JPS62179471A - Intratracheal cuff indicator - Google Patents

Abstract

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

Description

[Detailed description of the invention] field of invention The present invention generally relates to endotracheal tubes.

More specifically, when the present invention is placed in the patient's trachea,
The present invention relates to a device for indicating the degree of inflation of an endotracheal tube cuff.

BACKGROUND OF THE INVENTION Endotracheal tubes are used in surgeries other than tracheostomy tubes and in emergencies. A typical endotracheal tube consists of a tubular piece approximately one foot in length, which has an inflatable balloon-like device known as a cuff at its distal end. An air inflation cuff channel is formed in the wall of the tube that opens at the intracuff end for inflation.

A small bore cuff tube is sealingly connected to the cuff channel. A valve is attached to the end of the cuff and the cuff is inflated by a conventional syringe through the cuff tube and cuff channel.

During intubation, the patient's epiglottis is pulled with the laryngoscope, and then the endotracheal tube is passed through the vocal cords, past the epiglottis, and then into the patient's bronchi, so that it is below the patient's vocal cords and Position the endotracheal tube cuff over the bronchus. Remove the laryngoscope while holding the endotracheal tube in place. The endotracheal tube is then secured in place with adhesive straps. Place an occlusal block in the patient's mouth to prevent occlusal damage to the endotracheal tube.

Attach the syringe to the valve at the end of the cuff tube and then fully manipulate the syringe to inflate the cuff by pumping air into the cuff through the cuff tube and cuff channel. In order to optimize the inflation of the cuff and the seal between the lumen of the patient's bronchus and the extratracheal cuff,
Usually 2 to 3 pumpings are required.

Epitracheal tubes are commonly used because they have many advantages over tracheostomies. In particular, the use of an epitracheal tube allows for the delivery of anesthetic and analgesic gases to the lungs, as well as the removal of carbon dioxide. Proper inflation of the cuff allows for "tight" tracheal anesthesia and completely prevents the accumulation of large amounts of carbon dioxide. In addition to being able to administer anesthetic and analgesic gases, the epitracheal tube provides a passageway for suction catheters that are placed into the bronchi, thereby preventing mucus buildup within the lung tissue, thereby reducing the risk of infection.
Therefore, the risk of pneumonia can be significantly reduced. Additionally, during surgical operations, the extratracheal tube can prevent mucus, blood, saliva, vomit, etc. from flowing into the bronchi and lungs.

As is clear here, if the inflation of the cuff is not properly achieved and the air gap between the lumen of the bronchus and the cuff of the epitracheal tube itself cannot be sufficiently sealed, the long duration of the epitracheal tube is difficult to obtain. Therefore, there is a tendency to over-inflate the cuff to ensure a proper seal between the bronchial lumen and the cuff. Unfortunately, however, overinflation of the cuff beyond the point necessary for proper sealing can result in necrosis and failure of the bronchial lumen.

One attempt to reduce the tendency for cuff overinflation has included balloons in parallel with the cuff supply tube. When the extratracheal cuff is inflated, the balloon also inflates. In this case, the anesthesiologist tests the degree of inflation of the cuff itself by performing a balloon-like tactile test between the index finger and thumb. This is clearly a subjective procedure, relying on the anesthesiologist's ability to palpate the balloon pressure and relate this to the degree of cuff inflation within the patient's bronchus. Although this balloon device can be used almost universally, it has obvious limitations when used by anesthetists with limited lab experience.

Recently, caged balloons have been developed that attach to the end of a cuff supply tube. The caged balloon consists of a thin-walled balloon mounted within a rigid cage. Similar to conventional balloons, when the extratracheal cuff is inflated, the thin-walled caged balloon also inflates. The cage has an opening that allows the anesthesiologist to perform a full tactile test of the balloon's inflation. If the cuff over-inflates, the balloon will protrude through the opening into the cage. This device is described in US Pat. No. 4,154,407, for example.
It is fully described in the publication no.

The caged balloons described above are not widely used. The main reason for this is that the air pressure in the endotracheal cuff can only be determined subjectively, since it functions in much the same way as a conventional cage-free balloon. Furthermore, due to their structure, caged balloons cannot be manufactured on an industrial production basis, and therefore their costs are high.

