US20160220774A1 - Endotracheal tube and method of use - Google Patents

Endotracheal tube and method of use Download PDF

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Publication number
US20160220774A1
US20160220774A1 US14/917,540 US201414917540A US2016220774A1 US 20160220774 A1 US20160220774 A1 US 20160220774A1 US 201414917540 A US201414917540 A US 201414917540A US 2016220774 A1 US2016220774 A1 US 2016220774A1
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Prior art keywords
tube
guide
patient
endotracheal tube
tip
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Abandoned
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US14/917,540
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English (en)
Inventor
Sasanka Sekhar Dhara
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Naga Wire-Tracking Tracheal Tube Pty Ltd
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Naga Wire-Tracking Tracheal Tube Pty Ltd
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Priority claimed from AU2013903646A external-priority patent/AU2013903646A0/en
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Assigned to NAGA WIRE-TRACKING TRACHEAL TUBE PTY LTD reassignment NAGA WIRE-TRACKING TRACHEAL TUBE PTY LTD ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: DHARA, Sasanka Sekhar
Publication of US20160220774A1 publication Critical patent/US20160220774A1/en
Abandoned legal-status Critical Current

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/04—Tracheal tubes
    • A61M16/0488—Mouthpieces; Means for guiding, securing or introducing the tubes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/01—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes specially adapted for anaesthetising
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/04—Tracheal tubes
    • A61M16/0402—Special features for tracheal tubes not otherwise provided for
    • A61M16/0411—Special features for tracheal tubes not otherwise provided for with means for differentiating between oesophageal and tracheal intubation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/04—Tracheal tubes
    • A61M16/0434—Cuffs
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/04—Tracheal tubes
    • A61M16/0461—Nasoendotracheal tubes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/04—Tracheal tubes
    • A61M16/0486—Multi-lumen tracheal tubes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/04—Tracheal tubes
    • A61M16/0475—Tracheal tubes having openings in the tube
    • A61M16/0477—Tracheal tubes having openings in the tube with incorporated means for delivering or removing fluids
    • A61M16/0484—Tracheal tubes having openings in the tube with incorporated means for delivering or removing fluids at the distal end
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/04—Tracheal tubes
    • A61M16/0402—Special features for tracheal tubes not otherwise provided for
    • A61M16/0411—Special features for tracheal tubes not otherwise provided for with means for differentiating between oesophageal and tracheal intubation
    • A61M2016/0413—Special features for tracheal tubes not otherwise provided for with means for differentiating between oesophageal and tracheal intubation with detectors of CO2 in exhaled gases
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2207/00—Methods of manufacture, assembly or production
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2209/00—Ancillary equipment
    • A61M2209/06—Packaging for specific medical equipment
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2230/00—Measuring parameters of the user
    • A61M2230/40—Respiratory characteristics
    • A61M2230/43—Composition of exhalation
    • A61M2230/432—Composition of exhalation partial CO2 pressure (P-CO2)

