GB2463426A

GB2463426A - Multifunctional catheter for detecting respiration and ECG signals

Info

Publication number: GB2463426A
Application number: GB1000533A
Authority: GB
Inventors: Yuanming Luo; Nanshan Zhong
Original assignee: Individual
Current assignee: Individual
Priority date: 2007-06-20
Filing date: 2008-06-02
Publication date: 2010-03-17
Anticipated expiration: 2028-06-02
Also published as: GB201000533D0; WO2008154800A1; GB2463426B

Abstract

A multifunctional catheter (18) for detecting respiration and ECG signals can simultaneously detect esophageal pressure, multi-channel diaphragm EMG signals, and esophageal ECG, and has the function of nasal feeding. Three noncommunicating lumens inside the catheter (18) are used for accommodating electrode leads (24), conducting pressure and nasal feeding respectively. The outside of the catheter (18) is equipped with one balloon (22), which is communicated with a small lumen (19) inside the catheter (18) for measuring esophageal pressure. The distal end of the catheter (18) is provided with multiple big pores (14), which are connected witha gastric tube joint (29) at the proximal end of the catheter (18) through a big lumen (21) inside the catheter (18) for nasal feeding. The proximal end of the balloon (22) is provided with one grounding electrode (31) and the distal end of the balloon (22) is successively provided with one ECG electrode (10) and nine electrodes (1-9) for recording diaphragm EMG. There is a distance (15,32) between the grounding electrode (31) and the balloon (22), and between the balloon (22) and the ECG electrode (10) respectively. There is a bigger distance (11) between the ECG electrode (10) and the electrode (9) for recording diaphragm EMG, and there isa minimal distance (12) between the adjacent electrodes (1-9) for recording diaphragm EMG. There is a distance between each one of the big pores (14) at the distal end.

Description

A MULTI-FUNCTIONAL TUBE FOR DETECTING RESPIRATORY and

ELECTROCARDIOGRAM SIGNAL

FIELD OF THE INVENTION

The invention relates to medical detecting tube, and more particularly to a multi-functional tube that can not only detecting respiratory dynamics, diaphragmatic myoelectric signal and electrocardiogram signal but also act as a gastric canal. The tube is a nasogastric feeding tube which could detect the pressure of esophagus, diaphragmatic myoelectricity and electrocardiograph of esophagus simultaneously.

BACKGROUND ART

Generally, critically ill patients always need to place a gastric canal through the nasal passage.

Patients with respiratory failure are always applied with intubation and tracheotomy. And if the function of respiratory muscle and the drive of respiratory center would be detected, another two tubes would be placed additionally: one is a tube with balloon to be placed in esophagus; the other is esophageal electrode for detecting diaphragmatic myoelectricity. However, since the patient already had the intubation or tracheotomy and the gastric canal, it is so difficult that it is impossible to insert the other two tubes through the nasal passage. Because of the difficulty mentioned above in ICU, it is hard to be implemented and promoted for monitoring respiratory function, thus the vary of patient's condition can't be found timely and the rescue will be affected severely. Additionally, for acquiring ECG signal and heart rate, the chest of the patient will always to be placed three surface electrodes, which are easy to fall off, and the electrodes as well as their leads will impede the nursing given to the patient. If the monitor of ECG could also be acquired through nasogastric feeding tube, then the tube will displace the traditional chest surface electrodes and their leads, at the same time, more ECG information such as clear P wave will be acquired, and the monitor of ECG will be made more accurately and reliably. At present, a nasogastric feeding tube which can detect the pressure of esophagus, diaphragmatic myoelectricity and electrocardiograph of esophagus simultaneously does not exist intemationally.

SUMMARY OF THE INVENTION

The purpose of the invention is to provide a multi-functional tube for detecting respiratory and ECG signal which could detect the respiratory pressure, diaphragmatic myoelectricity and electrocardiograph of esophagus simultaneously, to overcome the difficulty of placing several tubes, avoid the affect to detection of respiratory muscle and the influence to nurse from chest ECG electrodes and their leads.

