US3799173A - Tracheal tubes - Google Patents

Tracheal tubes Download PDF

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Publication number
US3799173A
US3799173A US00237897A US23789772A US3799173A US 3799173 A US3799173 A US 3799173A US 00237897 A US00237897 A US 00237897A US 23789772 A US23789772 A US 23789772A US 3799173 A US3799173 A US 3799173A
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Prior art keywords
tube
cuff
end portion
distal end
tracheal
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US00237897A
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English (en)
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J Kamen
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Individual
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Individual
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Priority to US00237897A priority Critical patent/US3799173A/en
Priority to AU51977/73A priority patent/AU473080B2/en
Priority to CA165,587A priority patent/CA1005722A/en
Priority to BR731967A priority patent/BR7301967D0/pt
Priority to GB1387173A priority patent/GB1423712A/en
Priority to IT21997/73A priority patent/IT981586B/it
Priority to FR7310360A priority patent/FR2177873B1/fr
Priority to DK159973AA priority patent/DK142344B/da
Priority to DE2314608A priority patent/DE2314608C2/de
Application granted granted Critical
Publication of US3799173A publication Critical patent/US3799173A/en
Anticipated expiration legal-status Critical
Expired - Lifetime legal-status Critical Current

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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
    • A61M16/0443Special cuff-wall materials
    • 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
    • A61M16/0445Special cuff forms, e.g. undulated
    • 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
    • A61M25/00Catheters; Hollow probes
    • A61M25/10Balloon catheters
    • A61M2025/1043Balloon catheters with special features or adapted for special applications
    • A61M2025/1052Balloon catheters with special features or adapted for special applications for temporarily occluding a vessel for isolating a sector
    • 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
    • A61M25/00Catheters; Hollow probes
    • A61M25/10Balloon catheters