Definitions

  • This disclosure relates to equipment for use in, and methods of, performing anterograde or retrograde wire-guided endotracheal intubation.
  • An endotracheal tube is normally passed into the trachea of a patient to maintain a patent airway and allow the delivery of oxygen/air/anesthetic gases and vapors to the patient. It may also be used to separate the lungs from the aero-digestive tract and protect from soiling due to aspiration of bodily fluids or to clear respiratory tract of secretions or blood. This is achieved by suction through the ETT. Such procedures may be necessary during resuscitation or general anesthesia, in a patient being treated in an intensive care unit (ICU) or in accident and emergency treatment areas.
  • ICU intensive care unit
  • Tracheal intubation over a guide wire previously placed inside the larynx or trachea is an alternative method for anticipated or unanticipated difficult intubation.
  • the difficulties may arise mainly from anatomical variations, changes caused by disease, trauma, and/or surgical or radio therapeutic treatment in a patient.
  • the guide wire may be placed in an anterograde (also known as antegrade) way through the mouth or nose and across the laryngeal inlet into the trachea or through a puncture at the space at the front of the neck between the cricothyroid or cricotracheal junctions or upper tracheal rings and advanced upward in a retrograde fashion.
  • anterograde also known as antegrade
  • Wire-guided intubation is also used for exchange of endotracheal tubes and for trial of extubation in patients who are at a risk of developing an airway obstruction in post-operative period leading to an endotracheal re-intubation.
  • tracheal tubes used in daily practice have a stiffer consistency and a fixed curvature that may not negotiate the midline of mouth and pharynx or the acute pharyngo-laryngeal angle well and are known to drag relatively more flexible and redundant loop of guide (bougie, introducer, fiber-optic scope, airway exchange catheter) into the esophagus.
  • Pressures from the tip of an advancing tube can be high on points of contact with tissues, causing trauma to the airway structures.
  • Another problem of railroading a tracheal tube over a guide is “snagging” of the tip of the tracheal tube at the laryngeal inlet, [18, 19] which can result in delay in intubation/oxygenation, dislodgement of the tube from the larynx, esophageal intubation, and trauma to larynx and pharynx.
  • equipment like inflatable introducers (AIRGUIDETM RADLYNTM), AINTREETM catheter, and tubes with modified consistency and tips (PARKER-FLEXTM tubes, ILMATM tubes) are used. Obtuse bevel in these tubes also help avoiding impingement on tissues causing trauma to airway structures. [17]
  • AINTREETM catheter For wire-guided intubation, sometimes another catheter with wider diameter (AINTREETM catheter) is loaded over the first introducer (AEC, Exchange catheter or fiber-optic scope) before the tracheal tube is finally mounted over the (guide wire/introducer catheter/larger introducer) complex to build up a gradual increase in diameters between the guide wire to the tracheal tube at the tip—all for a smooth railroading process. It is apparent that presence of this rather solid complex will cause a sizable obstruction inside the larynx and trachea, making routine vital procedures like continuous delivery of Oxygen or monitoring of Capnography difficult to impossible.
  • This guiding procedure being “blind” and used as a rescue technique in a difficult intubation situation is often performed on an awake, sedated patient. Prevention of hypoxia and monitoring the progress and placement of the endotracheal tube are essential in such a situation. Attempts to deliver Oxygen under pressure via jet ventilation through the hollow introducer catheter have been associated with barotrauma of the
  • patent application 2010/0113916 in the name of Kumar which discloses an endotracheal tube with a channel to introduce equipment probe to monitor position of the endotracheal tube
  • Chinese utility patent 202096565 which discloses an endotracheal tube with an external channel for specific control of nasal intubation.
  • This disclosure aims to provide a simple easy to follow a system using a single piece of equipment and a single step for wire-guided endotracheal intubation (i.e., once the guide wire is placed, only a single piece of equipment is used).
  • the simple system provides the opportunity to deliver oxygen throughout the procedure and to monitor ETCO 2 to indicate the progress and correct placement of the tube. This offers unprecedented safety for management of difficult airways using wire-guided tracheal intubation techniques.
  • this disclosure provides an endotracheal tube for use in a wire-guided intubation procedure, the tube comprising: a) a main lumen and a sidewall; b) a proximal end portion suitable for attachment to a breathing circuit, which end portion in use protrudes from the mouth or nose of a patient; c) a distal end portion suitable for insertion into the nose and/or mouth of a patient, the distal end portion having a tip suitable for traversing the laryngeal inlet of a patient; and d) a guide housing means running between the portions having a proximal opening adjacent the proximal end portion and a distal opening adjacent to the tip, wherein the guide housing means is adjacent the sidewall of the main lumen and is suitable for slidingly receiving an anterograde or a retrograde guide during an intubation procedure to allow the tube to follow the guide into the patient.
  • endotracheal tube refers to a medical catheter that is inserted into the trachea through the nose or mouth in order to maintain a patent airway to deliver oxygen/artificial ventilation/anesthetic gases and vapors to a patient or to keep the tracheobronchial tree clean by removing secretions or blood.
