GB2340401A

GB2340401A - A tracheostomy tube

Info

Publication number: GB2340401A
Application number: GB9917374A
Authority: GB
Inventors: Stephen James Field
Original assignee: Smiths Group PLC
Current assignee: Smiths Group PLC
Priority date: 1998-08-12
Filing date: 1999-07-26
Publication date: 2000-02-23
Anticipated expiration: 2019-07-26
Also published as: GB9917374D0; GB2340401B; GB9817455D0

Abstract

The tube has a fenestration (20) in the wall of the tube (1) that can be closed by a closure member (24). The closure member (24) has a handle (25) at its machine end to enable slidable movement along a channel (21) within the wall to open or close the fenestration (20) and allow the patient to be weened off ventilation, and markers to indicate the extent of opening.

Description

2340401 TRACHEOSTOMY TUBES This invention relates to tracheostomy tubes.

Tracheostomy tubes are used to ventilate a patient during and after surgery. As the patient begins to recover, it is preferable for him to be weaned off breathing through the tube before it is completely removed. This can be done by partially deflating the cuff of the tube. Alternatively, a fenestrated tracheostomy tube can be used having one or more small openings in its side wall, so that a part of the patient's breathing passes through these openings and via his nose or mouth, instead of through the machine end of the tracheostomy tube. A problem with this procedure is that a skilled clinician is needed to replace the conventional tube with a fenestrated tube and the procedure can be traumatic for the patient. Tube assemblies are known comprising a fenestrated tracheostomy tube and two removable inner tubes, one being fenestrated and the other unfenestrated. The unfenestrated inner tube is used initially and this is replaced with the fenestrated inner tube when it is necessary to wean the patient off the tracheostomy tube. The use of inner tubes, however, can be undesirable in some situations and are more difficult to provide in tracheostomy tubes that are not curved in a continuous arc.

It is an object of the present invention to provide an improved tracheostomy tube.

According to the present invention there is provided a tracheostomy tube having a sealing member towards its patient end, an opening in its side wall above the sealing member 2 at a location positioned, in use, in the trachea, and a closure member mounted with the wall of the tube, the closure member being movable from a first position in which the opening is substantially open to a second position in which the opening is substantially closed.

The tube preferably has a channel formed in its wall, the closure member being slidable along the channel between the first and second positions. The channel is preferably extruded along the length of the tube. The closure member may be a strip member such as of a plastics material and its machine end may be provided with a handle. The sealing member is preferably an inflatable cuff and the opening is preferably axially elongate. The closure member may be marked in the region of its second end to indicate the amount by which the opening is open.

A tracheostomy tube according to the present invention will now be described, by way of example, with reference to the accompanying drawing, in which:

Figure 1 is a side elevation view of the tube; Figure 2 is a front elevation view along the arrow H showing a part of the tube; and Figure 3 is a enlarged, transverse sectional view along the line III-Ul of Figure 1.

3 The tracheostomy tube comprises an extruded tubular PVC shaft 1 having a circular cross-section. The patient end region 2 and the machine end region 3 of the tube are straight and are separated from one another by a curved intermediate region 4. A sealing member in the form of an inflatable cuff 5 encircles the patient end region 2, the interior of the cuff communicating with an inflation lumen 6 extruded within the wall of the tube. Towards the machine end of the tube, the inflation lumen 6 is connected with a small-bore inflation line 7, which is terminated by a connector and inflation indicator 8. A machine end connector 9 with an integral mounting flange 10 is secured in the machine end 3 of the shaft 1.

As so far described, the tube is conventional.

The tube differs from previous tubes by having a closable opening or fenestration 20 formed in its side wall, just above the cuff 5, in the intermediate region 4 on the outside of its bend. In use, the fenestration 20 is located within the trachea 11. The fenestration 20 is of an oval, axially elongated shape typically being about 3mm wide by 1 Omm long. The opening 20 cuts through an extruded channel 21 about 4mrn wide, which extends along the length of the tube but is sealed closed at its machine end. The channel 21 is curved across its width with the same radius as the tube wall. A closure slide member 24 is located in the channel 21 and extends rearwardly from a point just forwardly of the patient end of the opening 20. The closure member 24 is a strip of a flexible plastics material with sufficient axial rigidity to enable it to be slid in and out of the channel 21. The rear end of the closure member 24 emerges at the machine end of the tube through an opening in the connector 9, which communicates with the channel 21. The rear end of the closure member 24 is curved away 4 from the tube and is formed into a handle 25. The closure member 24 may be marked at its machine end with a scale to indicate the extent by which the fenestration 20 is open.

In its first position, as illustrated, the closure member 24 covers the fenestration 20 so that all gas flow along the tube is via its machine end. When it is necessary to start weaning the patient off the tracheostomy tube, the handle 25 is gripped and the closure member 24 is pulled rearwardly to a second position in which the forward end of the closure member is located to the rear of the forward end of the fenestration 20 and it is fully or partly open. Preferably, the fenestration 20 is only partially opened initially and is progressively opened to its full extent so that the patient is gradually accustomed to breathing via his nose and mouth.

It will be appreciated that the shaft I could have different shapes and could be of different materials. The slide member 24 could be of metal instead of plastics. The fenestration 20 could be of different shapes or be provided by a series of several separate fenestrations.

The present invention enables a patient to be gradually weaned off a tracheostomy tube without the need to use an inner tube and whilst maintaining the full seal of the cuff with the trachea. It will be appreciated that the arrangement of the present invention also has the advantage that it is very easy to close the fenestration quickly should it become necessary to ventilate the patient via the machine end of the tube.

Claims

A tracheostomy tube having a sealing member towards its patient end, an opening in its side wall above the sealing member at a location positioned, in use, in the trachea, and a closure member mounted with the wall of the tube, and wherein the closure member is movable from a first position in which said opening is substantially open to a second position in which said opening is substantially closed.
2. A tracheostomy tube according to Claim 1, wherein the tube has a channel formed in its wall, and wherein said closure member is slidable along the channel between the first and second positions.
A tracheostomy tube according to Claim 2, wherein the channel is extruded along the length of the tube.
4. A tracheostomy tube according to any one of the preceding claims, wherein the closure member is a strip member.
5. A tracheostomy tube according to Claim 4, wherein the strip member is of a plastics material.

6. A tracheostomy tube according to any one of the preceding claims, wherein the machine end of the closure member is provided with a handle.
6
7. A tracheostomy tube according to any one of the preceding claims, wherein the sealing member is an inflatable cuff.
8. A tracheostomy tube according to any one of the preceding claims, wherein said opening is axially elongate.
9. A tracheostomy tube according to any one of the preceding claims, wherein the closure member is marked in the region of its second end to indicate the amount by which said opening is open.
10. A tracheostomy tube substantially as hereinbefore described with reference to the accompanying drawing.
11. Any novel and inventive feature or combination of features as hereinbefore described.