RU2712846C2 - Endotracheal tube - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: group of inventions relates to four embodiments of the endotracheal tube. In the first embodiment, the endotracheal tube comprises a body in the form of a flexible curved transparent tube having open proximal and distal ends and convex and concave sides. Tube includes a connector installed on the proximal end of the tube for connection of the tube cavity to the apparatus of artificial pulmonary ventilation. Tube has an inflatable cuff tightly fixed around the distal end of the bent tube and configured to hold the distal endotracheal tube in the larynx in the required position. Tube contains a longitudinal channel for air supply, which is made in the wall of the bent tube and communicates with the cavity of the inflatable cuff. Tube has a tight balloon with elastic walls connected to the air supply port, connected by means of a catheter with a longitudinal channel for air supply into the cuff cavity and configured to maintain and monitor pressure in the cuff cavity. Tube comprises a longitudinal drug delivery channel made in the wall of the bent tube and connected by means of the catheter to the drug delivery container. Central angle between longitudinal channel for air supply and longitudinal channel for drug delivery is within 90–180 degrees. Tube comprises an annular channel for drug delivery into the area of the cuffs contact with the tracheal mucosa and into the lower respiratory tracts, made in the tube wall in the immediate vicinity of the inflatable cuff on the side of the proximal end of the tube, interconnected with longitudinal channel for drug delivery and containing holes of different direction, made at distance from each other along circumference in angular sector of 90–180 degrees. Holes have cone-shaped shape with larger diameter of cross section closer to outer surface of wall and axis of one hole of said pair is arranged at angle of 45 degrees to tube axis and directed towards distal end of tube. Axis of adjacent hole of said pair is arranged at angle of 90 degrees to tube axis. Tube contains cylindrical holes made in the said annular channel on the opposite side from cone-shaped holes in the angular sector of 60–90 degrees. On the surface of the tube there are marking marks, one of which is located from the annular channel so that it can be seen from the laryngopharynx at the required working position of the endotracheal tube at the border of the upper larynx. Second mark is located at distance of 2–2.5 cm from the first marking mark, closer to the proximal end of the tube. Tube includes channels in the wall of the bent tube in the immediate vicinity of the second marking mark on the side of the proximal end of the bent tube, divergent at angle of 90–120 degrees. to each other from longitudinal channel for drug delivery and ending with cone-shaped outlets with larger diameter of cross section closer to outer wall surface. Tube has channels made in the wall of the bent tube in close proximity to the distal end of the tube diverging at angle of 90–120 degrees to each other from longitudinal channel for drug delivery and ending with cone-shaped outlets with larger cross-section diameter closer to wall outer surface. Longitudinal channel for drug delivery comprises on the side of the distal end of the tube multidirectional cone-shaped holes for drug delivery into the area of the cuff contact with the tracheal mucosa and in the lower respiratory tract, located in close proximity to each other along the length of the tube between the cuff and channels. Cone axis of each hole is located at angle of 40–45 degrees to longitudinal axis of tube and directed towards proximal end of tube. In other embodiments of the endotracheal tube the design of the cone-shaped holes and their location are specified.

EFFECT: technical result is reduction of laryngopharyngeal reflexes when using it, reduced dose of common drugs, which increases safety of anaesthesia and its effectiveness, as well as provides high-quality synchronization of patient's breathing with artificial ventilation in cases of prolonged pulmonary ventilation in intensive therapy.

15 cl, 16 dwg

Description

Technical field

The present invention relates to medical equipment, and more specifically to an endotracheal tube and can be used for surgical operations with anesthetic support requiring endotracheal tube intubation.

State of the art

Endotracheal tubes are used in anesthesiology, intensive care, and critical care medicine for manipulations in the tracheobronchial tree, for the administration of various drugs, and also for photodynamic therapy (PDT) of the larynx.

Endotracheal tubes can also be used to protect and ensure patency of the upper respiratory tract when transporting the wounded and injured at the stages of medical evacuation.

In modern anesthesiology, serious problems arise with tracheal intubation. During tracheal intubation, phenomena such as reflex reactions associated with an increase in the vagus nerve tone or stimulation of the effector endings involved in reflex stimulation of the sympathetic nerves of the heart are possible. All these phenomena cause hemodynamic responses that pose a danger to the patient's life.

It is known that the reflexes of the mucous membrane of the larynx and trachea are so strong that the stages of anesthesia deeper are needed to suppress them than for the surgical anesthesia itself. To interrupt the cough reflex and prevent reflex hemodynamic reactions, anesthesia has to be deepened.

In cases where prolonged artificial ventilation of the lungs is required, laryngeal pharyngeal reflexes make it difficult to synchronize the patient’s breathing with the artificial lung ventilation apparatus and impair the quality of the latter.

The most effective known methods of reducing reflexogenicity are methods of anesthesia of the mucosa of the larynx and trachea with local anesthetics. These include: the use of various sprays, atomizers and inhalers; the use of ointments containing local anesthetics. All of these methods have significant drawbacks: the local anesthetic injected with aerosols does not get into the subglottic space in the required amount, not to mention the more distal airways, and the ointments with local anesthetics have delayed diffusion activity. However, the effective duration of anesthetics is limited by the duration of the local anesthetic.

Known endotracheal tube Lanza (see, for example, RU 2301082). The Lance tube contains a cuff, a catheter for inflating it, a connector for connecting the tube to the ventilator, a can for monitoring and optimizing the pressure in the cuff. However, when using the Lanz tube, laryngeal reflexes are not reduced enough due to the fact that the sensitivity of the mucous membrane and the reactivity of nerve endings in patients are different and the optimization of pressure in the cuff does not allow them to completely stop. Pharyngeal reflexes do not stop at all, therefore, increased doses of general anesthetics and muscle relaxants are required, which leads to a decrease in the safety of anesthesia and its effectiveness.

The closest technical solution is an endotracheal tube containing a flexible tube, a connector at the proximal end of the flexible tube for attachment to the ventilator, a distal portion of the flexible tube including an inflatable cuff around a portion of the distal portion to hold the distal portion in the larynx in a desired position, and longitudinal air channel in the wall of the flexible tube for connecting the cavity of the inflatable cuff with a means of inflating the cuff. The endotracheal tube also contains a longitudinal drug supply channel made in the wall of the flexible tube, and a radial annular channel or drug supply channels in the wall of the flexible tube connected to the longitudinal drug supply channel. There are a number of injection holes made in the outer wall of the radial annular channel or channels, and an indicator ring is made on the diameter of the flexible tube on the outer surface of the distal part of the flexible tube in the vicinity of the injection holes or in close proximity to it, the color of which differs from the color of the outer surface distal part of the flexible tube. The indicator ring is located so that it can be seen from the larynxopharynx at the required working position of the endotracheal tube, while being at the border of the upper part of the larynx (see, for example, patent for utility model RU 67448 U1, publication 27. 10.2007).

