JPH06505901A - A combination of a nutrition supply tube from the nose to the stomach and an electrode - Google Patents

Abstract

(57) [Summary] This bulletin contains application data before electronic filing, so abstract data is not recorded.

Description

[Detailed description of the invention] Combination of a nutrition supply tube from the nose to the stomach and an electrode The invention is a combination of a nutrition supply tube and an electrode from the nose to the stomach. Concerning union with poles.

A sick newborn baby (neonatal) or premature baby, e.g. at 24 weeks gestation Babies born early sometimes require electrocardiography (ECG) and constant monitoring of breathing. Great care is taken. It is traditionally placed on the baby's legs! Three skin electrodes It is done using poles. These electrodes are connected to the electrical current generated by the heart (ECG). Detect position. The third standard (3-lead linearity!) is the voltage difference between the two electrode tubes. It is common to detect IECG by measuring . But one criterion Detecting the ECG using one electrode based on the electrode (2+J- line configuration) You can also do it. The ECG electrodes provide respiratory support by applying high frequency voltage to two of the electrodes. to detect breathing by detecting impedance changes in the chest during cycling. can also be used.

The use of glued electrodes on the baby's legs not only causes discomfort to the patient and may cause the baby to fall prematurely. It causes severe damage to the extremely sensitive skin of the body and covers the lung area on chest X-ray.

All babies who need intensive care and many babies who need special care are at the other end of the spectrum. nasal passage having a luer fitting but with one end reaching the stomach, usually passed through the nose It has a tube that supplies nutrients from the stomach to the stomach. This baby is an injection containing milk into the Lua fitting above. Nutrients are supplied by pushing the container and holding the syringe, and the specific gravity of the mill Force the tube down the nasogastric tube. The tube has one or more holes on the side that allow milk to flow into the stomach. pass directly through.

Traditionally, measurements are made from the esophagus by using electrodes.

For example, ECG electrodes for the esophagus are used by being pushed through the nose and placed at appropriate points in the esophagus. .

The heart may be stimulated, for example by atrial basting, and the electrodes may be used for feeding purposes. There were no holes available for the baby, so a separate feeding tube was needed to feed the baby. , which is aesthetically unacceptable because it means two tubes passing through the baby's nose or mouth. It is something. These known electrodes are complex and therefore relatively expensive to manufacture.

The object of the present invention is to monitor the ECG and respiration mentioned above, for nutritional feeding purposes. Provides a nasal to stomach feeding tube and electrode combination while retaining the nasogastric tube There is a particular thing.

This requires a single skin electrode placed on the buttocks or upper back of the baby to be monitored. It is said that

According to one feature of the invention, the nasal to stomach feeding tube and electrode combination is at one end. The area of said coupling adjacent to the tube and other end with the coupling consists of a conductive material extending from the

In a preferred configuration, an electrical connector is removably coupled to the camp ring. to enable electrical contact with the conductive material.

The above electrical connector has two electrical leads of the same material electrically connected to it. The other end of each lead wire connects the electrode to the monitor. It is preferred to have a continuous bin connector.

In a preferred configuration, the coupling is a Luer.

Conveniently, the Lua is a conductive wire embedded within the wall that allows electrical connection of the electrodes. It is made of plastic material with material.

According to a second feature of the present invention, a combination of the above-mentioned nose-to-stomach nutrition supply tube and an electrode is provided. A method is provided for manufacturing a stainless steel wire, the method comprising: cleaning a length of stainless steel wire; Remove any residue, oil the wire above and attach it to a plug with a coupling at one end. Pass it through the center hole of the plastic tube, and insert the lower and upper notches into the other end of the tube. and pulling the wire from the tube wall through the upper notch, and Wrap the wire up to the lower notch until it re-enters the tube, and the end of the wire to the luer end of the tube with a heat-shrink plastic sleeve. It consists of the following steps.

According to a third aspect of the invention, there is provided a medico-surgical tube including a longitudinally extending electrically conductive wire. and this wire is wrapped around the outside of the tube in the patient's proximal area. The end of the tube then forms an integral electrode.

According to a fourth feature of the invention, an electrocardiogram supplying nutrients and having a medico-surgical tube as described above. A method for monitoring (ECG) is provided.

Embodiments of the present invention A combination of a nasal to stomach feeding tube and an electrode according to the present invention The description will be made with reference to the accompanying drawings showing elevations.

