JP5632922B2 - 気管内挿入管装置 - Google Patents
気管内挿入管装置 Download PDFInfo
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- JP5632922B2 JP5632922B2 JP2012532355A JP2012532355A JP5632922B2 JP 5632922 B2 JP5632922 B2 JP 5632922B2 JP 2012532355 A JP2012532355 A JP 2012532355A JP 2012532355 A JP2012532355 A JP 2012532355A JP 5632922 B2 JP5632922 B2 JP 5632922B2
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- tube
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- electrodes
- endotracheal
- emg
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Description
[0001]本出願は、35U.S.C.第119条(e)項(1)の下に、2009年10月2日に「気管内挿入管装置」(Endotracheal Tube Apparatus)という名称で出願されている米国仮出願であって弁理士事件番号M190.350.101/P0035756.00を付定された米国仮特許出願第61/248,294号に対する優先権を主張し、その教示全体をここに参考文献として援用する。
(態様1)患者の喉頭筋のEMG信号を監視するための装置において、外表面を有する気管内挿入管と、前記気管内挿入管の前記外表面上に形成されている導電性インク電極であって、当該気管内挿入管が患者の気管に設置されているときに喉頭筋からの前記EMG信号を受信するように構成されている導電性インク電極と、前記導電性インク電極に連結されていて、当該導電性インク電極によって受信される前記EMG信号を処理装置へ搬送するように構成されている少なくとも1つの導体と、を備えている、装置。
(態様2)態様1に記載の装置において、前記導電性インク電極は、銀充填ポリマー導電性インクを備えている、装置。
(態様3)態様1に記載の装置において、前記導電性インク電極は、炭素導電性インクを備えている、装置。
(態様4)態様1に記載の装置において、前記導電性インク電極は、長手方向に前記挿入管の長さに沿って延びていて前記気管内挿入管の周囲を取り囲むように離間されている少なくとも6つの導電性インク電極を含んでいる、装置。
(態様5)態様1に記載の装置において、前記気管内挿入管に接続されている膨らませることのできるカフと、前記膨らませることのできるカフ上に形成されている少なくとも1つの導電性インク電極と、を更に備えている、装置。
(態様6)態様5に記載の装置において、前記膨らませることのできるカフ上に形成されている前記少なくとも1つの導電性インク電極は、患者の声帯襞からのEMG信号を感知するように構成されている、装置。
(態様7)態様1に記載の装置において、前記気管内挿入管上には前記導電性インク電極付近に光源と磁石のうちの少なくとも一方が配置されて更に備えられている、装置。
(態様8)態様1に記載の装置において、前記気管内挿入管の近位端を当該気管内挿入管の遠位端に対して回転させられるように構成されている連結アダプタを更に備えている、装置。
(態様9)態様1に記載の装置において、前記気管内挿入管を取り囲んでいて当該気管内挿入管上の前記導電性インク電極の上方に配置されている第1リブと、前記気管内挿入管を取り囲んでいて当該気管内挿入管上の前記導電性インク電極の下方に配置されている第2リブと、を更に備えている、装置。
(態様10)態様1に記載の装置において、前記気管内挿入管上に形成されている少なくとも1つの自動式周期的刺激(APS)電極を更に備えており、前記処理装置は、前記気管内挿入管の位置を前記少なくとも1つのAPS電極によって生成される信号に基づいて確定するように構成されている、装置。
(態様11)態様1に記載の装置において、前記電極上には導電性ヒドロゲルと膨張性のある導電性発泡体のうちの少なくとも一方が形成されて更に備えられている、装置。
