JP2018000622A - Trachea tube, inflatable cuff, and sealing member - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a trachea tube, a balloon cuff, and a sealing member capable of completely cutting off a space in the trachea on a larynx side of the trachea and a space in the trachea on a main bronchial side by being applied to the cuff of the trachea tube, and capable of preventing inapparent aspiration, and, by extension, aspiration pneumonia.SOLUTION: A trachea tube 1 for an artificial respirator includes a tube 3 having a predetermined length, an inflatable cuff 5 attached to the external surface of the tube 3, and a sealing member 9 closely attached to the external surface of the inflatable cuff 5. The sealing member 9 airtightly seals a space between the external surface of the inflatable cuff 5 and the inner surface of the trachea when the inflatable cuff 5 is inflated, and deforms while being in close contact with the external surface of the inflatable 5 when the inflatable cuff is contracted.SELECTED DRAWING: Figure 2

Description

  The present invention relates to a tracheal tube, an inflatable cuff, and a sealing member, and particularly to a tracheal tube, an inflatable cuff, and a sealing member that can prevent aspiration pneumonia.

  Conventionally, a patient's breathing is assisted using a respirator for a patient who is difficult to breathe by himself or a patient who has undergone general anesthesia. In order to assist the patient's breathing using the ventilator, a tracheal tube having a diameter smaller than that of the patient's trachea is inserted into the patient's trachea, and air is directly sent to and discharged from the patient's trachea.

  In cases where ventilators are used, the patient's cough reflex or swallowing reflex may be reduced. In such a case, the patient prevents his / her own bacteria from entering the trachea. Inability to do so could result in subtle aspiration that caused bacteria to enter the trachea with saliva. And, when an inapparent aspiration occurred, aspiration pneumonia sometimes occurred.

  For the purpose of preventing occult aspiration during intubation and preventing aspiration pneumonia, a tracheal tube having an inflatable balloon or cuff provided on the tracheal tube has been developed (for example, Patent Documents). 1). In the tracheal tube of Patent Document 1, by providing an inflatable cuff on the outer wall of the tracheal tube, the space between the outer wall of the tracheal tube and the inner wall of the patient's trachea is eliminated, and the tracheal tube is directed from the larynx side to the main bronchus side. This prevents bacteria from entering.

Special table 2009-540922

  However, the inflatable cuff made of plastic as described in Patent Document 1 always takes a constant shape when air is introduced into the cuff and inflated, so that the diameter and the outer shape are always constant. In that case, the inflatable cuff described in Patent Document 1 may not have a shape that fits well with the surface of the patient's trachea having a complicated shape. And, for example, if the diameter of the patient's trachea is significantly smaller than the outer diameter of the cuff, or if the trachea surface is uneven at the position where the cuff is positioned, the cuff is completely removed even if air is introduced into the cuff. The tracheal tube is fixed in the trachea without expansion and with a claw on the outer surface of the cuff. And if there are wrinkles on the outer surface of the cuff, the space between the trachea on the larynx side of the trachea of the cuff and the space inside the trachea on the main bronchus side cannot be completely blocked, so that bacteria can be removed from the larynx side. There was a problem of invading the main bronchus.

  Therefore, the present invention has been made to solve the above-described problems, and by applying to the cuff of the tracheal tube, the space in the trachea on the larynx side of the trachea, the space in the trachea on the main bronchus side, and It is an object of the present invention to provide a tracheal tube, a balloon cuff, and a sealing member that can completely block the gap between them and prevent inapparent aspiration and eventually aspiration pneumonia.

  In order to solve the above-described problem, the present invention provides a tracheal tube for a ventilator, a tube having a predetermined length, an inflatable cuff attached to the outer surface of the tube, and the inflatable cuff. A sealing member attached in close contact with an outer surface, wherein the sealing member hermetically seals between an outer surface of the inflatable cuff and an inner surface of a trachea when the inflatable cuff is inflated; and When the expandable cuff is contracted, the expandable cuff is deformed while being in close contact with the outer surface of the expandable cuff.

  According to the present invention configured as described above, by providing the sealing member on the outer surface of the inflatable cuff, when the inflatable cuff is inflated, the sealing member causes the space between the outer surface of the inflatable cuff and the inner surface of the trachea. Can be hermetically sealed. And by sealing the space between the outer surface of the inflatable cuff and the inner surface of the trachea with a sealing member, the space between the trachea on the larynx side of the trachea and the space in the trachea on the main bronchus side Can be completely blocked, and bacteria can be prevented from entering the space in the trachea on the main trachea side.

