JP5507847B2 - 気管内チューブ及びそれを含む挿管システム - Google Patents
気管内チューブ及びそれを含む挿管システム Download PDFInfo
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- JP5507847B2 JP5507847B2 JP2008544000A JP2008544000A JP5507847B2 JP 5507847 B2 JP5507847 B2 JP 5507847B2 JP 2008544000 A JP2008544000 A JP 2008544000A JP 2008544000 A JP2008544000 A JP 2008544000A JP 5507847 B2 JP5507847 B2 JP 5507847B2
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- 238000002627 tracheal intubation Methods 0.000 title claims description 21
- 210000005177 subglottis Anatomy 0.000 claims description 67
- 230000002262 irrigation Effects 0.000 claims description 33
- 238000003973 irrigation Methods 0.000 claims description 33
- 239000012530 fluid Substances 0.000 claims description 31
- 238000009423 ventilation Methods 0.000 claims description 31
- 230000028327 secretion Effects 0.000 claims description 21
- 238000004140 cleaning Methods 0.000 claims description 18
- 238000005399 mechanical ventilation Methods 0.000 claims description 15
- 210000004072 lung Anatomy 0.000 claims description 13
- 210000001260 vocal cord Anatomy 0.000 claims description 8
- 239000007788 liquid Substances 0.000 claims description 6
- 238000003780 insertion Methods 0.000 claims description 5
- 230000037431 insertion Effects 0.000 claims description 5
- 230000000241 respiratory effect Effects 0.000 claims 1
- 238000005406 washing Methods 0.000 claims 1
- 206010003504 Aspiration Diseases 0.000 description 19
- 210000004400 mucous membrane Anatomy 0.000 description 12
- 238000010586 diagram Methods 0.000 description 5
- 238000000034 method Methods 0.000 description 5
- 230000015572 biosynthetic process Effects 0.000 description 4
- 210000003437 trachea Anatomy 0.000 description 4
- 206010035664 Pneumonia Diseases 0.000 description 3
- 210000001519 tissue Anatomy 0.000 description 3
- 238000005259 measurement Methods 0.000 description 2
- 238000012806 monitoring device Methods 0.000 description 2
- 238000012544 monitoring process Methods 0.000 description 2
- 208000009470 Ventilator-Associated Pneumonia Diseases 0.000 description 1
- 238000007796 conventional method Methods 0.000 description 1
- 230000006837 decompression Effects 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 230000029142 excretion Effects 0.000 description 1
- 230000007774 longterm Effects 0.000 description 1
- 239000000463 material Substances 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 210000003097 mucus Anatomy 0.000 description 1
- 238000005192 partition Methods 0.000 description 1
- 229920000915 polyvinyl chloride Polymers 0.000 description 1
- 239000004800 polyvinyl chloride Substances 0.000 description 1
- 230000002035 prolonged effect Effects 0.000 description 1