The specified endotracheal tube allows the flow of the drug into the contact area of the cuff and mucous membrane of the trachea, but has a number of significant drawbacks.

First of all, it does not provide the supply of drugs in front of the distal end of the tube and the preliminary anesthesia of the tracheal mucosa during intubation. The presence of annular channels leads to the occurrence of kinks of the tube at the locations of the annular channels, especially in the area of the upper annular channel with small tube diameters of 6 mm and 6.5 mm; therefore, it is necessary to resort to sealing the body of the tube in the places of the annular channels, which leads to turbulence of the air flow inside the tube itself and the process of mechanical ventilation worsens.

To supply the drug into the contact zone of the cuff and the tracheal mucosa, the cuff must be deflated, while the trachea-cuff contour is depressurized.

The specified tube does not provide the ability to supply drugs to the area of the larynx and pharynx during the final installation of the endotracheal tube, during the operation.

Summary of the invention

The basis of the present invention is the task of creating an endotracheal tube that provides a significant reduction in the laryngeal pharyngeal reflexes when it is used, a reduction in the dose of general medicines, which allows to increase the safety of anesthesia and its effectiveness, as well as to ensure high-quality synchronization of the patient’s breathing with the mechanical ventilation apparatus in cases of prolonged ventilation with intensive care.

According to a first embodiment of the invention, the problem is solved by creating an endotracheal tube containing

a body made in the form of a flexible curved transparent tube having open proximal and distal ends and convex and concave sides,

a connector mounted on the proximal end of the tube to connect the cavity of the tube to the ventilator,

an inflatable cuff tightly secured around a portion of the distal end of the curved tube and configured to hold the distal portion of the endotracheal tube in the larynx in the desired position,

a longitudinal air supply channel made in the wall of the curved tube and communicating with the cavity of the inflatable cuff,

a sealed balloon with elastic walls connected to the air supply port, connected via a catheter to a longitudinal channel for supplying air to the cuff cavity and configured to maintain and monitor the pressure in the cuff cavity,

a longitudinal channel for delivering drugs, made in the wall of a curved tube and connected by means of a catheter with a container for dosed delivery of drugs, with the Central angle between the longitudinal channel for air supply and the longitudinal channel for drug delivery is in the range of 90-180 degrees.,

an annular channel for supplying drugs to the contact zone of the cuff with the mucous membrane of the trachea and to the lower respiratory tract, made in the wall of the tube in the immediate vicinity of the inflatable cuff from the proximal end of the tube, communicating with the longitudinal channel for supplying drugs and containing

at least two pairs of holes of different directions, made at a distance from each other around the circumference in the angular sector of 90-180 degrees, while the holes have a conical shape with a large cross-sectional diameter closer to the outer surface of the wall and the axis of one hole of the specified pair is placed under angle of 45 degrees. to the axis of the tube and is directed towards the distal end of the tube, and the axis of the adjacent hole of the specified pair is placed at an angle of 90 degrees. to the axis of the tube, and

at least two cylindrical holes made in the specified annular channel on the opposite side from the conical holes in the angular sector 60-90 degrees.,

at the same time, at least two marking marks are made on the surface of the tube, one of which is located in the immediate vicinity of the annular channel so that it can be seen from the larynxopharynx with the required working position of the endotracheal tube at the border of the upper part of the larynx, the second marking mark is located at a distance about 2-2.5 cm from the first marking, closer to the proximal end of the tube,

at least two channels made in the wall of the curved tube in the immediate vicinity of the second marking from the side of the proximal end of the curved, diverging at an angle of 90-120 degrees. to each other from the longitudinal channel for the supply of drugs and ending in a cone-shaped outlet with a large cross-sectional diameter closer to the outer surface of the wall,

at least two channels made in the wall of the curved tube in the immediate vicinity of the distal end of the tube, diverging at an angle of 90-120 degrees. to each other from the longitudinal channel for the supply of drugs and ending in a cone-shaped outlet with a large cross-sectional diameter closer to the outer surface of the wall,

wherein the longitudinal channel for supplying drugs contains from the side of the distal end of the tube at least two multidirectional conical openings for supplying drugs to the contact area of the cuff with the mucous membrane of the trachea and to the lower parts of the respiratory tract located in close proximity to each other along the length of the tube between cuff and two channels, while the axis of the cone of each hole is located at an angle of about 40-45 degrees. to the longitudinal axis of the tube and is directed towards the proximal end of the tube.

Preferably, the endotracheal tube contains an additional marking mark located in the immediate vicinity of the second marking mark on the side of the first marking mark.

Preferably, the longitudinal air supply channel is formed on the convex or concave side of the wall of the curved tube.

Preferably, the endotracheal tube contains an additional channel for the supply of drugs, while the Central angle between the longitudinal channels for the supply of drugs ranged from 20 to 30 degrees.

Preferably, at least one longitudinal channel for the supply of drugs was made in the concave or convex side of the wall of the curved tube.

Preferably, in the annular channel, two pairs of holes of different directions were made at a distance from each other around the circumference on the concave side of the tube wall.

Preferably, in the specified annular channel two cylindrical holes were made on the convex side of the tube wall.

Preferably, at least two channels in the wall of the curved tube in the immediate vicinity of the distal end of the tube are made in a plane perpendicular to the axis of the tube.

Preferably, at least two channels in the wall of the curved tube in the immediate vicinity of the proximal end of the tube are made in a plane perpendicular to the axis of the tube.