Definitions

  • ABSTRACT A tracheal tube for use in intubating a trachea, and which embodies passageways and openings therein which are constituted and arranged in a manner particularly effective for the passage of suction catheters, and the like, therethrough into bronchi, and the like.
  • the present invention relates to tracheal tubes.
  • Another object of the present invention is to enable a novel tracheal tube to be afforded which is particularly well adapted for use in selectively inserting other instruments, such as suction catheters, and the like, into desired position, such as, for example, into selected ones of a patients bronchi, and the like.
  • Another object is to afford a novel tracheal tube embodying a leading or distal end for insertion into a patient, and in which the parts of the distal end are constituted and arranged in a novel and expeditious manner.
  • Tubes for insertion into a patient such as, for example, tracheal tubes, catheters, enema tubes, and the like, heretofore known in the art, have had side openings therein for the passage of fluids therethrough into and out of the patient.
  • all such openings in such tubular members have heretofore been disposed in positions, such as, for example, that of the side opening shown in my earlier U.S. Letters Pat. No. 3,640,382, issued Feb.
  • Another object of the present invention is to afford a novel tracheal tube having side openings therein, which are constituted and arranged in a novel and expeditious manner effective to enable suction catheters, and the like, to be fed therethrough quickly and easily, and in a manner which is not injurious to a patient.
  • Tracheal tubes may be of different types, such as, for example, orotracheal tubes, nasotracheal tubes and tracheostomy tubes.
  • such tubes may be flexible, the main body portion thereof being made of flexible material, such as, for example, rubber or a suitable plastic material, such as, polyethylene, or the like, or they may be stiff or rigid, being made of material such as stainless steel, or the like, the latter type of tubes being useful as tracheostomy tubes.
  • the present invention is intended for use in the construction of all such tracheal tubes.
  • tracheal tubes have commonly been inserted into the trachea of a person for various purposes, such as, for example, to enable a person to breathe, or to enable intermittent positive pressure ventilation of the respiratory tract to be carried out.
  • an airtight or substantially airtight seal be provided between the tracheal tube and the trachea.
  • Various attempts have been made there-tofore to effect such seals between tracheal tubes and the trachea, such as, for example, by using large tubes which completely fill the trachea, or
  • cuffs which are mounted on the tubes and which are engageable with the trachea.
  • the cuffed tubes heretofore known in the art have included tubes of the type shown in my aforementioned earlier issued U.S. Pat. No. 3,640,382, which have proven highly successful,
  • a cuff embodying a flexible, airimpervious cover disposed in surrounding relation to a portion of the tube and hermetically sealed thereto, and a porous resilient body portion made of suitable material, such as, for example, sponge rubber, mounted around the elongated tube, within the cover for yieldingly urging the cover outwardly away from the tube.
  • An auxiliary tube extends into the cover of the cuffed tubes of the last mentioned type, in hermetically sealed relation thereto, and air may be withdrawn from the cover through the auxiliary tube to thereby cause the cuff to collapse to facilitate the insertion thereof into a trachea, after which the auxiliary tube may be opened to the atmosphere to thereby permit the cuff to expand into yielding, sealing engagement with the trachea.
  • a further object of the present invention is to afford a novel tracheal tube, which, while it employs some of the principles of the highly effective tracheal tube disclosed in my aforementioned U.S. Pat. No. 3,640,382, embodies improvements thereover.
  • Another object of the present invention is to afford a novel tracheal tube embodying a cuff which is mounted on the sides and the end of the tubular member in a novel and expeditious manner.
  • Yet another object of the present invention is to afford a novel tracheal tube embodying a cuff which is effective, in a novel and expeditious manner, to protect a trachea against injury by the distal end of the tube during insertion of the latter, and, also, while the tube remains disposed in such a trachea.
  • Another object of the present invention is to afford a novel tracheal tube of the aforementioned type which embodies a novel, resilient cuff, which is normally disposed in expanded position, but which may be effecthereof and what I now consider to be the best mode in which I have contemplated applying these principles.
  • Other embodiments of the invention embodying the same or equivalent principles may be used and structural changes may be made as desired by those skilled in the art without departing from the present invention and the purview of the appended claims.
  • FIG. 1 is a fragmentary, side elevational view of a tracheal tube embodying the principles of the present invention
  • FIG. 2 is a longitudinal sectional view taken substantially along the line 2-2 in FIG. 1, and showing the tracheal tube disposed in operative position in a trachea which is shown diagrammatically;
  • FIG. 3 is a side elevational view of the tracheal tube shown in FIG. 1, looking in the direction of FIG. 2, but showing the cuff on the tracheal tube in collapsed posi tion;
  • FIG. 4 is a detail sectional view taken substantially along the line 4-4 in FIG. 2;
  • FIG. 5 is a detail sectional view taken substantially along the line 5--5 in FIG. 2;
  • FIG. 6 is a fragmentary, side elevational view of the distal end portion of a modified form of the present invention.
  • FIG. 7 is an enlarged, detail sectional view taken substantially along the line 7-7 in FIG. 6, and showing the tracheal tube disposed in operative position in a trachea, which is shown diagrammatically, and also showing a suction catheter disposed in the tracheal tube and trachea.
  • FIGS. l-5 of the drawings A tracheal tube or intubation device 1, embodying the principles of the present invention, is shown in FIGS. l-5 of the drawings to illustrate the presently preferred embodiment of the present invention.
  • the tracheal tube 1 embodies, in general, an elongated tube 2 having a cuff 3 mounted on one end portion thereof, with another tube 4 extending into the cuff 3 for a purpose which will be discussed in greater detail presently.
  • the tube 2 may be of any suitable construction and is for the purpose of feeding air, or the like, into and out of the respiratory tract of a patient into whose trachea the tracheal tube or intubation device I has been inserted.
  • the tube 2 thereof is preferably flexible and may be made of any suitable material such as, for example, rubber or a suitable plastic, such as polyethylene, or the like.
  • suitable material such as, for example, rubber or a suitable plastic, such as polyethylene, or the like.
  • the tube 2 thereof may be rigid in construction and made of suitable material such as, for example, stainless steel, or the like.
  • the tube 2, shown in FIGS. 1-5, embodies a front end or distal end portion 5, which is somewhat U- shaped in construction, embodying a front wall 6 and two oppositely disposed side walls 7 and 8 projecting rearwardly from respective ends of the front wall 6 toward the proximal end 9 of the tube 2, FIG. 2.
  • the tube 2 is round in cross sectional shape and is uniform in cross sectional size, such as, for example, having an outside diameter in the nature of seven/onesixteenth of an inch, throughout its length, rearwardly of the distal end portion 5.
  • the walls 6-8 of the distal end portion 5 of the tube 2 preferably are uniform in width, and preferably are substantially narrower in width than the remainder of the tube 2, such as, for example, having a width in the nature of one-half to three-fourths of the outside diameter of the remainder of the tube 2, and, preferably, in the nature of two-thirds thereof.
  • An opening 11 extends transversely through the distal end portion 5, between the side walls 7 and 8 thereof.
  • the upper side 12 and the lower side 13 of the opening 11, as viewed in FIG. 2 are defined by the inner faces of the side walls 7 and 8, respectively, and the front side 14 of the opening 11 is defined by the inner face of the front wall 6.
