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WO2002020077A1 - Appareil et procede pour realiser une tracheotomie percutanee - Google Patents

Appareil et procede pour realiser une tracheotomie percutanee Download PDF

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Publication number
WO2002020077A1
WO2002020077A1 PCT/IT2001/000457 IT0100457W WO0220077A1 WO 2002020077 A1 WO2002020077 A1 WO 2002020077A1 IT 0100457 W IT0100457 W IT 0100457W WO 0220077 A1 WO0220077 A1 WO 0220077A1
Authority
WO
WIPO (PCT)
Prior art keywords
tubular body
tubular
tracheoscope
perforation
along
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/IT2001/000457
Other languages
English (en)
Inventor
Gianmario Monza
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.)
LEGRIX Ltd
Original Assignee
LEGRIX 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 LEGRIX Ltd filed Critical LEGRIX Ltd
Priority to AU2001292217A priority Critical patent/AU2001292217A1/en
Publication of WO2002020077A1 publication Critical patent/WO2002020077A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3415—Trocars; Puncturing needles for introducing tubes or catheters, e.g. gastrostomy tubes, drain catheters
    • 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
    • A61M16/0472—Devices for performing a tracheostomy
    • 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
    • A61M16/0429—Special features for tracheal tubes not otherwise provided for with non-integrated distal obturators

Definitions

  • TECHNICAL FIELD This invention relates to an apparatus for performing percutaneous tracheostomy. BACKGROUND ART
  • Percutaneous tracheostomy is a method used in medicine to accomplish a stoma in an intra-annular space of the trachea of a patient and to position a tracheostomy tube through the stoma with the purpose of assuring ventilation of the airways.
  • the tracheostomy is performed with an apparatus comprising a tracheoscope which is introduced in the mouth until entering the trachea, and a needle/cannula which is inserted through the trachea from the inside to the outside.
  • the said tracheoscope comprises a straight rigid tube into which a visual endoscope can be inserted fitted with an optical probe and a light source.
  • the endoscope allows, thanks to endoscopic vision and transillumination of the tissues through the light source, identifying the intra-annular space in which to insert the needle/cannula from the outside to the inside until positioning it inside the said rigid tube .
  • the said apparatus moreover comprises a traction wire which, after inserting the needle/cannula in the rigid tube, is introduced through the lumen of the needle/cannula and pushed inside the rigid tube until one end of the traction wire exits from the mouth.
  • the end of the traction wire is then inserted in a tracheostomy tube fitted at one end with a dilating cone/cannula and is subsequently enlarged, normally by means of a knot.
  • a pulling action is performed on the free end of the traction wire coming out of the stoma in such a way that the tracheostomy tube is drawn through the mouth until entering the trachea and is extracted from the inside to the outside thanks to the progressive dilatation of the dilating cone/cannula.
  • the purpose of this invention is to provide an apparatus for performing percutaneous tracheostomy, which does not create the problem described above and which, moreover, is easy and inexpensive to make. According to this invention, an apparatus for performing percutaneous tracheostomy is provided as asserted in Claim 1.
  • This invention moreover relates to a method for performing percutaneous tracheostomy.
  • a method for performing percutaneous tracheostomy is provided as asserted in Claim 24.
  • FIG. 1 schematically illustrates, with sections removed for the sake of clarity, a side view of an apparatus for performing percutaneous tracheostomy according to the principles of this invention in a first operating position;
  • Figure 3 is an enlarged cross-section of Figure 2 along the line III-III;
  • Figure 1 ; - Figures 5 and 6 illustrate an enlarged cross-section, with sections removed for clarity, of a detail of Figure 1 in two different operating positions;
  • FIG. 7 illustrates an alternative form of implementation of an apparatus according to this invention in a first operating position
  • Figure 8 is an enlarged cross-section of Figure 7 along the line VIII-VIII;
  • the apparatus (1) comprises a tracheoscope (2) and a control device (3) to which, during use, an end section (2a) of the tracheoscope (2) is connected.
  • the tracheoscope (2) comprises an elongated tubular body (4) which extends along a longitudinal axis (5) , is made of a semi-rigid material and has, in correspondence to its end section (2b) opposite the end section (2a) a curved extension (6) which extends from one section of the periphery of the tubular body (4) and defines a mouthpiece (7) .