According to a second embodiment of the invention, the endotracheal tube comprises

a body made in the form of a flexible curved transparent tube having open proximal and distal ends and convex and concave sides,

a connector mounted on the proximal end of the tube to connect the cavity of the tube to the ventilator,

an inflatable cuff tightly secured around a portion of the distal end of the curved tube and configured to hold the distal portion of the endotracheal tube in the larynx in the desired position,

a longitudinal air supply channel made in the wall of the curved tube and communicating with the cavity of the inflatable cuff,

a sealed balloon with elastic walls connected to the air supply port, connected via a catheter to a longitudinal channel for supplying air to the cuff cavity and configured to maintain and monitor the pressure in the cuff cavity,

a longitudinal channel for delivering drugs, made in the wall of a curved tube and connected by means of a catheter with a container for dosed delivery of drugs, with the Central angle between the longitudinal channel for air supply and the longitudinal channel for drug delivery is in the range of 90-180 degrees.,

at least two channels made in the wall of the curved tube in the immediate vicinity of the distal end of the tube, diverging at an angle of 90-120 degrees. to each other from the longitudinal channel for the supply of drugs and ending in a cone-shaped outlet with a large cross-sectional diameter closer to the outer surface of the wall,

wherein the longitudinal channel for supplying drugs contains from the side of the distal end of the tube at least two multidirectional conical openings for supplying drugs to the contact area of the cuff with the mucous membrane of the trachea and to the lower parts of the respiratory tract located in close proximity to each other along the length of the tube between cuff and two channels, while the axis of the cone of each hole is located at an angle of about 40-45 degrees. to the longitudinal axis of the tube and is directed towards the proximal end of the tube,

at the same time, at least two marking marks are made on the surface of the tube, one of which is located in the immediate vicinity of the annular channel so that it can be seen from the larynxopharynx with the required working position of the endotracheal tube at the border of the upper part of the larynx, the second marking mark is located at a distance about 2-2.5 cm from the first marking, closer to the proximal end of the tube,

wherein the longitudinal channel for supplying drugs contains, from the side of the proximal end of the tube between the cuff and the first marking mark, at least two conically-shaped openings for supplying drugs to the contact area of the cuff with the tracheal mucosa and to the underlying respiratory tract, located in close proximity to each other from each other along the length of the tube, while the axis of the cone of each hole is located at an angle of about 40-45 degrees. to the longitudinal axis of the tube and is directed towards the proximal end of the tube,

at least two channels made in the body of the curved tube in the immediate vicinity of the second marking from the side of the proximal end of the curved tube, diverging at an angle of 90-120 degrees. to each other from the longitudinal channel for the supply of drugs and ending in a cone-shaped outlet with a large cross-sectional diameter closer to the outer surface of the wall.

Preferably, the endotracheal tube contains an additional marking mark located in the immediate vicinity of the second marking mark closer to the first marking mark.

According to a third embodiment of the invention, the endotracheal tube comprises

a body made in the form of a flexible curved transparent tube having open proximal and distal ends and convex and concave sides,

a connector mounted on the proximal end of the tube to connect the cavity of the tube to the ventilator,

an inflatable cuff tightly secured around a portion of the distal end of the curved tube and configured to hold the distal portion of the endotracheal tube in the larynx in the desired position,

a longitudinal air supply channel made in the wall of the curved tube and communicating with the cavity of the inflatable cuff,

a sealed balloon with elastic walls connected to the air supply port, connected via a catheter to a longitudinal channel for supplying air to the cuff cavity and configured to maintain and monitor the pressure in the cuff cavity,

a longitudinal channel for delivering drugs, made in the wall of a curved tube and connected by means of a catheter with a container for dosed delivery of drugs, with the Central angle between the longitudinal channel for air supply and the longitudinal channel for drug delivery is in the range of 90-180 degrees.,

an annular channel for supplying drugs to the contact zone of the cuff with the mucous membrane of the trachea and to the lower respiratory tract, made in the wall of the tube in the immediate vicinity of the inflatable cuff from the proximal end of the tube, communicating with the longitudinal channel for supplying drugs and containing

a pair of holes of different directions, made at a distance from each other around the circumference in the angular sector of 90-180 degrees, while the holes have a conical shape with a large cross-sectional diameter closer to the outer surface of the wall and the axis of one hole of the specified pair is placed at an angle of 45 degrees. to the axis of the tube and is directed towards the distal end of the tube, and the axis of the adjacent hole of the specified pair is placed at an angle of 90 degrees. to the axis of the tube, and

at least one cylindrical hole made in the specified annular channel on the opposite side from the conical holes,

at the same time, at least two marking marks are made on the surface of the tube, one of which is located in the immediate vicinity of the annular channel so that it can be seen from the larynxopharynx with the required working position of the endotracheal tube at the border of the upper part of the larynx, the second marking mark is located at a distance about 2-2.5 cm from the first marking, closer to the proximal end of the tube,

at least one channel made in the tube body in the immediate vicinity of the second marking from the side of the proximal end of the curved tube, communicating with the longitudinal channel for the supply of drugs and ending in a cone-shaped outlet, with a large cross-sectional diameter closer to the outer surface of the wall,

at least one channel made in the body of the tube in the immediate vicinity of the distal end, communicating with a longitudinal channel for supplying drugs and ending in a cone-shaped outlet with a large cross-sectional diameter closer to the outer surface of the wall,

wherein the longitudinal channel for supplying drugs contains from the side of the distal end of the tube at least one cone-shaped opening for supplying drugs to the contact area of the cuff with the mucous membrane of the trachea and to the lower parts of the respiratory tract, while the axis of the cone of the hole is located at an angle of about 40-45 hail. to the longitudinal axis of the tube and is directed towards the proximal end of the tube.

Preferably, the endotracheal tube contains an additional marking mark located in the immediate vicinity of the second marking mark closer to the first marking mark.

Preferably, the endotracheal tube contains an additional longitudinal channel for the delivery of drugs.

According to a fourth embodiment of the invention, the endotracheal tube comprises

a body made in the form of a flexible curved transparent tube having open proximal and distal ends and convex and concave sides,

a connector mounted on the proximal end of the tube to connect the cavity of the tube to the ventilator,

an inflatable cuff tightly secured around a portion of the distal end of the curved tube and configured to hold the distal portion of the endotracheal tube in the larynx in the desired position,

a longitudinal air supply channel made in the wall of the curved tube and communicating with the cavity of the inflatable cuff,

a sealed balloon with elastic walls connected to the air supply port, connected via a catheter to a longitudinal channel for supplying air to the cuff cavity and configured to maintain and monitor the pressure in the cuff cavity,

a longitudinal channel for delivering drugs, made in the wall of a curved tube and connected by means of a catheter with a container for dosed delivery of drugs, with the Central angle between the longitudinal channel for air supply and the longitudinal channel for drug delivery is in the range of 90-180 degrees.,

at least one channel for supplying drugs, made in the wall of the tube at the distal end, communicating with a longitudinal channel for supplying drugs and ending in a cone-shaped outlet with a large cross-sectional diameter closer to the outer surface of the wall,

