US3529596A - Automatic intermittent tracheotomy tube cuff inflator-deflator - Google Patents

Automatic intermittent tracheotomy tube cuff inflator-deflator Download PDF

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US3529596A
US3529596A US3529596DA US3529596A US 3529596 A US3529596 A US 3529596A US 3529596D A US3529596D A US 3529596DA US 3529596 A US3529596 A US 3529596A
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cuff
piston
line
respirator
trachea
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Charles G Garner
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Charles G Garner
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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
    • 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
    • A61M16/04Tracheal tubes
    • A61M16/0465Tracheostomy tubes; Devices for performing a tracheostomy; Accessories therefor, e.g. masks, filters
    • 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

United States Patent Charles G. Garner Fort Worth, Texas 718,404

April 3, 1968 Seat. 22, 1970 Lynn E. Bennett Fort Worth, Texas inventor App]. No. Filed Patented Assignee AUTOMATIC INTERMITTENT TRACHEOTOMY TUBE CUFF INFLATOR-DEFLATOR 3 Claims, 5 Drawing Figs.

U.S. C1 128/ 145.6, 128/351 Int. Cl A6lm 16/00, A61m 25/00 Field otSearch 128/145.5 145.8.

[56] References Cited UNITED STATES PATENTS 3,173,418 3/1965 Baran 128/351 3,211,152 10/1965 Stern 128/351 3,407,817 10/1968 Galleher... 128/351 3,461,877 8/1969 Morch 128/351 Primary Examiner-Charles F. Rosenbaum Attorney-Herbert J. Brown ABSTRACT: An automatic tracheotomy cuff inflator-deflator for use in conjunction with a cycling respirator that insures against damage to the trachea and aspiration of foreign matter into the lungs. Generally, the invention is comprised of a pneumatic cylinder with a piston operated by the control line from the respirator which inflates and deflates the tracheotomy cuff in response to the cycle of the respirator.

Winning;

Patented SeptQZZ, 1 970 7 3,529,596

l9 I5 I FIG. I.

I k 1e u 2 .ii 2.9 23/ 28 a l 2/ I CHARLES 6. GARNER ATTORNEY INVENTOR.

AUTOMATIC INTERMITTENT TRACI'IEOTOMY TUBE CUFF INFLATOR-DEFLATOR This invention relates to cycling respirators used in surgery and treatment of respiratory conditions and is directed primarily to an automatic metering system for controlling the inflation of a tracheotomy cuff used with such respirators. It is necessary in the use of cycling respirators to provide an airtight seal between the breathing tube inserted into the trachea and the walls of the trachea itself so that accurate lung pressure can be maintained at all times throughout the ventilating cycle. This is accomplished by an inflatable cuff of soft rubber which surrounds the breathing tube and is expanded to press against the trachea wall. It is essential that the pressure of the cuff against the trachea be regulated with extreme accuracy as the trachea is easily damaged. Also, where the cuff presses against the trachea wall the blood circulation in the wall is temporarily blocked and the pressure must be released periodically to allow circulation to resume before the tissue is damaged. On the other hand, if the cuff is deflated to the point where it separates from the trachea wall the breathing cycle is impaired by the escape of air and, also, there is danger of foreign matter entering the lungs if the patient vomits, or if there is foreign matter from other causes in the patients oral and nasal passages.

An object of this invention is to provide a cycled pressure change within the cuff to match the cycle of the respirator so that the cuff is inflated to a maximum, but accurately controlled volume, while the respirator is forcing air into the lungs, and deflated to a minimum volume while still maintaining contact with the trachea wall during the expiration part of the cycle, thus allowing blood circulation in the trachea wall to resume momentarily but still maintaining the closure. This result is accomplished by the attachment of an inflator-deflator to the pneumatic line running from the respirator to the nebulizer, a medication metering device always included in the system when an automatic cycling respirator is used.

The inflator-deflator consists essentially of a pneumatic cylinder with a free running piston as hereinafter described. The pressure in the pneumatic line fluctuates with the ventilating cycle and is used in connection with the invention to power the pressure cycle in the tracheotomy cuff.

Another object of the invention is to provide an instantaneous indication of the occurrence of a leak in the cuff which if not detected can have serious detrimental effects on the breathing cycle or may allow the entry of foreign matter into the lungs to the serious detriment of the patient.

