US3504676A - Endotracheal balloon catheter provided with inflation pressure regulating valve - Google Patents

Endotracheal balloon catheter provided with inflation pressure regulating valve Download PDF

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US3504676A
US3504676A US3504676DA US3504676A US 3504676 A US3504676 A US 3504676A US 3504676D A US3504676D A US 3504676DA US 3504676 A US3504676 A US 3504676A
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pressure
bladder
air
respiration
trachea
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Vagn Niels Finsen Lomholt
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Lomholt Vagn Niels Finsen
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Lomholt Vagn Niels Finsen
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M16/00Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/04Tracheal tubes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M16/00Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/04Tracheal tubes
    • A61M16/0434Cuffs
    • A61M16/044External cuff pressure control or supply, e.g. synchronisation with respiration
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M16/00Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/08Bellows; Connecting tubes ; Water traps; Patient circuits
    • A61M16/0816Joints or connectors
    • A61M16/0833T- or Y-type connectors, e.g. Y-piece

Description

Apnl 7, 1970 v. N. F. LOMHOLT 3,504,676

ENDOTRACHEAL BALLOON CATHETER PROVIDED WITH INFLATION PRESSURE REGULATING VALVE Filed June 13, 1967 I Y WRW X w- United States Patent U.S. Cl. 128-351 3 Claims ABSTRACT OF THE DISCLOSURE A respiratory catheter in which the tube for delivering respiration air under pressure to a patients lungs is enclosed along a portion of its lower end with a bladder of non-resilient material adapted to engage the patients trachea and provide a seal preventing entry of vomit to the lungs, the bladder being connected with a separate source of air under lesser pressure than that delivered to the lungs by means of a pipeline connected with a twoway blocking valve disposed in the tube and controlled by the respiration air. The respiration air during the inhalation phase closes the two-way valve and applies pressure to the outside of the bladder at the downstream end to maintain the seal, whereas, during exhalation, the absence of the respiration air pressure allows the two-way valve to open to enable the lower pressure air to provide suflicient inflation of the bladder for sealing purposes.

This invention relates to respiratory catheters of the type consisting of a tube for introducing air to the lungs of the patient, adapted to be introduced in the trachea of the patient and provided with a tube surrounding bladder to create a tightening in relation to the wall of the trachea, whereby the interior of said bladder is in connection with a separate pipe connected to a source of pressure.

It has been found to be most important in using respiratory catheters to obtain a really eifective tightening or construction therewith in relation to the wall of the trachea and especially to maintain the tightening also during the expiration phase, more especially because when treating unconscious patients, one may be in need of a breathing security, i.e. a protection against any vomit that may arise and push through the trachea and down to the lungs. In respiratory catheters such as are known in the art, various types of tightening means for providing construction between the catheter and the trachea wall have been used, such as a vesicle or bladder made of a resilient material and, therefore, capable to be inflated against the trachea wall and thereby provide tightening. It appears, however, that such a tightening in order to be etficient under all conditions has to be provided at a comparatively high pressure, the resilient bladder for sealing purposes being constantly required to exert a pressure against the mucous membranes of the trachea during both the inspiratory and exspiratory sure. Such a constant pressure against the trachea wall often has a harmful elfect on the mucous membranes of the wall, leading to a decrease of or eventually a cessation of the blood circulation in the area in question.

The aim of the present invention is to provide a respiratory catheter applicable to artificial respiration without such disadvantages as found in prior art respiratory catheters. It is an object of the present invention to provide means with which to obtain an airtight closure of the trachea during both the inspiratory and expiratory phase of artificial ventilation of the lungs without subjecting the mucosa of the trachea to pressures harmful ice thereto. This is achieved according to the present invention by a respiratory catheter tube which is provided With a bladder comprised of a thin, preferably nonresilient foil material with such dimensions that it can readily be brought into tightening abutment against the wall of the trachea without resilient deformation of the bladder, and which communicates With a compressed air source through a two-Way blocking valve disposed in the pipe through which respiration air is supplied to the catheter tube, said blocking valve being controlled by the pressure of the respiration air.

The invention will now be described with reference to the accompanying drawing, representing a longitudinal section view of a respiratory catheter incorporating the principles of the present invention.

In the drawing is shown a respiratory catheter consisting of a catheter tube 1, which at one or its upper end is joined to a T-shaped tube 2, one branch of which is closed olf as by a cork 3, the main branch 4 of the tube serving as inlet nozzle for the respiration air to the catheter tube 1.