wherein the longitudinal channel for supplying drugs contains, from the side of the distal end of the tube between the cuff and the channel, at least one cone-shaped opening for supplying drugs to the contact zone of the cuff with the mucous membrane of the trachea and to the lower respiratory tract, while the axis of the cone of the hole is at an angle about 40-45 degrees. to the longitudinal axis of the tube and is directed towards the distal end of the tube,

at the same time, at least two marking marks are made on the surface of the tube, one of which is located in the immediate vicinity of the annular channel so that it can be seen from the larynxopharynx with the required working position of the endotracheal tube at the border of the upper part of the larynx, the second marking mark is located at a distance about 2-2.5 cm from the first marking, closer to the proximal end of the tube,

at least one channel made in the body of the curved tube in the immediate vicinity of the cuff from the side of the proximal end of the curved tube, communicating with the longitudinal channel for supplying drugs and ending in a cone-shaped outlet

wherein the longitudinal channel for supplying drugs contains, from the side of the proximal end of the tube between the cuff and the first marking label, at least one cone-shaped opening for supplying drugs to the contact area of the cuff with the mucous membrane of the trachea and to the lower parts of the respiratory tract, while the axis of the cone of the hole is located at an angle of about 40-45 degrees. to the longitudinal axis of the tube and is directed towards the proximal end of the tube,

at least one channel made in the body of the curved tube in the immediate vicinity of the second marking from the side of the proximal end of the curved tube, communicating with the longitudinal channel for the supply of drugs and ending in a cone-shaped outlet.

Preferably, the endotracheal tube contains an additional marking mark located in the immediate vicinity of the second marking mark closer to the first marking mark.

The technical effect provided by the claimed invention lies in the fact that the endotracheal tube will allow the supply of drugs both in the cuff zone and the extra-ligamentous space, and will ensure the supply of drugs along the entire length of the tube in the areas of greatest contact with the mucosa of the trachea, pharynx and larynx, and provide the opportunity early drug delivery during intubation itself until the tube is finally installed in the trachea, it will eliminate the kinks and kink of the tube in the ve hnego annular channel and reduce the turbulence of the air flow inside the tube.

Due to the powerful and high-quality local anesthesia of the mucous membrane of the oropharynx and trachea, the endotracheal tube provides a significant reduction in the dosage of drugs of general effect, namely anesthetics, analgesics and muscle relaxants, which is extremely important for patients in critical condition.

In addition, the endotracheal tube provides the ability to control using an additional marking ring, the beginning of the supply of drugs during intubation in order to avoid the entry of drugs into the glottis.

The presence of holes in the annular channel of a multidirectional orientation of a conical shape allows you to:

- irrigate the area of the cuff space through a cone-shaped hole located at an angle of 90 degrees to the longitudinal axis of the tube,

- irrigate the area of the cuff in contact with the mucosa of the trachea by administering drugs through cone-shaped holes located at an angle of 40-45 degrees to the tube axis.

The presence of three marking rings provides the doctor with control over the supply of drugs, to exclude the ingress of drugs into the glottis at different stages of using the endotracheal tube, i.e. start manipulating drug administration after the upper marking ring passes through the glottis. An intermediate marking ring additionally provides the doctor with more precise control over the position of the tube in relation to the glottis.

Brief Description of the Drawings

The invention is further explained in the description of the preferred embodiment with reference to the accompanying drawings, in which:

FIG. 1 is a perspective view of an endotracheal tube (first embodiment) according to the invention;

FIG. 2 is a section along the line P-P in FIG. 1;

FIG. 3 schematically shows a cone-shaped hole of one pair of holes made in an annular channel;

FIG. 4 schematically shows a cone-shaped hole of another pair of holes made in an annular channel;

FIG. 5 schematically shows a cylindrical hole made in an annular channel;

FIG. 6 schematically depicts a portion of a tube with a cuff and marking marks, schematically showing the directions of the jets of the drug supplied from the holes made in the tube (first embodiment);

FIG. 7 is a section along the line YP-YP in FIG. 6;

FIG. 8 is a section along the line YP-YP in FIG. 6, an embodiment with an additional hole;

FIG. 9 is a section along line IX-IX of FIG. 6;

FIG. 10 schematically depicts a distal portion of a tube with a cuff and with cone-shaped holes;

FIG. 11 is a perspective view of an endotracheal tube (second embodiment) according to the invention;

FIG. 12 schematically depicts a portion of a tube with a cuff and marking marks, schematically showing the directions of the jets of the drug supplied from the holes made in the tube (second embodiment);

FIG. 13 depicts schematically a portion of a tube between a cuff and markings and with cone-shaped holes;

FIG. 14 is a section along the line XIY-XIY in FIG. 12;

FIG. 15 depicts schematically a portion of a tube with a cuff and marking marks, schematically showing the directions of the jets of the drug supplied from the holes made in the tube (third embodiment);

FIG. 16 depicts schematically a part of a tube with a cuff and marking marks, schematically showing the directions of the jets of the drug supplied from the holes made in the tube (fourth embodiment).

DESCRIPTION OF PREFERRED EMBODIMENTS

The endotracheal tube 1 (Fig. 1) according to the first embodiment of the invention comprises a body 2 made in the form of a flexible curved transparent tube having open proximal 3 and distal 4 ends and convex 5 and concave 6 sides.

Tube 1 contains a connector 7 mounted on the proximal end 3 of the tube for connecting the cavity 8 of the tube to a ventilator (not shown), and an inflatable cuff 9 tightly secured around a portion of the distal end 4 of curved tube 2 and configured to hold the distal part of the endotracheal tube in the larynx in the required position. The longitudinal channel 10 (Fig. 2) for supplying air is made in the wall of the curved tube 2 and communicates with the cavity of the inflatable cuff 9. The longitudinal channel 10 for supplying air can can be made in the convex 5 or concave 6 side of the wall of the curved tube. Preferably, it was made from the convex side 5 of the wall of the tube 2 (Fig. 1).

A sealed balloon 11 with elastic walls is connected to an air supply port (not shown) and connected via a catheter 12 to a longitudinal channel 10 for supplying air to the cavity of the cuff 9 and is configured to maintain and monitor the pressure in the cavity of the cuff.