  • the rear side 15 of the opening 11 preferably is disposed at the junction of the distal end portion 5 with the remainder of the tube 2.
  • the inner face of each of the walls 6-8 preferably is flat in a direction perpendiculr to the length of the tube 2, as illustrated with respect to the side walls 7 and 8 in FIG. 5, or is convex inwardly, for a purpose which will be discussed in greater detail presently.
  • the walls 7 and 8 are spaced from each other the diameter of the passageway 10 so as to afford unobstructed communication between the passageway 10 and the opening 11.
  • the cuff 3, FIGS. 2 and 4 includes an air-impervious cover 16 and a body portion 17 disposed within the cover 16.
  • the cuff 3 embodies a main portion 18, a front end portion 19 and a rear end portion 20, FIGS. 1 and 2, the end portions 19 and 20 being smaller in cross sectional size than the main portion 18, as will be discussed in greater detail presently.
  • the main portion 18 of the cuff 3 preferably is substantially elliptical in shape, in longitudinal cross section, when it is in fully expanded position, as shown in FIG. 1, and the body portion 17 and the cover portion 16 of the main portion 18 are disposed around a portion of the tube 2, in surrounding relation thereto, immediately adjacent and in rearwardly extending relation to the distal end portion 5.
  • the portions of the cover 16 disposed around the main portion 18 and the rear end portion 20 of the cuff 3 are tubular in form, and the portion of the cover 16, which defines the rear end portion 20 of the cuff 3, is hermetically sealed to the outer surface of the tube 2 by suitable means, such as, for example, being vulcanized thereto or by a suitable cement such as rubber cement, or the like.
  • reinforcing rings 20 are mounted on the end portion 20 of the cuff 3 to insure the maintenance of an effective seal between the end portion 20 and the tube 2.
  • the reinformcing rings 20' may be made of any suitable material such as rubber or a suitable plastic such as polyethylene amd may be secured to the outer face of the end portion 20 by suitable means such as vulcanization or a suitable cement.
  • the front end portion 19 of the cuff 3, like the main portion 18 thereof embodies a portion of the body portion 17 and of the cover 16. It is substantially U-shaped, having a front end portion 21 disposed in covering relation to the front wall 6 of the distal end portion 5 of the tube 2, and two legs 22 and 23 projecting rearwardly from the front end portion 21 in covering relation to the outer faces of the side walls 7 and 8 of the distal end portion 5, respectively.
  • the front end portion 19 of the cuff 3 preferably is relatively narrow in width, preferably being of such width that it will just cover the outer peripheral face of the distal end portion 5 of the tube 2.
  • the portion of the cover 16 disposed on the distal end portio 5 of the tube 2 is hermetically sealed by suitable means, such as vulcanization or cement, or the like, along its respective longitudinal edges 24 and 25, FIG. 5, to respective sides of the distal end portion 5 along a line 26, FIG. 3, which extends along the sides 12-14 of the opening 11 and terminates at its rear ends, at respective ends of a line 27, FIG. 3, along which the front edge of the portion of the cover portion 16 of the main portion 18 of the cuff 3 is similarly hermetically sealed to the outer surface of the corresponding side of the tube 2 between the legs 22 and 23 of the front end portion 19 of the cuff 3.
  • suitable means such as vulcanization or cement, or the like
  • the cover 16 is flexible and may be made of any suitable material, such as, for example, latex rubber or a suitable plastic sheet material, such as, polyethylene, or the like. Preferably, it also is elastic for reasons which will be discussed in greater detail presently, and, of course, under such circumstances it would be made of a suitable elastic material such as the aforementioned latex rubber.
  • the body portion 17 of the cuff 3 affords a resilient mass which preferably completely fills the cover 16 forwardly of the end portion 20 thereof and, when the intubation device 1 is disposed in normal inoperative position, outside the trachea, preferably is effective to yieldingly hold the cover 16 in fully expanded position, as shown in FIG. 1.
  • the body portion may be made of any suitable resilient material, but, preferably, is made of a sponge-like resilient material having a multitude of interstices spread therethrough, such as, for example, sponge rubber or a suitable resilient plastic material, such as, for example, foamed polyurethane, or the like, for a purpose which will be discussed in greater detail presently.
  • the tube 4 has one end portion 28, FIG. 2, extending into the cuff 3. As shown in the drawings, the tube 4 extends along the tube 2, preferably, the tube 4 is formed integrally with the tube 2 and terminates in a free end portion 29 which extends outwardly beyond the proximal end 9 of the tube 2. However, as will be appreciated by those skilled in the art, the tube 4 may be formed separately from the tube 2 and inserted into the cuff 3 in a suitable manner without departing from the purview of the broader aspects of the present invention.
  • the tube 4 extends along the tube 2, FIG. 2
  • the tube 4 extends through the end portion 20 of the cuff 3, and the portion of the cover 16, which affords the end portion 20, is hermetically sealed to the tube 4 in the same manner as it is so sealed to the tube 2.
  • the body portion 17 is effective to yieldingly hold the cover 16 in fully outwardly extended position, as shown in FIG. 1.
  • a partial vacuum may be applied to the end portion 29 of the tube 4 to thereby cause the cuff 3 to move from its normal expanded position shown in FIG. 1 to a collpased position such as that shown in FIG. 3.
  • the tracheal tube 1 may be inserted into a trachea, such as the trachea 30, the cuff being disposed in the aforementioned collapsed position to thereby facilitate such insertion.
  • the vacuum on the tube 4 may be released to thereby permit the cover 16 to be expanded outwardly by the yielding expansion of the resilient body member 17, the expansion of the cover from the collapsed position being to a position wherein it is yieldingly held by the body portion 17 in engagement with the inner wall 31 of the trachea 30, such as shown in FIGS. 2 and 4.
  • Such expansion is caused by the resiliency of the body portion 17 and is a direct result of the volumetric expansion thereof.
  • the cover 16 is wrinkled when the cuff 3 is in fully collapsed position, as shown in FIG. 3, and it is not essential or an absolute requirement that no wrinkles be formed in the cover 16 when the cuff 3 is disposed in operative engagement with the trachea, such as is shown in FIG. 2, it is preferred that no such wrinkles be present when the cuff 3 is in operative engagement with the trachea. Therefore, to insure against such wrinkles, we prefer that the cover 16 be made of a suitable elastic material such as, for example, the aforementioned latex rubber, which is stretched by the expansion of the body portion 17.
  • the size of the cuff 3 in its normal, fully expanded state, as shown in FIG. 1, and the characteristics of the cover 16 and the body portion 17 are factors in the determination of the pressure with which the cuff 3 presses outwardly on a trachea, such as the trachea 30 when it is disposed in operative engagement with the inner wall 31 of such a trachea.
  • the size of the cuff 3 and the characteristics of the cover 16 and the body portion 17 are such that the outward pressure of the cuff 3 on a trachea is no greater than 25 centimeters of water, when the intubation device 1 is in normal operative position in the trachea and the cuff 3 is in effective sealing engagement with the latter.
  • the cuff 3 embodied in the intubation device 1 shown in FIGS. 1-5 of the drawings not only affords an effective means for sealing the intubuation device 1 against leakage therepast in the trachea, but it affords effective protection against injury to the trachea during insertion of the intubation device into the trachea.
  • the cuff 3 including both the cover portion 16 and the body portion 17 thereof, not only extends around the tube 2, rearwardly of the distal end portion thereof, but also extends around the outer peripheral surface of the distal end portion 5 in covering relation thereto.