SUMMARY OF THE INVENTION Accordingly, it is an object of the present invention to provide an improved device which overcomes the above-mentioned drawbacks of prior art devices and which significantly contributes to the advancement of endotracheal tubes.

Another object of the present invention is to provide a means that can objectively indicate when the cuff of an endotracheal tube is inflated to properly seal the air gap between the bronchial lumen and the cuff wall. be.

Still another object of the present invention is to provide an indicator that indicates the full degree of inflation of the cuff of an endotracheal tube and allows proper cuff inflation during use.

Yet another object of the present invention is to provide an endotracheal cuff indicator that can be used with conventional endotracheal tubes without modifying the tubes themselves.

It is a further object of the present invention to provide an endotracheal cuff indicator that can be mass produced at relatively low cost, is simple in construction and highly reliable.

Still another object of the present invention is to provide an endotracheal cuff indicator that can visually and objectively indicate the degree of inflation of the endotracheal cuff to an anesthesiologist.

Yet another object of the present invention is to provide a tracheal cuff to which a conventional syringe can be attached and which can be manipulated by the syringe after injecting air to inflate the endotracheal cuff through the cuff tube and cuff channel. removed from the directional valve and immediately closed the valve to prevent air from escaping the cuff;
An object of the present invention is to provide an endotracheal cuff indicator manufactured together with the valve.

Other objects and features of the present invention will become apparent from the following detailed description of the invention.

DETAILED DESCRIPTION OF THE INVENTION In summary, the present invention provides a visual pressure indicator for an endotracheal cuff (
total). That is, the indicator according to the present invention comprises an indicator diaphragm that is disposed in a sealed manner within a main body by a cap.

An opening is formed in this cap to allow the indicator stem of the diamond 7 arm to protrude. A passage <m passage) provides fluid communication with the cuff supply tube throughout the gap between the diaphragm and the body. A one-way valve that can be operated by a syringe is provided in the main body, and air is inserted into the endotracheal cuff by the syringe. Fill the cuff and prevent air from escaping from the cuff after filling.

In use, the indicator of the present invention is attached to the end of the cuff delivery tube and a conventional infusion tube is attached to the indicator.

After the endotracheal tube is in place within the patient's bronchus, a syringe is used to force air into the endotracheal cuff through the one-way valve, cuff supply tube, and cuff supply channel.

As the cuff internal pressure increases, the indicator diaphragm of the indicator bends. Further, as the pressure increases, the indicator stem of the diaphragm protrudes from the opening in the cap attached to the indicator body. The indicator stem optimizes cuff inflation,
Once this indicates that the seal between this and the bronchial lumen is sufficient, remove the injector from the body of the indicator and then close the two-way valve to allow the air in the cuff to escape to the atmosphere. prevent this from happening.

The indicator of the present invention objectively indicates the degree of inflation of the cuff.

If air leaks from the cuff due to osmosis, or if anesthetic gas or analgesic gas leaks into the cuff due to osmosis, the resulting rise or fall in pressure will be visually and objectively indicated to the anesthetist. It will be done. In this case, the anesthesiologist can reattach the entire injector to the main body of the indicator and increase or decrease the internal pressure of the cuff by injecting air into the cuff or removing air from the cuff. Therefore, cuff inflation can be optimized throughout the entire surgery or emergency procedure. Additionally, the indicator of the present invention eliminates the subjectivity associated with conventional devices.

Preferred Embodiment of the Invention FIG. 1 is a detailed view of the endotracheal cuff indicator 10' of the present invention in use with a conventional endotracheal tube 12. The endotracheal tube 12 consists of a main tube 14 that is one foot or more in length. Main tube 14
A connector 16 is connected to the proximal end of the tube 14 to allow the anesthesiologist's equipment to be connected to the main tube 14. Endotracheal tube 12 is equipped with an inflatable device commonly known as a cuff 18 at its distal end. A cuff supply channel 22 is formed within the wall of the main tube 14 along its length. next,
Cuff supply tube 22t connects in fluid communication to cuff channel 20 at junction 24 . cuff tube 2
The air forcefully supplied to 2 has a force of 7 due to the opening 26.
0 into the cuff 18 itself.

The endotracheal cuff indicator 10 of the present invention is adapted to be attached to the end of the cuff tube 22 so that a conventional syringe 28 can be used to fill the cuff 1B with air.

