JPS63270064A - Catheter assembly - 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 [Industrial Field of Application] The present invention is directed to the trachea, endotracheal tube, and tracheostomy tube.
The present invention relates to catheters, particularly balloon-tipped suction catheters, for suctioning and removing mucus, secretions and other deposits (hereinafter collectively referred to as "secretions"). SUMMARY OF THE INVENTION It is an object of the present invention to provide a catheter with improved tip structure and suction control structure that is capable of aggressively removing secretions and reducing the possibility of trauma during the removal operation.

The invention also relates to the use of such catheters. Balloon-tipped suction catheters, when used with a “Y” shaped connector that has a self-sealing diaphragm assembly, are designed to reduce positive pulmonary end-expiratory pressure (rPEEP).
J) can be maintained.

[Prior Art] Tracheobronchial secretions from an endotracheal tube or tracheostomy tube are
Usually removed by suction. This method of passing a suction catheter through the tracheostomy tube is ineffective, especially if the secretions are sticky and adhere to the walls of the tube. In addition, regardless of the carefulness of the method, complications may occur with this method.

These complications include mucosal damage, hemorrhage, and erosion of the tracheal mucosa. These drawbacks occur even in patients without lung disease.

Penny et al. U.S. Patent No. 3.9
No. 65.901 describes a catheter having an opening in the side of the distal end. These openings are intended to improve catheter effectiveness and reduce tissue damage. U.S. Pat. No. 4,240,433 to Bordow describes a sharp tip fluid aspiration needle with an inflatable balloon.

The balloon can be inflated and placed between the sharp tip of the needle and the internal organ during aspiration, minimizing movement of the sharp needle and thereby reducing the risk of accidental puncture.

Another drawback of the aspiration method described above is that it is not possible to preserve PEEP of the lungs.

While mechanically insufflating a patient, the usual practice is to use PEE where the ventilator applies a specific amount of pressure during the exhalation phase of the
Use P. During ventilation, it is desirable not to lose the positive pressure built up in the lungs.

Lung PEEP can generally be lost during the two steps of the aspiration method described above. First, PEEP can be lost during catheterization of the endotracheal tube. Positive pressure can be lost by exposing the inside of the tube to atmospheric pressure. Various sealing means to maintain pressure have been proposed. ! The first means is a slidable balloon surrounding the catheter. With the catheter in place, the balloon is then slid over the opening to close it. A disadvantage of this sealing method is that it requires the user to manually move the slidable balloon to form a seal. Another sealing device is Grimms (G
US Pat. No. 4,416,27
It is stated in No. 3. This patent describes a connector pulp assembly for retaining PEEP during catheter insertion and withdrawal. A check valve is used to prevent loss of positive pressure.

Second, positive pressure can be lost when suction is applied to the catheter to draw body fluids. In extreme cases, traditional suction catheters can destroy the lungs due to the negative pressure created by suction.

A balloon-tipped catheter for the male urethra containing the prostate is disclosed. Generally, such catheters are disclosed for use in injecting fluid into or removing fluid from a particular region. One or more balloons are used to isolate the area to be treated. These catheters do not disclose means for controlling the suction force to ensure that the downstream portion of the treatment section is not exposed to reduced pressure.

Control of these forces in the male urethra is less important than in the endotracheal tube. Significantly, the suction applied through the catheter can destroy the lungs when inserted into the endotracheal tube.

Another problem that is not considered a problem with male urethral treatment catheters is that
One problem is the removal of secretions that are tightly adhered to the walls of the passage or tube to be cleaned.

Male urethral secretions, such as pus, are not firmly attached to the surfaces on which they reside. Therefore, male urethral catheters generally include suction as a suitable means for removing secretions. Endotracheal tube secretions cannot be easily removed by suction because the secretions are tightly adhered to the walls of the endotracheal tube.

