WO2015110774A1 - Ensembles tubes de trachéotomie - Google Patents

Ensembles tubes de trachéotomie Download PDF

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Publication number
WO2015110774A1
WO2015110774A1 PCT/GB2014/000520 GB2014000520W WO2015110774A1 WO 2015110774 A1 WO2015110774 A1 WO 2015110774A1 GB 2014000520 W GB2014000520 W GB 2014000520W WO 2015110774 A1 WO2015110774 A1 WO 2015110774A1
Authority
WO
WIPO (PCT)
Prior art keywords
outer tube
inner cannula
tracheostomy
tube
assembly according
Prior art date
Application number
PCT/GB2014/000520
Other languages
English (en)
Inventor
Timothy Bateman
Stephen James Field
Andrew Thomas Jeffrey
Original Assignee
Smiths Medical International 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 Smiths Medical International Limited filed Critical Smiths Medical International Limited
Publication of WO2015110774A1 publication Critical patent/WO2015110774A1/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
    • A61M16/0402—Special features for tracheal tubes not otherwise provided for
    • A61M16/0427—Special features for tracheal tubes not otherwise provided for with removable and re-insertable liner tubes, e.g. for cleaning
    • 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
    • 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
    • A61M16/0402—Special features for tracheal tubes not otherwise provided for
    • A61M16/0418—Special features for tracheal tubes not otherwise provided for with integrated means for changing the degree of curvature, e.g. for easy intubation
    • 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 tracheostomy tube assemblies of the kind including an outer tube having a seal arranged to form a seal between the outer surface of the outer tube and the trachea, the assembly including a removable inner cannula.
  • Tracheostomy tube assemblies commonly include an outer tube and an inner tube or cannula that is a removable fit within the outer tube.
  • the inner cannula can be removed and replaced periodically to ensure that the passage through the assembly does not become blocked by secretions. This avoids the need to remove the outer tube frequently.
  • the inner cannula has substantially the same length as the outer tube so that the inner cannula does not protrude, or does not protrude significantly, beyond the end of the outer tube.
  • the length of the outer tube is chosen such that the patient end of the tube locates, in use, just above the carina.
  • the inner cannula can be of various different forms.
  • WO94/01156 and WO2004/101048 describe inner cannulae made of PTFE.
  • EP1938857 describes an arrangement of tracheostomy tubes and inner cannulae where the hubs of the inner cannulae of different sizes are shaped differently so that they will only fit in the appropriate tracheostomy tube.
  • EP2224985 describes an arrangement for attaching a hub to the shaft of an inner cannula.
  • GB205628S describes an inner cannula having a wall corrugated both externally and internally and a longitudinal groove or other reinforcement member traversing at least some of the corrugations.
  • US4315505 describes an arrangement where the inner cannula protrudes from the patient end by about 0.05 inches (1.27mm).
  • US4817598 describes a smooth-walled inner cannula having a ring-pull formation at its rear, machine end.
  • US5119811 describes an inner cannula with a flared patient end and formed of two layers of different materials.
  • US5386826 describes an inner cannula with an outer helical filament or layer of low friction material.
  • US5983895 describes an inner cannula with straight sections at opposite ends joined by an intermediate curved section.
  • US6019753 describes an inner cannula with two elongate regions of different flexibility so that the cannula has a plane of preferential bending.
  • US6019753 describes an inner cannula having a shaft formed with slots to make it more flexible, the slots being covered by an outer thin sheath.
  • US6135110 describes a curved inner cannula that is retained with the outer tube by means of a rotatable spring fitting.
  • PCT/GB2014/000042 describes an inner cannula having a corrugated outer surface and a smooth inner surface.
  • PCT/GB2014/000043 describes an inner cannula with an off-centre bore.
  • US2011083672 describes a tracheostomy tube assembly having an inner cannula that projects beyond the patient end of the outer tube and carries a sealing cuff.
  • a tracheostomy tube assembly of the above-specified kind, characterised in that the length of the inner cannula exceeds that of the outer tube so that the patient end of the inner cannula projects beyond the patient end of the outer tube by a distance greater than the internal diameter of the outer tube.
  • the inner cannula preferably projects beyond the patient end of the outer tube by a distance that is at least substantially one third the length of the outer tube, such as by a distance between about 20mm and 30mm.
  • the seal may include an inflatable sealing cuff.
