WO1990006077A1 - Improvement in and relating to catheter tubes - Google Patents

Improvement in and relating to catheter tubes Download PDF

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Publication number
WO1990006077A1
WO1990006077A1 PCT/GB1989/001484 GB8901484W WO9006077A1 WO 1990006077 A1 WO1990006077 A1 WO 1990006077A1 GB 8901484 W GB8901484 W GB 8901484W WO 9006077 A1 WO9006077 A1 WO 9006077A1
Authority
WO
WIPO (PCT)
Prior art keywords
tube
fibre optic
endotracheal
sleeve
passage
Prior art date
Application number
PCT/GB1989/001484
Other languages
French (fr)
Inventor
Colin Edward Perry
Original Assignee
Warne Surgical Products Limited
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Warne Surgical Products Limited filed Critical Warne Surgical Products Limited
Publication of WO1990006077A1 publication Critical patent/WO1990006077A1/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/267—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the respiratory tract, e.g. laryngoscopes, bronchoscopes
    • A61B1/2676—Bronchoscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00064—Constructional details of the endoscope body
    • A61B1/00071—Insertion part of the endoscope body
    • A61B1/0008—Insertion part of the endoscope body characterised by distal tip features
    • A61B1/00082—Balloons
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/06—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with illuminating arrangements
    • A61B1/07—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with illuminating arrangements using light-conductive means, e.g. optical fibres
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/04—Tracheal tubes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/04—Tracheal tubes
    • A61M16/0465—Tracheostomy tubes; Devices for performing a tracheostomy; Accessories therefor, e.g. masks, filters