Referring to FIG. 2, the indicator 10 of the present invention includes a body member 30 that includes a diaphragm receiving portion 52.
and a valve receiving portion 34. A diaphragm 36 is provided within the diaphragm receiving portion 32 of the main body 50, and a cap 38 is attached to the diaphragm receiving portion 32 of the main body 50, thereby enclosing the diaphragm 36. Further, a reciprocating valve member 40 for operating the syringe is provided in the valve receiving seat 34 of the main body 30, and a retainer is provided in the valve receiving seat 34.
Install 42.

More specifically, the diaphragm receiving portion 3 of the main body 30
2 comprises a peripheral upright annular wall 44 and a centrally disposed upright support 46 through which a central passageway extends into the valve seat portion 34 of the body 60.

The diaphragm 36 of the indicator 10 has a generally circular configuration with a diameter substantially equal to the diameter defined by the edges of the upright walls 44 of the body 30. Additionally, the diaphragm 36 has an upright stem 50 all centrally disposed. Preferably, the stem 50 and diaphragm 36 themselves are made from a resilient material such as 40 durometer polyvinyl chloride or silicone. Molded integrally. At the same time, the annular bellows portion 52 is integrally formed on the diaphragm 36, so that the elastic material does not need to be stretched too much.
The upward bending of the diamond 7 ram 66 is strengthened.

Cap 38 is shaped to secure diaphragm 36 in position on the edge of upright wall 44 of body 30. Preferably, the cap 38 comprises an annular step 54 whose inner edge engages the outer circumferential edge of the diaphragm 36 and presses it fully against the upper edge of the upright wall 44. An annular projection 56 is provided on the outer peripheral edge of the diaphragm 36 to enable it to be sealed to the upright wall 44 by the applied pressure of the cap 38.

The cap 38 is held in place around the vertical wall 44 of the body 30 by an annular projection 58 extending inwardly from the cap 38 and engaging within a corresponding annular notch 60 formed in the bottom edge of the diaphragm receiving portion 32 of the body 60. Preferably, it is fixed in position.

Furthermore, the cap 38 is centered around an opening 62 whose diameter is considerably larger than the diameter of the indicator stem 5Q. When the diaphragm 36 is in the unbent state, the stem 50 is in the opening 6.
The cap 38 and the stem 5o are mutually dimensioned so that they do not protrude outwardly from the stem 5o. Therefore, when not in use, the stem 50 protrudes from the opening 62.
The stem 50 will not be damaged during transportation or storage of the indicator 10.

The valve receiving portion 34 of the body 30 of the indicator 10 has a substantially cylindrical configuration with a central passageway 64 passing through its center. The passageway 64 has a smaller diameter portion 66 and a larger diameter portion 68 which together form a valve seat 70 . Valve member 40 is allowed to tail within passageway 64. The valve member 40 is made of neoprene, silicone, rubber, or the like, and its corresponding small diameter portion 74 and large diameter portion 76 together form a valve seat portion 78. Valve member 4
Since the interior 40A of 0 is hollow, the wall of the large diameter portion 76 is elastic.

In use, the valve member 40t is inserted into the central passageway 64 and then secured in place by the tube retainer 42. Preferably, retainer 42i is sonic welded to the wall of valve receiving portion 34 of body 30. When valve member 64f is held in place within passageway 46, valve seats 70 and 78 are forced together by notched leg member 8'2 integrally formed with retainer 42. Retainer 42 has a passageway 84 disposed in its center. Fluid communication between passageways 48 and 84 is provided by a notched channel 86 and notched leg member 82 formed in the wall of central passageway 64 of valve receiving portion 34.

When in use, the can tube 14 is installed in the passage 84 of the retainer 42 so as to be completely sealed. Next, the tip of the syringe 28 is attached to the other end of the indicator 10, and the end 88 of the valve member 40 is
to engage. The valve member 4 resists the elasticity of the wall of the large diameter portion 76.
The seal between valve seats 70 and 78 is broken and valve 40 is opened by pushing the tip of syringe 28 inward and sealing it to the edge of passageway 64 while moving the valve rearward. Syringe 28 is then operated to force air through passageway 64, cuff tube 22, and cuff channel 20 into cuff 18.

