JPS5944060B2 - endotracheal tube - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION The present invention relates to endotracheal tubes, and more particularly to endotracheal tubes that are particularly useful for insertion into the left main bronchus.

Unilateral pulmonary anesthesia completely collapses the lung on the side where the thoracotomy is performed,
This method performs general anesthesia by ventilating only the lung on the side where the thoracotomy has not been made, and is extremely useful for facilitating operations on the lungs, esophagus, mediastinum, thoracic aorta, etc.

A single-lumen endobronchial tube, which is used as a method for performing unilateral pulmonary anesthesia, is mainly used for left-sided pulmonary anesthesia due to the length of the main bronchus. is a tube as shown in FIG.

However, the single lumen endobronchial tube 1°1 has the following drawbacks.

(a) The tracheal bifurcation 14 is often slightly to the left (to the right in the figure) of the center line of the trachea 13, and the right main bronchus 15 has a bend of about -25° with respect to the trachea 13. However, the left main bronchus 16 is curved at an angle of approximately 45 degrees with respect to the trachea 13, and it is difficult to insert the endobronchial tube 11 into the left main bronchus 16 reliably from the anatomical point of view of the bronchus. With a single-lumen endobronchial tube, it is not possible to suction out secretions (such as sputum, blood, etc.) in the bronchus on the opposite side of the tube, and gases such as oxygen cannot be delivered. The present invention has been made to solve the above-mentioned conventional problems, and an object of the present invention is to provide an endotracheal tube that can be easily and reliably inserted into the left main bronchus. .

That is, in the endotracheal tube of the present invention, the tube is curved, and the wall portion on the curved side of the tube exhibiting the concave portion is the thinnest, and the wall portion of the tube on the curved side exhibiting the convex portion is the thickest. It is characterized by

FIG. 2 is a perspective view showing an example of the configuration of the endotracheal tube of the present invention, and FIG. 3 is a sectional view taken along line A-A.

The endotracheal tube has a curved tube 17, a cuff 1B is provided in the middle of the tube, and a small hole 20 for cuff inflation is provided in the tube wall 21, and this hole is inserted into the cuff attached to the tube. It communicates with the air supply means 19 of.

The wall portions of the tube have different thicknesses in the circumferential direction, with the wall portion on the curved side 17a representing the four parts of the tube being the thinnest, and the wall portion on the curved side 17b representing the convex portion of the tube being the thickest.

As a result, the inner peripheral surface of the tube is eccentric with respect to the outer peripheral surface.

In other words, the lumen of the tube is eccentric with respect to the tube.

Note that the curved side of the tube that exhibits the concave portion is located furthest forward during endotracheal intubation.

The distal end portion of the endotracheal tube may be cut straight (with a circular cut surface) or diagonally in a locus shape (with an elliptical cut surface).

From the viewpoint of ease of insertion into the trachea, the cut surface should be at an angle of approximately 90° with respect to the curved line of the tube.In other words, when the tube is placed on a flat surface, the cut surface should be at an upward angle (see Figure 2) or downward (180° offset relative to that in Figure 2).

) is preferable.

FIG. 4 is a perspective view showing another structural example of the endotracheal tube of the present invention, and FIG. 5 is a sectional view taken along line BB.

In this configuration example, a small-diameter through hole 23 is further bored in the wall portion over almost the entire length of the tube in the longitudinal direction.

Although the position of the through hole 23 in the circumferential direction does not matter, it is preferable that the through hole 23 be bored in the wall portion on the side where the convex portion is formed as shown in the figure.

Further, the through hole 23 communicates with a mantle tube 24 attached to the tube.

The lumen 22 functions as a ventilation hole and also serves as a guide hole when inserting an endobronchial tube, which will be described next, into the left main bronchus.

In addition, after the endobronchial tube passes through the ventilation hole of the endotracheal tube and is inserted into the left main bronchus, the through hole becomes a hole that communicates the outside world with the right main bronchus, but it should be plugged when it is not needed. put.

Although the endotracheal tube may be made of any suitable material, it is preferable that the endotracheal tubes be made of different materials in order to ensure smooth insertion of the endobronchial tube, which will be described later.

FIG. 6 is a perspective view showing an example of the configuration of the left endobronchial tube inserted through the lumen (ventilation hole) of the endotracheal tube of the present invention, and FIG. 7 is a sectional view taken along the line C-C. It is.

The shape is that of a normal endotracheal tube that is made thinner and longer, but it is preferable that the degree of curvature of the 3 to 5 parts from the distal end is larger than that of the other parts.

The tube 17' is curved as a whole and has a cuff 1B' having a length of about 2 to 3 cm near the tip.