Definitions

  • This invention relates to an endotracheal tube or catheter or to a tracheostomy tube.
  • Known endotracheal tubes comprise a length of flexible tubing which is inserted into the nasal passage or trachea.
  • the tubes are often provided near the inserted end with an outer sleeve or balloon which is connected to a source of air or liquid so that it can be inflated when the tube is correctly positioned.
  • the connection comprises a capilliary tube secured along the internal surface of the endotracheal tube. One end of the capilliary tube exits the endotrocheal tube adjacent the insertion end and is
  • the other end of the capilliary tube is closed and is positioned near the inserted end.
  • Air or liquid passes from the capilliary tube to the balloon to inflate the latter through at least one suitable positioned hole in tho endotracheal tube.
  • the inflated balloon acts as a cushion to protect the internal tissues from traumatic damage and to hold the tube in place and also provides a gas seal to facilitate respiration by the ventilator.
  • the fibre optio may partially block the flow of gas down the endotracheal tube.
  • endotracheal tubes are normally provided in a sterile condition, and insertion of the fibre optic violates the sterility.
  • An endotracheal tube or tracheostomy tube in accordance with the invention comprises a fibre optic which is located within a passage formed at or attached to the internal surface of the tube or within the tube wall with the light emitting end of the fibre optic located adjacent the inserted end of the tube.
  • the arrangement allows the tube to be simply and accurately located in the patient's trachea since the fibre optic is held in position. The only movement of the spot of light emitted by the fibre optic will be due to movement of the tube itself so that any slippage of this from the
  • the location of the fibre optic against the inner wall reduces to a minimum the chance of interruption of the gas flow down the tube.
  • the problems with sterility do not airse since the fibre optic is separated from the remainder of the interior surface of the tube by the passage.
  • the tube is provided with an outer sleeve towards the inserted end which is capable of being inflated with air or liquid once the tube has been positioned
  • the sleeve acts to protect the internal tissue and hold the tube in place as well as providing a gas seal between the tube and the patient's trachea.
  • the means for inflating the sleeve preferably comprises a capilliary tube secured along the interior surface of the tube. One end of the capilliary tube is closed and is located adjacent the inserted end of the tube whilst the other end of the capilliary tube which exits the endotracheal tube at or adjacent the insertion end is connected to the supply of liquid or air. At least one hole is provided in the endotracheal tube suitably located to allow passage of the air or liquid from the capilliary tube to the sleeve.
  • the capilliary tube also acts as the passage for the fibre optic.
  • the amount of intrusion into the gas flow region is then reduced to a minimum.
  • the light emitting end of the fibre optic is bevelled to help direct light emission directly through the tissue.
  • the arrangement thus allows for accurate inspection of the throat tissue for damage without the need for a bronchoscope which could partially or fully block the tube especially since, as noted above, there is less diffusion of the light. Furthermore there is no need to x-ray the patient's trachea to determine the position of the tube which reduces costs and benefits the patient by reduction of the amount of radiation to which he or she is exposed.
  • Figure 1 is a longitudinal section through an endotracheal tube in accordance with the invention.
  • Figure 2 is a similar view to Figure 1 with the sleeve inflated and
  • Figure 3 is an enlarged cross-sectional view of part of a fibre optic particularly suitable for use in the tube of Figures 1 and 2.
  • the endotracheal tube comprises a length of flexible tubing 2, the inserted end 4 of which is c cut obliquely to form a mouth and is provided with rounded edges 6 for patient comfort.
  • a sleeve or balloon 8 is provided around the tube, the ends 7 of the sleeve or balloon 8 being secured to the tube 2.
  • Gas or liquid is supplied to the space 9 between the sleeve 8 and the tube 2 to inflate the sleeve 8 (see Figure 2) from an external pump 10 via capilliary tube 12, secured to the interior surface of the tube or provided internally thereof, and an outlet 14 in the tube 2.
  • the sleeve 8 may be provided with a gas impermeable coating either externally, see 26, internally or both. This inhibits expansion of the sleeve due to permeation of gasses into the region 9 between the sleeve 8 and the tube 2 while the tube is in position which can lead to discomfort and damage to the patient. This is more fully described in co-pending Patent Application No. 0025236.6.
  • the endotracheal tube is shown in. Figure 1 ready for insertion.
  • a loose fitting cover 16 formed from a soft flexible material covers the mouth A and the sleeve 8.
  • the other end 24 of the tube protrudes from the insertion end 22 of the tube a sufficient distance to allow it to be firmly gripped.
  • the tube 2 is inserted into the nose or trachea and correctly position by monitoring the location of a spot of light emitted from the end of a fibre optic 20.
  • the fibre optic 20 is located within the capilliary tube 12 which holds it against the side of tube 2 to prevent it from obstructing gas flow through the tube.
  • the light emitting end 30 of the fibre optic is shown located at the lower end of the sleeve 8 but it can be positioned in any desired location. The fact that the light emitting end 30 is close to the throat tissues means that there will be less
  • the end 30 is preferably bevelled as shown in Figure 3 to take
  • beams 32 light emission is predominately directly radial of the tube through the tissue.
  • the fibre optic can also be used to inspect throat tissue so obviating the need for a bronchoscope which may block the endotracheal tube.
  • the fibre optic exits the tube 2 via an aperture therein and is protected from damage by a cover 34.
  • the sleeve 0 is inflated by pumping the pump 10 and the cover 16 is removed by pulling protuding end 24 of the tube 18 to turn the cover 16 inside out thereby enclosing any retained mucus or the like so that this does not come into contact with the inner surface of the tube. A clear pathway to the lungs is therefore ensured.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Pulmonology (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • General Health & Medical Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Pathology (AREA)
  • Biophysics (AREA)
  • Molecular Biology (AREA)
  • Radiology & Medical Imaging (AREA)
  • Physics & Mathematics (AREA)
  • Optics & Photonics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Emergency Medicine (AREA)
  • Anesthesiology (AREA)
  • Hematology (AREA)
  • Otolaryngology (AREA)
  • Physiology (AREA)
  • Media Introduction/Drainage Providing Device (AREA)

Abstract

An endotracheal or tracheostomy tube wherein a fibre optic is located within a passage formed at or attached to the inner surface of the tube or within the tube wall. The passage serves to hold the fibre optic in position. The light emitting end of the fibre optic is suitably located adjacent to the end of the tube which is inserted into the trachea.