The disadvantages of aspiration can be avoided by removing secretions by excision. Removal can be performed using a balloon-tipped catheter. An arterial embolectomy catheter commercially available as Fogarty™ can be used. Insert the balloon into the endotracheal tube with it deflated. Once the desired location is reached, inflate the balloon until it contacts the side of the endotracheal tube. Pull the catheter out of the endotracheal tube while keeping the balloon inflated. When the catheter is pulled up, secretions adhering to the wall of the endotracheal tube are dislodged due to the balloon's contact with the tube wall. This is usually referred to as a ``squeegee''.
It is called action. The squeegee action is particularly useful for removing secretions from endotracheal tubes that are tightly adhered to the tube wall.

As the balloon is pulled up, secretions collect at the proximal end of the balloon. Accumulated secretions are removed when the balloon is removed from the endotracheal tube.

The disadvantage of excision is the efficiency of removing secretions. The secretion is
The balloon cannot be removed until it is fully raised from the endotracheal tube. Therefore, since the concentration of secretions proximal to the balloon is increasing, when the balloon is withdrawn,
The efficiency and ease of removing secretions is reduced.

[Structure of the Invention] The present invention attempts to eliminate these drawbacks. The present invention provides a balloon-tipped suction catheter and a method of using such a catheter to more efficiently and safely remove secretions from the trachea, endotracheal tube, and tracheostomy tube. The catheter of the present invention is uniquely designed to take advantage of both ablation and aspiration.

Another advantage of the present invention is that PEEP of a patient's tumor can be maintained by using a balloon tipped suction catheter in combination with a "Y" shaped connector having a self-sealing diaphragm assembly. To maintain pressure in the endotracheal tube, the seal must be maintained throughout. The self-pairing diaphragm assembly of the present invention retains its sealing capability throughout insertion and removal of the catheter. There is no need for user-operated sealing means to ensure that the interior of the tube is not exposed to environmental pressures.

A third advantage of the present invention is that it allows the operator to control the transmission of suction pressure through the catheter. The operator can ensure that the suction horn is not applied to the distal end of the catheter until after the balloon is inflated and seals the downstream portion of the balloon.

The present invention relates to methods and devices for the removal and aspiration of body secretions from the trachea, endotracheal tubes and tracheostomy tubes. The device comprises a hollow, long tube having distal and proximal ends. The distal end is inserted into the endotracheal tube to be irrigated.

The distal tip is rounded and soft to avoid damaging tissue. Additionally, the device comprises an inflatable membrane, sometimes referred to as a balloon, located at the distal end.

The hollow long tube is typically made from a suitable material such as polyvinyl chloride. The expandable membrane is made from a flexible material such as latex.

The cannula provides fluid communication to the interior of the expandable membrane at its distal end. The expandable membrane can be attached to the outer wall of the distal end of the long tube or directly to the distal end of the cannula. On the proximal side of the expandable membrane, there is an opening in the wall of the long tube that provides fluid communication between the inside and outside of the tube. Mucus and other secretions can be aspirated through these openings.

The proximal end of the long tube, ie, the end that is not inserted into the body cavity, is connected to a source of negative pressure. Negative pressure is provided by conventional methods known in the art.

A finger control portion is located at the proximal end of the long tube so that the operator can control the transmission of suction force applied to the distal end of the tube.

The proximal end of the cannula is connected to a positive pressure source capable of providing sufficient pressure to inflate the expandable membrane. This positive pressure source is typically a syringe.

The catheter is inserted into the endotracheal tube with the expandable membrane deflated. The digital control portion is not closed to prevent suction from being applied to the distal end of the catheter. After reaching the desired location, inflate the expandable membrane until it contacts the wall of the endotracheal tube. The catheter is then withdrawn from the endotracheal tube and the squeegee action between the balloon and the tube wall causes the secretions to be dislodged from the tube wall. As secretions build up proximal to the expandable membrane, they are removed by suction through an opening in the catheter wall. Suction can be achieved by placing a finger on the finger control portion and closing that portion.