  • the cuff 3 affords an effective pad for preventing injury to the trachea by engagement of the front end portion of the tube 2 therewith, and is particularly effective to prevent injury to such a trachea by the direct impingement of the front end of the tracheal tube 1 against a portion of the trachea, both during insertion of the tracheal tube 1 into the trachea and during the time that the tracheal tube 1 remains in the trachea.
  • the intubation device 1 shown in FIGS.
  • l-S affords a novel and effective tracheal tube, the construction of which is such that other instruments, such as suction catheters, and the like, may be readily, selectively inserted therethrough into various positions in a patient, as will be discussed in greater detail hereinafter.
  • FIGS. 6 and 7 A modified form of my intubation tube is shown in FIGS. 6 and 7, and parts which are the same as parts shown in FIGS. 1-5 are indicated by the same reference numerals as used in FIGS. 1-5, and parts which are similar but have been substituted for parts of the preferred form of my invention shown in FIGS. 1-5 are indicated by the same reference numerals with the suffix a added thereto. All of the changes made in the modified form of my invention over the preferred form as shown are embodied in the cuff 3a attached to the tube 2.
  • the tracheal tube or intubation device la shown in FIGS. 6 and 7 is the same in construction and mode of operation as the tracheal tube shown in FIGS. l-S, except that the front end portion 32 of the cuff 3a terminates on the tube 2 adjacent to, but rearwardly of the distal end 5 thereof, and like the rear end portion 20 of the cuff 3 comprises merely a portion of the cover 16a, which is hermetically sealed by suitable means, such as, for example, vulcanization or cement to the outer surface of the tube 2.
  • a reinforcing ring 33 like the reinforcing ring 20 on the rear end portion 20, preferably is mounted on the end portion 32 of the cuff 3a to insure the maintenance of an effective seal between the end portion 32 and the tube 2.
  • the cuff 3a of the tracheal tube 1a unlike the cuff 3 of the tracheal tube 1, does not extend across the distal end portion 5 of the tube 2 in covering relation thereto.
  • the tracheal tube la may be inserted into and then sealingly engaged with a trachea in the same manner as heretofore discussed with respect to the tracheal tube 1, by collapsing the cuff 3a, inserting the tracheal tube 1a into the desired position in the trachea, and then permitting the cuff 3a to expand into sealing engagement with the latter.
  • This affords a highly effective and practical tracheal tube for enabling a person to breathe, or to enable intermittent positive pressure ventilation of the respiratory tract to be carried out.
  • the tracheal tube Ia has another important advantage over tracheal tubes heretofore known in the art, as does the tracheal tube 1 as will now be discussed.
  • liquid such as mucus from cavities within a patient, such as, for example, from within the bronchi of the patient.
  • suction tubes such as suction catheters heretofore well known in the art
  • the present invention both in the form shown in FIGS. l-5 and in the form shown in FIGS. 6 and 7, affords a novel tracheal tube which is highly effective in assisting in such insertion of another instrument, such as suction catheter, into desired position in a patient.
  • the tracheal tube may be inserted into a trachea into a desired position, such as, for example, the position shown for the tracheal tube la in FIG. 7 for the insertion of a suction catheter into one of the bronchi of a patient.
  • a desired position such as, for example, the position shown for the tracheal tube la in FIG. 7 for the insertion of a suction catheter into one of the bronchi of a patient.
  • the distal end 5 of the tube 2 is disposed in closely adjacent relation to the junction 34 between the left bronchus 35 and the right bronchus 36, and is disposed in uniplanar relation to the plane of separation between the bronchi 35 and 36.
  • a suitable suction tube such as, for example, the suction catheter 37, shown in FIG. 7, may be inserted longitudinally through the tube 2 from the proximal end 9 into the distal end portion 5 thereof. From that position, the operator may readily manipulate the tube 37 so that it may be further advanced through tthe upper or lower side of the opening 11 in the distal end portion 5, as viewed in FIG. 7, into the right bronchus 36 or the left bronchus 35, respectively.
  • the front end portions of such suction tubes used for this purpose such as, for example, the front end portion 38 of the tube 37, commonly are preset at an angle relative to the adjacent portion of the tubes, in the manner illustrated in FIG. 7. With the suction catheter so constructed, it will be seen that the front end portion 38 may be readily inserted through the tube 2 in such position, that when it enters the distal end 5 of the tube 2 it automatically is guided thereby into the desired bronchus 35 or 36.
  • the inner faces of the walls 6-8 of the distal end 5 of the tube 2 preferably are perpendicular, in a lateral direction, to the longitudinal center line of the distal end portion 5, or are convex inwardly.
  • the tracheal tube la shown in FIGS. 6 and 7, afford a novel tracheal tube which may be quickly and easily disposed in operative position in a trachea, or the like, in sealing engagement therewith, for the passage of air, or the like, therethrough, and which also affords a novel and practical device for effectively assisting in the selective positioning of other instruments, such as, for example, suction catheters in or beyond the trachea.
  • the tracheal tube 1 shown in FIGS. 1-5 of the drawings has the same advantages of construction and mode of operation as the tracheal tube Ia, and, in addition, embodies a cuff which protects against contact betwen the distal end 5 of the tracheal tube 1 and the trachea, which would be injurious to the latter, both during the insertion of the tracheal tube 1 into the trachea, and during the time that it is so positioned in the trachea.
  • the opening 11 in the distal end portion 5 of the tube 2 in each of the tracheal tubes 1 and 1a is shown as extending completely through the distal end portion 5, this is merely by way of illustration of the preferred construction of the tracheal tubes 1 and la, and not by way of limitation, and, if desired, the opening 11, which is in communication with the passageway may be only in one side of the distal end 5 of the tube 2 of either of the tracheal tubes 1 or la without departing from the purview of the broader aspects of the present invention.
  • the present invention affords a novel intubation device embodying a cuff which is constituted and arranged in a novel and expeditious manner.
  • the present invention affords a novel intubation device for use in tracheae wherein the parts thereof are constituted and arranged in a novel and expeditious manner effective to afford a device for effectively assisting in the insertion of other instruments, such as, for example, suction catheters, and the like, into a patient.
  • a tracheal tube comprising a. an elongated tube having 1. a distal end portion having a. an end wall,
  • said distal end portion 1. being narrower in width transversely to the length of said tube than the portion of said tube adjacent said distal end portion, and
  • transverse opening 1. being defined on one side by said end wall
  • a cuff (I) mounted on and extending around the outer surface of said portion of said tube which is adjacent to said distal end portion, and also (2) mounted on and extending along the outer surface of said end wall outwardly of said opening, said cuff having means therein normally expanding said cuff away from both said outer surfaces.
  • said distal end portion includes two oppositely disposed side walls extending from said end wall toward said proximal end in spaced relation to each other,
  • said side walls define respective opposite sides 0 said opening, and d. said cuff is mounted on and extends along the outer peripheral surface of said side walls outwardly of said opening.
  • a resilient body portion a. mounted in said cover, and b. having (1') normally an expanded position, wherein it is effective to hold a portion of said cover outwardly away from said portion and walls of said elongated tube, and (2') a collapsed position, wherein the outer surface thereof is disposed closer to said elongated tube than in said expanded position to thereby permit said portion of said cover to assume a position closer to said elongated tube, and b. which includes means connected to said cuff for creating and releasing a vacuum in said cover to thereby cause said body portion to move toward said collapsed and expanded positions, respectively.