Description

Improvement in and Relating to Catheter Tubes
This invention relates to an endotracheal tube or catheter or to a tracheostomy tube.
Known endotracheal tubes comprise a length of flexible tubing which is inserted into the nasal passage or trachea. The tubes are often provided near the inserted end with an outer sleeve or balloon which is connected to a source of air or liquid so that it can be inflated when the tube is correctly positioned. The connection comprises a capilliary tube secured along the internal surface of the endotracheal tube. One end of the capilliary tube exits the endotrocheal tube adjacent the insertion end and is
connected to the source of air or liquid. The other end of the capilliary tube is closed and is positioned near the inserted end. Air or liquid passes from the capilliary tube to the balloon to inflate the latter through at least one suitable positioned hole in tho endotracheal tube. The inflated balloon acts as a cushion to protect the internal tissues from traumatic damage and to hold the tube in place and also provides a gas seal to facilitate respiration by the ventilator.
It is also known to insert a fibre optic into the endotrocheal tube to aid in correct insertion of the tube. With care the end of the fibre optic can be located adjacent the balloon so that by moving the tube until the light spot emitted by the end is in the desired position, the balloon can be inflated in the correct location.
This arrangement has several disadvantages. Firstly the fibre optio may partially block the flow of gas down the endotracheal tube. Secondly, endotracheal tubes are normally provided in a sterile condition, and insertion of the fibre optic violates the sterility. Thirdly a
relatively large fibre optio is required to ensure that the light can be seen since dispersion of the light will occur due to the distance between the light emitting end and the throat tissues. Finally, and as noted above, care is
required to locate the fibre optic in the correct position and moreover, it is easy for the fibre optic to move during use of the endotracheal tube so giving a false locating image for the balloon position.
It is the object of this invention to provide an endotracheal tube which allows accurate location of the tube in the patient's trachea but which overcomes one or more of the above mentioned problems.
An endotracheal tube or tracheostomy tube in accordance with the invention comprises a fibre optic which is located within a passage formed at or attached to the internal surface of the tube or within the tube wall with the light emitting end of the fibre optic located adjacent the inserted end of the tube.
The arrangement allows the tube to be simply and accurately located in the patient's trachea since the fibre optic is held in position. The only movement of the spot of light emitted by the fibre optic will be due to movement of the tube itself so that any slippage of this from the
desired location will be noticed and can be corrected.
Since the fibre optic is held against the tube and therefore closely adjacent the throat there will be less dispersion of the light so that a smaller fibre optic can be employed which reduces the intrusion into the gas flow region.
Moreover, the location of the fibre optic against the inner wall reduces to a minimum the chance of interruption of the gas flow down the tube. Finally the problems with sterility do not airse since the fibre optic is separated from the remainder of the interior surface of the tube by the passage.
Suitably the tube is provided with an outer sleeve towards the inserted end which is capable of being inflated with air or liquid once the tube has been positioned
correctly. The sleeve acts to protect the internal tissue and hold the tube in place as well as providing a gas seal between the tube and the patient's trachea. The means for inflating the sleeve preferably comprises a capilliary tube secured along the interior surface of the tube. One end of the capilliary tube is closed and is located adjacent the inserted end of the tube whilst the other end of the capilliary tube which exits the endotracheal tube at or adjacent the insertion end is connected to the supply of liquid or air. At least one hole is provided in the endotracheal tube suitably located to allow passage of the air or liquid from the capilliary tube to the sleeve.
Preferably the capilliary tube also acts as the passage for the fibre optic. The amount of intrusion into the gas flow region is then reduced to a minimum.