The electrode has a standard nasal to stomach feeding tube 1. Here we have a wide range of dimensions Nose-to-stomach feeding tubes are available, but in practice they are usually simply placed on the nasal unit. Two dimensions are used. 4 French gauge with an outer diameter of approximately 1.3mm is approximately 1 Usually used for feeding babies less than 500g. Also, approximately 1500g or more A 6 French gauge (FG) with an outer diameter of approximately 2.0 II- ) The feeding tube in which the tube is used is 75 cm long, and the wall thickness is 4FG, approximately 0.0 35■- and 0.4s+m at 4FG. Here, any of the above dimensions However, the present invention is not limited thereto.

At one end of the feeding tube there is a luer 2 of conventional construction, with a strap 4 It has a closure cap 3 connected to said luer. The conductive wire 5 is the nutrient supply pipe 1 is secured to the Lua by a plastic sleeve 6 which is shrunk to the It passes down inside the feeding tube and emerges from the wall of said tube adjacent to the other end.

The electrodes are made of 0.1m surgical grade 316 soft stainless steel wire. Ru. To assemble the above electrode, a 1 m long wire 5 is thoroughly cleaned and then Remove any residue and apply genuine sunflower oil to the center of tube 1 from the Luer end. passed through the hole. Two small cuts 7 and 8 are each 12.5 cm from the tube end 9. m and 13.5 cm into the tube wall. Above stainless steel The end is pulled out of the wall at notch 8 and wrapped around the outside of the tube to complete the process. Form a two-turn spiral. Therefore, the end of the above wire was trimmed to approximately 1. Push the wire c- back into the cut 7 so that it re-enters the tube l.

Any slack in the helix 10 will pull the free end of the wire protruding from the Luer fitting. (.

Both cuts are 12.5 cm and 13.5 cm in the 6FG nasal to stomach feeding tube. Formed at 5 cm and 9.5 cm in the nasal to stomach feeding of 4FG It is formed at a distance of 10.5 cm. This is 13cm and 10cm respectively. Form an electrode with a heart.

Depcoat the electrode with PvC. This coating solution is in tetrahydrofuran. Formed from medical grade PvC granules dissolved in

The above electrode was dipped several times to ensure that both notches were fully repaired and the above stainless steel wire electrode was immersed several times. Make sure to cover the electrodes. Next, use a scalpel to cut the electrode wires together. The PvC is exposed by peeling it off from the layer. Cover the above electrode with PvC. The reason for this is to prevent the final electrode from causing trauma or damage to the baby's esophagus by tube 1. This is for the purpose of The above stainless steel is carried onto the top of Lua 2 and coated with PvC. Ru. Here, the stainless steel is passed down on the outside of Lua 2 to provide electrical insulation and safety. is applied and held in place by a heat-shrinked plastic sleeve 6.

The nasal to stomach feeding tube and electrode combination is connected to a monitoring device. This supervisor The visual device was manufactured by He May be 883 type series Neonatal, male and female Lua tubular connectors 11 is constructed of surgical grade 316 stainless steel. 2 electrical leads 1 2 and 13 are soldered to the outside of connector 11 at 14 using lead wire-free solder. be kicked. Each lead has a standard 21 straight bin connector 15 and 16, respectively. , allowing connection to the monitoring device at the other end.

The outside of the stainless steel Luer connector 11 is insulated using PvC heat shrink tubing. child The sleeve extends over the straight side of said Luer and its tapered end connects to the Luer fitting on tube 1. inserted into.

To supply nutrition to a baby fitted with the combination of the above-mentioned nose-to-stomach nutrition supply tube and electrode. To do this, insert the syringe containing milk into the female Lua at the top of the stainless steel Luer fitting 11. can be inserted into the baby without removing the electrodes from the monitoring device. Can provide nutrients.

The reason why two electrodes are attached to the above connector is that the conventional technology uses three skin electrodes. The purpose of this is to replace those with two electrodes that supply nutrients from the nose to the stomach. . The above monitoring device, namely the Hewlett Packard monitor, consists of three connected leads. The combination electrode is designed to accept this.

If a 4FG naso-gastric feeding tube is used, its open end should be fitted with the Luer connector described above. Due to the manufacturing process, the stainless steel electrodes mentioned above may The wire substantially closes this opening making it difficult to supply nutrients to the supply tube 1. Ru. To overcome this, the wire is routed through the side of the nasal-to-stomach feeding tube. and pull it directly below the Lua fitting mentioned above. The above cut in the above pipe is sealed with PVC. The above stainless steel wire is soldered to the two cables and the solder joint. so that any bare stainless steel wire is electrically insulated. Each cable is Having a two-way connector at its free end, the electrical connection to the monitoring device is No need for stainless steel luer connectors.