Another aspect of the invention uses a catheter in combination with a connector assembly, typically referred to as a "Y" shaped connector, to maintain pulmonary PEEP during ablation and aspiration with a balloon-tipped catheter. . The first end of the connector assembly is tightly connected to an endotracheal tube or tracheostomy tube. The second end of the "Y" shaped connector assembly is aligned with the first end.
The end has a self-sealing diaphragm assembly. Preferably, the diaphragm assembly has three diaphragms in series. Each diaphragm has a sliced opening. The sliced openings are arranged such that each slice is preferably angularly offset from an adjacent diaphragm by about 60°. Misalignment of sliced opening (i,
It is important to maintain a pressure-retainable seal during insertion and removal of the catheter. Diaphragms are typically made from latex. The third end of the connector assembly is connected to a conventional exhalation source for insufflating the lungs.

In use, the catheter is inserted through a self-sealing diaphragm assembly. The assembly provides a seal to the catheter tube and protects the interior of the endotracheal tube from exposure to atmospheric pressure. Therefore, no positive pressure is lost inside the endotracheal tube. The ventilator is not removed because the catheter is inserted through a separate section. The boat control portion is open and no suction is transmitted through the catheter. Suction is applied only after the expandable membrane has been inflated and sealed against the wall of the endotracheal tube. Since the opening for suction is on the proximal side of the inflatable membrane, positive pressure in the lungs is not lost due to suction forces.

Other advantages of the invention will be understood from the following description of preferred embodiments.

FIG. 1 is a side view of a catheter of the present invention inserted into an endotracheal tube.

To illustrate a preferred embodiment of the invention, FIG. 2 depicts a catheter 10 employing the principles of the invention.

The catheter 10 has a cannula 11 with an inflatable membrane 12 attached to its distal end, and a long tube 13 surrounding the cannula 1.1. The long tube 13 may be of any suitable construction and is for aspirating secretions of the trachea, endotracheal tube or tracheostomy tube. Preferably, the structure is a semi-rigid long tube 13.

As shown in FIG. 2, the long tube 13 has a distal end 21 with a closed soft tip to avoid damaging body tissue. In the proximal portion of the distal end 21 is a tube 1
There are openings 22 and 23 in the walls of 3. Two openings are shown for illustration purposes only. The number of openings may vary as desired. The proximal end 25 of the long tube 13 provides fluid communication with a conventional suction source. The transmission of suction force to openings 22 and 23 is controlled by operation of control portion 24, as explained below.

Preferably, the long tube 13 has a round cross-sectional shape and a uniform cross-sectional area. To facilitate insertion, the long tube 13 may be formed into a bent configuration by any suitable method known in the art.

The cannula 2 extends along a long tube 13. Cannula 11 can be attached to long tube 13 in a variety of ways, some of which are described herein. One method is to secure cannula 11 to a long tube 13 at proximal and distal points. The second method is to remove canyule 1 by a conventional method.
This method involves gluing or welding 1 to a long tube.

A third method is to embed the cannula 11 within the wall of a long tube 13, as shown in FIGS. 2 and 3. Kanyure! Preferably, l has a uniform cross-sectional area.

An inflatable membrane or balloon 12 is attached to the wall of a long tube 13 as shown in FIG.

Expandable membrane! 2 is attached on both its proximal side 31 and distal side 32. Preferably, expandable membrane 12 is made from an expandable material such as latex. The expandable membrane remains deflated until positive pressure is applied. The material of the expandable membrane is sufficiently flexible to allow expansion into contact with the wall of a body passageway, such as endotracheal tube 14, in which the catheter is placed. The expandable membrane remains deflated until positive pressure is applied. Proximal end 3 of cannula 11
5 is attached to a positive pressure source 33. Typically, this positive pressure source 33 is a syringe.

The distal end 26 of the cannula 11 is connected to the cannula l! and the inside of the expandable membrane 12. As previously mentioned, the distal end 21 of the long tube 13 is closed and has a soft tip to avoid damaging body tissue.

It is not possible to fluidly communicate any fluid through the distal end 21.