Another object of the invention is to provide a safeguard against overinflation of the cuff and resulting damage to the trachea wall.

These and other objects will become apparent from the following description and the accompanying drawing, in which:

FIG. 1 is a semi-diagrammatic illustration of the complete tracheotomy system including the invention.

FIG. 2 is a longitudinal sectional view of the inflator-deflator.

FIG. 3 is a diagram showing how the breathing tube and cuff are inserted through the mouth of the patient or an endotracheal insertion.

FIG. 4 is a diagram showing how the breathing tube and cuff are inserted through an incision or tracheotomy as is sometimes necessary.

FIG. 5 is a detailed vertical sectional view of the cuff and the breathing tube in place in the trachea.

As illustrated in FIG. 1 the system includes a respirator which automatically controls the breathing cycle, a main breathing tube 11 which carries air in and out of the lungs during surgery or treatment, a nebulizer 12 which adds a predetermined percentage of oxygen or medication to the air entering the lungs, and which is cycled by a pneumatic line 13 which alternates between high and low pressure in time with the respirator. A tracheal tube 14 is inserted in the patients trachea by means of a tracheotomy as shown in FIG. 4, or a similar tracheal tube 14a is inserted through the mouth as shown in FIG. 3. A soft rubber cuff l5 surrounds the tube 14 and is inflated by air pressure through a pneumatic line 16.

An inflator-deflator 17 is attached to the pneumatic line 13 by a branch line 18 connected at a T-joint l9, and is thus supplied with the pulsating air pressure fed into the line 13 by the respirator 10.

As shown in FIG. 2, the inflator-deflator l7-includes a transparent plastic cylinder 20 having a screw cap 21 from which extends a slide 22 ending in a bearing 23. The opposite end of the cylinder 20 is conical in shape with a center outlet 24 to the pneumatic line 16. A rubber piston 25 with integrally molded sealing rings 26 has one conical face 27 which will completely seal the center outlet 24 if the piston is forced against it. The piston 26 is attached to one end of a rod 28 which extends through the cap 21 and the bearing 23 and is supplied with an external handle 29. A stop 30 slidably attached to the rod 28 can be fixed in any position by a thumbscrew 31. A bleed off port 32, by means of which the rod 28 penetrates the cap 21, is accurately sized to allow the escape of exhaust low pressure air when the piston 25 moves towards the cap end of the cylinder 20 but holds sufficient high pressure air to move the piston 25 away from the cap end when high pressure air is fed through the branch line 18.

After the trachea tube 14 is inserted with the cuff 15 in its deflated condition, as shown by the dotted line 15a, and while the piston 25 is in the retracted position as shown by the dotted line 25a, the respirator is cycled until the high pressure builds up in the branch line 18. This moves the piston 25 forward to the position indicated by the dotted line 25b. The entrapped air ahead of the piston 25 inflates the cuff 15, as detailed in FIG. 5, making a tight seal between the wall of the trachea 33 and the breathing tube 14. The bleed off port 32 is matched to the characteristics of the respirator 10 so that optimum pressure is supplied to the cuff 15.

As the respirator 10 cycles, the pressure drops in the branch line 18 and the piston 25 retracts to a position shown by the dotted line 250. The elastic cuff l5 relaxes to the position indicated by the dotted line 15b which is just sufficient to maintain contact with the trachea wall 33, but allows the blood to circulate in the area of contact. The stop 30 is set on the rod 28 at such a point that it now bears against the bearing 23 as shown by the dotted line 30c.

The transparent cylinder 20 is calibrated on the outside as with marks 34 and the position of the piston 25 can be read at all times by the attendant. Should the cuff l5 spring a leak, the piston will either not return all the way to its position 25c or it will move over towards the outlet 24. Should the respirator 10, because of malfunction, introduce an unsafe pressure behind the piston 25, the latter will move over and seal the outlet 24, preventing excessive pressure build up in the cuff 15. In either case the condition will be immediately apparent to the attendant and the machine can be turned off. This malfunction indication is one of the most valuable features of the invention. Another valuable feature is that its operation is completely automatic once the cycle is started and adjusted.

Respirators used without the addition of this invention have required constant manipulation and adjustment by an expert operator and, while the present invention does not eliminate the necessity of supervision by a trained attendant, it substantually reduces the chance of error and of serious injury to the patient.