  • retrograde intubation refers to a procedure in which one end of a guide, most commonly a guide wire, is introduced from the front of the upper neck of the patient and is threaded up through the larynx and either out through the mouth or nose. The end of the guide wire is then retrieved and used as a guide to “railroad” an endotracheal tube into the larynx.
  • heating circuit refers to a circuit or system that helps to connect the patient to the anesthetic gas delivery machine.
  • the term “having a tip suitable for traversing the laryngeal inlet of a patient” refers to an end or extremity of the distal end portion of the tube that has a suitable shape, and is made of suitably flexible material to pass smoothly through the laryngeal inlet.
  • a guide housing means refers to a means for enclosing, or capturing the guide such that when the endotracheal tube is pushed over the guide, the tube will be able to closely follow the path of the guide.
  • the housing means is of a suitable shape, configuration and size that will substantially follow the long axis of the guide with little lateral movement or play.
  • the term “for slidably receiving a guide” refers to the guide housing means being of a size and suitable configuration to allow the endotracheal tube to slide along the guide when the guide is within the housing means.
  • follow the guide refers to the tube following the path or the route that the guide has taken through the anatomical spaces or structures; for example, through the center of the mouth negotiating various degrees of angular bends between the pharynx, the larynx and into the trachea, ideally without straying off course or snagging on airway structures.
  • guide used herein includes a guide wire and also contemplates other types of guides not made of wire. Many other materials had been used as guides including epidural catheters or long CVP lines.
  • the endotracheal tube is a flexible tube of suitable material that is reinforced along most of its length except for small sections at each end.
  • the endotracheal tube may be made of silicon or other suitable softer non-allergenic materials.
  • the tip of the distal end portion of the tube is in the form of a bevel with an appropriate angle.
  • the bevel is made of soft and deformable material.
  • the bevel wall and adjacent portion is devoid of reinforcing.
  • the guide housing means is in the form of a channel or passage adjacent the main lumen sidewall of the endotracheal tube, meaning that it is eccentric to, rather than concentric with, the central axis of the main lumen.
  • the guide housing means is integrated into the sidewall of the endotracheal tube.
  • the guide housing means comprises a smooth continuous lumen.
  • the disclosure provides a kit for wire-guided endotracheal intubation comprising: i) an endotracheal tube comprising: a) a main lumen and a sidewall; b) a proximal end portion suitable for attachment to a breathing circuit, which end portion in use protrudes from the mouth or nose of a patient; c) a distal end portion for insertion into the nose and/or mouth of a patient, the distal end portion having a tip suitable for traversing the laryngeal inlet of a patient; and d) a guide housing means running between the portions having a proximal opening adjacent the proximal end portion and a distal opening adjacent to the tip, wherein the guide housing means is adjacent the sidewall of the main lumen and is suitable for slidingly receiving an anterograde or a retrograde guide during an intubation procedure to allow the tube to follow the guide into the patient and ii) a wire guide.
  • the suitable guide is a guide wire.
  • the disclosure provides an improved method of endotracheal intubation comprising: i) introducing a suitable anterograde guide into the nose or mouth of a patient in a standard manner or introducing a retrograde guide by passing an end of a guide through the larynx of a patient and retrieving the end from the nose or mouth of a patient in a standard manner; ii) advancing into the patient's trachea an endotracheal tube of suitable length, wherein the tube comprises: a) a main lumen and a sidewall; b) a proximal end portion suitable for attachment to a breathing circuit; c) a distal end portion having a tip suitable for traversing the laryngeal inlet of a patient and; d) a guide housing means running between the portions having a proximal opening adjacent the proximal end portion and a distal opening adjacent to the tip, wherein the guide housing means is adjacent the sidewall of the main lumen and is suitable for slidingly receiving an
  • the improvement resides in the fact that once the guide is in place, the design of the ETT allows it to be positioned in a single step. This saves time compared to the existing practice, especially where in current retrograde procedures, the retrograde guide is withdrawn while either pressure is exerted on the ETT to keep it in place or the guide catheter is removed from the retrograde guide and re-introduced into the lumen of the tracheal tube, all to prevent unintended displacement of the tube from the larynx.
  • the method of this disclosure involves fewer pieces of equipment than existing methods, resulting in less potential confusion and lower costs. As the method involves fewer steps, this saves crucial time in achieving intubation. In addition, the method of the disclosure avoids certain undesirable effects of maneuvers required by current methods.
  • the disclosure also provides a system for an endotracheal tube insertion.