The opposite or lower end of the catheter tube is provided with an appropriate bent segment and has a bladder 5 secured on the outside of said tube around said bent segment. The bladder may be supplied with air under pressure through a duct 6 in the wall of the tube 1. From the duct a thin pipeline 7 leads into the main branch 4 of T-shaped tube 2 and is connected to one end of an inflatable-collapsible blocking valve 8 disposed in said main branch 4 as shown. The blocking valve 8 may comprise two plane foil members 8 welded together along their rims to thus form a hollow inflatable-collapsible valve. A thin pipe 9 is connected with the other end of the blocking valve and in turn outlets from the tube branch 4 to serve as an inlet nozzle for delivering compressed air to the bladder 5 from a source separate from that supplying the respiratory air.

The respiration air pressure applied is of course dependent on the patient and on varying external circumstances and should normally be of a pressure height corresponding to 20-70 cm. column of water, whereas, the air pressure in the bladder 5 may be maintained somewhat lower, eg at a height corresponding to 16-20 cm. column of water. A pressure like that cannot injure the mucous membranes of the trachea and the increase of pressure caused by the respiration pressure does not exceed the pressure imposed on the rest of the air passage by the respiratory treatment.

When using the catheter of the present invention, practically no force is required for pressing the bladder 5 against the trachea wall and the pressure exerted within the bladder is consequently entirely utilized to provide sealing. Moreover, the bladder tends, without alterations of the internal pressure, to comply with any alteration of the dimensions of the trachea still without requesting a particular pressure application; thus it is possible to maintain pressure in the bladder at the lowest possible level.

When using a blocking valve such as valve 8 to control pressure in bladder 5 with the opening and closing of the blocking valve in turn being controlled by the respiration pressure, a performance is achieved where the amount of air pressure introduced into the bladder 5 through duct 6 from a separate source of compressed air at a lower pressure than the respiration air so as to fill and enlarge said bladder, such air is confined in said bladder as soon as the respiration air under pressure being delivered through tube 1 rises. Thus the respiration air pressure closes blocking valve 8 preventing entry or outflow of the air under lower pressure from bladder 5, with the respiration air itself exerting a pressure against the outside of the bladder at the lower part, i.e., facing the lungs causing an increase of the abutting pressure of the bladder against the trachea. In the expiration periods, a rather low air pressure in the bladder is all that is required for proper operation of the bladder for tightening purposes. Such air pressure supply to the bladder during the expiration periods is substantially below a possibly harmful pressure. During the expiration period, the absence of the higher pressure air in branch 4 allows the blocking valve 8 to open or inflate and connection of the bladder 5 with the separate lower air pressure source occurs to thereby permit enlargement of the bladder against the trachea. Generally compressed air is used as pressure medium and since the respiration pressure frequently is considerably higher than the pressure required to provide breathing security, the confining of the amount of compressed air introduced in the bladder will merely lead to a squeezing by the respiration pressure of the extremity of the bladder which turns downwards the lungs to an extent resulting in a decrease of the total volume of the bladder and the pipe connected thereto, whereby the pressure will increase precisely as much as required to ensure the tightening.

As was indicated earlier, blocking valve 8 is located in branch 4 so as to provide an eflective control of the valve. This allows for a utilization of the drop of pressure which occurs in the course of the passage of the air between the entry orifice of the respiration tube 1 and the valve 8. When, e.g., the respiration pressure decreases from its maximum value, an opening of the valve 8 will occur which allows a part of the volume of air in the bladder and which was compressed therein by the externably located maximal respiration pressure, to escape, whereby the pressure in the bladder for a short moment becomes too low to keep up a perfect sealing of the trachea against the respiration pressure not yet dropped to its minimum value. By virtue of this, during a short moment a passage will be produced along the mucous membranes and between them and the bladder along which upward transport of phlegm and other undesirable matter can take place, just as said trachea and adjacent organs in the natural state always manage to remove such impurities. The perfect sealing is, however, again provided when the respiration pressure drops right down to its minimal value and the separate lower air pressure supply enlarges the bladder against the trachea.