The above electrode according to the present invention includes a reference electrode attached to the buttocks or lower part of the baby. Used as a New Vola ECG electrode. The baby's buttocks or upper back are It is the best place to use as a reference electrode because the signal generated is good. Baby's chest is monitored Motion artifacts revealed in the device are minimized.

The test conducted using the above naso-gastric electrode was carried out 10 cm from both ends of the above feeding tube. and 13 cm is the optimal position for installing the stainless steel electrode on the nutrient supply tube. It was shown that The best signal is obtained at the end of the electrode above, where it is monitored Projecting from both ends of the tube is positioned between the baby's vertebrae C3 and T3. good A good signal is obtained throughout the esophagus, and with the electrode at this level the signal is good. amplitude and minimal motion artifacts. From our tests, The electrodes placed at 10cm on the 4FG tube and at 13cm on the 6FG tube were originally It was calculated that it was properly positioned in the esophagus when it was in the correct position.

Various 1! Various configurations are possible with the nose-bielectrode of the present invention, for example, the electrical A duct can be provided in the hole described with reference to the drawings, in which case the duct The conductor shall be dimensioned so as not to interfere with the normal use of the supply pipe. . As the above plastic wall has sufficient electrical insulation properties, it can be used for ECG/respiratory use. There is no need to insulate the conductor within the lumen of the nasogastric tube.

In the modified configuration described and illustrated above, the electrical conductor has the required electrical insulation. It may be placed within the wall of the supply pipe while maintaining its properties.

The electrical conductor may be a non-toxic cable or material embedded within the wall of the supply pipe. The material may be formed from a conductive polymer such as PVC to which graphite is added before curing. , the conductive material can be formed by running radiation streaks over the supply tube.

A medical-surgical tube with conductive wires running along its length is integral! form a pole close to the patient side of the tube! with wire wrapped around the outside of the tube in the area The wire may have an exposed or conductive polymer on the surface of the electrode. may be coated with

In other configurations, one or more conductors within the nasogastric tube or the nasogastric The wall of the gastric tube is embedded with conductive muscle on the outside of the tapered part of the female Luer 6, so the wall of the gastric tube is It may be delivered outside the nasogastric tube.

A separate ring-shaped connector with a corresponding conductive strip on its inside is attached to the nasogastric tube. and fits onto the tapered portion of the female luer 6. Embedded in the ring type connector above The cable connected to the conductive muscle and thus the conductor in the nasogastric tube make electrical contact with the controller.

Inaccurate connections can be prevented if multiple electrodes are used as keys.

The electrode conductor described above may also be more suitable since it is more inert. said male or female tube in contact with a conductor in said nasogastric tube, which may be formed with a conductor; Both metal parts of a must be made of the same metal to avoid electrochemical reactions. Must be. In other u#a, interference effects such as common mode signals are 2-lead linear The above ECG monitoring in the 3 + J-line configuration has fewer advantages compared to the The two electrodes are placed close together on the supply tube, e.g. It is set up according to In other arrangements, the two electrodes may be one electrode as described above. in the upper or middle esophagus, and the other electrode is in the lower half of the esophagus or stomach. is installed on the supply pipe so that According to this aspect, the 21J-do wire EC G is obtained using the lower electrode as the reference electrode, and as such for ECG measurements. The skin electrodes are completely omitted. In other arrangements, the electrodes include two electrodes. are adjacent in the upper or middle esophagus and the third pole is located in the lower half of the esophagus or stomach. is provided on the supply pipe so as to This arrangement allows the recording of the 3-lead ECG. The recording is obtained using the lower electrode as the reference electrode, thus making it possible to The skin electrodes are completely omitted, and the advantages of the three-lead wire configuration are realized throughout the entire thickness. breathing is good This can be obtained using one of the lower electrode and upper electrode described below.

If only ECG and reading are required, the following arrangement can be adopted.

1. Run a cotton wick down through the above supply pipe so that it is installed on the outside of the above supply pipe. Make it work even if you are not kicked. In this case, the cotton wick is not provided with side holes. the ends of the supply tube that are connected. The above cotton wick can be used as an ion passage. There should be no moisture as this will affect the product. For example, the connection is the same as the stainless steel mentioned above. The luer end of the above feed tube with a silver luer connector of design is made to the cotton wick.