In another aspect of the invention, as shown in FIG. 5, expandable membrane 12a is attached to the distal end of cannula lla at junction 41. The joint 41 connects the expandable membrane 1
It can be formed by sealing between 2a and cannula lla.

Encapsulation is conventional in the art. Alternatively, the expandable membrane 12a and cannula lla may be a unitary structure that does not require sealing. Distal end 21a comprises an opening that provides fluid communication between the inside and outside of elongated tube 13a.

Secretions are removed from the distal end 21a during the inhalation operation described below.
Can be inhaled through.

The catheter 10 shown in FIG. 2 formed by the method described above is
As illustrated in FIG. 2, the expandable membrane 12 is inserted into a body cavity, such as an endotracheal tube 14, in a deflated state. Control portion 24 is open so that no suction force is transmitted to the distal end of catheter IO. When the catheter 10 reaches the predetermined position in the endotracheal tube 14, the cannula 1
Expandable membrane 12 is expanded by applying positive pressure to the inside of membrane 1 . The expandable membrane 12 is expanded until it is deformed by the wall of the endotracheal tube 14.

Secretions on the wall of the endotracheal tube 14 are removed by withdrawing the catheter IO from the endotracheal tube 14 while keeping the expandable membrane 12 inflated.

The squeegee action between the expandable membrane 12 and the endotracheal tube 14 removes secretions from the wall of the endotracheal tube 14 that are tightly adhered to the wall.

Secretions that accumulate on the proximal side of the expandable membrane 12 by pulling on the expandable membrane are removed by suction through the long dupe 13. Proximal end 25 of long tube 13
Sources of suction power attached to are commonly known in the art. Suction is typically continuous from the proximal end 25. If it is not desired to apply suction through the openings 22 and 23 of the long tube 13, the finger control portion 24 is left open. If suction at openings 22 and 23 is desired, portion 24 may be closed with the operator's fingers. By closing, suction force is transmitted to the openings 22 and 23 of the long tube 13. Once the secretions are removed, they are drawn inside the long tube 13 through the openings 22 and 23.

Catheter of the present invention! 0 may be used with a connector assembly, commonly referred to as a "Y" shaped connector assembly, as shown in FIG. 8, to preserve PEEP of a patient's lungs. The distal end opening 71 is placed tightly inside a body tract, such as endotracheal tube 14, so as to be in communication with the inside of the tube 14, as shown schematically in FIG. Side openings 72 provide fluid communication with a ventilator that supplies oxygen to the patient. Proximal end opening 73 is an entrance through which catheter 10 is inserted. Stopper 74 closes opening 73 when catheter IO is not inserted. Diaphragm assembly 75 includes three diaphragms. Each diaphragm has a sliced opening. As shown in FIG. 9, sliced openings 76-7
8 is about 6 angularly from the adjacent diaphragm opening.
It is preferable to arrange them so that they are shifted by 0°. This offset placement of the apertures ensures that the apertures are not aligned and cannot provide fluid communication through the assembly. The sliced opening in the diaphragm assembly allows insertion of a catheter but prevents fluid communication between the distal end 81 and proximal end 80 of the diaphragm assembly. Figure 9a is an exploded view of the diaphragm assembly. Preferably, the diaphragms are as close together as possible to ensure retention of a tight seal.

Jingle sliced openings 76-78 are shown in FIG. 9 for illustrative purposes only. As shown in FIG. 10, each diaphragm may be multiple slices. Diaphragms 76-78 are flexible and may be made of any suitable material, such as latex.

In use, stopper 74 is removed from opening 73 in connector assembly 70. Catheter assembly IO is inserted through opening 73 and diaphragm assembly 75 as shown in FIG. catheter!
0, the expandable membrane 12 is deflated. Upon insertion of catheter assembly IO, diaphragm assembly 75 seals around catheter IO to prevent loss of positive pressure from distal side 77 of diaphragm assembly 75. Catheter assembly! 0 reaches the desired position, inflate the inflatable membrane 12 until it contacts the wall of the endotracheal tube 14. The expandable membrane 12 seals against the wall of the endotracheal tube 14 to prohibit fluid communication from the proximal side to the distal side of the expandable membrane 12.