  In order to solve the above-described problems, the present invention includes an inflatable cuff attached to the outer surface of a tracheal tube for a ventilator, and a sealing member attached in close contact with the outer surface of the inflatable cuff. The sealing member hermetically seals between the outer surface of the inflatable cuff and the inner surface of the trachea when the inflatable cuff is inflated, and when the inflatable cuff is contracted, the outer surface of the inflatable cuff It is characterized by being deformed while being in close contact with.

  Moreover, in order to solve the problem mentioned above, this invention is a sealing member used for the inflatable cuff attached to the outer surface of the tracheal tube for ventilators, and is closely attached to the outer surface of the inflatable cuff. Configured such that when the inflatable cuff is inflated, the outer surface of the inflatable cuff and the inner surface of the trachea are hermetically sealed and in close contact with the outer surface of the inflatable cuff when the inflatable cuff is contracted It is characterized by being deformed as is.

  Also according to the present invention configured as above, when the inflatable cuff is inflated, the sealing member can hermetically seal between the outer surface of the inflatable cuff and the inner surface of the trachea. And by sealing the space between the outer surface of the inflatable cuff and the inner surface of the trachea with a sealing member, the space between the trachea on the larynx side of the trachea and the space in the trachea on the main bronchus side Can be completely blocked, and bacteria can be prevented from entering the space in the trachea on the main trachea side.

  As described above, according to the present invention, the space between the outer surface of the inflatable cuff and the inner surface of the trachea is hermetically sealed by the sealing member. It is possible to completely block the space in the trachea on the side, thereby preventing inapparent aspiration and eventually aspiration pneumonia.

It is a perspective view which shows the tracheal tube by embodiment of this invention. It is a side view which shows the state at the time of the shrinkage | contraction of the expansible cuff by embodiment of this invention. It is sectional drawing of the sealing member by embodiment of this invention. It is sectional drawing of the horizontal cross section of a tracheal tube at the time of use of the expansible cuff by embodiment of this invention.

  Hereinafter, a tracheal tube according to an embodiment of the present invention will be described with reference to the drawings. FIG. 1 is a perspective view showing a tracheal tube. As shown in FIG. 1, a tracheal tube 1 includes a tube 3 connected to a ventilator, an inflatable cuff 5 attached to the outer surface of the tube 3, and air to / from the inflatable cuff 5. A cuff tube 7 and a sealing member 9 are provided.

  One end of the tube 3 is connected to the exhalation / inspiration port of the ventilator, and the other end forms an open end having a predetermined bevel angle. An inflatable cuff 5 is attached to the outer surface of the tube 3.

  The inflatable cuff 5 is, for example, a plastic balloon such as polyethylene terephthalate, polyvinyl chloride, or silicon, and its internal space is completely blocked from the trachea. A cuff tube 7 is connected to the internal space of the inflatable cuff 5. Then, air is introduced into the inner space of the inflatable cuff 5 through the cuff tube 7, or the air is sucked from the inner space to expand or contract the inflatable cuff 5. .

  The sealing member 9 is, for example, a resin ring-shaped member, and the inner portion of the ring is in close contact with the outer surface of the inflatable cuff 5 when the inflatable cuff 5 is inflated or contracted. Further, it is bonded to the outer surface of the inflatable cuff 5. In order to adhere the sealing member 9 to the outer surface of the inflatable cuff 5, it is preferable to use a material that is harmless to the human body, such as a silicon adhesive.

FIG. 2 is a side view showing a state when the inflatable cuff is contracted. As shown in FIGS. 1 and 2, the sealing member 9 has biocompatibility, and when the expandable cuff 5 expands or contracts, the seal member 9 remains in close contact with the outer surface of the expandable cuff 5. It is made of a material that can be deformed so as to follow the shape of the cuff 5. And as a material for forming the sealing member 9, it is formed with the material excellent in biocompatibility like silicon, the material excellent in elasticity like various elastomers, etc., for example. The sealing member 9 is liquid between the upper and lower spaces of the trachea of the sealing member 9 when the internal pressure of the inflatable cuff 9 is about 340 KPa (40 cmH ₂ O) to about 590 KPa (60 cmH ₂ O). It is preferable that it adheres to the trachea to such an extent that it cannot go back and forth.

  FIG. 3 is a cross-sectional view of the sealing member. As shown in FIG. 3, the sealing member 9 has, for example, a circular cross section with a diameter of 3 to 5 mm, and the outer diameter when expanded following the expansion of the inflatable cuff 5 is larger than the diameter of the trachea. Also, for example, the thickness is set to 20 mm or more. Further, when the inflatable cuff 5 contracts, the sealing member 9 contracts following the contraction of the inflatable cuff 5, and the outer diameter thereof becomes, for example, 13 mm or less so as to be smaller than the diameter of the trachea. It is configured as follows. Further, the inner diameter of the sealing member 9 is appropriately selected according to the outer diameter of the inflatable cuff 5. Further, the sealing member 9 is formed of a material having a thickness of 2 mm or less, a Young's modulus of 0.05 Mpa or less, and a Shore A hardness of 10 degrees or less so as to suitably follow the deformation of the inflatable cuff 5. Preferably it is.