A longitudinal channel 13 for supplying drugs is made in the wall of a curved tube and is connected via a catheter 14 with a container for a metered supply of drugs (not shown), while the central angle α between the longitudinal channel 10 for supplying air and the longitudinal channel 13 for delivering drugs within 90-180 degrees. The endotracheal tube 1 contains an annular channel 15 for supplying drugs to the zone of contact of the cuff 9 with the mucous membrane of the trachea and in the lower parts of the respiratory tract. The annular channel 15 is made in the wall of the tube 2 in the immediate vicinity of the inflatable cuff 9 from the side of the proximal end 3 of the tube and communicates with the longitudinal channel 13 for the supply of drugs. The longitudinal channel 13 for the supply of drugs can be made in the concave 6 or convex 5 side of the wall of the curved tube 2, but it is preferable that it is made on the concave side 6 of the wall of the tube 2. The annular channel 15 contains at least two pairs of holes 16, 17 , 18, 19 (Fig. 2) of different directions, made at a distance from each other around the circumference in the angular sector β 90-180 degrees. In FIG. 2 shows four holes 16-19, which have a conical shape with a large cross-sectional diameter closer to the outer surface of the wall, while the axis of the holes 16, 19 (Fig. 3) of one pair are placed at an angle of 45 degrees. to the axis of the tube 2 and directed towards the distal end of the tube, and the axis of the neighboring holes 17, 18 (Fig. 4) of the other pair are placed at an angle of 90 degrees. to the axis of the tube 2.

In the annular channel 15, two pairs of holes 16-19 of different directions, preferably made at a distance from each other around the circumference on the concave side 5 of the tube wall.

The annular passage 14 comprises at least two cylindrical holes 20, 21 (FIG. 2) formed in said annular channel 15 in the angular sector Ύ 60-90 deg. on the opposite side of the conical holes 16, 17, 18, 19, while the axis of each hole 20, 21 is located at an angle of about 25-30 degrees. (Fig. 5) to the longitudinal axis of the tube and is directed towards the distal end 4 of the tube. In the specified annular channel 15 two cylindrical holes 20, 21 are made on the convex side 6 of the tube wall. The holes 20, 21 are made in such a way that on the outer surface of the tube from the side of the distal end 4, the body of the tube is cut, forming a bevel in the corners of 25-30 degrees. to the axis of the tube.

In FIG. 2 shows two cylindrical holes 20, 21, but the number of cylindrical holes may be three (option not shown).

At least two marking marks 22, 23 (Fig. 1.6) are made on the surface of the tube 2, one of which is located in the immediate vicinity of the annular canal 15 so that it can be seen from the larynxopharynx at the required working position of the endotracheal tube 1 borders of the upper part of the larynx. The second marking mark 23 is located at a distance of about 2-2.5 cm from the first marking mark 22, closer to the proximal end 3 of the tube.

In a preferred embodiment, the endotracheal tube comprises an additional marking mark 24 located in the immediate vicinity of the second marking mark 23 from the side of the first marking mark 22.

The endotracheal tube 1 contains at least two channels 25, 26 (Fig. 6), made in the wall of the curved tube 2 in the immediate vicinity of the second marking mark 23 from the side of the proximal end 3 of the curved tube 2, diverging at an angle of 90-120 degrees. to each other from the longitudinal channel 13 (Fig. 7) for the supply of drugs and ending in a cone-shaped outlet 27, 28 with a large cross-sectional diameter closer to the outer surface of the tube wall 2.

In FIG. 8 schematically shows a variant when the endotracheal tube 1 contains three channels 25, 26 and 29, made in the wall of the curved tube 2 in the immediate vicinity of the second marking mark 23 and diverging at an angle to each other from the longitudinal channel 13 (Fig. 7) for feeding drugs from the proximal end 3 of the bent tube 2.

In the described embodiment, the channels 25, 26 or 25, 26 and 29 in the wall of the curved tube are made in a plane perpendicular to the axis of the tube 2.

The endotracheal tube 1 also contains at least two channels 30, 31 (Fig. 6), made in the wall of the curved tube 2 in the immediate vicinity of the distal end 4 of the tube, diverging at an angle of 90-120 degrees. to each other from the longitudinal channel 13 (Fig.9) for the supply of drugs and ending in cone-shaped outlet openings 32, 33 with a large cross-sectional diameter closer to the outer surface of the wall. It is possible that the endotracheal tube 1 contains three channels 31, 32 and 34, diverging at an angle to each other from the longitudinal channel 13.

In the described embodiment, the channels 30, 31, 34 in the wall of the curved tube 2 in the immediate vicinity of the distal end 4 of the tube are made in a plane perpendicular to the axis of the tube.

The longitudinal channel 13 for the supply of drugs contains from the side of the distal end 4 of the tube at least two multidirectional cone-shaped openings 35, 36 (Fig.6) for supplying drugs to the contact zone of the cuff 9 with the mucous membrane of the trachea and into the lower respiratory tract. The holes 35, 36 are located in close proximity to each other along the length of the tube 2 (Fig. 10) between the cuff 9 and the holes 32, 33, while the axis of the cone of each hole 35, 36 is located at an angle of about 40-45 degrees. to the longitudinal axis of the tube 2 and is directed towards the proximal end 3 of the tube. A variant is possible when the number of holes is three, i.e. between holes 35 and 36 a similar hole 37 is made.

The endotracheal tube 1 may contain an additional channel for the supply of drugs (not shown), communicating with the annular channel 15, while the Central angle between the longitudinal channels for the supply of drugs is from 20 to 30 degrees. An additional channel is necessary for the supply of drugs that cannot be served on the main channel 13 for the supply of drugs.

All elements of the endotracheal tube 1 are best made from unpainted polymeric materials, for example, from polyvinyl chloride, and the inflatable cuff 9 is made of silicone, marking marks 22, 23, 24 are painted externally in thickness in bright red or blue. It is possible that the markers are stained with pigment visible with MRI, CT, fluoroscopy and other methods of observing the location.

In FIG. 2 shows an x-ray mark 38 extending inside the wall of the tube 2 along the entire length, which in some cases is necessary for x-ray control of the immersion depth of the tube in the trachea during surgery.

In the second embodiment, the endotracheal tube 1 (Fig. 11) contains a part of the elements inherent in the first embodiment.

A difference of the endotracheal tube 1 according to the second embodiment of the invention is that in the second embodiment, the endotracheal tube 1 does not contain an annular channel 15 with conical and cylindrical openings.

Instead of the annular channel with openings in the second embodiment of the endotracheal tube 1 in the section 39 between the cuff 9 and the first marking mark 22, the longitudinal drug supply channel 13 contains at least two multidirectional conical openings 40, 41 from the side of the proximal end of the tube (Fig. 12 ) for supplying drugs to the area of contact of the cuff with the mucosa of the trachea and to the lower parts of the respiratory tract, located in close proximity to each other along the length of the tube. The axis of the cone of each hole 40, 41 is located at an angle of about 40-45 degrees. to the longitudinal axis of the tube (Fig. 13) and is directed towards the proximal end 3 of the tube.