After reaching the desired location, excision and suction of the secretions are performed by the method described above. Expandable membrane! 2 is held deformed by the wall of the endotracheal intrusion tube 14, so that the PEEP is held in the patient's lungs. Expandable membrane 12 and endotracheal tube 1
4 prevents suction from being applied to the lungs.

Suction can be controlled by a three-way valve rather than by finger control as described above. The three-way valve prevents suction from being transmitted through the catheter 10 prior to inflating the expandable membrane 12. Any suitable three-way valve used in the art can be used. Operation of the three-way valve ensures that PEEP is not lost due to suction during catheter 10 insertion.

Also, an inflatable membrane! It is desirable to provide a safety mechanism to prevent operator error from causing suction through the catheter 10 prior to full inflation of the catheter 2. This safety feature can be provided in any conventional manner known in the art.

After reaching the desired location, removal and suction of secretions is performed as described above. Expandable membrane! 2 is endotracheal intrusion tube 1
PE in the lungs of W person
EP is retained. Expandable membrane 12 and endotracheal tube 14
The sealing contact between prevents inhalation from the lungs.

Although preferred embodiments and methods of use of the invention have been described in detail, it should be noted that these embodiments and methods of use are susceptible to variations and modifications.

The description of the invention is not intended to be limiting, but is merely illustrative of preferred embodiments and methods of use of the invention. Other catheters and methods of use that are modified or modified from those described herein are also encompassed by the present invention.

[Brief explanation of drawings]

FIG. 1 is a side view of the catheter of the present invention inserted into the endotracheal tube, FIG. 2 is a sectional view of the catheter of the present invention inserted into the endotracheal tube, and FIG. 3 is a line taken along the line in FIG. 3-3, FIG. 4 is a detailed cross-sectional view of the expandable membrane of a preferred embodiment of the catheter, FIG. 5 is a cross-sectional view of another embodiment of the invention, and FIG. FIG. 7 is a cross-sectional view of a catheter of the present invention with a "Y" shaped connector assembly; FIG. 8 is a "Y" shaped connector assembly; FIG. 9 is a detailed cross-sectional view taken along line 9-9 of FIG. 8; FIG. 9a is an exploded view of the diaphragm assembly; FIGS. FIG. 3 is a cross-sectional view of the embodiment. lO... Catheter, 11... Cannula, 12.
... Inflatable membrane, 13... Duplex, 14... Endotracheal tube, 21... Distal end, 22. 23... Opening, 24... Finger control portion, 25... Proximal end, 26...
- Distal end, 31... Proximal end, 32... Distal end, 33
...Positive pressure source, 35... Proximal end, 41... Joint portion, 70... Connector assembly, 71.72.7
3... Opening, 74... Stopper, 75... Diaphragm assembly, 76.77.78... Sliced opening, 80... Proximal end, 81... Distal end.

Claims (1)