The purpose of the above cotton wick is to prevent air bubbles from breaking their continuity in the absence of ion channels. This is to form an ion passage throughout the supply pipe.

When the cotton wick does not emerge from the side wall of the supply tube and comes into direct contact with the esophageal mucosa. In this case, air bubbles generated between the cotton wick and the mucous membrane collapse the conductive path. If the electrode is formed outside the supply pipe, there is a danger that the reliability become high. The current is applied to the fluid in the supply pipe or to the fluid in the cotton wick. Flows by diffusing ions.

The electrode impedance is the impedance between the monitoring device and its associated measurement side. may be specified as a The impedance of such an electrode is generally that of a metal wire. The magnitude is several orders of magnitude higher than that. ECG is set to 100, for example. is obtained from the electrode impedance of the system. while breathing is monitored as above. Impedance technology uses lower impedance electrodes, for example a few hundred ohms. I need. The impedance of this type of electrode is too high for breathing, but it is Suitable for picking.

2. ECG is a stainless steel tube that runs downward to both ends of the above supply pipe where side holes are provided. Obtained from conductors such as steel. In this case, the conductor goes outside the above supply pipe. The electrodes do not need to be carried, increasing reliability if the electrodes are carried outside the supply tube. However, the possibility of intermittent signal loss makes it impossible to hold the electrode inside the supply tube. . The above electrode location is too low for good respiratory tracking, but for ECG reading. is suitable.

Microsensors can measure important signals such as ECG, respiration, temperature, pI (, redox and blood gases). may be connected to detect physiological changes.

pH - This is an antimony/antimony oxide electrode or an iridium/iridic acid pH-sensitive electrodes, or other pH-sensitive materials such as pH-sensitive polymers. So This type of electrode may be placed anywhere on the NG tube as required. 1. A suitable method is to sputter the material onto the outside of the supply pipe to form the supply pipe. Contact with the conductor carried to the wall of the tube. This type of electrode also detects ECG. suitable for

Redox - This can be monitored using appropriate electrode materials such as platinum or gold. the The electrodes can be formed in a manner similar to the ECG/breathing electrodes described above.

This electrode is also suitable for ECG and respiration detection.

Temperature - This can be detected using a bead thermistor, for example. This is 1 diameter Can be manufactured according to groove dimensions. This thermistor can be implanted into the side wall of the nasogastric tube or can be installed at both ends of the supply pipe. Temperature monitoring uses thermistor ink as a sensor This can be done using

Pressure - This can be measured using balloon technology, small tensile gauges or other suitable pressure sensors. Can be determined.

Blood Gases - Blood gas measurements such as pcO2 and p02 are often performed on baby monitoring units. and these are measured as part of the nose to stomach according to the present invention, optionally with senna. can be combined into a combination of a nutrition supply tube and an electrode.

Other means of sensor connection can be used in conjunction with the apparatus of the present invention. Supply tube above the electrode Instead of using a conductive wire to connect to its connection at the Luer end of the conductive materials such as conductive ink, graphite loaded with silicone rubber, or P Optionally, a fiber optic cable is embedded within the wall of the supply pipe where vC can be used. Alternatively, the fiber optic cable can be passed through the hole in the supply pipe, suitable for the measurement position. It has a suitable sensor. As one optical fiber cable with such a configuration, the end thereof is For example, some are coated with a membrane that detects pH or engine activity.

Other types of measurements, such as measuring bladder pressure, can be used for this purpose using techniques such as those outlined. This can be done using catheters conventionally used for.

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Claims (28)