The invention is not limited to the exemplary construction herein shown and described, but may be made in various ways within the scope of the appended claims.

I claim:

1. An inflator-deflator for the tracheal cuff for an automatic cycling respirator system which includes a cycling respirator, a nebulizer and trachea tube with conventional pneumatic connections comprising an air cylinder connected at one end to a branch of the pulsating pneumatic control line running from the respirator to the nebulizer, a piston within said cylinder attached to a rod extending beyond that end of said cylinder to which the control line is attached, an outlet on the opposite end of said cylinder which is closed when said piston is pressed against it, a pneumatic tube leading from said outlet to the trachea cuff of said respirator system, a closure on the rod end piston rod and including alstop adjustably secured to said piston rod.

3. An inflator-deflator for the trachea cuff for automatic cycling respirator system as described in claim 2, in which the said piston rod runs in an aligning bearing at theouter end of said slide means and is equipped with a handle for manual location of the piston within the cylinder.

US3529596A 1968-04-03 1968-04-03 Automatic intermittent tracheotomy tube cuff inflator-deflator Expired - Lifetime US3529596A (en)

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Cited By (40)

* 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
US3794026A (en) * 1970-07-29 1974-02-26 H Jacobs Ventilating apparatus embodying selective volume or pressure operation and catheter means for use therewith
US3931822A (en) * 1974-02-26 1976-01-13 Marici Frank N Automatic alternating cuff endo tracheal tube inflator
US3976065A (en) * 1975-03-10 1976-08-24 Gerald Durkan Digital fluidic ventilator
US4020849A (en) * 1975-12-01 1977-05-03 Jackson Richard R Cuff inflation for tracheal tubes
FR2347058A1 (en) * 1976-04-06 1977-11-04 Leibinsohn Saul Syringe pressure indication
US4159722A (en) * 1977-03-28 1979-07-03 Sherwood Medical Industries, Inc. Pressure regulator for endotracheal tube cuff or the like
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
DE3321155A1 (en) * 1983-06-11 1984-12-13 Inthorn Dietrich Control device for tube cuff pressure
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
US4825862A (en) * 1986-02-14 1989-05-02 Tottori University Pressure regulator for cuff of endotracheal tube with superposition of ventilating pressure variation
DE3919634A1 (en) * 1989-06-16 1990-12-20 Dimitrov Pentcho Endotracheal tube with two inflatable balloons - has balloons connected to common air supply system
US5163904A (en) * 1991-11-12 1992-11-17 Merit Medical Systems, Inc. Syringe apparatus with attached pressure gauge
US5201753A (en) * 1989-03-17 1993-04-13 Merit Medical Systems, Inc. Totally self-contained, digitally controlled, disposable syringe inflation system, and method for monitoring, displaying and recording balloon catheter inflation data
US5209732A (en) * 1989-03-17 1993-05-11 Merit Medical Systems, Inc. Locking syringe with thread-release lock
US5235973A (en) * 1991-05-15 1993-08-17 Gary Levinson Tracheal tube cuff inflation control and monitoring system
US5259838A (en) * 1992-06-18 1993-11-09 Merit Medical Systems, Inc. Syringe apparatus with attached pressure gauge and timer
US5300027A (en) * 1989-03-17 1994-04-05 Merit Medical Systems, Inc. System and method for monitoring and displaying balloon catheter inflation and deflation data
US5425713A (en) * 1989-03-17 1995-06-20 Merit Medical Systems, Inc. System and method for monitoring, displaying and recording balloon catheter condition interval and inflation location data
US5431629A (en) * 1989-03-17 1995-07-11 Merit Medical Systems, Inc. System and method for monitoring, displaying and recording balloon catheter condition interval data
US5449345A (en) * 1989-03-17 1995-09-12 Merit Medical Systems, Inc. Detachable and reusable digital control unit for monitoring balloon catheter data in a syringe inflation system
US5449344A (en) * 1992-06-18 1995-09-12 Merit Medical Systems, Inc. Syringe apparatus with pressure gauge and detachable timer
US5453091A (en) * 1989-03-17 1995-09-26 Merit Medical Systems, Inc. RF transmission module for wirelessly transmitting balloon catheter data in a syringe inflation system
US5458571A (en) * 1989-03-17 1995-10-17 Merit Medical Systems, Inc. System and method for monitoring, displaying and recording balloon catheter condition interval data
US5472424A (en) * 1994-04-05 1995-12-05 Merit Medical Systems, Inc. Syringe with volume displacement apparatus
US20030101998A1 (en) * 1997-12-24 2003-06-05 Laryngeal Mask Company (Uk) Limited Monitoring and control for a laryngeal mask airway device
US20030172925A1 (en) * 1997-12-24 2003-09-18 Mario Zocca Monitoring and control for a laryngeal mask airway device
US20040123869A1 (en) * 2002-12-16 2004-07-01 Rutter Michael John Tracheotomy endotracheal tube
US20070047714A1 (en) * 1997-04-03 2007-03-01 Sbc Technology Resources, Inc. Profile management system including user interface for accessing and maintaining profile data of user subscribed telephony services
USRE39938E1 (en) 1996-03-01 2007-12-18 Indian Ocean Medical, Inc. Gastro-laryngeal mask
US7493901B2 (en) 1998-10-06 2009-02-24 The Laryngeal Mask Company Ltd. Laryngeal mask airway device
CN103301548A (en) * 2013-07-09 2013-09-18 江苏德威兰医疗器械有限公司 Manometer for balloon of trachea cannula
US8783256B2 (en) 2005-05-27 2014-07-22 The Laryngeal Mask Company Ltd. Laryngeal mask airway device
US9265904B2 (en) 2009-07-06 2016-02-23 Teleflex Life Sciences Artificial airway
US9528897B2 (en) 2009-08-13 2016-12-27 Chimden Medical Pty Ltd Pressure indicator
US9675772B2 (en) 2010-10-15 2017-06-13 The Laryngeal Mask Company Limited Artificial airway device
US9974912B2 (en) 2010-10-01 2018-05-22 Teleflex Life Sciences Unlimited Company Artificial airway device