Holes 40, 41 are similar to holes 35, 36, but the axes of these holes are directed in the opposite direction, i.e. towards the proximal end of 3 tubes.

A variant is possible when the number of holes is three, i.e. between holes 40 and 41 a similar hole 42 is made.

According to a second embodiment, at least two channels 43, 44 (FIG. 12) are made in the tube 2 in the immediate vicinity of the cuff 9 from the side of the proximal end 3 of the curved tube, diverging at an angle of 90-120 degrees. to each other (Fig. 14) from the longitudinal channel 13 for the supply of drugs and ending in cone-shaped outlet openings 45, 46 with a large cross-sectional diameter closer to the outer surface of the wall. It is possible that the endotracheal tube 1 contains three channels 43, 44 and 47, diverging at an angle to each other from the longitudinal channel 13.

In the described second embodiment, the channels 43, 44, 47 in the wall of the curved tube 2 are made in a plane perpendicular to the axis of the tube.

The third embodiment of the endotracheal tube 2 (Fig. 15) differs from the first embodiment in that it contains a cylindrical hole 20 made in the annular channel 15 on the opposite side from the conical holes 16.17, the channel 26 made in the body of the tube in the immediate vicinity of the second marking mark 23 from the side of the proximal end 3 of the bent tube 2, communicating with the longitudinal channel 13 for the supply of drugs and ending with a conical outlet 28 with a large diameter section closer to the outer wall surface of the channel 30 formed in the body of the tube in the vicinity of the distal end 4 communicating with the longitudinal bore 13 for delivering drugs and ending conical outlet 32 with a larger diameter cross-sectional area closer to the outer wall surface. At the same time, the longitudinal channel 13 for supplying drugs contains, from the side of the distal end 4 of the tube, one cone-shaped opening 36 for supplying drugs to the contact area of the cuff with the mucous membrane of the trachea and to the lower parts of the respiratory tract, while the axis of the cone of the hole is located at an angle of about 40-45 hail. to the longitudinal axis of the tube and is directed towards the proximal end of the tube.

The fourth embodiment of the endotracheal tube (Fig. 16) differs from the second embodiment only in that it contains a channel 30 for the supply of drugs made in the wall of the tube at the distal end 4, communicating with the longitudinal channel 13 for the supply of drugs and ending in a cone-shaped outlet 32 with a large cross-sectional diameter closer to the outer surface of the wall. In this case, the longitudinal channel 13 for the supply of drugs contains, on the side of the distal end 4 of the tube, between the cuff 9 and the cone-shaped channel 36 for supplying drugs to the contact area of the cuff with the mucous membrane of the trachea and to the lower respiratory tract, while the axis of the cone of the hole 36 is located under angle of about 40-45 degrees. to the longitudinal axis of the tube and is directed towards the distal end of the tube. There is also a channel 26 made in the body of the curved tube 2 in the immediate vicinity of the cuff 9 from the side of the proximal end 3 of the curved tube, communicating with the longitudinal channel 13 for the supply of drugs and ending with a conical outlet 28, while the longitudinal channel 13 for the supply of drugs contains from the side of the proximal end 3 of the tube between the cuff 9 and the first marking mark 22 conical holes 41 for supplying drugs to the contact area of the cuff with the mucosa of the trachea and the lower parts of the respiratory tract, while the axis of the cone of the hole 41 is located at an angle of about 40-45 degrees. to the longitudinal axis of the tube 2 and is directed towards the proximal end of the tube, and the channel 26 is made in the body of the curved tube in the immediate vicinity of the second marking 23 from the side of the proximal end 3 of the curved tube, communicating with the longitudinal channel 13 for the supply of drugs and ending in a cone-shaped outlet 28.

In FIG. 6, 15, 12, 16 dotted lines show the directions of the jets of the drug emerging from the holes.

The work of the proposed endotracheal tube is as follows.

Before using the endotracheal tube 1, the condition of the cuff 9 is checked, in particular, the tightness of the cuff. The degree of pressure in the cuff 9 should be in the range of 15-25 mm Hg. After this, the endotracheal tube 1 is inserted into the larynx. The endotracheal tube 1 is installed so that the glottis is between the middle and upper marking rings 22, 23. The drug is immediately injected in the form of a solution or aerosol through a catheter. The drug through the catheter 14, the radial annular channel 15 and the holes is fed directly into the larynopharynx zone into the subglottic space and simultaneously through the radial annular channel 15 and the holes into the contact zone of the cuff 9 with the laryngeal mucosa and into the underlying respiratory tract. Then from the canister 14, air is supplied to the catheter 12 and the cuff 9 is inflated. The cuff is inflated until the optimum pressure in the cuff is reached.

If necessary, re-injection of the drug into the zone of contact of the cuff with the mucous membrane of the larynx and into the lower sections of the respiratory tract, the air pressure in the cuff is previously reduced.

During the endotracheal intubation, after the lower marking ring 22 has passed the glottis, the drug is supplied for the highest quality irrigation of the tracheal mucosa during the manipulation. The doctor sets the endotracheal tube 1 in a position in which the glottis is between the middle 24 and upper 23 marking ring.

If it is necessary to supply the drug after installing the endotracheal tube 1 in the zone of contact of the cuff with the mucous membrane of the trachea, the doctor introduces the drug, then moves the endotracheal tube 2 cm deeper and re-supplies the drug, followed by the installation of the endotracheal tube in its original position, without carrying out the depressurization of the contour of the cuff - trachea.

Thus, during tracheal intubation, safe and effective anesthesia of the mucosa of the larynx and larynopharynx occurs, thereby reflex hemodynamic reactions are not allowed.

As a result, a reduction in the dose of general drugs and the dose of muscle relaxants is achieved, which helps to reduce intoxication of the patient's body and a more successful course of the postoperative period.

Industrial applicability

Endotracheal tubes are used in anesthesiology, intensive care, and critical care medicine for manipulations in the tracheobronchial tree, for the administration of various drugs, and also for photodynamic therapy (PDT) of the larynx. Endotracheal tubes can also be used to protect and ensure patency of the upper respiratory tract when transporting the wounded and injured at the stages of medical evacuation.