- 230000029058 respiratory gaseous exchange Effects 0.000 description 1
- 238000007789 sealing Methods 0.000 description 1
- 229910052710 silicon Inorganic materials 0.000 description 1
- 239000010703 silicon Substances 0.000 description 1
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- 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
- A61M16/0463—Tracheal tubes combined with suction tubes, catheters or the like; Outside connections
-
- 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
- A61M16/0434—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
- A61M16/0475—Tracheal tubes having openings in the tube
- A61M16/0477—Tracheal tubes having openings in the tube with incorporated means for delivering or removing fluids
- A61M16/0479—Tracheal tubes having openings in the tube with incorporated means for delivering or removing fluids above the cuff, e.g. giving access to the upper trachea
-
- 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
-
- 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
- A61M16/0411—Special features for tracheal tubes not otherwise provided for with means for differentiating between oesophageal and tracheal intubation
- A61M2016/0413—Special features for tracheal tubes not otherwise provided for with means for differentiating between oesophageal and tracheal intubation with detectors of CO2 in exhaled gases
-
- 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
- A61M2205/00—General characteristics of the apparatus
- A61M2205/15—Detection of leaks
-
- 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
- A61M2205/00—General characteristics of the apparatus
- A61M2205/32—General characteristics of the apparatus with radio-opaque indicia
-
- 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
- A61M2230/00—Measuring parameters of the user
- A61M2230/005—Parameter used as control input for the apparatus
-
- 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
- A61M2230/00—Measuring parameters of the user
- A61M2230/40—Respiratory characteristics
- A61M2230/43—Composition of exhalation
- A61M2230/432—Composition of exhalation partial CO2 pressure (P-CO2)
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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)
- External Artificial Organs (AREA)
- Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)
- Media Introduction/Drainage Providing Device (AREA)
Description
本発明は、添付図面を参照して例示としてのみここに記載される。
以下に記載される本発明の好ましい実施形態は、主に図1〜3に示された患者を機械的に換気するための挿管システムのタイプに関する。かかるシステムは、一般に10で示される気管内チューブを利用し、気管内チューブは、患者の気道2内へ挿入し、声帯3を通過し、声門下領域4を通って、そして患者の肺5内へ挿入するための遠位端10aを有する。気管内チューブ10の近位端10bは、特に以下に記載されるように、機械的換気装置6に並びに多数の制御装置に接続可能である。
図6及び7は、上記問題を避けるために本発明に従って構成された、一般に20で示される気管内チューブ、特にその遠位端20aの一実施形態を示す。気管内チューブ20は、通常の主内腔21、カフ22、及びカフを膨張するための膨張内腔23を含む。それはさらに、患者の機械的換気中に声門下領域から分泌物及び/又は洗浄液を排出するために、図1〜3に関して上で記載されたように、声門下領域に位置され、かつチューブの外部表面から先導する吸引入口24aを有する吸引内腔24を含む。
