WO1997032620A1 - Tube tracheal - Google Patents

Tube tracheal Download PDF

Info

Publication number
WO1997032620A1
WO1997032620A1 PCT/GB1996/000509 GB9600509W WO9732620A1 WO 1997032620 A1 WO1997032620 A1 WO 1997032620A1 GB 9600509 W GB9600509 W GB 9600509W WO 9732620 A1 WO9732620 A1 WO 9732620A1
Authority
WO
WIPO (PCT)
Prior art keywords
cuff
tube
intubating device
tongue
seal
Prior art date
Application number
PCT/GB1996/000509
Other languages
English (en)
Inventor
Amer Shaikh
Original Assignee
Amer Shaikh
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 Amer Shaikh filed Critical Amer Shaikh
Priority to PCT/GB1996/000509 priority Critical patent/WO1997032620A1/fr
Priority to AU48865/96A priority patent/AU4886596A/en
Publication of WO1997032620A1 publication Critical patent/WO1997032620A1/fr

Links

Classifications

    • 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
    • A61M16/0434—Cuffs

Definitions

  • This invention relates to anaesthetic techniques, and in particular, to a method and apparatus for keeping open the airway of a patient who is undergoing a surgical operation, under anaesthetic, or is able to tolerate any such intervention for purposes of maintaining a patent airway for any reason e.g., cardiopul onary resuscitation.
  • the present invention seeks to overcome such difficulties, by providing a device which is simply introduced into either the mouth or the nose and does not require the use of any introductory tools or require the visualisation of any lumen.
  • a first aspect of the present invention provides a method of maintaining the airway of a patient in an open condition, by inserting a tube into the oropharynx and sealing the oro-pharynx around the base of the tongue, the back of the tongue and the walls of the oro-pharynx by means of an anatomically-shaped low pressure, high volume cuff around the distal end of the tube which,pushes the tongue forward on inflation providing a patent airway and also expands laterally to form a seal.
  • the cuff has an oblate configuration when inflated.
  • the air filled cuff pushes the tongue forwards, along with the epiglottis, and forms an airtight seal around the oropharyngeal lumen, holding the tube in place.
  • oropharyngeal seal is important in allowing spontaneous and controlled (Intermittent Positive Pressure) ventilation, as without it, gases are free to bypass the tubular lumen, and pass around the outside of the tube to the exterior.
  • the oropharyngeal seal is also needed to allow the devices use in Facio-Maxillary, Ear-Nose-Throat and Dental surgery without the need for tracheal incubation and a throat-pack, which are both currently needed to prevent blood and secretions from passing into the orpharynx and larynx.
  • the invention also extends to an oropharyngeal intubating device, having a relatively large expansible cuff surrounding one end, which is adapted to seal the tube into the oropharyngeal region behind the tongue so as to prevent the tongue from falling back onto the back of the mouth and causing an obstruction to airflow.
  • the device may be inserted either through the nose, or through the mouth.
  • the expansible cuff is in the form of an inflatable "balloon", so that it can be inserted in a collapsed or partially inflated state, and subsequently inflated to form a seal.
  • the device may be removed inflated or uninflated. If suitably dimensioned, the device may alternatively be used to form a seal within the trachea or the oesophagus, and is thus considerably more versatile than other known devices of this kind.
  • the device may be used in situations where existing airways have failed to provide an airway e.g. a failed intubation scenario, whereby an anaesthetist is unable to achieve an essential airway, and tracheostomy may be indicated.
  • the device may be introduced deflated, or partially inflated, but upon inflation the expanding cuff pushes the tongue, epiglottis and mucosal folds out of the way, allowing the tubular lumen to pass within, with minimal trauma.
  • the cuff has a relatively high volume of 20 - 100 is.
  • the cuff is inflated by means of a pilot tube.
  • the outer end of the tube may be provided with a bite-block to provide an indication of the correct positioning of the cuff when inserted orally, when the cuff may be deflated or partially inflated.
  • a nasal form of the device may be inserted into the patient's nostril in an deflated or semi- deflated state and carries a marker indicating the correct depth of insertion.
  • the tubular length of the device can be made shorter than either the Endotracheal tube or the Laryngeal mask, as the oropharyngeal cuff sits much higher anatomically, compared to the intra-tracheal location of the Endotracheal tube.
  • the tubular lumen of the device has an anatomically determined curve, which corresponds to the curve descending dorsally and inferiorly from the lower teeth, over the surface of the tongue to its base. This corresponds to a "J" shape, with the greater curvature at - 3 -
  • the tube is soft, not kinkable, transparent plastic with rounded atrau atic edges.
  • the cuff is anatomically shaped to form an effective airtight seal within the oropharynx, so as to provide protection from descending blood and secretions and allow controlled and spontaneous ventilation.
  • the tube may be connected directly to anaesthetic circuits and may also be provided with a suction port on its outer portion which extends outside the patient's mouth.
  • a suction port on its outer portion which extends outside the patient's mouth. This preferably comprises a small sealable hole through which a suction catheter can be inserted while its patient continues to breathe.
  • the device is made in various internal diameters and lengths to suit different patients and applications.
  • Figure 1 is a vertical cross-section through the head of a patient showing a device according to the invention installed in its operative position;
  • FIG. 2 shows the construction of the device in more detail
  • Figure 3 is a diagrammatic plan view showing the device inserted in the oro-pharynx, and in the inflated condition.
  • Figure 1 shows the general structure of the human head in the region of interest, the upper jaw being indicated at 2, and the hard palate and soft palate at 4 and 6 respectively.
  • the lower jaw is indicated at 8, and the thyroid cartilage at 10.
  • the airway device of the invention comprises a tube 13 whose inner end is surrounded by an inflatable cuff 20, which, in its expanded condition, is of sufficiently large diameter to ensure that the rear of the tongue 22 is prevented from falling back into the throat, blocking the patient's airway, as can easily happen when a patient is lying on his or her back at a reduced level of consciousness.
  • a device of this kind can easily be introduced by an ambulance attendant, and can then be sufficient to remain in position throughout the patient's stay in the casualty department and operating theatre of the hospital.
  • This is in contrast to other known types of devices, such as endotracheal tubes, which can only be introduced by a skilled anaesthetist with the aid of a laryngoscope.
  • the main tube 13 is shown as carrying a pilot tube 26 for inflation which carries at its outer end a small air balloon 23 of the type commonly used in endotracheal tubes for estimating correct inflation pressure.
  • the inner end of the main tube carries the relatively large, balloon-like cuff 20 while the outer end carries a standard connector 30 for attachment to anaesthetic circuits.
  • Typical dimensions of the device are 6 - 9.5 mm internal diameter for the main tube, and a volume of 20 to 100 mis for the cuff.
  • the cuff has a somewhat elliptical cross-section so that it expands more in the lateral than the dorsal direction, and thereby also ensures a good seal in the oro-pharynx.
  • the device is directly connectable to wall piped or anaesthetic machine oxygen supplies, and removes the need for the anaesthetist to hold an oxygen mask upon the patients face, the patient currently would be using a Geudel airway, which requires lifting the patients chin to achieve a patent airway, which is neither efficient or easy.
  • the direct connectability to standard oxygen supplies makes this device “hands-free", once in position, and in some cases may remove the need for an anaesthetist to be present.