[Claims] 1. having a coupling at one end and adjacent to the other end an area of said coupling; Nasal-to-gastric feeding characterized by comprising a tube having an electrically conductive material extending from the tube. A combination of a supply pipe and an electrode. 2. An electrical connector is removably connected to the coupling to transmit electricity to the conductive conductor. 2. The nasal to stomach feeding tube and electrode combination of claim 1 in contact with the material. 3. The electrical connector is a surgical plug having two electrical leads electrically coupled. It is a tubular plug made of stainless steel, and the other end of each lead wire is connected to the above electrode. 3. The nasal-to-stomach feeding tube of claim 2, further comprising a pin connector for connecting the tube to the monitor. and an electrode. 4. From the nose to the stomach according to any one of claims 1 to 3, wherein the coupling is a Lua. A combination of a nutrition supply tube and an electrode. 5. The conductive material is applied to the feed pipe luer as a conductive streak on the outside of the luer fitting. 5. The nasal-to-stomach feeding tube and electrode combination of claim 4, wherein the nasal-to-stomach feeding tube and electrode combination terminates in the aperture. 6. The electrically conductive material is one or more conductors embedded in the Lua, of which A ring-shaped connector with corresponding conductive stripes on the side fits into the Lua and connects the connector. 5. The nasal-to-gastric feeding tube and electrode combination of claim 4 in contact with the duct. 7. The nose of any one of claims 1 to 6, wherein the electrically conductive material is a metal wire. A combination of a nutrition supply tube to the stomach and an electrode. 8. The nasal to stomach feeding tube of claim 7, wherein the metal wire is stainless steel. and an electrode. 9. The nasal to stomach feeding tube and electrode according to claim 7, wherein the metal wire is titanium. A union with. 10. The electrically conductive material is a non-toxic strip embedded within the wall of the supply tube and is electrically conductive. Nasal gastric nutrition according to any one of claims 1 to 5, formed of a polymer. A combination of a supply pipe and an electrode. 11. The conductive material is a cotton wire that runs below the supply pipe to read the ECG. The tube for feeding from the nose to the stomach and the electrode according to any one of claims 1 to 5, Union. 12. A bead thermistor implanted into the wall of the nasogastric supply tube to monitor temperature. The feeding tube from the nose to the stomach according to any one of claims 1 to 11, including the star, and the electrode. A combination of. 13. A bead thermistor is installed at the gastric end of the supply tube to monitor temperature. A combination of the nasal-to-stomach nutrition supply tube and electrode according to any one of claims 1 to 11, Combined. 14. Nose according to any one of claims 1 to 5, wherein the conductive material is a conductive ink. A combination of a nutrition supply tube from the stomach to the stomach and an electrode. 15. The nasal passage according to any one of claims 1 to 5, wherein the sensor is a thermistor ink. A combination of a nutrition supply tube to the stomach and an electrode. 16.1 Lower and upper cuts into a plastic pipe with a coupling at the end form a hole in the tube, push the wire into the hole in the tube, and insert the wire into the tube through the upper notch. Pull it from above and wrap it around the above pipe until it re-enters the above pipe through the above lower cut. The feeding tube from the nose to the stomach and the electrode according to any one of claims 1 to 15, comprising the steps of: A method of manufacturing an assembly of 17. Clean the wire to remove any residue and allow passage into the tube. 17. The method of claim 16, wherein the method is coated with edible oil for ease of use. 18. the last wire before introducing the rigid wire into the coupling of the tube. 18. The method of claim 16 or 17, wherein the method is attached to. 19. The incision is made between 11 cm and 20 cm from the gastric end of the tube, and 19. The method according to claim 16, wherein the distance between the upper and lower notches is between 0.1 cm and 6 cm. Either one method. 20. The notch is repaired with PVC or silicone rubber, and the electrode center The part is also coated with PVC or silicone rubber, which is then scraped off and 20. The method of any one of claims 16 to 19, wherein the electrode is exposed. 21. The wire is wound helically around the outside of the tube between the cuts. The method according to any one of claims 16 to 20. 22. Claim 1: The wire is formed of surgical grade 316 stainless steel. Any 1 method from 6 to 20. 23. Claim: wherein the helical wire around the tube is two to four complete turns. Method 21 or 22. 24. A removable connector from the metal rod for insertion into the above coupling. form, solder the two leads to the connector above, and connect the standard straight pin connector. Insert the tube into each end of each lead wire to connect the nutrition supply tube from the nose to the stomach. Any of claims 16 to 23, facilitating connection of the assembly with electrodes to a monitoring machine. Method 1. 25. A method according to any one of claims 16 to 24, wherein the coupling is a Lua. . 26. A medico-surgical tube comprising an electrically conductive wire extending along its length, said wire is an integral electrode wrapped around the outside of the tube in an area near the patient end of the tube. A medical-surgical tube characterized by forming a. 27. the exposed surface of the wire of the electrode is coated with a conductive polymer; 27. The medico-surgical tube of claim 26. 28. A device for providing and monitoring an electrocardiogram comprising a medico-surgical tube according to claim 26. Law.