図8は、本発明に従って構成された別の気管内チューブ30の遠位端30aを示し、それはまた、図6及び7に関して上述された基本的要素、主に主内腔31、カフ32、膨張内腔33、及び患者の声門下領域に位置されるための吸引入口34aを有する吸引内腔34を含む。この場合において、気管内チューブの遠位端は、吸引入口において気管内チューブの外部表面から外側に半径方向に突出するように、そして吸引入口の閉塞を防止するのに効果的であるように、吸引入口34aに隣接するが吸引入口34aの反対側上に位置される隆起35を伴って形成される。
図9は、図8に関して上述されたのと同様の構造の本発明に従って構成された別の気管内チューブ40の遠位端40aを示す。しかしながら、図9の気管内チューブ40では、一般に45で示される隆起は、膨張すると、吸引入口においてチューブの外部表面から外側に半径方向に突出し、それによって吸引入口の閉塞を効果的に防止する膨張可能な要素又はバルーンの形である。膨張可能な要素45は、示されたようなふくれ形状を持ってもよく、又は別の形状、例えば環状形状を持ってもよい。
図10は、図10の気管内チューブが声門下領域4を洗浄するための洗浄内腔をさらに含むこと以外、図6及び7と同様に構成された気管内チューブ50の遠位端50aを示す。かかる場合において、洗浄内腔57は、声門下領域と通じる出口57aを、好ましくはカフ52に隣接したその遠位端に持つ。
図11のフローチャート、及び図12のタイミング図は、図6〜8に示された上記の気管内チューブの操作の一例を示し、そこでは別個の洗浄内腔が存在せず、吸引内腔が洗浄のためにも使用される。図13及び14の対応するフローチャート及びタイミング図は、図10に示されたように別個の洗浄内腔が与えられる気管内チューブの対応する操作を示す。両タイプの操作時、換気内腔、例えば26,36,46,56は、声門下領域を大気に換気すること、及び肺から漏れかつ声門下領域から放出された吐き出された空気のCO2含有量を測定することを交互にして、間欠的に使用される。
図15及び16は、一般に80で示される気管内チューブの壁を通る通路として形成された前述の全ての内腔を含む気管内チューブを示す。従って、気管内チューブ80は、主内腔81、チューブの遠位端81aにあるカフ82、カフを膨張/収縮するための膨張内腔83、声門下領域4から分泌物及び/又は洗浄液を排出するための吸引内腔84、声門下領域を大気に換気するための換気内腔86、及び洗浄液を声門下領域内に導入するための洗浄内腔87を含む。
Claims (17)
- 患者を機械的に換気するための気管内チューブにおいて、前記気管内チューブが、呼吸ガスを患者の肺中に送達するための主内腔であって、機械的な換気装置への連結のために構成された近位端から、声帯を通過し、声門下領域を通って、そして患者の下部気管気道内へ挿入するように構成された遠位端まで延びる主内腔;声帯の下の患者の声門下領域に位置されるための、気管内チューブの前記遠位端にあるカフ;前記カフを膨張させるための膨張内腔;及び前記気管内チューブの壁に一体的に形成され、かつ声門下領域に位置されるためのそれぞれの口を有する、前記主内腔及び前記膨張内腔以外の少なくとも3つの追加の内腔;を含み、前記少なくとも3つの追加の内腔が、(i)前記声門下領域を通って洗浄液を循環させるために;(ii)患者の機械的な換気時に前記声門下領域から分泌物及び/又は洗浄液を排出するために;及び(iii)声門下領域を大気に換気するために構成されていることを特徴とする気管内チューブ。
- 前記少なくとも3つの追加の内腔は、前記声門下領域を大気に換気することを実行するために、気管内チューブの外部表面から先導しかつ患者の声門下領域に位置されるための換気内腔を含む、請求項1に記載の気管内チューブ。
- 前記少なくとも3つの追加の内腔は、吸引内腔を含み、前記吸引内腔の近位端は、吸引源へ、又は前記声門下領域を通って洗浄液を循環するための洗浄液源への選択的接続のために構成されている、請求項1に記載の気管内チューブ。
- 前記少なくとも3つの追加の内腔は、前記声門下領域を通って前記吸引内腔によって除去されるための洗浄液を循環するために洗浄液源への接続のための別個の洗浄内腔を含む、請求項1に記載の気管内チューブ。
- 前記換気内腔は、肺から前記声門下領域中に漏れる空気の組成を分析するための分析装置へ又は大気への選択的接続のために構成されている、請求項2に記載の気管内チューブ。
- 以下のものを含む挿管システム:
請求項4に記載の気管内チューブ;
前記気管内チューブの近位端に接続可能な吸引源;
前記気管内チューブの近位端に接続可能な洗浄液源;及び
気管内チューブの前記近位端を前記吸引源へ又は前記洗浄液源へのいずれかに選択的に接続するための制御装置。 - 前記少なくとも3つの追加の内腔は、換気内腔をさらに含み、前記挿管システムは、肺から前記声門下領域中に漏れる空気を分析するための前記換気内腔の近位端に接続された分析装置をさらに含み、前記制御装置はまた、換気内腔の前記近位端を大気に又は前記分析装置に選択的に接続する、請求項6に記載の挿管システム。
- 以下のものを含む挿管システム:
請求項5に記載の気管内チューブ;
前記吸引内腔の近位端に接続された吸引源;及び
前記声門下領域を通って前記吸引内腔によって除去されるための洗浄液を循環するために前記洗浄内腔の近位端に接続可能な洗浄液源。 - 前記少なくとも3つの追加の内腔は、換気内腔をさらに含み、前記挿管システムは、肺から前記声門下領域中に漏れる空気を分析するための前記換気内腔の近位端に接続された分析装置をさらに含み、前記制御装置はまた、換気内腔の前記近位端を大気に又は前記分析装置に選択的に接続する、請求項8に記載の挿管システム。
- 前記吸引内腔は、前記気管内チューブの壁に一体的に形成され、前記壁の外部表面は、前記吸引入口から前記気管内チューブの近位端まで延びる凹所を伴って形成され、前記吸引入口は、前記凹所に隣接する気管内チューブの外部表面が前記凹所から外側に半径方向に突出し、それによって吸引入口の前記閉塞を防止するように、前記気管内チューブの外部表面の前記凹所に形成されている、請求項1に記載の気管内チューブ。