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  • Health & Medical Sciences (AREA)
  • Pulmonology (AREA)
  • Emergency Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Anesthesiology (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Hematology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Media Introduction/Drainage Providing Device (AREA)
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US00237897A 1972-03-24 1972-03-24 Tracheal tubes Expired - Lifetime US3799173A (en)

Priority Applications (9)

Application Number Priority Date Filing Date Title
US00237897A US3799173A (en) 1972-03-24 1972-03-24 Tracheal tubes
AU51977/73A AU473080B2 (en) 1972-03-24 1973-02-08 Tracheal tubes
CA165,587A CA1005722A (en) 1972-03-24 1973-03-08 Tracheal tubes
BR731967A BR7301967D0 (pt) 1972-03-24 1973-03-20 Tubos traqueais
GB1387173A GB1423712A (en) 1972-03-24 1973-03-22 Tracheal tubes
IT21997/73A IT981586B (it) 1972-03-24 1973-03-22 Tubo tracheale
FR7310360A FR2177873B1 (is) 1972-03-24 1973-03-22
DK159973AA DK142344B (da) 1972-03-24 1973-03-23 Struberør med en elastisk manchet.
DE2314608A DE2314608C2 (de) 1972-03-24 1973-03-23 Trachealtubus

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US00237897A US3799173A (en) 1972-03-24 1972-03-24 Tracheal tubes

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US3799173A true US3799173A (en) 1974-03-26

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US00237897A Expired - Lifetime US3799173A (en) 1972-03-24 1972-03-24 Tracheal tubes

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US (1) US3799173A (is)
AU (1) AU473080B2 (is)
BR (1) BR7301967D0 (is)
CA (1) CA1005722A (is)
DE (1) DE2314608C2 (is)
DK (1) DK142344B (is)
FR (1) FR2177873B1 (is)
GB (1) GB1423712A (is)
IT (1) IT981586B (is)