What I claim is:

1. A respiratory catheter comprising a tube adapted to be introduced into the trachea of a patient for delivery of respiration air under pressure to the patients lungs,

said tube having an upper entry end anda lower bent section, a bladder of thin, non-resilient material enclosing the bent section of said tube and being secured thereto, said tube having a duct therein communicating with the interior of said bladder, an elongated in-flatablecollapsible blocking valve disposed in said tube at the entry end thereof, a pipe line connecting one end of said blocking valve with said duct, and a pipe connecting the opposite end of said blocking valve with a source of air at a pressure lower than that of the respiration air, the pressure of respiration air flowing through said tube during inspiration collapsing said blocking valve to isolate said bladder from the source of air at pressure lower than that of said respiration air whereby the respiration air flowing to the patients lungs exerts a pressure on the outside of said bladder at the end nearest the lugs to thereby force said bladder into tightening engagement with said trachea, said blocking valve becoming inflated during expiration when the pressure of said respiration air is released whereby said air at a pressure lower than that of said respiration air can flow to said bladder to enlarge same against the patients trachea.

2. The respiratory catheter of claim 1, further comprising a T-shaped fitting on the entry end of said tube, said fitting having one branch received in said tube, another branch closed off with a plug, and a third branch serving as an inlet for respiration air, said blocking valve being disposed in said third branch.

3. The respiratory catheter of claim 2 wherein said blocking valve is comprised of a pair of foil sheets connected together along their rims to form an inflatablecollapsible structure.

References Cited UNITED STATES PATENTS 3,087,493 4/1963 Schossow 128-351 3,211,152 10/1965 Stern 128-351 3,407,817 10/1968 Galleher 128-351 OTHER REFERENCES Martinez: Jour. Thoracic and Card. Surg., vol. 47, #3, March 1964, pp. 404405.

' DALTON L. TRULUCK, Primary Examiner US. Cl. X.R. 128-208 UNITED STATES PATENT OFFICE CERTIFICATE OF CQRRECTION Patent No. 3 ,504, 676 Dated April 7 1970 Inv Vagn Niels Finsen Lomholt It is certified that error appears in the above-identified patent and that said Letters Patent are hereby corrected as shown below:

Column 1, line 43, "construction" should read --constriction--; Column 1, line 51, "construction" should read --constriction--; Column 1, lines 60 and 61, after "trachea" on line 60,

"during both the inspiratory and exspiratory sure." should read --amounting to the maximum respiratory pressure. Column 1, line 71, "phase" should read --phases--..

Column 4, line 5, "in-flata-" should read --inflata---; Column 4, line 17, "lugs" should read --lungs--.

3|GNER Nib SEALED SEPIEIQYD Edward x. mm Ir.

Attesting Officer VIII-LIAM 2. sum, JR- Gomissioner of Patents

US3504676A 1966-06-16 1967-06-13 Endotracheal balloon catheter provided with inflation pressure regulating valve Expired - Lifetime US3504676A (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
DK309966A DK111149B (en) 1966-06-16 1966-06-16 A respiration catheter.

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DE (1) DE1566625C3 (en)
DK (1) DK111149B (en)
GB (1) GB1182436A (en)
NL (1) NL152759B (en)