Cited By (49)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3794026A (en) * 1970-07-29 1974-02-26 H Jacobs Ventilating apparatus embodying selective volume or pressure operation and catheter means for use therewith
US3640282A (en) * 1970-08-06 1972-02-08 Jack M Kamen Tracheal tube with normally expanded balloon cuff
US3931822A (en) * 1974-02-26 1976-01-13 Marici Frank N Automatic alternating cuff endo tracheal tube inflator
US3976065A (en) * 1975-03-10 1976-08-24 Gerald Durkan Digital fluidic ventilator
US4020849A (en) * 1975-12-01 1977-05-03 Jackson Richard R Cuff inflation for tracheal tubes
FR2347058A1 (en) * 1976-04-06 1977-11-04 Leibinsohn Saul Syringe pressure indication
US4159722A (en) * 1977-03-28 1979-07-03 Sherwood Medical Industries, Inc. Pressure regulator for endotracheal tube cuff or the like
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
DE3321155A1 (en) * 1983-06-11 1984-12-13 Inthorn Dietrich Control device for tube cuff pressure
US4633864A (en) * 1984-10-22 1987-01-06 Dacomed Corporation Speaking endotracheal tube
US4627433A (en) * 1984-11-23 1986-12-09 Lieberman Edgar M Tracheostomy device
US4596248A (en) * 1984-11-23 1986-06-24 Lieberman Edgar M Tracheostomy device
US4825862A (en) * 1986-02-14 1989-05-02 Tottori University Pressure regulator for cuff of endotracheal tube with superposition of ventilating pressure variation
US5449345A (en) * 1989-03-17 1995-09-12 Merit Medical Systems, Inc. Detachable and reusable digital control unit for monitoring balloon catheter data in a syringe inflation system
US5425713A (en) * 1989-03-17 1995-06-20 Merit Medical Systems, Inc. System and method for monitoring, displaying and recording balloon catheter condition interval and inflation location data
US5201753A (en) * 1989-03-17 1993-04-13 Merit Medical Systems, Inc. Totally self-contained, digitally controlled, disposable syringe inflation system, and method for monitoring, displaying and recording balloon catheter inflation data
US5209732A (en) * 1989-03-17 1993-05-11 Merit Medical Systems, Inc. Locking syringe with thread-release lock
US5431629A (en) * 1989-03-17 1995-07-11 Merit Medical Systems, Inc. System and method for monitoring, displaying and recording balloon catheter condition interval data
US5458571A (en) * 1989-03-17 1995-10-17 Merit Medical Systems, Inc. System and method for monitoring, displaying and recording balloon catheter condition interval data
US5300027A (en) * 1989-03-17 1994-04-05 Merit Medical Systems, Inc. System and method for monitoring and displaying balloon catheter inflation and deflation data
US5385549A (en) * 1989-03-17 1995-01-31 Merit Medical Systems, Inc. Digitally controlled, disposable syringe inflation system, and method for monitoring, displaying balloon catheter inflation data
US5453091A (en) * 1989-03-17 1995-09-26 Merit Medical Systems, Inc. RF transmission module for wirelessly transmitting balloon catheter data in a syringe inflation system