  • the tubular body (4) comprises a ventilation channel (8) coaxial with the axis (5) and connectable, during use, to a ventilation device (9) ( Figure 1) .
  • a ventilation device 9
  • (4) has, in correspondence to its internal walls, a longitudinal groove (10) which extends parallel to the axis (5) and defines an area of lesser width of the tubular body (4) .
  • the tubular body (4) moreover comprises various channels extending parallel to the axis (5) and with the same width as the tubular body (4) and include a channel
  • an optical probe (12) in which an optical probe (12) can be inserted, three channels (13) in which respective optical illumination fibres (14) are inserted, an insufflation line including a channel (15) in which a tube (16) is inserted, and four aspiration and/or washing channels (17) which, during use, can be utilised to wash one end of the optical probe (12) , to wash the mouthpiece (7) or to aspirate secretions which deposit on the optical probe
  • the channels (13) are uniformly distributed along the periphery of the tubular body (4) in such a way that one channel (13) extends along the extension (6) and the relevant optical fibre (14) extends up to the end of the extension (6) ( Figures 5 and 6) .
  • the number of channels (13) and the relevant optical fibres (14) , the number of channels (17) , the number of channels ('11) and the respective optical probes (12) is indicated by way of unrestrictive example and may vary depending on requirements .
  • the tracheoscope (2) comprises an inflatable external peripheral cuff (18) ( Figures 5 and 6) communicating with the tube (16) and positioned in proximity of the extension (6) of the tracheoscope.
  • the tracheoscope (2) moreover comprises a tubular guide (19) which extends parallel to the axis (5) , is fixed inside the channel (8) and is arranged with its curvilinear end section along the extension (6) .
  • the tube (20) in its turn defines a tubular guide for a perforation and traction element (21) , which is mounted axially sliding along the tube (20) and, together with the tube (20) constitutes part of the tracheoscope (2) .
  • the perforation and traction element (21) comprises a rectilinear needle (22) made of elastically deformable material, and a steel traction wire (23) securely connected to one end of the needle (22) .
  • the wire (23) has a cylindrical enlargement (24) securely connected to one end ( Figure 4) .
  • the apparatus (1) comprises a tracheostomy tube (25) which, as better illustrated in Figure 4, extends along a longitudinal axis (26) and, during use, the tube (20) and the perforation and traction element (21) slide inside it.
  • the tracheostomy tube (25) comprises a cannula (27) made of a flexible material, across whose width a spiral stiffening spring (28) is inserted, and it has an internal cylindrical channel (29) coaxial with the axis (26) with a certain diameter greater than the diameter of the cylindrical enlargement (24) .
  • the tracheostomy tube (25) moreover comprises a penetration element (30) which is coupled to one end
  • the cuff (31) is connected to an air adduction tube (32) which extends parallel to the axis (26) and is arranged for most of its length across the width of the cannula (27) , while one end section including a nonreturn valve (known and not illustrated) is inserted in the channel (29) .
  • the penetration element (30) comprises a detachable flexible dilating cone/cannula (33) coupled to the end (27a) of the cannula (27) by means of a threaded coupling.
  • the cone/cannula (33) has an internal cylindrical channel (34) coaxial with the axis (26) with a diameter smaller than the diameter of the channel (29) and the diameter of the cylindrical enlargement (24) .
  • the cone/cannula (33) is fitted with a metallic insert (35) in correspondence to the penetration tip.
  • the apparatus (1) also comprises a safety wire (36) ( Figure 2) , preferably a silk wire, one end of which, during use, is connected to the end (27a) of the cannula (27) .
  • the control device (3) comprises a multifunction gun (37) as illustrated in Figure 1.
  • the gun (37) comprises a control lever (38) selectively connectable - in a known manner and not illustrated - by means of a mobile selector (39) between two positions A and B, to the tube (20) or to the perforation and traction element (21) , respectively.
  • the gun (37) is fitted with a terminal
  • the gun (37) comprises a releasable tubular cap (46) coupled, to the tubular body (43) by means of a bayonet joint (47) of known type.