Cited By (33)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3640282A (en) * 1970-08-06 1972-02-08 Jack M Kamen Tracheal tube with normally expanded balloon cuff
US3693624A (en) * 1969-10-02 1972-09-26 Donald P Shiley Tracheotomy tube
US3731692A (en) * 1971-03-19 1973-05-08 Foregger Co Tracheotomy or endotracheal tube cuff
US3794036A (en) * 1972-08-02 1974-02-26 R Carroll Pressure regulated inflatable cuff for an endotracheal or tracheostomy tube
FR2196176A1 (en) * 1972-08-14 1974-03-15 Hakim Salomon
US3865106A (en) * 1974-03-18 1975-02-11 Bernard P Palush Positive pressure breathing circuit
US3886948A (en) * 1972-08-14 1975-06-03 Hakim Co Ltd Ventricular shunt having a variable pressure valve
US3945378A (en) * 1974-03-18 1976-03-23 Paluch Bernard R Positive pressure breathing circuit
US4020849A (en) * 1975-12-01 1977-05-03 Jackson Richard R Cuff inflation for tracheal tubes
US4030492A (en) * 1975-02-05 1977-06-21 Dragerwerk Aktiengesellschaft Device for supporting human breathing and artificial respiration
US4041936A (en) * 1975-04-23 1977-08-16 Medical Engineering Corporation Bronchoscopy tube
US4119101A (en) * 1976-03-01 1978-10-10 Victor Igich Multiple lumen endotracheal tube and cuff with limited inflation and pressure
US4178938A (en) * 1977-06-24 1979-12-18 Au Anthony S Pressure control systems
US4178940A (en) * 1977-06-24 1979-12-18 Au Anthony S Pressure control systems
US4280492A (en) * 1979-10-05 1981-07-28 Latham Phillip B Tracheostomy tube
US4285340A (en) * 1979-03-16 1981-08-25 Gezari Walter A Apparatus for controlling the pressure in a tracheal cuff
US4495948A (en) * 1981-08-10 1985-01-29 Bivona Surgical Instruments, Inc. Tracheal tubes
US4596248A (en) * 1984-11-23 1986-06-24 Lieberman Edgar M Tracheostomy device
US4627433A (en) * 1984-11-23 1986-12-09 Lieberman Edgar M Tracheostomy device
US4633864A (en) * 1984-10-22 1987-01-06 Dacomed Corporation Speaking endotracheal tube
US5235973A (en) * 1991-05-15 1993-08-17 Gary Levinson Tracheal tube cuff inflation control and monitoring system
US5265593A (en) * 1991-05-02 1993-11-30 Odland Rick M Balloon-tipped catheter ventilation system and method for using same having rhythmically inflated and deflated balloon
US5318021A (en) * 1991-06-05 1994-06-07 Alessi David M Endotracheal tube with automatic cuff inflation and deflation
US5538002A (en) * 1994-09-14 1996-07-23 Boussignac; Georges Device for respiratory assistance
US5638813A (en) * 1995-06-07 1997-06-17 Augustine Medical, Inc. Tracheal tube with self-supporting tracheal tube cuff
US5660175A (en) * 1995-08-21 1997-08-26 Dayal; Bimal Endotracheal device
US5974604A (en) * 1998-04-07 1999-11-02 Barnea; Eyal Height adjustment mechanism
US6662804B2 (en) 2001-11-02 2003-12-16 Antonio Ortiz Tracheostomy tube with cuff on inner cannula
US20030230309A1 (en) * 2002-06-18 2003-12-18 Lma International, Sa Automatic high temperature venting for inflatable medical devices
US20040123867A1 (en) * 2001-03-23 2004-07-01 Shai Efrati Method and system for intubation
US20050274382A1 (en) * 2004-06-11 2005-12-15 Vagn Niels Finsen Lomholt Respiration catheter with sealing cuff and gas inflation cut-off valve
US20090038620A1 (en) * 2005-12-05 2009-02-12 Shai Efrati Endotracheal Tube and Intubation System Including Same
US20090229605A1 (en) * 2005-08-24 2009-09-17 Hospitech Respiration Ltd. Ajustment of endotracheal tube cuff filling

Families Citing this family (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0010880B1 (en) * 1978-10-09 1984-02-01 Dovecourt Limited Cuffed endotracheal and tracheostomy tubes
DK163641C (en) * 1990-01-12 1992-08-17 Vagn Niels Finsen Lomholt A respiration catheter

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3087493A (en) * 1960-04-27 1963-04-30 George W Schossow Endotracheal tube
US3211152A (en) * 1961-11-15 1965-10-12 Ernest A Stern Safety endotracheal tube cuff
US3407817A (en) * 1965-07-26 1968-10-29 Air Reduction Inc Catheter with cuff inflater and indicator

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3087493A (en) * 1960-04-27 1963-04-30 George W Schossow Endotracheal tube
US3211152A (en) * 1961-11-15 1965-10-12 Ernest A Stern Safety endotracheal tube cuff
US3407817A (en) * 1965-07-26 1968-10-29 Air Reduction Inc Catheter with cuff inflater and indicator

