SU858823A1

SU858823A1 - Pulmonary artificial ventilation apparatus

Info

Publication number: SU858823A1
Application number: SU792758526A
Authority: SU
Inventors: Владимир Сергеевич Молостовский; Евгений Соломонович Горобец; Вадим Леонидович Тюков; Василий Федорович Антонив
Original assignee: Первый Московский Ордена Ленина И Ордена Трудового Красного Знамени Медицинский Институт Им.И.М.Сеченова
Priority date: 1979-04-26
Filing date: 1979-04-26
Publication date: 1981-08-30

Description

Изобретение относится к медицинской технике, а именно к устройствам., для трахеотомии и может быть использовано для осуществления анестезио- , логического и реанимационного пособия у больных с обструкцией гортани.The invention relates to medical equipment, namely to devices., For tracheotomy and can be used to perform anesthesia, logical and resuscitation in patients with obstruction of the larynx.

Известно устройство для искусственной вентиляции легких, содержащее катетер, выполненный с возможностью соединения с источником кислорода, ^υ и перфоратор [1J .A device for artificial ventilation of the lungs containing a catheter made with the possibility of connection with an oxygen source, ^υ and a perforator [1J.

Однако известное устройство не обеспечивает проведение транстрахеальной инжекционной искусственной 15 вентиляции легких с пассивным выдохом. Кроме того, устройство не позволяет проводить санацию верхних дыхательных путей одновременно с искусственной вентиляцией легких. Пере- .20 численные недостатки снижают эффективность искусственной вентиляции легких и ограничивают область использования устройства.However, the known device does not provide transracheal injection artificial ventilation 15 of the lungs with passive exhalation. In addition, the device does not allow sanitation of the upper respiratory tract at the same time as mechanical ventilation. Enumerated .20 numerical disadvantages reduce the effectiveness of mechanical ventilation and limit the area of use of the device.

Цель изобретения - обеспечение транстрахеальной инжекционной искусственной вентиляции легких с пассивным выдохом при одновременном проведении санации трахеобронхиального тракта. 30The purpose of the invention is the provision of transtracheal injection of artificial ventilation with passive expiration while reorganization of the tracheobronchial tract. thirty

Указанная цель достигается тем, что в устройстве, содержащем катетер, выполненный с возможностью соединения с источником кислорода, и перфоратор, катетер выполнен У-образным, один канал предназначен для введения перфоратора, а другой снабжен инжекционной иглой, выполненной с возможностью соединения с источником кислорода.This goal is achieved by the fact that in a device containing a catheter configured to connect to an oxygen source, and a perforator, the catheter is made U-shaped, one channel is for introducing a perforator, and the other is equipped with an injection needle made with the possibility of connection with an oxygen source.

При этом в качестве перфоратора использован стилет, диаметр которого равен внутреннему диаметру канала.At the same time, a stylet, the diameter of which is equal to the inner diameter of the channel, is used as a perforator.

Кроме того, устройство снабжено какапилляром, присоединенным к наружной стенке канала для перфоратора, причем капилляр соединен с общим каналом катетера .In addition, the device is equipped with a capillary attached to the outer wall of the channel for the hammer, and the capillary is connected to a common channel of the catheter.

На фиг. 1 схематично- изображено устройство для искусственной вентиляции легких) на фиг. 2 - то же. с перфоратором, продольное сечение.In FIG. 1 schematically shows a device for artificial ventilation of the lungs) in FIG. 2 is the same. with perforator, longitudinal section.

Устройство выполнено в виде У-образного катетера с двумя каналами. Канал 1 предназначен для циркуляции воздуха (создания инжекционного потока и осуществления выдоха), санации трахеобронхиального тракта. Наружная стенка канала снабжена капилляром 2 с отверстием 3,, через которое капилляр сообщается с общим каналом '4 катетера. Капилляр предназначен для измерения внутритрахеального давления. Другой канал 5 содержит инжекционную иглу 6’ с гайкой 7 для подсоединения кислородного шланга. Устрой- : ство снабжено перфоратором 8, в качестве которого использован стилет, диаметр стилета равен внутреннему диаметру канала 1.The device is made in the form of a U-shaped catheter with two channels. Channel 1 is designed for air circulation (creating an injection flow and exhaling), sanitation of the tracheobronchial tract. The outer wall of the channel is equipped with a capillary 2 with an opening 3, through which the capillary communicates with the common channel '4 of the catheter. The capillary is designed to measure intratracheal pressure. The other channel 5 contains an injection needle 6 ’with a nut 7 for connecting an oxygen hose. Device-: the device is equipped with a punch 8, which is used as a stylet, the diameter of the stylet is equal to the inner diameter of the channel 1.