Cited By (50)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3889685A (en) * 1973-11-02 1975-06-17 Cutter Lab Tubular unit with vessel engaging cuff structure
US3991767A (en) * 1973-11-02 1976-11-16 Cutter Laboratories, Inc. Tubular unit with vessel engaging cuff structure
US4022217A (en) * 1975-09-15 1977-05-10 Dupaco Incorporated Cuff configuration for cuff tracheal tubes
EP0010880A1 (en) * 1978-10-09 1980-05-14 Dovecourt Limited Cuffed Endotracheal and Tracheostomy Tubes
US4227293A (en) * 1978-12-11 1980-10-14 The Kendall Company Method of catheter manufacture
US4228801A (en) * 1977-11-29 1980-10-21 Elektromedical Company S.R.L. Dilator for application in medical field
US4240433A (en) * 1977-07-22 1980-12-23 Bordow Richard A Fluid aspiration device and technique for reducing the risk of complications
FR2504012A1 (fr) * 1981-04-15 1982-10-22 Kruger Christian Instrument medical
DE3119854A1 (de) * 1981-05-19 1982-12-16 Drägerwerk AG, 2400 Lübeck Vorrichtung zur positionierung eines trachealtubus
EP0088173A1 (en) * 1982-03-05 1983-09-14 Bivona, Inc. Device for exercising the vaginal muscles
US4636195A (en) * 1982-04-02 1987-01-13 Harvey Wolinsky Method and apparatus for removing arterial constriction
US4653514A (en) * 1980-12-22 1987-03-31 Bivona, Inc. Device for strengthening the vaginal muscles
US4684363A (en) * 1984-10-31 1987-08-04 American Hospital Supply Corporation Rapidly inflatable balloon catheter and method
US4762125A (en) * 1986-03-07 1988-08-09 The University Of Texas System Balloon-tipped suction catheter
US4768522A (en) * 1987-02-24 1988-09-06 Exta, Inc. Device for exercising vaginal muscles
US4795430A (en) * 1988-01-15 1989-01-03 Corpak, Inc. Device for intubation of percutaneous endoscopic ostomy
US4819664A (en) * 1984-11-15 1989-04-11 Stefano Nazari Device for selective bronchial intubation and separate lung ventilation, particularly during anesthesia, intensive therapy and reanimation
US4840172A (en) * 1986-09-04 1989-06-20 Augustine Scott D Device for positioning an endotracheal tube
US4900306A (en) * 1988-01-15 1990-02-13 Corpak, Inc. Device for intubation of percutaneous endoscopic ostomy
US4979505A (en) * 1989-06-06 1990-12-25 Cox Everard F Tracheal tube
US5027812A (en) * 1989-09-19 1991-07-02 Bivona, Inc. Tracheal tube for laser surgery
US5067497A (en) * 1990-03-16 1991-11-26 Progressive Medical Design, Inc. Intubation device with adjustable suction means above the cuff
US5100384A (en) * 1990-03-30 1992-03-31 Wilson-Cook Medical, Inc. Method and device for percutaneous intubation
US5176638A (en) * 1990-01-12 1993-01-05 Don Michael T Anthony Regional perfusion catheter with improved drug delivery control
US5192290A (en) * 1990-08-29 1993-03-09 Applied Medical Resources, Inc. Embolectomy catheter
US5263478A (en) * 1991-05-09 1993-11-23 Ballard Medical Products Endotracheal tube insertion and positioning apparatus
US5308325A (en) * 1991-01-28 1994-05-03 Corpak, Inc. Retention balloon for percutaneous catheter
US5339809A (en) * 1991-12-04 1994-08-23 Beck Jr Charles A Method of inserting a cricothyroidal endotracheal device between the cricoid and thyroid cartilages for treatment of chronic respiratory disorders
US5366562A (en) * 1990-02-16 1994-11-22 Continental Aktiengesellschaft Method for removing viscoelastic contaminants from holes
US5439444A (en) * 1991-01-28 1995-08-08 Corpak, Inc. Pre-formed member for percutaneous catheter
US5588424A (en) * 1995-06-28 1996-12-31 The Cleveland Clinic Foundation Bronchial blocker endotracheal apparatus
US5638813A (en) * 1995-06-07 1997-06-17 Augustine Medical, Inc. Tracheal tube with self-supporting tracheal tube cuff
US5649902A (en) * 1988-07-22 1997-07-22 Yoon; Inbae Multifunctional devices for endoscopic surgical procedures
US5700239A (en) * 1990-07-24 1997-12-23 Yoon; Inbae Multifunctional devices for use in endoscopic surgical procedures and method therefor
US5779685A (en) * 1995-11-13 1998-07-14 Quest Medical, Inc. Retrograde cardioplegia catheter and method of use
US5819733A (en) * 1995-10-10 1998-10-13 Vbm Medizintechnik Gmbh Transpharyngeal tube with pharyngeal and esophageal cuffs, and protected tip
US5988167A (en) * 1997-05-02 1999-11-23 Kamen; Jack M. Foam cuff for laryngeal mask airway
US6012452A (en) * 1997-10-16 2000-01-11 Smiths Industries Public Limited Company Laryngeal mask assemblies
US6378521B1 (en) * 1996-11-28 2002-04-30 Ideamed N.V. Artificial airway device
US20040116899A1 (en) * 2002-12-16 2004-06-17 Shaughnessy Michael C. Bolus for non-occluding high flow enteral feeding tube
US20050159712A1 (en) * 2000-07-12 2005-07-21 Erik Andersen Catheter having a tip with an elongated collar
US20050229933A1 (en) * 2004-04-14 2005-10-20 Mcgrail Thomas W Non-tracheal ventilation tube
US20050235996A1 (en) * 2004-04-27 2005-10-27 Hooser David Theron V Clamping assembly for limiting the depth of insertion of a respiratory care treatment device
WO2006130992A1 (en) * 2005-06-10 2006-12-14 Universite Laval Right double lumen endobronchial tube
US20090211572A1 (en) * 2004-11-19 2009-08-27 Matera Paul A Endotracheal intubation apparatus providing enhanced stability in an intubated patient
US7654264B2 (en) * 2006-07-18 2010-02-02 Nellcor Puritan Bennett Llc Medical tube including an inflatable cuff having a notched collar
US7976518B2 (en) 2005-01-13 2011-07-12 Corpak Medsystems, Inc. Tubing assembly and signal generator placement control device and method for use with catheter guidance systems
US9028441B2 (en) 2011-09-08 2015-05-12 Corpak Medsystems, Inc. Apparatus and method used with guidance system for feeding and suctioning
US9526856B2 (en) 2011-12-15 2016-12-27 The Board Of Trustees Of The Leland Stanford Junior University Devices and methods for preventing tracheal aspiration
US9770194B2 (en) 2013-11-05 2017-09-26 Ciel Medical, Inc. Devices and methods for airway measurement

Families Citing this family (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE8705894U1 (de) * 1987-04-23 1987-06-19 Fresenius AG, 6380 Bad Homburg Gastral/duodenal-Katheter für die künstliche Ernährung
US5186167A (en) * 1990-10-31 1993-02-16 The United States Of America As Represented By The Department Of Health And Human Services Catheter tip for intratracheal ventilation and intratracheal pulmonary ventilation

Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2548602A (en) * 1948-04-09 1951-04-10 Greenburg Leonard Inflatable dilator
US2701559A (en) * 1951-08-02 1955-02-08 William A Cooper Apparatus for exfoliating and collecting diagnostic material from inner walls of hollow viscera
US2862498A (en) * 1957-06-14 1958-12-02 Don J Weekes Endotracheal tube
US3211152A (en) * 1961-11-15 1965-10-12 Ernest A Stern Safety endotracheal tube cuff
US3292627A (en) * 1963-03-25 1966-12-20 Pharmaseal Lab Catheter
US3638655A (en) * 1970-05-18 1972-02-01 George O Doherty Intubation tubes
US3640282A (en) * 1970-08-06 1972-02-08 Jack M Kamen Tracheal tube with normally expanded balloon cuff