Claims (65)

1. Endotracheal tube containing a body made in the form of a flexible curved transparent tube having open proximal and distal ends and convex and concave sides, a connector mounted on the proximal end of the tube to connect the cavity of the tube to the ventilator, an inflatable cuff tightly secured around a portion of the distal end of the curved tube and configured to hold the distal portion of the endotracheal tube in the larynx in the desired position, a longitudinal air supply channel made in the wall of the curved tube and communicating with the cavity of the inflatable cuff, a sealed balloon with elastic walls connected to the air supply port, connected via a catheter to a longitudinal channel for supplying air to the cuff cavity and configured to maintain and monitor the pressure in the cuff cavity, a longitudinal channel for delivering drugs, made in the wall of a curved tube and connected by means of a catheter with a container for dosed delivery of drugs, with the Central angle between the longitudinal channel for air supply and the longitudinal channel for drug delivery is in the range of 90-180 degrees., an annular channel for supplying drugs to the contact zone of the cuff with the mucous membrane of the trachea and to the lower respiratory tract, made in the wall of the tube in the immediate vicinity of the inflatable cuff from the proximal end of the tube, communicating with the longitudinal channel for supplying drugs and containing at least two pairs of holes of different directions, made at a distance from each other around the circumference in the angular sector of 90-180 degrees, while the holes have a conical shape with a large cross-sectional diameter closer to the outer surface of the wall and the axis of one hole of the specified pair is placed under angle of 45 degrees. to the axis of the tube and is directed towards the distal end of the tube, and the axis of the adjacent hole of the specified pair is placed at an angle of 90 degrees. to the axis of the tube, and at least two cylindrical holes made in the specified annular channel on the opposite side from the conical holes in the angular sector of 60-90 degrees, at the same time, at least two marking marks are made on the surface of the tube, one of which is located in the immediate vicinity of the annular channel so that it can be seen from the larynxopharynx with the required working position of the endotracheal tube at the border of the upper part of the larynx, the second marking mark is located at a distance 2-2.5 cm from the first marking, closer to the proximal end of the tube, at least two channels made in the wall of the curved tube in the immediate vicinity of the second marking from the side of the proximal end of the curved tube, diverging at an angle of 90-120 degrees. to each other from the longitudinal channel for the supply of drugs and ending in a cone-shaped outlet with a large cross-sectional diameter closer to the outer surface of the wall, at least two channels made in the wall of the curved tube in the immediate vicinity of the distal end of the tube, diverging at an angle of 90-120 degrees. to each other from the longitudinal channel for the supply of drugs and ending in a cone-shaped outlet with a large cross-sectional diameter closer to the outer surface of the wall, wherein the longitudinal channel for supplying drugs contains from the side of the distal end of the tube at least two multidirectional conical openings for supplying drugs to the contact area of the cuff with the mucous membrane of the trachea and to the lower parts of the respiratory tract located in close proximity to each other along the length of the tube between cuff and two channels, while the axis of the cone of each hole is located at an angle of 40-45 degrees. to the longitudinal axis of the tube and is directed towards the proximal end of the tube. 2. The endotracheal tube according to claim 1, containing an additional marking label located in the immediate vicinity of the second marking mark on the side of the first marking mark. 3. The endotracheal tube according to claim 1, in which the longitudinal channel for supplying air is made in the wall of the curved tube. 4. The endotracheal tube according to claim 1, in which the longitudinal channel for supplying drugs is made in the wall of a curved tube. 5. The endotracheal tube according to claim 1, in which in the annular channel two pairs of holes of different orientations are made at a distance from each other around the circumference on the concave side of the tube wall. 6. Endotracheal tube according to claim 1, in which in the specified annular channel two cylindrical holes are made on the convex side of the tube wall. 7. The endotracheal tube according to claim 1, in which at least two channels in the wall of the curved tube in the immediate vicinity of the distal end of the tube are made in a plane perpendicular to the axis of the tube. 8. The endotracheal tube according to claim 1, in which at least two channels in the wall of the curved tube in the immediate vicinity of the proximal end of the tube are made in a plane perpendicular to the axis of the tube. 9. An endotracheal tube containing a body made in the form of a flexible curved transparent tube having open proximal and distal ends and convex and concave sides, a connector mounted on the proximal end of the tube to connect the cavity of the tube to the ventilator, an inflatable cuff tightly secured around a portion of the distal end of the curved tube and configured to hold the distal portion of the endotracheal tube in the larynx in the desired position, a longitudinal air supply channel made in the wall of the curved tube and communicating with the cavity of the inflatable cuff, a sealed balloon with elastic walls connected to the air supply port, connected via a catheter to a longitudinal channel for supplying air to the cuff cavity and configured to maintain and monitor the pressure in the cuff cavity, a longitudinal channel for delivering drugs, made in the wall of a curved tube and connected by means of a catheter with a container for dosed delivery of drugs, with the Central angle between the longitudinal channel for air supply and the longitudinal channel for drug delivery is in the range of 90-180 degrees., at least two channels made in the wall of the curved tube in the immediate vicinity of the distal end of the tube, diverging at an angle of 90-120 degrees. to each other from the longitudinal channel for the supply of drugs and ending in a cone-shaped outlet with a large cross-sectional diameter closer to the outer surface of the wall, wherein the longitudinal channel for supplying drugs contains from the side of the distal end of the tube at least two multidirectional conical openings for supplying drugs to the contact area of the cuff with the mucous membrane of the trachea and to the lower parts of the respiratory tract located in close proximity to each other along the length of the tube between cuff and two channels, while the axis of the cone of each hole is located at an angle of 40-45 degrees. to the longitudinal axis of the tube and is directed towards the proximal end of the tube, at the same time, at least two marking marks are made on the surface of the tube, one of which is located in the immediate vicinity of the annular channel so that it can be seen from the larynxopharynx with the required working position of the endotracheal tube at the border of the upper part of the larynx, the second marking mark is located at a distance 2-2.5 cm from the first marking, closer to the proximal end of the tube, wherein the longitudinal channel for supplying drugs contains, from the side of the proximal end of the tube between the cuff and the first marking mark, at least two conically-shaped openings for supplying drugs to the contact area of the cuff with the tracheal mucosa and to the underlying respiratory tract, located in close proximity to each other from each other along the length of the tube, while the axis of the cone of each hole is located at an angle of 40-45 degrees. to the longitudinal axis of the tube and is directed towards the proximal end of the tube, at least two channels made in the body of the curved tube in the immediate vicinity of the cuff from the side of the proximal end of the curved tube, diverging at an angle of 90-120 degrees. to each other from the longitudinal channel for the supply of drugs and ending in a cone-shaped outlet with a large cross-sectional diameter closer to the outer surface of the wall, at least two channels made in the body of the curved tube in the immediate vicinity of the second marking from the side of the proximal end of the curved tube, diverging at an angle of 90-120 degrees. to each other from the longitudinal channel for the supply of drugs and ending in a cone-shaped outlet with a large cross-sectional diameter closer to the outer surface of the wall. 10. Endotracheal tube according to claim 9, containing an additional marking label located in the immediate vicinity of the second marking label closer to the first marking label. 