The multi-functional tube for detecting respiratory and ECG signal includes three lumen, that is a small lumen for detecting the pressure of esophagus, a small lumen for accommodating the electrodes' leads, and a big lumen for nasogastric feeding. A sealed balloon is attached to the surface of the tube. The balloon communicates with the small lumen for detecting the pressure of esophagus through many small holes. The distal end of the tube has many big holes. These big holes communicate with the big lumen for nasogastric feeding. The small lumen for

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accommodating the electrodes' leads is provided with electrodes' leads. The surface of the tube have several electrodes which are positioned at the distal end of the balloon for recording diaphragmatic myoelectricity and electrocardiograph of esophagus. There is a space between the balloon and the ECG electrode. Also the ECG electrode and the diaphragmatic myoelectricity electrodes is spaced apart. There is a tiny insulating space between the adjacent diaphragmatic myoelectricity electrodes. The distal recording electrode is spaced a distance from the big holes at the distal end of the tube. Each of the ECG electrodes and each of the electrodes for recording diaphragmatic myoelectricily are of equal length and cormect with leads in the small lumen. The small lumen for detecting esophageal pressure, the small lumen for accommodating the electrodes' leads, and the big lumen for nasogastric feeding, they all branch off at the proximal end and connect with their joints respectively. In use, the above three joints connect with esophageal pressure sensor, diaphragmatic myoelectricity senor, ECG sensor and stomach-tube.

A grounded electrode is set at the proximal end of the surface of the tube's balloon. A electrode for recording esophageal ECG and nine electrodes for recording diaphragmatic myoelectricity are attached to the distal end of the balloon.

The length of the tube's balloon is from five to ten centimeters, and its perimeter is about three centimeters. There is a ground electrode at the proximal end of the balloon, and there is a space that is one centimeter between the distal end of the balloon and ECG electrode. Each electrode's length is one centimeter. The space between the ECG electrode and the electrode adjacent electrodes for recording diaphragmatic myoelectricity is two centimeters, and the space between adjacent electrodes for recording diaphragmatic myoelectricity is equal or less than one millimeter.

Ten recording electrodes constitute six leads, the lead I is composed of electrode 1 and electrode 5, the lead II is composed of electrode 2 and electrode 6, the lead III is composed of electrode 3 and electrode 7, the lead IV is composed of electrode 4 and electrode 8, the lead V is composed of electrode 5 and electrode 9, the lead VI for recording esophageal ECG is composed of electrode 9 and electrode 10. So the electrode 9 acts not only as a diaphragmatic myoelectricity electrode, but also as a ECG electrode.

In use, when electrode 5 had been placed at the esophageal position equal to the diaphragm muscle, two leads which include electrode 5 would record the diaphragmatic myoelectricity signal which amplitude is similar and greater than the diaphragmatic myoelectricity signal recorded by other leads. Electrode 5 could be placed at the esophageal position equal to the diaphragm muscle accurately and quickly by observing the amplitude of diaphragmatic myoelectricity signal. The interference from the diaphragmatic movement in breath on recording diaphragmatic myoelectricity signal have been overcome due to the very little space of two electrodes. When a electrode which is primarily adjacent to diaphragm is away from it, another electrode will be near to the diaphragm, that is just as a lead moves along with diaphragm always, thereby the interference from the diaphragmatic movement could be avoided. When electrode 5 locates in the diaphragmatic plane, according to the anatomic relationship, the balloon locates at the esophagus and the distal end of the tube is in the stomach.

The invention had the following advantages. The multi-functional tube for detecting respiratory and electrocardiogram signal have all the functions of four traditional tubes which is stomach-tube, esophageal balloon, esophageal electrode tube for recording diaphragmatic myoelectricity and electrode tube for recording ECG. The electrodes of the tube could be placed at the esophageal position equal to the diaphragm muscle accurately and quickly, the esophageal balloon could be placed at the esophagus, the ECG electrodes could be placed near to the heart, and the distal end of the tube is in the stomach.

The multi-functional tube for detecting respiratory and electrocardiogram signal have four functions. Place the tube in the stomach-esophagus, it acts not only as an ordinary stomach-tube for nasogastric feeding, but also could be used to measure the pressure of esophagus which reflect the intrathoracic pressure, record esophageal ECG and diaphragmatic myoelectricity accurately without the interference from the diaphragmatic movement on recording diaphragmatic myoelectricity signal. The multi-functional tube for detecting respiratory and electrocardiogram signal changes the situation of placing three tubes for detecting esophageal pressure, diaphragmatic myoelectricity and nasogastric feeding, it also takes place of three chest surface ECU electrodes and their leads in order to nurse conveniently and acquire more information about ECG Furthermore, the esophageal pressure, diaphragmatic myoelectricity recorded by the tube could regulate breathing machine to send air and select the chance of offline.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 illustrates the structure of the multi-functional tube for detecting respiratory and electrocardiogram signal of the invention.

FIG.2 is an enlarged sectional view taken along line A-A of fig. 1.

FIG.3 is a sectional view of the multi-functional tube for detecting respiratory and electrocardiogram signal of the invention.