Suitably the light emitting end of the fibre optic is bevelled to help direct light emission directly through the tissue.
The arrangement thus allows for accurate inspection of the throat tissue for damage without the need for a bronchoscope which could partially or fully block the tube especially since, as noted above, there is less diffusion of the light. Furthermore there is no need to x-ray the patient's trachea to determine the position of the tube which reduces costs and benefits the patient by reduction of the amount of radiation to which he or she is exposed.
The invention will now be further described by way of example with reference to the accompanying drawings in which:
Figure 1 is a longitudinal section through an endotracheal tube in accordance with the invention;
Figure 2 is a similar view to Figure 1 with the sleeve inflated and
Figure 3 is an enlarged cross-sectional view of part of a fibre optic particularly suitable for use in the tube of Figures 1 and 2.
The endotracheal tube comprises a length of flexible tubing 2, the inserted end 4 of which is c cut obliquely to form a mouth and is provided with rounded edges 6 for patient comfort.
Near the inserted end 4 of the tube 2, a sleeve or balloon 8 is provided around the tube, the ends 7 of the sleeve or balloon 8 being secured to the tube 2. Gas or liquid is supplied to the space 9 between the sleeve 8 and the tube 2 to inflate the sleeve 8 (see Figure 2) from an external pump 10 via capilliary tube 12, secured to the interior surface of the tube or provided internally thereof, and an outlet 14 in the tube 2.
The sleeve 8 may be provided with a gas impermeable coating either externally, see 26, internally or both. This inhibits expansion of the sleeve due to permeation of gasses into the region 9 between the sleeve 8 and the tube 2 while the tube is in position which can lead to discomfort and damage to the patient. This is more fully described in co-pending Patent Application No. 0025236.6.
The endotracheal tube is shown in. Figure 1 ready for insertion. A loose fitting cover 16 formed from a soft flexible material covers the mouth A and the sleeve 8. A tube 18, one end of which 20 is securely attached to the inside of the cover 16, extends through tube 2. The other end 24 of the tube protrudes from the insertion end 22 of the tube a sufficient distance to allow it to be firmly gripped.
The tube 2 is inserted into the nose or trachea and correctly position by monitoring the location of a spot of light emitted from the end of a fibre optic 20. The fibre optic 20 is located within the capilliary tube 12 which holds it against the side of tube 2 to prevent it from obstructing gas flow through the tube. The light emitting end 30 of the fibre optic is shown located at the lower end of the sleeve 8 but it can be positioned in any desired location. The fact that the light emitting end 30 is close to the throat tissues means that there will be less
dispersion than with known endotracheal tubes. The end 30 is preferably bevelled as shown in Figure 3 to take
advantage of total internal reflection so that, as
illustrated by beams 32, light emission is predominately directly radial of the tube through the tissue. The fibre optic can also be used to inspect throat tissue so obviating the need for a bronchoscope which may block the endotracheal tube.
The fibre optic exits the tube 2 via an aperture therein and is protected from damage by a cover 34.
During insertion of the tube, mucus or other matter which might otherwise block' the mouth of the tube is
retained on the outer surface of the cover 16. The sleeve 0 is inflated by pumping the pump 10 and the cover 16 is removed by pulling protuding end 24 of the tube 18 to turn the cover 16 inside out thereby enclosing any retained mucus or the like so that this does not come into contact with the inner surface of the tube. A clear pathway to the lungs is therefore ensured.
Any movement out of the optimum position by the tube will be observed since, because the fibre optic is fixed in position, any change in position of the light spot will be due to tube spillage. The light spot will be
clearly seen because firstly the reduced amount of
dispersion and secondly the bevelled end. Thus the need to x-ray patients to determine the position of the tube (by means of an x-ray sensitive coating on the inserted end) is obviated with consequent advantages of cost and patient safety.