  • the disclosure provides a method of making an endotracheal tube for use in a wire-guided intubation procedure, the method comprising forming an endotracheal tube of suitable materials, the tube having a) a main lumen and a sidewall; b) a proximal end portion suitable for attachment to a breathing circuit; c) a distal end portion suitable for insertion into the nose and/or mouth of a patient, the distal end portion having a tip suitable for traversing a laryngeal inlet of a patient; and d) a guide housing means running between the portions having a proximal opening adjacent the proximal end portion and a distal opening adjacent to the tip, wherein the guide housing means is adjacent the sidewall of the main lumen and is suitable for slidingly receiving an anterograde or a retrograde guide during an intubation procedure to allow the tube to follow the guide into the patient.
  • the current techniques of wire-guided tracheal intubation consist of: a hollow semi-rigid introducer/catheter over the guide wire already placed inside the airway; sometimes using another larger introducer catheter (AINTREETM catheter) over the first introducer (FOS, AECs); or tracheal tube railroaded over the guide wire/introducer complex.
  • AINTREETM catheter another larger introducer catheter
  • FOS, AECs first introducer
  • tracheal tube railroaded over the guide wire/introducer complex.
  • the problems with these protocols include: restriction of size of a tracheal tube that can be used as it is determined by outer diameter of the guide (e.g., FOS); a gap between the guide and the tracheal tube that causes difficulties with placement; pressure- (from tip of the tube) related injuries and esophageal intubation; trauma from the semi-rigid guides inside airway; failure to railroad a tracheal tube over guides every time; continuous delivery of oxygen to the patient is difficult and delivery of oxygen through the hollow guide from a high pressure source (jet) had caused barotrauma; the procedure does not have definite marker for completion of a step before proceeding to the next step.
  • FOS outer diameter of the guide
  • a gap between the guide and the tracheal tube that causes difficulties with placement
  • pressure- (from tip of the tube) related injuries and esophageal intubation trauma from the semi-rigid guides inside airway
  • failure to railroad a tracheal tube over guides every time failure to railroad a tracheal
  • Another problem is the mass of guide/larger guide/tracheal tube complex when presented at the larynx can cause sizable obstruction to the airway and it may be difficult for a patient to breathe. This problem can be even worse in a patient with a narrower larynx (laryngeal tumor) as the airway is simply plugged shut, leaving no room to breathe; the number of steps and a certain sequence involved makes the procedure lengthy and difficult.
  • FIG. 1 b is a cross-section through the line A-A of FIG. 1 a;
  • FIG. 2 is a representation of a cross-sectional view through part of a patient's head and neck showing alternative guide wire insertions (A being anterograde and B being retrograde) with the ETT railroaded over the guide prior to insertion of the ETT into the patient's mouth.
  • the inflation cuff is omitted from the inserted tube for clarity.
  • ETT 10 comprises a generally cylindrical sidewall 12 with a central lumen 15 with a central axis that runs the entire length of the tube from proximal end portion 20 to distal end portion 30 .
  • Distal end portion 30 comprises beveled end 35 .
  • Inflation tube 60 which runs partway along the length of the ETT 10 , is used to inflate inflatable annular cuff 67 once tube 10 is located within the trachea to create a fluid seal.
  • Guide housing means 50 in the form of guiding channel 55 is located off center, or eccentrically with respect to the central axis opposite inflation tube 60 in cylindrical sidewall 12 of ETT 10 .
  • Guiding channel 55 has a smooth, continuous (un-perforated) lumen and has a proximal opening 55 a at one end and distal opening 55 b at the other end adjacent tip 35 a .
  • Proximal opening 55 a may be sealed by stopper 56 .
  • the diameter of guiding channel 55 is tubular and suitable to allow sliding movement of suitable guide wire 70 within (see FIG. 2 ).
  • the diameter of guiding channel 55 is wide enough to snugly accommodate a guide wire, for example, to accommodate a 0.038 inch (0.9652 mm) guide wire in a 7.5 mm tracheal tube.
  • Suitable guide wire 70 and tube 10 have complementary flexural rigidity.
  • ETT 10 may be made of any suitable material such as silicon that is non-reactive to tissues.
  • ETT 10 is of a suitable diameter to fit a patient's anatomy (adult or child).
  • ETT 10 has an internal diameter of 7.5 mm with a wall thickness of 3.2 mm.
  • ETT 10 has a number of benefits over normal PVC ETTs. These include flexibility, which allows it to follow a retrograde guide easily across the tortuous upper airway. Where axial pressure is applied, ETT 10 does not impinge adversely on tissues causing trauma. Further, it is kink resistant. In addition, having no pre-determined curve, ETT 10 can be easily rotated about its long axis.
  • the ETT of this disclosure is employed in intubation as follows: Thorough lubrication of the tip 35 a and cuff area 67 of the ETT 10 and the guide wire 70 with suitable lubricant is performed. This is a very important step of preparation for the guiding at all times.
  • Suitable guide wire 70 in the form of a 0.038-inch diameter suitably coated wire is placed in the trachea 97 of a patient using one of the following techniques:
  • guiding channel 55 is aligned with tip 35 a of tube 10 provides a convenient visual indicator of the orientation of the tip 35 a.
  • the trajectory of the tip of the advancing tube is solely determined by the guide wire inside the airway.
  • the soft non-reinforced section at the tip of the tube while negotiating the vocal cords, deforms inward to a smaller size but readily re-expands inside the wider subglottic space.
  • Fluoroscopic video of wire-guided intubation using this tube was recorded to illustrate the way it advances along the airway.
  • the tube was found to follow the guide wire across the entire upper airway smoothly without straying.