11. Endotracheal tube containing a body made in the form of a flexible curved transparent tube having open proximal and distal ends and convex and concave sides, a connector mounted on the proximal end of the tube to connect the cavity of the tube to the ventilator, an inflatable cuff tightly secured around a portion of the distal end of the curved tube and configured to hold the distal portion of the endotracheal tube in the larynx in the desired position, a longitudinal air supply channel made in the wall of the curved tube and communicating with the cavity of the inflatable cuff, a sealed balloon with elastic walls connected to the air supply port, connected via a catheter to a longitudinal channel for supplying air to the cuff cavity and configured to maintain and monitor the pressure in the cuff cavity, a longitudinal channel for delivering drugs, made in the wall of a curved tube and connected by means of a catheter with a container for dosed delivery of drugs, with the Central angle between the longitudinal channel for air supply and the longitudinal channel for drug delivery is in the range of 90-180 degrees., an annular channel for supplying drugs to the contact zone of the cuff with the mucous membrane of the trachea and to the lower respiratory tract, made in the wall of the tube in the immediate vicinity of the inflatable cuff from the proximal end of the tube, communicating with the longitudinal channel for supplying drugs and containing a pair of holes of different directions, made at a distance from each other around the circumference in the angular sector of 90-180 degrees, while the holes have a conical shape with a large cross-sectional diameter closer to the outer surface of the wall and the axis of one hole of the specified pair is placed at an angle of 45 degrees. to the axis of the tube and is directed towards the distal end of the tube, and the axis of the adjacent hole of the specified pair is placed at an angle of 90 degrees. to the axis of the tube, and at least one cylindrical hole made in the specified annular channel on the opposite side from the conical holes, at the same time, at least two marking marks are made on the surface of the tube, one of which is located in the immediate vicinity of the annular channel so that it can be seen from the larynxopharynx with the required working position of the endotracheal tube at the border of the upper part of the larynx, the second marking mark is located at a distance 2-2.5 cm from the first marking, closer to the proximal end of the tube, at least one channel made in the tube body in the immediate vicinity of the second marking from the side of the proximal end of the curved tube, communicating with the longitudinal channel for the supply of drugs and ending in a cone-shaped outlet, with a large cross-sectional diameter closer to the outer surface of the wall, at least one channel made in the body of the tube in the immediate vicinity of the distal end, communicating with a longitudinal channel for supplying drugs and ending in a cone-shaped outlet with a large cross-sectional diameter closer to the outer surface of the wall, wherein the longitudinal channel for supplying drugs contains from the side of the distal end of the tube at least one cone-shaped hole for supplying drugs to the contact area of the cuff with the mucous membrane of the trachea and to the lower respiratory tract, while the axis of the cone of the hole is located at an angle of 40-45 degrees . to the longitudinal axis of the tube and is directed towards the proximal end of the tube. 12. The endotracheal tube according to claim 11, containing an additional marking label located in the immediate vicinity of the second marking label closer to the first marking label. 13. The endotracheal tube according to claim 11, containing an additional longitudinal channel for supplying drugs. 14. An endotracheal tube containing a body made in the form of a flexible curved transparent tube having open proximal and distal ends and convex and concave sides, a connector mounted on the proximal end of the tube to connect the cavity of the tube to the ventilator, an inflatable cuff tightly secured around a portion of the distal end of the curved tube and configured to hold the distal portion of the endotracheal tube in the larynx in the desired position, a longitudinal air supply channel made in the wall of the curved tube and communicating with the cavity of the inflatable cuff, a sealed balloon with elastic walls connected to the air supply port, connected via a catheter to a longitudinal channel for supplying air to the cuff cavity and configured to maintain and monitor the pressure in the cuff cavity, a longitudinal channel for delivering drugs, made in the wall of a curved tube and connected by means of a catheter with a container for dosed delivery of drugs, with the Central angle between the longitudinal channel for air supply and the longitudinal channel for drug delivery is in the range of 90-180 degrees., at least one channel for supplying drugs, made in the wall of the tube at the distal end, communicating with a longitudinal channel for supplying drugs and ending in a cone-shaped outlet with a large cross-sectional diameter closer to the outer surface of the wall, wherein the longitudinal channel for supplying drugs contains, from the side of the distal end of the tube between the cuff and the channel, at least one cone-shaped opening for supplying drugs to the contact zone of the cuff with the mucous membrane of the trachea and to the lower respiratory tract, while the axis of the cone of the hole is at an angle 40-45 degrees. to the longitudinal axis of the tube and is directed towards the distal end of the tube, at the same time, at least two marking marks are made on the surface of the tube, one of which is located in the immediate vicinity of the annular channel so that it can be seen from the larynxopharynx with the required working position of the endotracheal tube at the border of the upper part of the larynx, the second marking mark is located at a distance 2-2.5 cm from the first marking, closer to the proximal end of the tube, at least one channel made in the body of the curved tube in the immediate vicinity of the cuff from the side of the proximal end of the curved tube, communicating with the longitudinal channel for supplying drugs and ending in a cone-shaped outlet wherein the longitudinal channel for supplying drugs contains, from the side of the proximal end of the tube between the cuff and the first marking label, at least one cone-shaped opening for supplying drugs to the contact area of the cuff with the mucous membrane of the trachea and to the lower parts of the respiratory tract, while the axis of the cone of the hole is located at an angle of 40-45 degrees. to the longitudinal axis of the tube and is directed towards the proximal end of the tube, at least one channel made in the body of the curved tube in the immediate vicinity of the cuff from the side of the proximal end of the curved tube, communicating with the longitudinal channel for supplying drugs and ending in cone-shaped outlet openings with a large cross-sectional diameter closer to the outer surface of the wall, at least one channel made in the body of the curved tube in the immediate vicinity of the second marking from the side of the proximal end of the curved tube, communicating with the longitudinal channel for the supply of drugs and ending in a cone-shaped outlet. 15. The endotracheal tube according to claim 14, containing an additional marking label located in the immediate vicinity of the second marking label closer to the first marking label.

Images