Valve member 48 allows free flow from air return injector 28.
A notch 90 may be provided at the end.

As the internal pressure of cuff 18 increases, diaphragm 36 bends and indicator stem 50 begins to protrude from cap 38 through opening 62vi-. Upon proper inflation of the cuff 18, as shown by the stem 50 extending from the cap 38, the syringe 28 is disengaged from the end of the body 30 and the valve member 40 is again forced forwardly by the leg members 82.

Thereafter, the valve seats 70 and 78 are tightly engaged with each other.

As can be understood from the above, according to the indicator 10 of the present invention, the drawbacks of conventional devices can be eliminated and all of the above objects can be achieved. In particular, the indicator 10 of the present invention eliminates the subjectivity associated with conventional devices in indicating to the anesthesiologist when the endotracheal tube 120 cuff 18 is correctly inflated. In this regard, it is also possible to form a scale on the indicator stem 50 to visually indicate the proportion f of the indicator stem 50 extending from the cap 38 during use.

Although the present invention has been described above with respect to its preferred embodiments, the present invention is not limited thereto.

[Brief explanation of drawings]

FIG. 1 shows full details of the endotracheal tube in its proper position within the patient's bronchus, with the indicator of the present invention attached to its cuff supply tube, allowing control of cuff inflation by means of a syringe. FIG. 2 is a longitudinal cross-sectional view of the indicator of the present invention to illustrate the indicator diaphragm with the stem projecting from the opening in the cap and to illustrate the one-way valve operated by the syringe; It is. In the drawings, the same figure number indicates the same member. 10: indicator, 12: endotracheal tube, 18: cuff, 2
0: Cuff supply channel, 22: Cuff supply tube, 28
: Syringe, 60: Main body, 32: Diaphragm receiver 9 parts,
34: Valve seat number part, 36: Diamond 7 ram. Agent Benj11. ± 1:°; Nobuwaga Procedural Amendments (released) May 3, 1986

Claims (5)

[Claims] (1) In an indicator for use with an endotracheal tube with a cuff inflatable via a cuff tube, a rigid body having a diaphragm receiving portion; an integral annular bellows portion to enhance mobility of the stem after bending; a flexible diaphragm disposed in the diaphragm receiving portion; means for sealing the flexible diaphragm within the diaphragm receiving portion to form a gap aligned with the stem and for retaining the stem after bending of the diaphragm; a cap having a projecting opening above the diaphragm and over at least a portion of the diaphragm;
and means for fluidly communicating the void with the cuff tube, thereby bending the diaphragm in proportion to the pressure within the cuff tube, and thus the cuff; An endotracheal cuff indicator that visually indicates the relative degree of (2) The indicator according to claim 1, wherein the diaphragm receiving portion comprises a vertical wall, and the diaphragm is sealed therein by the cap. (3) The indicator according to claim 2, wherein an annular projection is provided on the periphery of the diaphragm to strengthen the sealing engagement with the upright wall. (4) In an indicator for use with an endotracheal tube having a cuff inflatable via the cuff tube, a rigid body having a diaphragm receiving portion; an integral annular bellows portion to enhance mobility of the stem after bending; a flexible diaphragm disposed in the diaphragm receiving portion; means for sealing the flexible diaphragm within the diaphragm receiving portion to form a gap aligned with the stem and for retaining the stem after bending of the diaphragm; a cap having a projecting opening above the diaphragm and over at least a portion of the diaphragm;
and means for fluidly communicating the void with the cuff tube, thereby bending the diaphragm in proportion to the pressure within the cuff tube, and thus the cuff; an endotracheal cuff indicator having a one-way valve operable by a syringe in fluid communication with the cuff tube at the distal end thereof. (5) The one-way valve operable by the syringe includes: a main body having a valve receiving portion extending through a central passage; and a valve member reciprocably provided within the flow passage; forming an engagement surface in the flow path and the valve member that sealingly engages the valve member when pressed forward, and further pressing the valve member forward, thereby causing the syringe to engage the valve receiving portion. When the valve member is attached to the valve receiver, the valve member is pushed backward to cause fluid to flow from the syringe into the cuff tube through the flow path, and the valve member is removed by removing the syringe from the valve receiving portion. 5. The indicator according to claim 4, having means for moving the indicator forward and preventing fluid leakage.