used. Various materials could be used, subject to the normal requirements concerning toxicity of materials introduced in the stomach.

Claims (17)

1. A device for preventing the aspiration of stomach contents, comprising an elongate member which carries at least one inflatable portion and provides a duct or ducts through which the inflatable portion or portions may be inflated, the inflatable portion or portions being so formed as to be able to block the path of stomach contents from the stomach to the pharynx when inflated, and the enlongate member being of sufficient length to entend, in use, from the inflatable portion or portions out of the patient through the oesophagus and pharynx of the patient, to allow inflation to be controlled from outside the patient.
2. A device according to claim 1, wherein one of the inflatable portions is located, in use, in the stomach, to prevent the stomach contents entering the oesophagus.
3. A device according to claim 2, wherein the inflatable portion located in the stomach, when inflated, has a surface which generally conforms to the stomach walls around the cardiac orifice, and which is placed agsinst that region of the stomach walls during use.
4. A device according to any preceding claim, wherein the or one of the inflatable members is located, in use, in the oesophagus.
5. A device according to claim 4, wherein the inflatable member in the oesophagus has a generally cylindrical shape, when inflated.
6. A device according to claim 5, wherein the cylindrical inflatable member locates, in use, below the crico pharyngeal sphincter.
7. A device according to any preceding claim, and preferably comprising two inflatable portions located, respectively, in the stomach and in the oesophagus, in use.
8. A device according to claim 7, wherein the two inflatable portions are about 18 centimetres apart when the device is in use.
9. A device according to any preceding claim, wherein the elongate member provides a separate inflation duct for each inflatable portion.
10. A device according to any preceding claim, wherein the or each inflation duct has a releasable one-way valve operable from outside the patient when the device is in use.
11. A device according to any preceding claim, wherein the elongate member further provides a drainage duct which extends into the stomach, in use, and is in communication therewith to allow the stomach contents to be drained.
12. A device according to claim 11, wherein the drainage duct is sufficiently long to extend at least 20 centimetres into the stomach, in use.
13. A device according to any preceding claim, wherein the elongate member provides a drainage duct which extends into the oesophagus, in use, and is in communication therewith to allow material in the oesophagus to be drained.
14. A device according to any preceding claim, wherein the elongate member extends, in use, at least 15 centimetres from the patient.
15. A device according to any preceding claim, wherein the lowermost end of the device is weighted to assist introduction into a patient.
16. A device substantially as described above, with reference to the accompanying drawings.
17. Any novel subject matter or combination including novel subject matter herein disclosed, whether or not within the scope of or relating to the same invention as any of the preceding claims.
GB8907737A 1988-04-27 1989-04-06 Device for preventing the aspiration of stomach contents Withdrawn GB2217606A (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
GB888809965A GB8809965D0 (en) 1988-04-27 1988-04-27 Device for preventing aspiration of stomach contents

Publications (2)

Publication Number Publication Date
GB8907737D0 GB8907737D0 (en) 1989-05-17
GB2217606A true GB2217606A (en) 1989-11-01

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Family Applications (2)

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GB888809965A Pending GB8809965D0 (en) 1988-04-27 1988-04-27 Device for preventing aspiration of stomach contents
GB8907737A Withdrawn GB2217606A (en) 1988-04-27 1989-04-06 Device for preventing the aspiration of stomach contents

Family Applications Before (1)

Application Number Title Priority Date Filing Date
GB888809965A Pending GB8809965D0 (en) 1988-04-27 1988-04-27 Device for preventing aspiration of stomach contents

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GB (2) GB8809965D0 (en)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0613698A2 (en) * 1993-03-05 1994-09-07 Gaspar Estrada Salo A pleuvral drainage probe
WO2008101307A2 (en) * 2007-02-23 2008-08-28 Gilberto Clemente Pereira Obturator cannula for prophylaxis of pulmonary aspiration of gastric contents and positive-pressure ventilation

Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB1553915A (en) * 1975-06-06 1979-10-10 Kendall & Co Catheter
US4327720A (en) * 1979-01-22 1982-05-04 Bronson Paul A Esophageal-endotracheal airway
US4368739A (en) * 1979-07-18 1983-01-18 Nelson Jr Richard L Long intestinal catheter
EP0092618A1 (en) * 1982-04-27 1983-11-02 Patrick Albert Wallace Esophageal-endotracheal airway
EP0137142A1 (en) * 1983-07-16 1985-04-17 NATEC Institut für naturwissenschaftlich- technische Dienste GmbH Balloon catheter, especially an endotracheal catheter, with a connector
GB2168256A (en) * 1984-12-14 1986-06-18 Archibald Ian Jeremy Brain Endobronchial tube assembly
GB2171017A (en) * 1985-02-20 1986-08-20 Michael Frass Endotracheal and/or esophageal-obturator ventilator
EP0266469A1 (en) * 1986-11-07 1988-05-11 Synthelabo Oesophagus catheter

Patent Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB1553915A (en) * 1975-06-06 1979-10-10 Kendall & Co Catheter
US4327720A (en) * 1979-01-22 1982-05-04 Bronson Paul A Esophageal-endotracheal airway
US4368739A (en) * 1979-07-18 1983-01-18 Nelson Jr Richard L Long intestinal catheter
EP0092618A1 (en) * 1982-04-27 1983-11-02 Patrick Albert Wallace Esophageal-endotracheal airway
EP0137142A1 (en) * 1983-07-16 1985-04-17 NATEC Institut für naturwissenschaftlich- technische Dienste GmbH Balloon catheter, especially an endotracheal catheter, with a connector
GB2168256A (en) * 1984-12-14 1986-06-18 Archibald Ian Jeremy Brain Endobronchial tube assembly
GB2171017A (en) * 1985-02-20 1986-08-20 Michael Frass Endotracheal and/or esophageal-obturator ventilator
EP0266469A1 (en) * 1986-11-07 1988-05-11 Synthelabo Oesophagus catheter

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0613698A2 (en) * 1993-03-05 1994-09-07 Gaspar Estrada Salo A pleuvral drainage probe
EP0613698A3 (en) * 1993-03-05 1994-12-14 Salo Gaspar Estrada A pleuvral drainage probe.
US5489264A (en) * 1993-03-05 1996-02-06 Salo; Gaspar E. Pleural drainage probe
WO2008101307A2 (en) * 2007-02-23 2008-08-28 Gilberto Clemente Pereira Obturator cannula for prophylaxis of pulmonary aspiration of gastric contents and positive-pressure ventilation
WO2008101307A3 (en) * 2007-02-23 2009-02-12 Gilberto Clemente Pereira Obturator cannula for prophylaxis of pulmonary aspiration of gastric contents and positive-pressure ventilation

Also Published As

Publication number Publication date
GB8809965D0 (en) 1988-06-02
GB8907737D0 (en) 1989-05-17

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