(態様12)態様1に記載の装置において、前記気管内挿入管は、編組型の気管内挿入管を備えている、装置。
(態様13)態様1に記載の装置において、前記電極は4つの電極を含み、前記少なくとも1つの導体は少なくとも4つの導体対を含み、それぞれの導体対は前記4つの電極の異なった対に連結されて、当該4つの電極からのEGM信号の少なくとも4つのチャネルを提供している、装置。
(態様14)態様13に記載の装置において、前記処理装置は、前記EMG信号の4つのチャネルを分析し、前記分析に基づいて当該4つのチャネルの表示させるべきサブセットを識別するように構成されている、装置。
(態様15)態様1に記載の装置において、前記気管内挿入管上に少なくとも1つの無線センサを更に備えており、前記少なくとも1つの無線センサは無線式に情報を前記処理装置へ送信するように構成されている、装置。
(態様16)態様1に記載の装置において、前記電極のそれぞれは長さが少なくとも約1.9インチ(約4.826cm)である、装置。
(態様17)態様1に記載の装置において、前記電極は、少なくとも2つの水平方向電極と少なくとも2つの垂直方向電極を用いて電極格子を形成している、装置。
(態様18)態様1に記載の装置において、温度感知要素、光ファイバ要素、及びビデオ要素のうちの少なくとも1つを更に備えている、装置。
(態様19)態様1に記載の装置において、歪み測定要素、加速度測定要素、及び圧電要素のうちの少なくとも1つを更に備えている、装置。
(態様20)患者の喉頭筋のEMG信号を監視する方法において、外表面と前記外表面上に形成されている導電性インク電極を有する気管内挿入管を提供する段階と、前記気管内挿入管を患者の気管に設置しておいて、喉頭筋からの前記EMG信号を前記導電性インク電極を用いて感知する段階と、前記導電性インク電極によって感知される前記EMG信号を処理装置へ出力する段階と、を備えている方法。
(態様21)患者の喉頭筋のEMG信号を監視するための装置において、外表面を有する気管内挿入管と、前記気管内挿入管の前記外表面上に形成されている4つの電極であって、当該気管内挿入管が患者の気管に設置されているときに喉頭筋からの前記EMG信号を受信するように構成されている4つの電極と、前記4つの電極に連結されていて当該電極によって受信される前記EMG信号を処理装置へ搬送するように構成されている少なくとも4つの導体対であって、それぞれの導体対は前記4つの電極の異なった対に連結されて、当該4つの電極からのEGM信号の少なくとも4つのチャネルを提供している、装置。
102 ソリッドワイヤ
104 管継手
106 カフ膨張用導管
108 相互接続部
110 押出成形ポリマー管
112 ワイヤ電極
113 可撓性のある管分節
114 一次カフ
120 神経保全モニタ(NIM)デバイス
300 EMG気管内挿入管
302 ソリッドワイヤ
304 管継手
306 カフ膨張用導管
308 相互接続部
310 押出成形ポリマー管
312 テープ貼り電極
314 一次カフ
316 電極ワイヤ
500 EMG気管内挿入管
502 ソリッドワイヤ
504 管継手
506 カフ膨張用導管
508 相互接続部
510 PVC管
512 導電性インク電極
514 一次カフ
520 管の壁
522 ルーメン
800 EMG気管内挿入管
804 管継手
806 カフ膨張用導管
810 PVC管
812 複数対の導電性インク電極
814 一次カフ
820 管の壁
822 ルーメン
1100 EMG気管内挿入管
1110 PVC管
1114 一次カフ
1130、1130−1、1130−2 二次カフ
1132 導電性インク電極
1133、1137 二次カフの端部
1135 二次カフの中央部分
1300 EMG気管内挿入管
1302 ソリッドワイヤ
1304 管継手
1306 カフ膨張用導管
1310 PVC管
1312 電極
1314 一次カフ
1320 視覚標示
1500 EMG気管内挿入管
1502 ソリッドワイヤ
1506 カフ膨張用導管
1510 管
1512 電極
1514 一次カフ
1520 磁石標示
1530 磁石ピックアップセンサを含むデバイス
1800 EMG気管内挿入管
1802 ソリッドワイヤ
1804 管継手
1806 カフ膨張用導管
1810 PVC管
1812 電極
1814 一次カフ
1820 連結アダプタ
1830 挿入管近位端の旋回方向
2000 EMG気管内挿入管
2002 ソリッドワイヤ
2004 管継手
2006 カフ膨張用導管