Family Cites Families (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE823181C (de) * 1949-08-15 1951-12-03 Ruesch Fa Ballonkatheter und Verfahren zu seiner Herstellung
FR1296423A (fr) * 1961-07-31 1962-06-15 Sonde chirurgicale
FR1354519A (fr) * 1963-04-11 1964-03-06 Kendall & Co Sonde médicale
BE631277A (is) * 1963-04-17
US3348542A (en) * 1964-12-02 1967-10-24 Richard R Jackson Anesthetic articles
US3417744A (en) * 1966-03-15 1968-12-24 Mishkin Sidney Catheter for selective bronchography
US3438375A (en) * 1966-03-18 1969-04-15 Kendall & Co Non-traumatic retention catheter

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2548602A (en) * 1948-04-09 1951-04-10 Greenburg Leonard Inflatable dilator
US2701559A (en) * 1951-08-02 1955-02-08 William A Cooper Apparatus for exfoliating and collecting diagnostic material from inner walls of hollow viscera
US2862498A (en) * 1957-06-14 1958-12-02 Don J Weekes Endotracheal tube
US3211152A (en) * 1961-11-15 1965-10-12 Ernest A Stern Safety endotracheal tube cuff
US3292627A (en) * 1963-03-25 1966-12-20 Pharmaseal Lab Catheter
US3638655A (en) * 1970-05-18 1972-02-01 George O Doherty Intubation tubes
US3640282A (en) * 1970-08-06 1972-02-08 Jack M Kamen Tracheal tube with normally expanded balloon cuff