Устройство работает следующим об-, разом.The device operates as follows.

Устройство вводят по средней линии передней поверхности шеи в области конической связки путем пункции на глубину 0,5 см под прямым углом. После извлечения перфоратора, убедившись в нахождении конца катетера в просвете гортани (дыхательные шумы) , катетер продвигают вниз по направлению к трахее на 2-3 см. Этим достигают экстренное восстановление проходимости дыхательных путей и возможность немедленного проведения инжекционной искусственной вентиляции легких (ИВЛ) и санации трахеобронхиального тракта. Для обеспечения ИВЛ инжекционную иглу, подсоединенную к источнику кислорода, вводят во второй канал 5 устройства. .The device is inserted along the midline of the anterior surface of the neck in the area of the conical ligament by puncture to a depth of 0.5 cm at right angles. After removing the perforator, making sure that the end of the catheter is in the lumen of the larynx (breathing noises), the catheter is advanced down to the trachea by 2-3 cm. This achieves an emergency restoration of airway patency and the possibility of immediate injection of mechanical ventilation (IVL) and rehabilitation tracheobronchial tract. To ensure mechanical ventilation, an injection needle connected to an oxygen source is introduced into the second channel 5 of the device. .

ИВЛ осуществляют подачей преры- . вистой струи кислорода. Через первый канал при необходимости вводят катетер для аспирации жидкости содержимого трахеи и бронхов. Капилляр для измерения внутритрахеального давления соединяют с мановакуумметром. Подсасывание атмосферного воздуха на входе· и пассивный выдох также происходит через первый канал. В зависимости от показаний, одинаково легко проводится как искусственная, так и вспомогательная вентиляция легких.IVL is carried out by supply of a break. cystic jet of oxygen. If necessary, a catheter is inserted through the first channel to aspirate the fluid of the contents of the trachea and bronchi. A capillary for measuring intratracheal pressure is connected to a manovacuum meter. The intake of atmospheric air at the inlet · and passive exhalation also occurs through the first channel. Depending on the indications, both artificial and assisted ventilation are equally easy.

Таким образом, предлагаемое устройство позволяет добиться быстрого, в течение 10-15 сек, восстановления свободной проходимости дыхательных путем у больных с обструкцией гортани без дополнительной операции трахеотомии (на что обычно требуется 3-5 мин) немедленного, в течение 20-30 сек, обеспечения эффективности ИВЛ при негерметичном дыхательном контуре в любом режиме, в том числе вспомогательной ИВЛ, простого и эф фективного осуществления контроля внутритрахеального давления.Thus, the proposed device allows you to quickly, within 10-15 seconds, the restoration of free airway in patients with obstruction of the larynx without additional tracheotomy (which usually takes 3-5 minutes), immediate, within 20-30 seconds, providing the effectiveness of mechanical ventilation in an unpressurized respiratory circuit in any mode, including auxiliary mechanical ventilation, simple and effective monitoring of intratracheal pressure.

Устройство отличается возможностью создания инжекционного потока без увеличения диаметра катетера (отсутствует необходимость наличия ^.катетеров различного диаметра), обладает минимальным мертвым .пространством и минимальным сопротивлением выдоху в связи с отсутствием присоединительных узлов и клапанов, обеспечивает, подачу высоких концентраций кислорода, не требует аппарата для ИВЛ. Устройство простое в работе, может использоваться в любой обстановке, в том числе - в полевых условиях, при массовых поражениях, может быть использовано для повышения качества . оказания хирургической помощи у больных с обструкцией гортани в клинических условиях.The device is distinguished by the possibility of creating an injection flow without increasing the diameter of the catheter (there is no need for ^ catheters of various diameters), it has minimal dead space and minimal resistance to expiration due to the absence of connecting nodes and valves, provides high oxygen concentrations, does not require an apparatus for Mechanical ventilation The device is easy to use, can be used in any environment, including in the field, with mass lesions, can be used to improve quality. the provision of surgical care in patients with obstruction of the larynx in a clinical setting.