FIG4 is a sketch map of relationship between the electrodes and their leads of the multi-functional tube for detecting respiratory and electrocardiogram signal In the drawings, 1-10 represent recording electrodes, 11 represents the space between two ECG electrodes, 12 represents the insulating space between the adjacent electrodes for recording diaphragmatic myoelectricity, 13 represents the distance between the distal electrode and the distal big hole, 14 represents the big hole at the distal end of the tube, 15 represents the distance between the proximal electrode and the balloon, 16 represents the joint at the distal end of balloon, 17 represents the joint at the proximal end of balloon, 18 represents the multi-functional tube for detecting respiratory and electrocardiogram signal, 19 represents the small lumen in the tube for detecting the pressure of esophagus, 20 represents the small lumen in the tube for accommodating the electrodes' leads, 21 represents the big lumen in the tube for nasogastric feeding, 22 represents the balloon, 23 represents the small holes on the small lumen communicated with the balloon, 24 represents electrode leads, 25 represents the branch of the leads' small lumen communicated with the proximal end of the tube, 26 represents the branch of the small lumen for detecting esophageal pressure communicated with the proximal end of the tube, 27 represents the branch of the big nasogastric feeding lumen communicated with the proximal end of the tube, 28 represents the joint of electrodes' leads, 29 represents the joint of stomach tube, 30 represents the joint of three way pipe, 31 represents the grounded electrode, 32 represents the space between the balloon and the grounded electrode.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT(S) The multi-ftinctional tube for detecting respiratory and electrocardiogram signal of the invention include three tube lumen without mutual communication which are used for detecting the esophageal pressure, holding the electrodes' leads and nasogastric feeding respectively. The tube also includes the joints at the proximal end, a balloon, ten electrodes which are of equal length and connect with leads, and the distal end with holes. There joints at the proximal end are a joint of three way pipe, a joint of electrodes' leads, and ajoint of stomach tube. The balloon lies at the distal end of the grounded electrode and communicates with a small lumen in the tube for measuring the esophageal pressure. The electrode located at the nearest proximal end is the reference electrode to be grounded. Others are recording electrodes for recording multichannel diaphragmatic myoelectricity and ECU simultaneously. There is a tiny insulating space of equal length between adjacent electrodes for recording diaphragmatic myoelectricity.

The distal end of the tube involve many big holes which communicate with the big lumen for nasogastric feeding in the tube.

A distal electrode is to be grounded, and ten recording electrodes is to record ECG and diaphragmatic myoelectricity.

Referring now to the drawings, the invention is disclosed more as follows: As shown in fig.1, the multi-functional tube 18 for detecting respiratory and electrocardiogram signal is composed of eleven electrodes 1-10,31 of equal length, balloon 22, big holes 14 at the distal end and the joints at the proximal end of the tube. The distal end of the balloon 22 is connected to the tube 18 with the balloon's distal joint 16, and the proximal end of the balloon 22 is connected to the tube 18 with the balloon's proximal joint 17. The balloon 22 is spaced a distance 15 from the electrode 10. There is a space 32 between the electrode 31 and the balloon 22.

As shown in fig.2, the tube 18 includes three tube lumen without mutual communication.

One is the small lumen 19 which provides the measurement of intratracheal esophageal pressure.

The small lumen 19 communicates with the balloon 22, other one is another small lumen 20 which provides a channel for leads 24, another one is a big lumen 21 for nasogastric feeding. The big lumen 21 communicates with the big holes 14 for nasogastric feeding.

As shown in fig.3, the balloon 22 communicates with the small lumen 19 by the small holes 23 located in the lumen 19, and the lumen 19 connects with the joint 30 of three way pipe by the branch 26, then the pressure of the balloon could be measured. The proximal electrode is to be grounded as reference electrode, the other ten electrodes are recording electrodes 1-10. The ECG electrode 10 is spaced a distance 15 from the balloon. A space 11 exists between the ECG electrode 10 and the electrode 9. There is a tiny insulating space 12 between adjacent recording electrodes. The recording electrode 1 and the big hole 14 at the tubal distal end space apart a distance 13. Each electrode connects with the respective lead 24 in the small lumen 20, and extends to the lead joint 28 at the tubal proximal end through the branch 25, thus the diaphragmatic myoelectricity signal could be detected. The holes 14 at the tubal distal end communicates with the intratracheal big lumen 21, and connect to stomach tube joint 29 by the tubal branch 27 for nasogastric feeding.

As shown in fig.4, as preferable embodiment, the balloon 22 of the tube have a length from 5 to 10 cm, a perimeter about 3 cm. The distance 15 between balloon 22 and electrode 10 is 1cm.