Cited By (64)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3991767A (en) * 1973-11-02 1976-11-16 Cutter Laboratories, Inc. Tubular unit with vessel engaging cuff structure
US3889685A (en) * 1973-11-02 1975-06-17 Cutter Lab Tubular unit with vessel engaging cuff structure
US4022217A (en) * 1975-09-15 1977-05-10 Dupaco Incorporated Cuff configuration for cuff tracheal tubes
US4240433A (en) * 1977-07-22 1980-12-23 Bordow Richard A Fluid aspiration device and technique for reducing the risk of complications
US4228801A (en) * 1977-11-29 1980-10-21 Elektromedical Company S.R.L. Dilator for application in medical field
EP0010880A1 (en) * 1978-10-09 1980-05-14 Dovecourt Limited Cuffed Endotracheal and Tracheostomy Tubes
US4227293A (en) * 1978-12-11 1980-10-14 The Kendall Company Method of catheter manufacture
US4653514A (en) * 1980-12-22 1987-03-31 Bivona, Inc. Device for strengthening the vaginal muscles
US4454887A (en) * 1981-04-15 1984-06-19 Krueger Christian Medical instruments for introduction into the respiratory tract of a patient
FR2504012A1 (fr) * 1981-04-15 1982-10-22 Kruger Christian Instrument medical
DE3119854A1 (de) * 1981-05-19 1982-12-16 Drägerwerk AG, 2400 Lübeck Vorrichtung zur positionierung eines trachealtubus
US4449522A (en) * 1981-05-19 1984-05-22 Dragerwerk A.G. Positioning device for use with a tracheal tube which is insertable into a person's trachea for respiration purposes
EP0088173A1 (en) * 1982-03-05 1983-09-14 Bivona, Inc. Device for exercising the vaginal muscles
US4636195A (en) * 1982-04-02 1987-01-13 Harvey Wolinsky Method and apparatus for removing arterial constriction
US4684363A (en) * 1984-10-31 1987-08-04 American Hospital Supply Corporation Rapidly inflatable balloon catheter and method
US4819664A (en) * 1984-11-15 1989-04-11 Stefano Nazari Device for selective bronchial intubation and separate lung ventilation, particularly during anesthesia, intensive therapy and reanimation
US4762125A (en) * 1986-03-07 1988-08-09 The University Of Texas System Balloon-tipped suction catheter
US4840172A (en) * 1986-09-04 1989-06-20 Augustine Scott D Device for positioning an endotracheal tube
US4768522A (en) * 1987-02-24 1988-09-06 Exta, Inc. Device for exercising vaginal muscles
US4795430A (en) * 1988-01-15 1989-01-03 Corpak, Inc. Device for intubation of percutaneous endoscopic ostomy
US4900306A (en) * 1988-01-15 1990-02-13 Corpak, Inc. Device for intubation of percutaneous endoscopic ostomy
US5649902A (en) * 1988-07-22 1997-07-22 Yoon; Inbae Multifunctional devices for endoscopic surgical procedures
US4979505A (en) * 1989-06-06 1990-12-25 Cox Everard F Tracheal tube
US5027812A (en) * 1989-09-19 1991-07-02 Bivona, Inc. Tracheal tube for laser surgery
US5176638A (en) * 1990-01-12 1993-01-05 Don Michael T Anthony Regional perfusion catheter with improved drug delivery control
US5366562A (en) * 1990-02-16 1994-11-22 Continental Aktiengesellschaft Method for removing viscoelastic contaminants from holes
US5067497A (en) * 1990-03-16 1991-11-26 Progressive Medical Design, Inc. Intubation device with adjustable suction means above the cuff
US5100384A (en) * 1990-03-30 1992-03-31 Wilson-Cook Medical, Inc. Method and device for percutaneous intubation
US6602218B2 (en) 1990-07-24 2003-08-05 Inbae Yoon Apparatus for ablation of the endometrium of the uterus
US6277089B1 (en) 1990-07-24 2001-08-21 Inbae Yoon Method for ablating portions of the uterus
US5700239A (en) * 1990-07-24 1997-12-23 Yoon; Inbae Multifunctional devices for use in endoscopic surgical procedures and method therefor
US5192290A (en) * 1990-08-29 1993-03-09 Applied Medical Resources, Inc. Embolectomy catheter
US5411509A (en) * 1990-08-29 1995-05-02 Applied Medical Resources Corporation Embolectomy catheter
US5439444A (en) * 1991-01-28 1995-08-08 Corpak, Inc. Pre-formed member for percutaneous catheter
US5308325A (en) * 1991-01-28 1994-05-03 Corpak, Inc. Retention balloon for percutaneous catheter
US5263478A (en) * 1991-05-09 1993-11-23 Ballard Medical Products Endotracheal tube insertion and positioning apparatus
US5339809A (en) * 1991-12-04 1994-08-23 Beck Jr Charles A Method of inserting a cricothyroidal endotracheal device between the cricoid and thyroid cartilages for treatment of chronic respiratory disorders
US5638813A (en) * 1995-06-07 1997-06-17 Augustine Medical, Inc. Tracheal tube with self-supporting tracheal tube cuff
US5588424A (en) * 1995-06-28 1996-12-31 The Cleveland Clinic Foundation Bronchial blocker endotracheal apparatus
US5819733A (en) * 1995-10-10 1998-10-13 Vbm Medizintechnik Gmbh Transpharyngeal tube with pharyngeal and esophageal cuffs, and protected tip
US5779685A (en) * 1995-11-13 1998-07-14 Quest Medical, Inc. Retrograde cardioplegia catheter and method of use
US6378521B1 (en) * 1996-11-28 2002-04-30 Ideamed N.V. Artificial airway device
US5988167A (en) * 1997-05-02 1999-11-23 Kamen; Jack M. Foam cuff for laryngeal mask airway
US6012452A (en) * 1997-10-16 2000-01-11 Smiths Industries Public Limited Company Laryngeal mask assemblies
US7066914B2 (en) 2000-07-12 2006-06-27 Bird Products Corporation Catheter having a tip with an elongated collar
US20050159712A1 (en) * 2000-07-12 2005-07-21 Erik Andersen Catheter having a tip with an elongated collar
US20040116899A1 (en) * 2002-12-16 2004-06-17 Shaughnessy Michael C. Bolus for non-occluding high flow enteral feeding tube
US20050229933A1 (en) * 2004-04-14 2005-10-20 Mcgrail Thomas W Non-tracheal ventilation tube
US7201168B2 (en) 2004-04-14 2007-04-10 King Systems Corporation Non-tracheal ventilation tube
US20050235996A1 (en) * 2004-04-27 2005-10-27 Hooser David Theron V Clamping assembly for limiting the depth of insertion of a respiratory care treatment device
US7353822B2 (en) 2004-04-27 2008-04-08 Kimberly-Clark , Worldwide, Inc. Clamping assembly for limiting the depth of insertion of a respiratory care treatment device
US20090211572A1 (en) * 2004-11-19 2009-08-27 Matera Paul A Endotracheal intubation apparatus providing enhanced stability in an intubated patient
US9131956B2 (en) 2005-01-13 2015-09-15 Corpak Medsystems, Inc. Tubing assembly and signal generator placement control device and method for use with catheter guidance systems
US7976518B2 (en) 2005-01-13 2011-07-12 Corpak Medsystems, Inc. Tubing assembly and signal generator placement control device and method for use with catheter guidance systems
US9579488B2 (en) 2005-01-13 2017-02-28 Corpak Medsystems, Inc. Tubing assembly and signal generator placement control device and method for use with catheter guidance systems
US9889277B2 (en) 2005-01-13 2018-02-13 Avent, Inc. Tubing assembly and signal generator placement control device and method for use with catheter guidance systems
US10549074B2 (en) 2005-01-13 2020-02-04 Avent, Inc. Tubing assembly and signal generation placement device and method for use with catheter guidance systems
US20080135052A1 (en) * 2005-06-10 2008-06-12 Bussieres Jean Right double lumen endobronchial tube
WO2006130992A1 (en) * 2005-06-10 2006-12-14 Universite Laval Right double lumen endobronchial tube
US7654264B2 (en) * 2006-07-18 2010-02-02 Nellcor Puritan Bennett Llc Medical tube including an inflatable cuff having a notched collar
US9028441B2 (en) 2011-09-08 2015-05-12 Corpak Medsystems, Inc. Apparatus and method used with guidance system for feeding and suctioning
US9918907B2 (en) 2011-09-08 2018-03-20 Avent, Inc. Method for electromagnetic guidance of feeding and suctioning tube assembly
US9526856B2 (en) 2011-12-15 2016-12-27 The Board Of Trustees Of The Leland Stanford Junior University Devices and methods for preventing tracheal aspiration
US9770194B2 (en) 2013-11-05 2017-09-26 Ciel Medical, Inc. Devices and methods for airway measurement

Also Published As

Publication number Publication date
IT981586B (it) 1974-10-10
DE2314608A1 (de) 1973-10-04
GB1423712A (en) 1976-02-04
DE2314608C2 (de) 1982-05-13
AU473080B2 (en) 1976-06-10
DK142344C (is) 1981-03-30
AU5197773A (en) 1974-08-08
CA1005722A (en) 1977-02-22
FR2177873A1 (is) 1973-11-09
DK142344B (da) 1980-10-20
FR2177873B1 (is) 1976-09-10
BR7301967D0 (pt) 1974-08-29

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