[Scope of Claims] 1. A catheter assembly having a proximal end and a distal end and for removing secretions from the trachea, endotracheal tube, or tracheostomy tube by removal or suction, comprising: (a) a catheter assembly; the distal end thereof is capable of being inserted into an opening at the proximal end of the trachea, endotracheal tube, or tracheostomy tube and positioned at a predetermined position within the tube;
a catheter, the proximal end of which extends outside the opening of the proximal end of the tube and is adapted to connect to a source of negative pressure; (b) disposed at or near the distal end of the catheter; (c) one or more inflatable balloons, the at least one of which is disposed proximate the proximal end of the balloon; (d) a cannula connected at its distal end to a balloon and connectable at its proximal end to a suitable pressure source for inflating the balloon; a cannula extending along and attached to the catheter; and (e) a control portion in the wall near the proximal end of the catheter that can be closed or opened to transmit suction to the distal end of the catheter. A catheter assembly consisting of: 2. a "Y" shaped connector assembly having a distal end opening aligned with the proximal end opening, a lateral opening and a diaphragm assembly, the catheter being connected between the opening and the control portion; A Y-shaped connector is disposed around the catheter to pass through two end openings, the distal end opening being adapted to connect to the proximal end of the tube, and the side opening The diaphragm assembly is designed to be connected to a breathing device, and the diaphragm assembly is
a "Y" shaped connector mounted within the "Y" shaped connector between the proximal end opening and the lateral opening to seal the annulus between the catheter and the "Y" shaped connector; Claim 1 further comprising an assembly.
Catheter assembly as described in Section. 3. A catheter assembly according to claim 2, comprising three diaphragms having sliced openings that are offset from each other. 4. The catheter assembly of claim 1, wherein an inflatable balloon is mounted on and around the catheter. 5. The catheter assembly of claim 1, wherein the inflatable balloon is connected to the distal end of the cannula, and the distal end of the cannula extends beyond the distal end of the catheter. 6. The catheter assembly according to claim 1, wherein the cannula is embedded in the wall of the catheter. 7. A catheter assembly having a proximal end and a distal end and for removing secretions from within the trachea, endotracheal tube, or tracheostomy tube by ablation or aspiration, the catheter assembly comprising: (a) a catheter at its distal end; the end is adapted to be inserted into an opening in the proximal end of the trachea, endotracheal tube, or tracheostomy tube and placed in position within the tube;
a catheter, the proximal end of which extends outside the opening of the proximal end of the tube and is adapted to connect to a source of negative pressure; (b) disposed at or near the distal end of the catheter; (c) one or more inflatable balloons, the at least one of which is disposed proximate the proximal end of the balloon; (d) a cannula connected at its distal end to a balloon and connectable at its proximal end to a suitable pressure source for inflating the balloon; a cannula extending along and attached to (e) a control portion in the wall near the proximal end of the catheter that can be closed and opened to transmit suction to the distal end of the catheter; ) A "Y" shaped connector assembly having a distal end opening, a lateral opening and a diaphragm assembly aligned with the proximal end opening, the catheter having a "Y" shaped connector assembly between the opening and the control portion; 2 of the “” shape connector
the catheter is arranged around the catheter to pass through two end openings, the distal end opening being connectable to the proximal end of the tube, and the side openings being adapted to connect to the proximal end of the tube. The diaphragm assembly has a "Y" shape between the proximal end opening and the lateral opening.
Mounted within the shape connector to connect the catheter and the “Y”
A catheter assembly comprising a "Y" shaped connector assembly attached to the tube adapted to seal the annulus therebetween. 8. A catheter assembly for removing secretions from the trachea, endotracheal tube, or tracheostomy tube by ablation or aspiration, the catheter assembly having: (a) a distal end and a proximal end and sized to be inserted into a human; Insertion tubes and tracheostomy tubes, the distal end of which is structured to provide access to mucus within the trachea or lungs and adapted to receive a catheter from outside the patient's mouth. (b) a catheter, the distal end of which extends to the proximal end of the trachea, the interior surface of the tube being adapted to slidably receive an elastic balloon; the proximal end of an endotracheal tube or tracheostomy tube and is adapted to be inserted into and positioned within the tube, the proximal end extending outside the opening of the proximal end of the tube; , a catheter adapted to connect to a source of negative pressure; (c) disposed at or near the distal end of the catheter and inflated to the wall of the vessel to form a slidable seal therebetween; (d) at least one opening in the wall of the catheter proximate the proximal end of the balloon capable of providing fluid communication between the interior of the catheter and the tube; (e) a cannula; a cannula extending along the catheter, connected at its distal end to the balloon and connectable at its proximal end to a suitable pressure source for inflating the balloon; and (f) a cannula extending along the catheter; A catheter assembly comprising a control portion in a wall near the proximal end of the catheter that controls transmission to the distal end of the catheter. 9. The catheter assembly of claim 8, wherein an inflatable balloon is mounted on and around the catheter. 10. The catheter assembly of claim 8, wherein the cannula is embedded in the wall of the catheter.