2010 PVC管
2012 EMG電極
2014 一次カフ
2020 リブ
2200 EMG気管内挿入管
2204 管継手
2206 カフ膨張用導管
2210 管
2212 電極
2214 一次カフ
2400 EMG気管内挿入管
2402 ソリッドワイヤ
2404 管継手
2406 カフ膨張用導管
2410 管
2412 電極
2414 一次カフ
2700 EMG気管内挿入管
2704 管継手
2710 管
2712 電極
2714 一次カフ
2720 食道伸張部
2722 食道電極
2730 舌
2732 気管
2734 食道
2800A EMG気管内挿入管
2802A 電極
2800B EMG気管内挿入管
2802B 電極
2802B−1 電極の第1セット
2802B−2 電極の第2セット
2800C EMG気管内挿入管
2802C−1、2802C−2 電極
2800D EMG気管内挿入管
2802D 電極アレイ
2802D−1、2802D−2 水平方向電極
2802D−3、2802D−4 垂直方向電極
2900 EMG気管内挿入管
2902 ソリッドワイヤ
2904 管継手
2910 管
2912 電極
2914 一次カフ
3000 EMG気管内挿入管
3002A、3002B、3002C、3002D 電極
3004 管
3100 EMG気管内挿入管
3110 管
3112A、3112B 電極
3114 一次カフ
3120A、3120B 電極キャリア
3200 カフ
3202 展開可能なカフ部分
3204 引張部材
3302 電極
3304 共通ノード
3306 正極端子
3308 端子
3410 管
3412 可撓性電極
3422、3424 一対の保持リング
3500 EMG気管内挿入管
3510 管
3512 電極、
3512A、3512C 前部電極
3512B 後部電極
3514 一次カフ
3520 電極の管周囲方向の距離
3522 電極同士の管周囲方向の離間距離
3524A、3524B、3524C トレース
3526A、3526B 露出(非マスク)領域
3528 防護(マスク)領域
3530 電極重複領域
3600 気管内挿入管
3610 管
3612 電極
3612A、3612B 後部電極
3612C、3612D 前部電極
3614 一次カフ
3620 電極の管周囲方向の距離
3622 電極同士の管周囲方向の離間距離
3624A、3624B、3624C、3624D トレース
3626A、3626B 露出(非マスク)領域
3628 防護(マスク)領域
3630 電極重複領域
3700 EMG気管内挿入管
3710 管
3712、3712A、3712B、3712C、3712D 電極
3714 一次カフ
3724A、3724B、3724C、3724D トレース
3726A、3726B 露出(非マスク)領域
3728 防護(マスク)領域
3730 電極離隔領域
3800 EMG気管内挿入管
3810 管
3812、3812A 電極、リング電極
3814 一次カフ
3900A EMG気管内挿入管
3902、3904、3906 帯
3908 垂直方向線分
3900B EMG気管内挿入管
3910 帯
3914 垂直方向線分
3916、3918、3920 水平方向線分
3900C EMG気管内挿入管
3922 帯
3924 共通の点
3926 垂直方向線分
3928 水平方向線分
3930、3932 対角方向線分
3900D EMG気管内挿入管
3934 帯
3936、3940 三角形のマーク
3938 共通の点
3942 垂直方向線分
3900E EMG気管内挿入管
3950 帯
3952 垂直方向の線又は条片
3952A、3952C 垂直方向条片の端部分
3952B 垂直方向条片の中央部分
3954 水平方向の線又は条片
Claims (19)
- 患者の喉頭筋のEMG信号を監視するための装置において、
外表面を有する気管内挿入管と、
前記気管内挿入管の前記外表面上に形成されている導電性インク電極であって、当該気管内挿入管が患者の気管に設置されているときに喉頭筋からの前記EMG信号を受信するように構成されている導電性インク電極と、
前記導電性インク電極に連結されていて、当該導電性インク電極によって受信される前記EMG信号を処理装置へ搬送するように構成されている少なくとも1つの導体と、
を備えており、
前記気管内挿入管上に形成されている少なくとも1つの自動式周期的刺激(APS)電極を更に備えており、