Claims

The invention relates to medical technology, namely, devices for tracheotomy and can be used to carry out anesthesia and resuscitation aid in patients with laryngeal obstruction. A device for art ventilation of the lungs, containing a tether capable of connecting to an oxygen source, and perforator tlj However, the known device does not provide for carrying out transtracheal injection artificial ventilation of the lungs with passive exhalation. In addition, the device does not allow for the rehabilitation of the upper respiratory tract simultaneously with artificial ventilation of the lungs. These disadvantages reduce the efficiency of artificial ventilation of the lungs and limit the area of use of the device. The purpose of the invention is to provide a trans-tracheal injection artificial ventilation of the lungs with a passive expiration while simultaneously rehabilitating the tracheobronchial tract. This goal is achieved by having a catheter in the device comprising a catheter configured to be connected to an oxygen source and a perforator. In the form of, one channel is intended for insertion of a perforator, and the other is provided with an injection needle adapted to be connected to an oxygen source. In this case, a stylet is used as a perforator, the diameter of which is equal to the internal diameter of the channel. In addition, the device is equipped with a capapillum attached to the outer wall of the perforator channel, the capillary being connected to the common channel of the catheter. FIG. 1 schematically shows a device for artificial ventilation of the lungs) in FIG. 2 - the same. with perfo ator, longitudinal section. The device is made in the form of a U-shaped catheter with two channels. Channel 1 is designed for air circulation dp (creating injection flow and exhalation), reorganization of the tracheobronchial tract. The outer wall of the channel is provided with a capillary 2 with an opening 3, through which the capillary communicates with the common channel 4 of the catheter. The capillary is intended to measure intratracheal pressure. The other channel 5 contains an injection needle b with a nut 7 for feeding the oxygen hose. The device is equipped with a perforator 8, which is used as a stylet, the diameter of the stylet is equal to the inner diameter of the channel 1. The device works as follows. The device is inserted along the midline of the anterior surface of the neck in the conical binder area by puncture to a depth of 0.5 cm at a right angle. After removing the perforator, making sure that the end of the catheter is in the lumen of the larynx (breathing noise), the catheter is pushed downward to the trachea by 2-3 cm. This achieves an emergency restoration of airway patency and the possibility of immediate injection ventilation (ALV) and sanation. tracheobronchia tract. To provide the IVL, an injection needle connected to an oxygen source is introduced into the second channel 5 of the device. . The ventilation is carried out by interrupting. whistle of oxygen. If necessary, a catheter for aspirating the liquid from the trachea and bronchi is inserted through the first channel. The capillary tube is connected to the vacuum tube with a manometer to measure intratracheal pressure. The flow of atmospheric air at the entrance and passive exhalation also occur through the first channel. Depending on the indications, it is equally easy to carry out both artificially and auxiliary to the ventilation of the lungs. Thus, the proposed device allows to achieve fast within 10-15 seconds, restoring the free airway of the respiratory tract in patients with obstruction of the larynx without additional tracheotomy surgery (which usually takes 3-5 minutes) immediately, within 20-30 seconds, ensuring the effectiveness of mechanical ventilation in the unsealed respiratory circuit in any mode, including auxiliary mechanical ventilation, simple and effective control of intratracheal pressure. The device is characterized by the possibility of creating an injection flow without increasing the diameter of the catheter (there is no need for catheters of different diameters), it has minimal dead space and minimal resistance to exhalation due to the absence of connecting nodes and valves, provides high concentrations of oxygen, does not require a ventilator. The device is simple to use, can be used in any environment, including - in field conditions, with mass lesions, can be used to improve quality. providing surgical care in patients with laryngeal obstruction in clinical conditions. Claim 1. A device for artificial ventilation of the lungs, comprising a catheter made with the possibility of connecting with an oxygen source, and a perforating device, characterized in that, in order to ensure fear of the injection of artificial ventilation of the lungs with a passive breath, while carrying out the sanation of the tracheobronchial tract, the catheter is made Y-shaped, one channel is designed to insert a perforator, and the other is provided with an injection needle configured to be connected to an oxygen source. 2 A device according to claim 1, characterized in that a stylet is used as a perforator, the diameter of which is equal to the inner diameter of the channel, 3. The device according to iF characterized in that it is equipped with a capillary tube / attached to the outer wall of the perforator channel p is connected to the common channel of the catheter. Sources of information taken into account in examination 1, U.S. Patent W 3682166, cl. A 61 H 31/00, 1972.