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  • Health & Medical Sciences (AREA)
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  • Anesthesiology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • General Health & Medical Sciences (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Hematology (AREA)
  • Emergency Medicine (AREA)
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  • Engineering & Computer Science (AREA)
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  • Veterinary Medicine (AREA)
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  • Media Introduction/Drainage Providing Device (AREA)
  • Surgical Instruments (AREA)
US14/917,540 2013-09-23 2014-08-05 Endotracheal tube and method of use Abandoned US20160220774A1 (en)

Applications Claiming Priority (5)

Application Number Priority Date Filing Date Title
AU2013903646A AU2013903646A0 (en) 2013-09-23 Endotracheal Tube and Method of Use
AU2013903646 2013-09-23
AU2014901331A AU2014901331A0 (en) 2014-04-11 Endotracheal Tube and Method of Use
AU2014901331 2014-04-11
PCT/AU2014/000784 WO2015039164A1 (en) 2013-09-23 2014-08-05 Endotracheal tube and method of use

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EP (1) EP3049138B1 (enExample)
JP (1) JP2016531706A (enExample)
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WO2018187527A1 (en) * 2017-04-07 2018-10-11 Hamad Medical Corporation Method and kit for performing percutaneous dilational tracheostomy
WO2021026566A1 (en) * 2019-08-06 2021-02-11 Chris Salvino Endotracheal tube assembly
IT202000017461A1 (it) * 2020-07-17 2022-01-17 Giuseppe Maggio Kit di componenti per tracheotomia dilatativa percutanea estrusiva
US20220184334A1 (en) * 2020-12-16 2022-06-16 Tien-Sheng Chen Endotracheal Tube

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HK1223575A1 (zh) 2013-09-23 2017-08-04 Naga Wire-Tracking Tracheal Tube Pty Ltd 气管内插管及使用方法
WO2018025888A1 (ja) * 2016-08-03 2018-02-08 株式会社Ｍｉｃｏｔｏテクノロジー 医療シミュレータ
CN107007917A (zh) * 2017-06-06 2017-08-04 肖金仿 效托式可变气管导管通气装置
CN107261284B (zh) * 2017-07-25 2023-08-15 烟台芝罘医院 一种经颈部的手术用气管穿刺插管
CN108245277A (zh) * 2018-01-19 2018-07-06 东北农业大学 一种大体型猪用气管插管
CN110538369A (zh) * 2019-09-30 2019-12-06 张馥镇 可直接连呼气末二氧化碳监测的硅胶钢丝加强型气管插管
CN110812649B (zh) * 2019-12-11 2020-10-13 姜虹 一种呼气末co2引导气管插管装置

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EP3049138A1 (en) 2016-08-03
EP3049138B1 (en) 2020-12-09
AU2014324068A1 (en) 2016-05-05
CN105579090A (zh) 2016-05-11
AU2014324068B2 (en) 2020-04-02
US11850362B2 (en) 2023-12-26
US20200197643A1 (en) 2020-06-25
HK1223575A1 (zh) 2017-08-04

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