A small hole 20' is provided in the wall of the tube and communicates with the cuff for inflation of the cuff, and this small hole 20' communicates with means 19' attached to the tube for supplying air to the cuff.

Further, 2z represents the inner cavity (ventilation hole).

The distal end of the endobronchial tube has a beveled shape with a diametrical inclination.

As shown in Fig. 6, this locus-shaped shape is inclined so that the cut end faces the curved line that presents the convex part of the tube, and the 8th
The bevel-shaped inclination at the distal end of the conventional endotracheal tube shown in the figure is deviated by 90°.

As a result, the endobronchial tube shown in FIG. 6 can be inserted more reliably into the left main bronchus.

Next, a method of using the endotracheal tube of the present invention will be explained.

The direction of the cut end of this tube is deviated by 18d' from that shown in FIG. 2 or 4.

According to the usual method, the endotracheal tube 25 of the present invention is inserted with some care into the patient's trachea 13 (see FIG. 9).

Then, the endotracheal tube 25 is rotated 90° counterclockwise, and the lumen (ventilation hole) 22, that is, the guide hole for the endobronchial tube, is rotated so that the beveled tip of the endotracheal tube faces toward the left main bronchus 16. Orient yourself.

Then, after inflating the cuff 18 of the endotracheal tube 25, the tube is secured to the patient.

When administering left-side pulmonary anesthesia, the endobronchial tube is inserted through the guide hole 22 of the endotracheal tube 25, but the wall thickness of the endotracheal tube is different, and the guide hole 22 of the endotracheal tube is different from the guide hole 22 of the endotracheal tube. Since it is eccentric with respect to the outer peripheral surface, the central axis of the guide hole 22 is deviated toward the left main bronchus 16, and the endobronchial tube is quickly inserted into the left main bronchus 16.

The above situation is shown in FIGS. 10 and 11. When the endobronchial tube 26 is inserted, the ventilation hole of the endotracheal tube is deviated to the left main bronchus 16 side, and the endobronchial tube 26 is Since the endobronchial tube is delivered in an outward curve, the distal end of the endobronchial tube enters the left main bronchus 16 so as to rub against the left wall of the trachea, so that the endobronchial tube is easily and reliably inserted into the left main bronchus 16.

The endobronchial tube is then connected to the anesthesia machine and the cuff 18 of the endobronchial tube 26 is inflated (FIG. 11).

Next, while ventilating with the anesthesia machine bag, auscultate the left lung to confirm that normal breath sounds can be heard throughout the left lung.

Of course, the position of the endobronchial tube can also be confirmed by chest X-ray photography or fiberoptic bronchoscopy.

The endobronchial tube is then secured to the endotracheal tube with tape or a suitable stopper.

As explained above, by using the endotracheal tube of the present invention, the endobronchial tube can be easily and reliably inserted into the left main bronchus.

In addition, if a through hole is provided in the endotracheal tube, even after the endobronchial tube has been inserted into the left main bronchus, if secretions in the right bronchus need to be suctioned, a suction catheter can be inserted through this hole. If you wish to introduce oxygen or the like into the right bronchus, you can do so through this hole.

Therefore, the present invention makes it possible to perform left-side lung ventilation more easily and reliably than when using only a conventional single-tube pulmonary endotracheal tube, and its effects are extremely significant.

[Brief explanation of the drawing]

FIG. 1 is a diagram showing a state in which a conventional single-lumen endobronchial tube is inserted into the left main bronchus. FIG. 2 is a perspective view showing an example of the configuration of the endotracheal tube of the present invention, and FIG. 3 is a sectional view taken along the line A-A. FIG. 4 is a perspective view showing an example of the configuration of the endotracheal tube of the present invention, and FIG. 5 is a sectional view taken along the line BB. FIG. 6 is a perspective view showing an example of the configuration of the endobronchial tube, and FIG. 7 is a sectional view taken along the line CC. FIG. 8 is a perspective view showing the shape of the tip of a conventional endobronchial tube. FIGS. 9 to 11 are explanatory views of how to use the endotracheal tube of the present invention. 13...Trachea, 15...Right main bronchus,
16...Left main bronchus, 17...Tube, 17a...Curved side of the tube exhibiting a concave portion, 11b...Curve exhibiting a convex portion of the tube Curved side, 1B, 18...Cuff, 22.22'...
...Inner cavity, 23...Through hole, 25...
・Endotracheal tube, 26...Endobronchial tube.

Claims (1)

[Scope of Claims] 1. The tube is curved, and the wall portion of the tube on the side of the curved line exhibiting a concave portion is the thinnest, and the wall portion of the tube on the side of the curved line exhibiting a convex portion is the thickest. Endotracheal tube. 2. The method according to claim 1, wherein a small-diameter through hole is bored in the wall portion representing the mortar along substantially the entire length of the tube.