- 前記吸引内腔の対向する側上の前記気管内チューブ壁の外部表面に二つの前記凹所が形成され、前記吸引内腔は前記二つの凹所の各々に吸引入口を含む、請求項10に記載の気管内チューブ。
- 前記少なくとも3つの追加の内腔は、前記声門下領域を通って洗浄液を循環するための洗浄内腔をさらに含む、請求項11に記載の気管内チューブ。
- 前記洗浄内腔は、気管内チューブの壁を通って形成され、その遠位端で洗浄液出口を有する、請求項12に記載の気管内チューブ。
- 前記吸引内腔及び前記洗浄内腔は、前記二つの凹所間の気管内チューブの前記壁に半径方向に整列された関係で形成され、気管内チューブの前記壁に一体的に形成された仕切りによって分離され、前記洗浄内腔は、前記二つの凹所の各々に前記洗浄液出口を含む、請求項13に記載の気管内チューブ。
- 前記少なくとも3つの追加の内腔は気管内チューブの別の壁部分を通って形成されている膨張内腔を含む、請求項14に記載の気管内チューブ。
- 気管内チューブは、前記膨張内腔を形成された壁部分の向かい側の壁部分に放射線不透過性ストリップをさらに含む、請求項15に記載の気管内チューブ。
- 前記少なくとも3つの追加の内腔は、前記吸引内腔及び洗浄内腔の壁の向かい側の壁を通って形成された換気内腔をさらに含み、前記換気内腔は、声門下領域を大気に換気するため、又は分析のために肺から前記声門下領域内に漏れる空気の試料を供給するために患者の声門下領域に位置されるための入口を有する、請求項16に記載の気管内チューブ。
Applications Claiming Priority (5)
Application Number | Priority Date | Filing Date | Title |
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US74190005P | 2005-12-05 | 2005-12-05 | |
US60/741,900 | 2005-12-05 | ||
US83011106P | 2006-07-12 | 2006-07-12 | |
US60/830,111 | 2006-07-12 | ||
PCT/IL2006/001401 WO2007066332A2 (en) | 2005-12-05 | 2006-12-05 | Endotracheal tube and intubation system including same |
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JP2009518104A JP2009518104A (ja) | 2009-05-07 |
JP2009518104A5 JP2009518104A5 (ja) | 2010-01-07 |
JP5507847B2 true JP5507847B2 (ja) | 2014-05-28 |
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JP2008544000A Active JP5507847B2 (ja) | 2005-12-05 | 2006-12-05 | 気管内チューブ及びそれを含む挿管システム |
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US (2) | US9555205B2 (ja) |
EP (1) | EP1960024B1 (ja) |
JP (1) | JP5507847B2 (ja) |
KR (1) | KR20080080574A (ja) |
AU (1) | AU2006322905B2 (ja) |
BR (1) | BRPI0620592A2 (ja) |
CA (1) | CA2631516A1 (ja) |
NZ (1) | NZ569496A (ja) |
WO (1) | WO2007066332A2 (ja) |
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JP5011298B2 (ja) | 2005-08-24 | 2012-08-29 | ホスピテック レスピレーション リミテッド | 気管内チューブカフ充填の調整 |
KR20080080574A (ko) | 2005-12-05 | 2008-09-04 | 호스피테크 레스피레이션 리미티드 | 기관내 튜브 및 이것을 포함하는 삽관 시스템 |
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2006
- 2006-12-05 KR KR1020087015266A patent/KR20080080574A/ko not_active Application Discontinuation
- 2006-12-05 US US12/085,909 patent/US9555205B2/en active Active
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NZ569496A (en) | 2010-12-24 |
CA2631516A1 (en) | 2007-06-14 |
US11938270B2 (en) | 2024-03-26 |
US20170113011A1 (en) | 2017-04-27 |
EP1960024A2 (en) | 2008-08-27 |
US9555205B2 (en) | 2017-01-31 |
JP2009518104A (ja) | 2009-05-07 |
KR20080080574A (ko) | 2008-09-04 |
AU2006322905A1 (en) | 2007-06-14 |
US20090038620A1 (en) | 2009-02-12 |
WO2007066332A2 (en) | 2007-06-14 |
AU2006322905B2 (en) | 2013-10-03 |
EP1960024B1 (en) | 2014-02-12 |
WO2007066332A3 (en) | 2007-11-01 |
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