DE3919634A1 (en) * 1989-06-16 1990-12-20 Dimitrov Pentcho Endotracheal tube with two inflatable balloons - has balloons connected to common air supply system
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
US5163904A (en) * 1991-11-12 1992-11-17 Merit Medical Systems, Inc. Syringe apparatus with attached pressure gauge
US5259838A (en) * 1992-06-18 1993-11-09 Merit Medical Systems, Inc. Syringe apparatus with attached pressure gauge and timer
US5449344A (en) * 1992-06-18 1995-09-12 Merit Medical Systems, Inc. Syringe apparatus with pressure gauge and detachable timer
US5472424A (en) * 1994-04-05 1995-12-05 Merit Medical Systems, Inc. Syringe with volume displacement apparatus
USRE39938E1 (en) 1996-03-01 2007-12-18 Indian Ocean Medical, Inc. Gastro-laryngeal mask
US20070047714A1 (en) * 1997-04-03 2007-03-01 Sbc Technology Resources, Inc. Profile management system including user interface for accessing and maintaining profile data of user subscribed telephony services
US20030101998A1 (en) * 1997-12-24 2003-06-05 Laryngeal Mask Company (Uk) Limited Monitoring and control for a laryngeal mask airway device
US20030172925A1 (en) * 1997-12-24 2003-09-18 Mario Zocca Monitoring and control for a laryngeal mask airway device
US7273053B2 (en) 1997-12-24 2007-09-25 Mario Zocca Monitoring and control for a laryngeal mask airway device
US7331346B2 (en) 1997-12-24 2008-02-19 Indian Ocean Medical, Inc. Monitoring and control for a laryngeal mask airway device
US7493901B2 (en) 1998-10-06 2009-02-24 The Laryngeal Mask Company Ltd. Laryngeal mask airway device
US7506648B2 (en) 1998-10-06 2009-03-24 The Laryngeal Mask Company Ltd. Laryngeal mask airway device
US20040123869A1 (en) * 2002-12-16 2004-07-01 Rutter Michael John Tracheotomy endotracheal tube
US7140369B2 (en) 2002-12-16 2006-11-28 Rutter Michael John Tracheotomy endotracheal tube
US9662465B2 (en) 2005-05-27 2017-05-30 The Laryngeal Mask Company Ltd. Laryngeal mask airway device
US8783256B2 (en) 2005-05-27 2014-07-22 The Laryngeal Mask Company Ltd. Laryngeal mask airway device
US9522245B2 (en) 2005-05-27 2016-12-20 The Laryngeal Mask Company Ltd. Laryngeal mask airway device and method of manufacture
US9498591B2 (en) 2005-05-27 2016-11-22 The Laryngeal Mask Company Ltd. Laryngeal mask airway device with a support for preventing occlusion
US9265904B2 (en) 2009-07-06 2016-02-23 Teleflex Life Sciences Artificial airway
US9528897B2 (en) 2009-08-13 2016-12-27 Chimden Medical Pty Ltd Pressure indicator
US9974912B2 (en) 2010-10-01 2018-05-22 Teleflex Life Sciences Unlimited Company Artificial airway device
US9675772B2 (en) 2010-10-15 2017-06-13 The Laryngeal Mask Company Limited Artificial airway device
CN103301548A (en) * 2013-07-09 2013-09-18 江苏德威兰医疗器械有限公司 Manometer for balloon of trachea cannula

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