  • the maximum external diameter of the inner cannula may be less than or equal to the internal diameter of the outer tube such that the outer tube can be removed rearwardly over the inner cannula while leaving the inner cannula in the trachea.
  • the outer tube may be gas pervious along a part at least of its length and may have an open wall structure.
  • an outer tube for a tracheostomy tube assembly according to the above one aspect of the present invention.
  • an inner cannula for a tracheostomy tube assembly according to the above one aspect of the present invention.
  • a tracheostomy tube assembly according to the present invention will now be described, by way of example, with reference to the accompanying drawing, in which:
  • Figure 1 is a partly sectional side elevation view of a first form of tracheostomy tube assembly
  • Figure 2 is a side elevation view of a second form of tracheostomy tube assembly.
  • the tracheostomy assembly comprises an outer tracheostomy tube 1 and a removable inner cannula 2 inserted within the outer tube.
  • the outer tube 1 has a shaft 10 that is curved along its length between its patient, forward end 11 and its machine, rear end 12.
  • An inflatable sealing cuff 14 embraces the tube 1 close to its patient end 11, the cuff being inflated via an inflation lumen 16 and a combined connector and inflation indicator 18. Other forms of seal could be used.
  • the outer tube 1 has a hub 20 and flange 22 to which a retaining tape (not shown) can be fastened for securing the tube with the patient's neck.
  • the outer tube 1 typically has an internal diameter between about 6mm and 10mm.
  • the outer tube 1 is shorter than a conventional tracheostomy tube having the same diameter, being about two thirds its length.
  • the inner cannula 2 comprises a shaft 30 and a hub 31 bonded to the rear or machine end 32 of the shaft.
  • the shaft 30 may be of various different kinds but is typically extruded of a bendable plastics material and has a smooth internal bore and external surface.
  • the outer diameter of the shaft 30 is closely matched to the internal diameter of the outer tube 1 so that it is a smooth sliding fit along it without leaving any significant gap for leakage of air between the outside of the inner cannula 2 and the inside of the outer tube.
  • the inner cannula 2 differs from previous inner cannulae in that its length is selected such that its forward, patient end 33 extends substantially beyond the patient end 11 of the outer tube 1.
  • the patient end 33 of the inner cannula 2 projects from the patient end 11 of the outer tube 1 by a distance equivalent to at least the internal diameter of the outer tube and preferably about one third the length of the shaft 10 of the outer tube, typically between about 20mm and 30mm. In this way, the patient end 33 of the inner cannula 2 extends to approximately the same location in the trachea T as would a conventional tracheostomy tube.
  • the inner cannula 2 is not provided with any sealing cuff or other inflatable means.
  • the outer tube 1 serves the function of supporting the assembly in the stoma and providing the seal with the trachea T whereas the inner cannula 2 provides the path for gas flow to and from the trachea.
  • This arrangement avoids the need to ensure that the patient end of the inner cannula and outer tube are accurately aligned lengthwise, which can be difficult to achieve in conventional tracheostomy tube assemblies having an inner cannula.
  • the hub 31 of the inner cannula 2 could be arranged to have an external diameter just smaller than the internal diameter of the shaft 10 of the outer tube 1, so that the maximum external diameter of the inner cannula is less than or equal to the internal diameter of the outer tube. This would enable the outer tube 1 to be removed from the patient (after deflating the sealing cuff) around the inner cannula 2, which would be left in place to provide an air passage into the trachea and a guide along which a new or cleaned outer tube could be slid. This enables the outer tube 1 to be replaced with reduced risk of trauma to the patient.
  • the inner cannula 2 can be removed from the outer tube 1 and replaced when necessary in the usual way by pulling its hub 31 out from the hub 20.
  • the outer tube does not itself provide an air passage into the trachea there is no requirement for it to have an impervious wall.
  • the outer tube ⁇ could have a shaft 10' that is gas pervious along a part at least of its length, such as in the form of an open wall structure, framework or lattice 40 with gaps 41.
  • the shaft 10' has sufficient structure to support the sealing cuff 14' and to guide the inner cannula 2' during insertion but does not provide any gas conduit.
  • Such an outer tube could be made very flexible along its length. This would enable the sealing cuff 14' to be positioned centrally in the trachea with low force applied by the shaft 10'. This would then provide an accurately located track along which the inner cannula 2' could be inserted.