Cited By (41)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3693624A (en) * 1969-10-02 1972-09-26 Donald P Shiley Tracheotomy tube
US3640282A (en) * 1970-08-06 1972-02-08 Jack M Kamen Tracheal tube with normally expanded balloon cuff
US3731692A (en) * 1971-03-19 1973-05-08 Foregger Co Tracheotomy or endotracheal tube cuff
US3794036A (en) * 1972-08-02 1974-02-26 R Carroll Pressure regulated inflatable cuff for an endotracheal or tracheostomy tube
US3886948A (en) * 1972-08-14 1975-06-03 Hakim Co Ltd Ventricular shunt having a variable pressure valve
FR2196176A1 (en) * 1972-08-14 1974-03-15 Hakim Salomon
US3945378A (en) * 1974-03-18 1976-03-23 Paluch Bernard R Positive pressure breathing circuit
US3865106A (en) * 1974-03-18 1975-02-11 Bernard P Palush Positive pressure breathing circuit
US4030492A (en) * 1975-02-05 1977-06-21 Dragerwerk Aktiengesellschaft Device for supporting human breathing and artificial respiration
US4041936A (en) * 1975-04-23 1977-08-16 Medical Engineering Corporation Bronchoscopy tube
US4020849A (en) * 1975-12-01 1977-05-03 Jackson Richard R Cuff inflation for tracheal tubes
US4119101A (en) * 1976-03-01 1978-10-10 Victor Igich Multiple lumen endotracheal tube and cuff with limited inflation and pressure
US4178938A (en) * 1977-06-24 1979-12-18 Au Anthony S Pressure control systems
US4178940A (en) * 1977-06-24 1979-12-18 Au Anthony S Pressure control systems
US4285340A (en) * 1979-03-16 1981-08-25 Gezari Walter A Apparatus for controlling the pressure in a tracheal cuff
US4280492A (en) * 1979-10-05 1981-07-28 Latham Phillip B Tracheostomy tube
US4495948A (en) * 1981-08-10 1985-01-29 Bivona Surgical Instruments, Inc. Tracheal tubes
US4633864A (en) * 1984-10-22 1987-01-06 Dacomed Corporation Speaking endotracheal tube
US4596248A (en) * 1984-11-23 1986-06-24 Lieberman Edgar M Tracheostomy device
US4627433A (en) * 1984-11-23 1986-12-09 Lieberman Edgar M Tracheostomy device
US5265593A (en) * 1991-05-02 1993-11-30 Odland Rick M Balloon-tipped catheter ventilation system and method for using same having rhythmically inflated and deflated balloon
US5487383A (en) * 1991-05-15 1996-01-30 Levinson; Gary Tracheal tube cuff inflation control and monitoring system
US5235973A (en) * 1991-05-15 1993-08-17 Gary Levinson Tracheal tube cuff inflation control and monitoring system
US5318021A (en) * 1991-06-05 1994-06-07 Alessi David M Endotracheal tube with automatic cuff inflation and deflation
US5538002A (en) * 1994-09-14 1996-07-23 Boussignac; Georges Device for respiratory assistance
US5638813A (en) * 1995-06-07 1997-06-17 Augustine Medical, Inc. Tracheal tube with self-supporting tracheal tube cuff
US5660175A (en) * 1995-08-21 1997-08-26 Dayal; Bimal Endotracheal device
US5974604A (en) * 1998-04-07 1999-11-02 Barnea; Eyal Height adjustment mechanism
US20040123867A1 (en) * 2001-03-23 2004-07-01 Shai Efrati Method and system for intubation
US6843250B2 (en) 2001-03-23 2005-01-18 Hospitec Inc. Method and system for intubation
US6662804B2 (en) 2001-11-02 2003-12-16 Antonio Ortiz Tracheostomy tube with cuff on inner cannula
US20030230309A1 (en) * 2002-06-18 2003-12-18 Lma International, Sa Automatic high temperature venting for inflatable medical devices
US6679263B2 (en) * 2002-06-18 2004-01-20 Lma International, S.A. Automatic high temperature venting for inflatable medical devices
US20050274382A1 (en) * 2004-06-11 2005-12-15 Vagn Niels Finsen Lomholt Respiration catheter with sealing cuff and gas inflation cut-off valve
US7073503B2 (en) 2004-06-11 2006-07-11 Vagn Niels Finsen Lomholt Respiration catheter with sealing cuff and gas inflation cut-off valve
US20090229605A1 (en) * 2005-08-24 2009-09-17 Hospitech Respiration Ltd. Ajustment of endotracheal tube cuff filling
US20110100373A1 (en) * 2005-08-24 2011-05-05 Hospitech Respiration Ltd. Method of detecting endotracheal tube misplacement
US8424529B2 (en) 2005-08-24 2013-04-23 Hospitech Respiration Ltd. Adjustment of endotracheal tube cuff filling
US9004069B2 (en) 2005-08-24 2015-04-14 Hospitech Respiration Ltd. Method of detecting endotracheal tube misplacement
US9555205B2 (en) 2005-12-05 2017-01-31 Hospitech Respiration Ltd. Endotracheal tube and intubation system including same
US20090038620A1 (en) * 2005-12-05 2009-02-12 Shai Efrati Endotracheal Tube and Intubation System Including Same

Also Published As

Publication number Publication date Type
NL152759B (en) 1977-04-15 application
NL6708384A (en) 1967-12-18 application
DK111149B (en) 1968-06-17 grant
GB1182436A (en) 1970-02-25 application
DE1566625A1 (en) 1970-02-19 application
DE1566625B2 (en) 1977-09-08 application
DE1566625C3 (en) 1978-05-11 grant

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