Claims

CLAIMS :
1. An endotracheal tube or tracheostomy tube comprising a fibre optic which is located within a passage formed at, or attached to, the internal surface of the tube or within the tube wall having the light emitting end of the fibre optic located adjacent to the inserted end of the tube.
2. A tube as claimed in Claim 1 wherein the light emitting end of the fibre optic is bevelled to direct light radially outwards through the throat tissue.
3. A tube as claimed in either Claim 1 or 2 including an outer sleeve near the inserted end of the tube, means being provided to inflate the sleeve with a fluid.
4. A tube as claimed in Claim 3 wherein the inflation means comprises a capillary tube, one end of which is closed, the other end of which communicates with a fluid source, a hole being provided to allow passage of the fluid from the capillary tube to the sleeve.
5. A tube as claimed in Claim 4 wherein the capillary tube acts as the passage for the fibre optic.
6. A tube as claimed in either Claim 4 or 5 wherein the capillary tube is secured along the interior surface of the endotracheal tube.
7. An endotracheal or tracheostomy tube
substantial as described herein with reference to the accompanying drawings.
PCT/GB1989/001484 1988-12-09 1989-12-06 Improvement in and relating to catheter tubes WO1990006077A1 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
GB8828778.4 1988-12-09
GB8828778A GB8828778D0 (en) 1988-12-09 1988-12-09 Improvements in & relating to catheter tubes

Publications (1)

Publication Number Publication Date
WO1990006077A1 true WO1990006077A1 (en) 1990-06-14

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ID=10648235

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/GB1989/001484 WO1990006077A1 (en) 1988-12-09 1989-12-06 Improvement in and relating to catheter tubes

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AU (1) AU4753690A (en)
GB (1) GB8828778D0 (en)
WO (1) WO1990006077A1 (en)

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1991012044A1 (en) * 1990-02-14 1991-08-22 Adair Edwin Lloyd Endotracheal tube intubation assist device
WO2002070038A2 (en) 2001-03-05 2002-09-12 O'mara Sean T Intubation device and method
WO2005061034A1 (en) * 2003-12-11 2005-07-07 The Research Foundation Of State University Of New York An atraumatic endotracheal tube introducer and atraumatic intubation methods
US6978784B2 (en) * 2003-12-11 2005-12-27 The Research Foundation State University Of New York Atraumatic endotracheal tube introducer and atraumatic intubation methods

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4041936A (en) * 1975-04-23 1977-08-16 Medical Engineering Corporation Bronchoscopy tube
US4567882A (en) * 1982-12-06 1986-02-04 Vanderbilt University Method for locating the illuminated tip of an endotracheal tube
EP0177124A2 (en) * 1984-07-18 1986-04-09 Sumitomo Electric Industries Limited Catheter

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4041936A (en) * 1975-04-23 1977-08-16 Medical Engineering Corporation Bronchoscopy tube
US4567882A (en) * 1982-12-06 1986-02-04 Vanderbilt University Method for locating the illuminated tip of an endotracheal tube
EP0177124A2 (en) * 1984-07-18 1986-04-09 Sumitomo Electric Industries Limited Catheter

Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1991012044A1 (en) * 1990-02-14 1991-08-22 Adair Edwin Lloyd Endotracheal tube intubation assist device
WO2002070038A2 (en) 2001-03-05 2002-09-12 O'mara Sean T Intubation device and method
EP1372774A2 (en) * 2001-03-05 2004-01-02 O'Mara, Sean T. Intubation device and method
EP1372774A4 (en) * 2001-03-05 2004-05-26 Sean T O'mara Intubation device and method
US7552729B2 (en) 2001-03-05 2009-06-30 The United States Of America As Represented By The Secretary Of The Army Intubation device and method
WO2005061034A1 (en) * 2003-12-11 2005-07-07 The Research Foundation Of State University Of New York An atraumatic endotracheal tube introducer and atraumatic intubation methods
US6978784B2 (en) * 2003-12-11 2005-12-27 The Research Foundation State University Of New York Atraumatic endotracheal tube introducer and atraumatic intubation methods

Also Published As

Publication number Publication date
GB8828778D0 (en) 1989-01-18
AU4753690A (en) 1990-06-26

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