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WO1990004992A1 - Tube tracheal - Google Patents

Tube tracheal Download PDF

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Publication number
WO1990004992A1
WO1990004992A1 PCT/GB1989/001239 GB8901239W WO9004992A1 WO 1990004992 A1 WO1990004992 A1 WO 1990004992A1 GB 8901239 W GB8901239 W GB 8901239W WO 9004992 A1 WO9004992 A1 WO 9004992A1
Authority
WO
WIPO (PCT)
Prior art keywords
tracheal
lining
tracheal tube
tubular portion
tube according
Prior art date
Legal status (The legal status 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 status listed.)
Ceased
Application number
PCT/GB1989/001239
Other languages
English (en)
Inventor
Timothy Inglis
Michael Millar
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
University of Leeds Industrial Services Ltd
Original Assignee
University of Leeds Industrial Services Ltd
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 University of Leeds Industrial Services Ltd filed Critical University of Leeds Industrial Services Ltd
Priority to AU45006/89A priority Critical patent/AU4500689A/en
Priority to JP89511181A priority patent/JPH04504508A/ja
Publication of WO1990004992A1 publication Critical patent/WO1990004992A1/fr
Priority to GB9107622A priority patent/GB2242632A/en
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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. ventilators; 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. ventilators; 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. ventilators; 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 a tracheal tube for use in the mechanical ventilation of a patient.
  • Pneumonia is an important cause of morbidity and mortality in Intensive Care Units, and ventilator- associated pneumonia is preceeded by bacterial colonisat-ion of the ventilated lung.
  • a double- walled tracheal tube intended for child or adult use, and comprising a tubular outer portion, and an inner tubular portion in the form of a lining which is removably mounted therein to permit withdrawal of the inner tubular portion when a build-up of secretion thereon has occured, and in which the inner tubular portion is arranged within the outer portion in such a way as to promote substantially laminar gas flow through the tube.
  • the invention provides a significant improvement in tracheal tubes, and especially double-walled tubes, by arranging the removable inner lining in such a way as to promote substantially turbulence free gas flow in either direction along the tube i.e. inspiratory gas flow and exhaling gas flow.
  • the tracheal end of the lining i.e. the end inside the trachea and remote from the mouth end of the tracheal tube, is arranged to form a gas type seal with the adjacent end of the outer tubular portion.
  • the tracheal end of the lining defines a smooth transition from the inner surface of the lining to the adjacent inner surface of the outer portion. This may be achieved, in one embodiment, by aerodynamic shaping of the tracheal end of the lining.
  • the tracheal end of the lining may be arranged to engage against a shoulder or abutment face of a curved lip at the tracheal end of the outer tubular portion.
  • the inner lining can form a smooth prolongation of this lip, whereby laminar flow of gas in either direction is encouraged.
  • the engagement between the tracheal end of the lining and the lip may be of any suitable form, including a releasable snap-fit engagement which also provides a substantially gas-tight seal. However, this engagement is capable of being uncoupled, by withdrawal of the inner lining from the mouth end of the tracheal tube.
  • the mouth end of the tracheal tube may be provided with a flange or lip to prevent accidental passage into the patient, and which is joined to the mouth end of the outer tubular portion.
  • the adjacent end of the inner lining may be fixed to this flange in any convenient manner, , which of course is the end which is attached to a ventilator circuit .
  • an inflatable cuff may be provided as a component part of the outer tubular portion, located near to the tracheal end thereof, and which can be inflated upon location in a desired position, in order as far as possible to prevent aspiration of extraneous material into the lung.
  • Figure 1 is a diagramatic i llustraction in longitudinal section of a first embodiment of double-walled tracheal tube according to the invention
  • Figure 2 is a detail view of the fixed upper end of the tracheal tube shown in Figure 1;
  • Figure 3 is a detail view showing the tracheal end of the tracheal tube shown in Figure 1; and.
  • Figure 4 is a diagramatic illustration in longitudinal section of a second embodiment of double-walled tracheal tube according to the invention.
  • a double-walled tracheal tube which comprises a tubular outer portion and a tubular lining replaceably mounted in the outer portion so that it can be removed entirely from the outer portion when secretions or biofilm build-up on its inner wall to a certain extent, so that the lining can be cleaned and then re-used.
  • a sterilised replacement lining will normally be made available for introduction into the outer portion after removal of the contaminated lining which will be cleaned and sterilised for subsequent use.
  • a film of respiratory secretions are built-up on the inner wall of the lining, and it is important to remove the lining before these build-up to such an extent as to cause an obstruction to gas flow, or even give rise to risk of complete blockage.