Landscapes

  • 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)
  • Surgical Instruments (AREA)

Abstract

Un ensemble tubes de trachéotomie comporte un tube extérieur court (1, 1') doté d'un manchon d'étanchéité gonflable (14) et une canule intérieure (2, 2') qui est plus longue que le tube extérieur si bien qu'elle fait saillie depuis l'extrémité située du côté du patient (11) du tube extérieur sur une distance représentant environ un tiers de la longueur du tube extérieur. Le diamètre extérieur de l'embout situé du côté de la machine (31) sur la canule intérieure (2, 2') peut être tel à permettre le retrait du tube extérieur (1, 1') par coulissement vers l'arrière le long de la canule intérieure. Le tube extérieur (1') peut comporter une structure de type paroi ouverte perméable (40, 41).
PCT/GB2014/000520 2014-01-21 2014-12-18 Ensembles tubes de trachéotomie WO2015110774A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
GBGB1401022.7A GB201401022D0 (en) 2014-01-21 2014-01-21 Tracheostomy tube assemblies
GB1401022.7 2014-01-21

Publications (1)

Publication Number Publication Date
WO2015110774A1 true WO2015110774A1 (fr) 2015-07-30

Family

ID=50239265

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/GB2014/000520 WO2015110774A1 (fr) 2014-01-21 2014-12-18 Ensembles tubes de trachéotomie

Country Status (2)

Country Link
GB (1) GB201401022D0 (fr)
WO (1) WO2015110774A1 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20200030558A1 (en) * 2018-07-26 2020-01-30 Aninimed, LLC Endotracheal tube exchange

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5287852A (en) * 1993-01-13 1994-02-22 Direct Trends International Ltd. Apparatus and method for maintaining a tracheal stoma
US5515844A (en) * 1989-11-02 1996-05-14 Christopher; Kent L. Method and apparatus for weaning ventilator-dependent patients
DE29812634U1 (de) * 1998-07-16 1998-12-17 Wosnitza Annette Trachealkanüle zur seitengetrennten Beatmung bei tracheotomierten Patienten
US20080156323A1 (en) * 2003-08-22 2008-07-03 Artificial Airways, Inc. Airway assembly and methods of using an airway assembly
US20110083672A1 (en) * 2009-08-12 2011-04-14 Vanderbilt University Tracheostomy tube having a cuffed inner cannula
GB2500933A (en) * 2012-04-05 2013-10-09 John Stephen Rubin Artificial syrinx comprising a fenestrated tracheostomy tube

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5515844A (en) * 1989-11-02 1996-05-14 Christopher; Kent L. Method and apparatus for weaning ventilator-dependent patients
US5287852A (en) * 1993-01-13 1994-02-22 Direct Trends International Ltd. Apparatus and method for maintaining a tracheal stoma
DE29812634U1 (de) * 1998-07-16 1998-12-17 Wosnitza Annette Trachealkanüle zur seitengetrennten Beatmung bei tracheotomierten Patienten
US20080156323A1 (en) * 2003-08-22 2008-07-03 Artificial Airways, Inc. Airway assembly and methods of using an airway assembly
US20110083672A1 (en) * 2009-08-12 2011-04-14 Vanderbilt University Tracheostomy tube having a cuffed inner cannula
GB2500933A (en) * 2012-04-05 2013-10-09 John Stephen Rubin Artificial syrinx comprising a fenestrated tracheostomy tube

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20200030558A1 (en) * 2018-07-26 2020-01-30 Aninimed, LLC Endotracheal tube exchange
US11684737B2 (en) * 2018-07-26 2023-06-27 Aninimed Llc Endotracheal tube exchange

Also Published As

Publication number Publication date
GB201401022D0 (en) 2014-03-05

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