  FIG. 4 is a cross-sectional view of the horizontal cross section of the tracheal tube when the inflatable cuff is used. As shown in FIG. 4, when the inflatable cuff 5 is inflated, the sealing member 9 around the inflatable cuff 5 is deformed according to the shape of the inner surface of the trachea, and the outer surface of the inflatable cuff 5 and the inner surface of the trachea Is completely sealed. Thereby, when the inflatable cuff 5 is arranged in the trachea, the space on the larynx side of the inflatable cuff 5 and the space on the main bronchus side can be completely blocked. Thereby, bacteria can be prevented from entering the main bronchus side from the larynx side space.

  In the above example, the sealing member has been described in detail as a ring having a circular cross section. However, the cross sectional shape of the sealing member is not limited to a circular cross section, but an elliptical cross section. May be used. Further, the sealing member is not limited to the ring shape, and may have a tubular shape extending along the length direction of the cuff.

  In the above example, since the outer diameter of the sealing member is larger than the outer diameter of the inflatable cuff, when the inflatable cuff is used, only the sealing member contacts the inner surface of the trachea. By applying a sealing member to the expansive cuff, both the sealing member and the large diameter portion of the inflatable cuff may contact the inner surface of the trachea. Thereby, a sealing effect can be improved more.

  Hereinafter, the Example and comparative example of this invention are explained in full detail.

In the embodiment, a 7 mm inner diameter vinyl chloride tube resembling the trachea, a 50 μm thick vinyl chloride cuff having a maximum diameter of 30 mm, and a silicon resin ring-shaped sealing member attached to the cuff are prepared. did. The sealing member has a circular cross section, has an inner diameter of 15 mm, an outer diameter of 16 mm, and is bonded to a portion having the maximum diameter of the cuff using silicon resin. The cuff and the sealing member were inserted into a vertically fixed tube to increase the internal pressure of the cuff up to 1176 KPa (120 cmH ₂ O). Thereafter, 2 ml of dye water was dropped into the tube from the upper opening of the tube. Thereafter, the internal pressure of the cuff was decreased stepwise, and measurement of the internal pressure of the cuff and the internal volume of the cuff was repeated three times when the dye water passed through the cuff and the sealing member and leaked to the lower side of the tube.

  Moreover, as a comparative example, a commercially available polyurethane cuff (commercial product: Covidien Japan Co., Ltd., Seal Guard Evac tracheal tube) was prepared, and the same test was performed.

  Table 1 shows the test results of the above examples and comparative examples.

Generally, it is known that tissue damage occurs when a pressure of 686 KPa (70 cmH ₂ 0) is continuously applied to a tissue such as a trachea for 2 hours or more. And in the Example of this invention, it turns out that the leakage of pigment water can be prevented, suppressing the internal pressure of a cuff to 686 KPa or less.

1 Tracheal tube 3 Tube 5 Inflatable cuff 9 Sealing member

Claims (3)

A tracheal tube for a ventilator,
A tube having a predetermined length;
An inflatable cuff attached to the outer surface of the tube;
A sealing member attached in close contact with the outer surface of the inflatable cuff;
The sealing member hermetically seals between the outer surface of the inflatable cuff and the inner surface of the trachea when the inflatable cuff is inflated, and is attached to the outer surface of the inflatable cuff when the inflatable cuff is contracted. A tracheal tube characterized by being deformed while in close contact. An inflatable cuff attached to the outer surface of a tracheal tube for a ventilator,
A sealing member attached in close contact with the outer surface of the inflatable cuff,
The sealing member hermetically seals between the outer surface of the inflatable cuff and the inner surface of the trachea when the inflatable cuff is inflated, and is attached to the outer surface of the inflatable cuff when the inflatable cuff is contracted. An inflatable cuff characterized by being deformed while in close contact. A sealing member used for an inflatable cuff attached to the outer surface of a tracheal tube for a ventilator,
The inflatable cuff is configured to be attached in close contact with the outer surface of the inflatable cuff. When the inflatable cuff is inflated, the outer surface of the inflatable cuff and the inner surface of the trachea are hermetically sealed. A sealing member that is deformed while being in close contact with the outer surface of the inflatable cuff when contracted.

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