前記処理装置は、前記気管内挿入管の位置を前記少なくとも1つのAPS電極によって生成される信号に基づいて確定するように構成されている、装置。 - 請求項1に記載の装置において、
前記導電性インク電極は、銀充填ポリマー導電性インクを備えている、装置。 - 請求項1に記載の装置において、
前記導電性インク電極は、炭素導電性インクを備えている、装置。 - 請求項1に記載の装置において、
前記導電性インク電極は、長手方向に前記挿入管の長さに沿って延びていて前記気管内挿入管の周囲を取り囲むように離間されている少なくとも6つの導電性インク電極を含んでいる、装置。 - 請求項1に記載の装置において、
前記気管内挿入管に接続されている膨らませることのできるカフと、
前記膨らませることのできるカフ上に形成されている少なくとも1つの導電性インク電極と、を更に備えている、装置。 - 請求項5に記載の装置において、
前記膨らませることのできるカフ上に形成されている前記少なくとも1つの導電性インク電極は、患者の声帯襞からのEMG信号を感知するように構成されている、装置。 - 請求項1に記載の装置において、
前記気管内挿入管上には前記導電性インク電極付近に光源と磁石のうちの少なくとも一方が配置されて更に備えられている、装置。 - 請求項1に記載の装置において、
前記気管内挿入管の近位端を当該気管内挿入管の遠位端に対して回転させられるように構成されている連結アダプタを更に備えている、装置。 - 請求項1に記載の装置において、
前記気管内挿入管を取り囲んでいて当該気管内挿入管上の前記導電性インク電極の近位端側に配置されている第1リブと、
前記気管内挿入管を取り囲んでいて当該気管内挿入管上の前記導電性インク電極の遠位端側に配置されている第2リブと、を更に備えている、装置。 - 請求項1に記載の装置において、
前記電極上には導電性ヒドロゲルと膨張性のある導電性発泡体のうちの少なくとも一方が形成されて更に備えられている、装置。 - 請求項1に記載の装置において、
前記気管内挿入管は、編組型の気管内挿入管を備えている、装置。 - 請求項1に記載の装置において、
前記電極は4つの電極を含み、前記少なくとも1つの導体は少なくとも4つの導体対を含み、それぞれの導体対は前記4つの電極の異なった対に連結されて、当該4つの電極からのEGM信号の少なくとも4つのチャネルを提供している、装置。 - 請求項12に記載の装置において、
前記処理装置は、前記EMG信号の4つのチャネルを分析し、前記分析に基づいて当該4つのチャネルの表示させるべきサブセットを識別するように構成されている、装置。 - 請求項1に記載の装置において、
前記気管内挿入管上に少なくとも1つの無線センサを更に備えており、前記少なくとも1つの無線センサは無線式に情報を前記処理装置へ送信するように構成されている、装置。 - 請求項1に記載の装置において、
前記電極のそれぞれは長さが少なくとも約1.9インチ(約4.826cm)である、装置。 - 請求項1に記載の装置において、
前記電極は、少なくとも2つの水平方向電極と少なくとも2つの垂直方向電極を用いて電極格子を形成している、装置。 - 請求項1に記載の装置において、
温度感知要素、光ファイバ要素、及びビデオ要素のうちの少なくとも1つを更に備えている、装置。 - 請求項1に記載の装置において、
歪み測定要素、加速度測定要素、及び圧電要素のうちの少なくとも1つを更に備えている、装置。 - 患者の喉頭筋のEMG信号を監視するための装置において、
外表面を有する気管内挿入管と、
前記気管内挿入管の前記外表面上に形成されている4つの電極であって、当該気管内挿入管が患者の気管に設置されているときに喉頭筋からの前記EMG信号を受信するように構成されている4つの電極と、
前記4つの電極に連結されていて当該電極によって受信される前記EMG信号を処理装置へ搬送するように構成されている少なくとも4つの導体対であって、それぞれの導体対は前記4つの電極の異なった対に連結されて、当該4つの電極からのEGM信号の少なくとも4つのチャネルを提供している、少なくとも4つの導体対を備えており、
また、前記気管内挿入管上に形成されている少なくとも1つの自動式周期的刺激(APS)電極を更に備えており、
前記処理装置は、前記気管内挿入管の位置を前記少なくとも1つのAPS電極によって生成される信号に基づいて確定するように構成されている、装置。
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