  • This build-up also should not be allowed to take place to such an extent that droplets of the film can be liable to fall under gravity into the lungs, or to be conveyed along the tube into the lungs by the inspiratory gas flow.
  • the tubular lining is arranged within the tubular outer portion in such a way that it imparts substantially turbulence free and laminar gas flow to the gas passing along it in either direction.
  • the means whereby the tubular lining can be suitably arranged to achieve this effect will be described in more detail below with reference to the two preferred embodiments of the invention.
  • the first embodiment of double-walled tracheal tube according to the invention is designated generally by reference 10 and comprises a tubular outer portion 11 and a tubular lining 12 replaceably mounted therein.
  • the lining 12 closely fits within the tubular outer portion 11. and is fixed in position at the upper fixed end 13 by a peg or similar mechanism (not shown) to fix the lining in position and prevent accidental passage into the trachea.
  • the upper end of the lining 12 is therefore contained within a usual tracheal tube connector 13, as shown in Figures 1 and 2.
  • the lower tracheal end 14 of the lining 12 is aerodynamically shaped and also forms a gas-tight seal with the lower end of the tubular portion 11, as shown to an enlarged scale in Figure 3.
  • the tubular lining 12 is therefore able to generate substantially turbulence free and laminar gas flow to both inspiratory gas. and also expired gas, which thereby minimises the risk of droplets of biofilm being carried into the lungs.
  • the tracheal end of the lining 12 is smoothly curved to form a smooth transition with the adjoining inner wall surface 11a of the tubular outer portion 11.
  • An inflatable cuff 15 is provided as a component part of the outer portion 11, and located near the tracheal end, and can be inflated to provide a gas seal within the trachea, with a view to prevent as far as possible aspiration of extraneous material into the lungs.
  • Figures 1 to 3 therefore provides a double-walled tracheal tube having the following features: a tubular lining that allows frequent removal of biofilm without necessitating replacement of the entire tracheal tube; a construction of tracheal tube which is resistant to collapse, whether constructed of plastics, ceramic, metal or other non-collapsable material; a curved lining structure which may be provided in a range of sizes to closely fit inside a tracheal tube of any internal diameter, covering its entire internal surface, and without projection beyond the lower end of the tracheal tube: a lower end structure which is constructed to resist folding or buckling, and forms a gas-tight seal with the tracheal tube, providing minimum interference with gas flow; and, an upper end assembly which can be fixed to prevent accidental passage into the trachea or unintended removal from the tracheal tube, causing minimum interference with gas flow and no additional circuit dead space, and constructed in such a way as to cause no impediment to the connection of the tracheal
  • FIG. 4 there is shown a second embodiment of double-walled tracheal tube according to the invention, and which is designated generally by reference
  • This comprises a tubular outer portion 21 and a replaceable tubular inner lining 22 which is a close substantially gas-tight fit within outer portion or sleeve
  • the sleeve 21 has the inflatable cuff 15 to provide a gas seal within the trachea, and also has a lip 23 arranged to prevent accidental passage into the patient, and to provide for fixation to an adjacent flange 24 provided at the upper end of the inner lining 22 and to other external structures.
  • the tubular lining 22 has a forward projection in the form of a short wider section 25 which is shaped to provide a connection with ventilator tubing or other ventilator circuit devices (not shown) .
  • This embodiment also has an arrangement of the tubular lining which is such as to impart substantially turbulence free and laminar gas flow through the tracheal tube in either direction, while also being mounted in such a way as to be capable of easy replacement.
  • the lower tracheal end 26 of the lining 22 has a smooth connection with an inturned lip 27 at the lower end of the outer sleeve 21.
  • the connection between end 26 and lip 27 forms a substantially uninterrupted and smooth continuing surface, thereby promoting turbulence free and laminar gas flow. Also, by virtue of the gas tight seal provided therebetween, this prevents passage of expired gases and respiratory secretions between both components.
  • the embodiment of Figure 4 therefore provides a double-walled tracheal tube with the following features: a removable core to allow removal of secretions adhering to the inner surface of the tube, without necessitating removal of the entire device; a structure which is resistant to collapse or kinking, including during removal and placement of the core; a lower end structure which can resist folding or buckling, and to prevent the inner and outer components from separation by secretions or expired gases; and. in which the upper end of both the inner and outer components is constructed to prevent accidental passage into the trachea, to allow for fixation of both parts to each other and to a third structure, and to provide the upper section of the inner lining or core with a push pit into the outer sleeve and into adjacent ventilator circuit devices.