Abstract

La présente invention concerne un dispositif d'intubation oro-pharyngée constitué d'un tube pourvu d'un coussin expansible relativement grand entourant une extrémité, et qui est monté pour maintenir le tube dans la région oro-pharyngée derrière la langue de façon à l'empêcher de retomber dans l'arrière-gorge.
PCT/GB1996/000509 1996-03-06 1996-03-06 Tube tracheal WO1997032620A1 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
PCT/GB1996/000509 WO1997032620A1 (fr) 1996-03-06 1996-03-06 Tube tracheal
AU48865/96A AU4886596A (en) 1996-03-06 1996-03-06 Tracheal tube

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/GB1996/000509 WO1997032620A1 (fr) 1996-03-06 1996-03-06 Tube tracheal

Publications (1)

Publication Number Publication Date
WO1997032620A1 true WO1997032620A1 (fr) 1997-09-12

Family

ID=10786869

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/GB1996/000509 WO1997032620A1 (fr) 1996-03-06 1996-03-06 Tube tracheal

Country Status (2)

Country Link
AU (1) AU4886596A (fr)
WO (1) WO1997032620A1 (fr)

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4256099A (en) * 1979-03-21 1981-03-17 Dryden Gale E Two-tube resuscitation system
WO1995006492A1 (fr) * 1993-08-31 1995-03-09 The Johns-Hopkins University Canule buccopharyngee a ballonnet
WO1995033506A1 (fr) * 1994-06-04 1995-12-14 Archibald Ian Jeremy Brain Dispositif d'intubation a fibres optiques comprenant un tube tracheal et un masque larynge

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4256099A (en) * 1979-03-21 1981-03-17 Dryden Gale E Two-tube resuscitation system
WO1995006492A1 (fr) * 1993-08-31 1995-03-09 The Johns-Hopkins University Canule buccopharyngee a ballonnet
WO1995033506A1 (fr) * 1994-06-04 1995-12-14 Archibald Ian Jeremy Brain Dispositif d'intubation a fibres optiques comprenant un tube tracheal et un masque larynge

Also Published As

Publication number Publication date
AU4886596A (en) 1997-09-22

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