The space 32 between the balloon 22 and the electrode 31 is 1 cm. Each electrode is 1 cm in length, the space 11 between the ECG electrode 10 and the diaphragmatic myoelectricity electrode 9 is 2 cm in length, and the space 12 between the adjacent electrodes of the electrodes 1-9 is about 1mm. The ten recording electrodes constitute six leads, the lead I is composed of electrode 1 and electrode 5, the lead II is composed of electrode 2 and electrode 6, the lead III is composed of electrode 3 and electrode 7, the lead IV is composed of electrode 4 and electrode 8, the lead V is composed of electrode 5 and electrode 9, the lead VI for recording esophageal ECG is composed of electrode 9 and electrode 10. Leads I -V are used for recording the diaphragmatic myoelectricity, and the distance between the two electrodes of each above lead is about 3.4 cm.

Lead VI is used for recording the ECG of esophagus, and the distance of their two electrodes is 2 cm. When the electrodes are placed, the amplitude of the diaphragmatic myoelectricity recorded by leads I -V should be observed in real time. If the lead I and lead V record a signal which amplitude is similar and greater than the signal recorded by the other leads, it suggests that the electrode 5 lies at the esophageal position equal to the diaphragm muscle. At the time, lead III could record only a very small diaphragmatic myoelectricity since the two electrodes upper and below are equal of distance from the diaphragm muscle that lead to the balance of potential.

Because the diaphragmatic movement of the esophagus part in the maximal respiratory movement is less than 1.5cm, and there is only a space of 1mm between the adjacent recording electrodes, so if the recording electrode 5 is placed at the esophageal position equal to the diaphragm muscle, one of the electrodes will be at the diaphragmatic level regardless of however the respiratory amplitude is. For example, when the diaphragm muscle moves down 1cm due to the increased volume during inspiration or diaphragmatic contraction, the electrode 5 initially at the diaphragmatic level leaves the place, then the recording electrode 6 would move to the diaphragmatic level. The biggest diaphragmatic myoelectricity is selected dynamically from the five leads, that is just like an electrode moves along with the diaphragm muscle all the time. In this way the interference from respiratory or diaphragmatic movement could be avoided during recording the diaphragmatic myoelectricity. Since the esophageal diaphragm plane is apart from cardia 2-3 cm, when the electrode lies in the diaphragmatic plane of the esophagus, the big hole 14 at the distal end lies in the stomach, a nasogastric feeding could be carried on favourably through the joint of stomach tube at the proximal end. At this time, the balloon 22 in the lower segment of the esophagus could measure the pressure in the esophagus, and the respiratory machine could be triggered to send gas.

Claims

CLAIMS1. a multi-functional tube for detecting respiratory and electrocardiogram signal, said tube includes three tubal lumen, that is a small lumen for detecting the pressure of esophagus, a small lumen for holding electrode leads and a big lumen for nasogastric feeding; a sealed balloon attached to the surface of said multi-functional tube, communicates with the small lumen for detecting the pressure of esophagus by a plurality of small holes; a plurality of big holes at the distal end of said tube, communicates with the big lumen for nasogastric feeding; the small lumen for holding electrode leads contains said electrode leads; said tube, is characterized by: many electrodes on the surface of the tube, attached to the distal portion of the balloon for recording esophageal ECG and diaphragmatic myoelectricity; there is a space between the balloon and the ECG electrode, also a space between the ECG electrode and the diaphragmatic myoelectricity electrode, and a tiny insulating space between the adjacent diaphragmatic myoelectricity electrodes; the distal recording electrode is spaced a distance from the big holes at the distal end of the tube; the ECG electrode and each of the electrodes for recording diaphragmatic myoelectricity is connected with leads in the small lumen; said small lumen for detecting the pressure of esophagus, said small lumen for holding electrode leads and said big lumen for nasogastric feeding all branch off at the proximal end of the tube and connect with their respective joint; a ground electrode attached to the proximal end of the balloon on the surface of the tube.
2. A multi-functional tube according to claim I, wherein an electrode for recording esophageal ECG and nine for recording diaphragmatic myoelectricity electrodes attached to the distal portion of the balloon on the surface of the tube.
3. A multi-functional tube according to claim 1, wherein the length of said balloon is from 5 to 10 cm, its perimeter is about 3cm; an electrode is grounded at the proximal end of the balloon, there is a space 1cm between the distal end of the balloon and the BCG electrode; the length of each electrode is 1cm, the space between the ECG electrode and the diaphragmatic myoelectricity electrode is 2cm, and the space between the adjacent electrodes for recording diaphragmatic myoelectricity is equal or less than 1mm.