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)
  • Prostheses (AREA)
  • External Artificial Organs (AREA)
  • Endoscopes (AREA)

Abstract

Tube trachéal à double paroi (10, 20) pour enfants et adultes se composant d'une enveloppe externe tubulaire (11, 21) dans laquelle est montée de manière détachable une sorte de doublure interne tubulaire (12, 22) que l'on peut enlever en cas de sécrétions accumulées. La doublure interne tubulaire est disposée dans l'enveloppe externe de façon à promouvoir de façon notable l'écoulement laminaire du gaz dans le tube trachéal et à éliminer notablement les turbulences qui tendent à déceler de la paroi interne du tube les goutelettes de sécrétion, dans les deux sens de l'écoulement du gaz.
PCT/GB1989/001239 1988-11-08 1989-10-19 Tube tracheal Ceased WO1990004992A1 (fr)

Priority Applications (3)

Application Number Priority Date Filing Date Title
AU45006/89A AU4500689A (en) 1988-11-08 1989-10-19 Tracheal tube
JP89511181A JPH04504508A (ja) 1988-11-08 1989-10-19 気道チューブ
GB9107622A GB2242632A (en) 1988-11-08 1991-04-10 Tracheal tube

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
GB888826170A GB8826170D0 (en) 1988-11-08 1988-11-08 Double walled tracheal tube
GB8826170.6 1988-11-08
GB8900097.0 1989-01-04
GB8900097A GB8900097D0 (en) 1988-11-08 1989-01-04 Tracheal tuibe

Publications (1)

Publication Number Publication Date
WO1990004992A1 true WO1990004992A1 (fr) 1990-05-17

Family

ID=26294597

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/GB1989/001239 Ceased WO1990004992A1 (fr) 1988-11-08 1989-10-19 Tube tracheal

Country Status (5)

Country Link
EP (1) EP0442914A1 (fr)
JP (1) JPH04504508A (fr)
AU (1) AU4500689A (fr)
GB (3) GB8826170D0 (fr)
WO (1) WO1990004992A1 (fr)

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB2251386A (en) * 1991-01-04 1992-07-08 Smiths Industries Plc Tracheal tube assembly
EP0852153A1 (fr) * 1997-01-06 1998-07-08 Georges Boussignac Dispositif pour échanger des sondes respiratoires dans la trachée d'un patient
WO2014057491A1 (fr) * 2012-10-10 2014-04-17 Novo Path Ltd Dispositif d'introduction et enveloppe tapissant la face interne d'une sonde d'intubation endotrachéale, système et méthode associés
US10099027B2 (en) 2014-01-24 2018-10-16 Cole Research & Design Oral suction device
EP4427782A1 (fr) * 2023-03-07 2024-09-11 The Provost, Fellows, Scholars and other Members of Board of Trinity College Dublin Dispositif de tube de voie respiratoire

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE72467C (de) * Dr. E. HARTSTEIN, prakt. Arzt, in Bad Oeynhausen Doppel-Canüle für den Luftröhrenschnitt mit unabhängig von einander zu handhabenden Röhren
DE1268313B (de) * 1965-06-22 1968-05-16 Draegerwerk Ag Trachealkanuele
EP0107779A1 (fr) * 1980-04-07 1984-05-09 Shiley Incorporated Tube trachéal avec un tube intérieur amovible
FR2539998A1 (fr) * 1983-01-31 1984-08-03 Gauch Laurent Dispositif d'intubation tracheale par voie orale ou nasale

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE72467C (de) * Dr. E. HARTSTEIN, prakt. Arzt, in Bad Oeynhausen Doppel-Canüle für den Luftröhrenschnitt mit unabhängig von einander zu handhabenden Röhren
DE1268313B (de) * 1965-06-22 1968-05-16 Draegerwerk Ag Trachealkanuele
EP0107779A1 (fr) * 1980-04-07 1984-05-09 Shiley Incorporated Tube trachéal avec un tube intérieur amovible
FR2539998A1 (fr) * 1983-01-31 1984-08-03 Gauch Laurent Dispositif d'intubation tracheale par voie orale ou nasale

Cited By (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB2251386A (en) * 1991-01-04 1992-07-08 Smiths Industries Plc Tracheal tube assembly
US5184611A (en) * 1991-01-04 1993-02-09 Smiths Industries Public Limited Company Tracheal tube assemblies and liners
GB2251386B (en) * 1991-01-04 1995-01-18 Smiths Industries Plc Tracheal tube assemblies and liners
EP0852153A1 (fr) * 1997-01-06 1998-07-08 Georges Boussignac Dispositif pour échanger des sondes respiratoires dans la trachée d'un patient
FR2758089A1 (fr) * 1997-01-06 1998-07-10 Georges Boussignac Procede et dispositif pour echanger des sondes respiratoires dans la trachee d'un patient
WO1998030264A1 (fr) * 1997-01-06 1998-07-16 Georges Boussignac Dispositif pour echanger des sondes respiratoires dans la trachee d'un patient
US6415787B1 (en) 1997-01-06 2002-07-09 Georges Boussignac Device for changing respiratory probes in the trachea of a patient
WO2014057491A1 (fr) * 2012-10-10 2014-04-17 Novo Path Ltd Dispositif d'introduction et enveloppe tapissant la face interne d'une sonde d'intubation endotrachéale, système et méthode associés
US10099027B2 (en) 2014-01-24 2018-10-16 Cole Research & Design Oral suction device
EP4427782A1 (fr) * 2023-03-07 2024-09-11 The Provost, Fellows, Scholars and other Members of Board of Trinity College Dublin Dispositif de tube de voie respiratoire
WO2024184496A1 (fr) * 2023-03-07 2024-09-12 The Provost, Fellows, Scholars And Other Members Of Board Of Trinity College Dublin Dispositif de tube de voie respiratoire

Also Published As

Publication number Publication date
EP0442914A1 (fr) 1991-08-28
GB9107622D0 (en) 1991-06-12
JPH04504508A (ja) 1992-08-13
GB8900097D0 (en) 1989-03-01
GB8826170D0 (en) 1988-12-14
AU4500689A (en) 1990-05-28
GB2242632A (en) 1991-10-09

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