  • the cap (46) has a channel (48) coaxial with the axis (44) and houses an end section (43a) of the tubular body (43).
  • the gun (37) moreover comprises a cutting element (49) which is coupled to the cap (46) and is movable between a rest position (indicated with a solid line in Figures 2 and 3) and an operating position (indicated with a broken line in Figure 3) .
  • the cutting element (49) comprises a blade (50) securely connected to a button (51) by means of interposition of a rod (52) .
  • the blade (50) is housed in the rest position inside a radial housing (53) cut across the width of the cap (46) and extending along an axis
  • the cutting element (49) is maintained in the rest position by means of a spring (55) wound around the rod (52) and interposed between the button (51) and the outer wall of the cap (46) and by means of a catch (56) connected to the rod (52) which engages the housing (53) and is held in place against an appendix (57) extending parallel to the axis (44) by one side wall of the housing (53) .
  • the blade (50) has a cutting profile defined by a first inclined section (58) with respect to the axis (44) and a second concave section (59) arranged on a lateral end of the blade and defining a hook together with the inclined section (58) .
  • the end section (43a) has, in a position rotated by an angle of about 30° with respect to the axis (54) , a through slit ( Figure 3) which extends parallel to the axis (44) along the entire extension of the section (43a) .
  • the apparatus (1) comprises a ventilation tube (61) ( Figures 9-13) of known type, which is fitted with an inflatable cuff (62) at one peripheral end section.
  • the tube (61) is moreover fitted with an air adduction line
  • the apparatus (1) moreover comprises an obturator (65) ( Figures 12-14) which, during use, is utilised to turn the cannula (27) from the cranial to the caudal position.
  • the obturator (65) has a longitudinal channel (66) along which, as will be better explained below, the optical probe (12) can be inserted after it has been removed from the tracheoscope (2) .
  • the obturator (65) is preferably made of a material able to transmit light, for example, polycarbonate, and can be connected to a light source
  • the ventilation tube (61) forms part of the tracheoscope (2) and is connected to the tubular body (4) in such a way that it can be released.
  • the tubular body (4) has an external longitudinal groove (67) which extends parallel to the axis (5) and houses the ventilation tube (61) .
  • the ventilation tube (61) is held inside the groove (67) by means of a film (68) which extends along almost the entire length of the groove (67) , and is connected to the peripheral sections of the tubular body (4) adjacent to the groove (67) in such a way that it can be removed, and allows the ventilation tube (61) to slide along the groove (67) .
  • the ventilation tube (61) is held in position by means of two elastic rings (68) integral to the tubular body (4) .
  • the tracheostomy tube (25) is placed in the housing (45) with the tube (20) and the traction wire (23) fitted with the cylindrical enlargement (24) arranged along the channel (29) ( Figures 2 and 4) .
  • the end section (2a) of the tracheoscope (2) is positioned in the housing (45) along the end section
  • the tracheoscope (2) is arranged in the housing (45) in such as way that the groove (10) is set at an angle of about 30° with respect to the axis (54) and in correspondence to the slit (60) .
  • the optical probe (12) is connected to the eyepiece (42) (known and not illustrated) and inserted in the channel (11) .
  • the tube (20) and the wire (23) are connected - in a known manner and not illustrated - to the control lever (38) and the selector (39) , and the optical fibres (14) are connected - in a known manner and not illustrated - to the light source (41) .
  • the tracheoscope (2) is partially inserted through the mouth of a patient in a supine position until entering the trachea with the end section (2b) with the mouthpiece (7) facing the upper wall of the trachea.
  • the tracheoscope (2) is then locked into position by inflating the cuff (18) by means of a pumping device (70) which is connected by interposing a non-return valve (known and not illustrated) to the tube (16) .
  • the patient is ventilated by connecting the ventilation channel (8) , known and not illustrated, to the ventilation device (9) .
  • the lever (38) is operated with the selector (39) locked in position A, exercising an axial thrust on the tube (20) thus making it slide along the tubular guide (19) .
  • the tube (20) is bent in correspondence to the extension (6) , but being elastically deformable, it reacquires a rectilinear configuration when exiting from the tracheoscope (2) , thus being oriented towards the upper wall of the trachea.
  • the tube (20) is advanced until coming into contact with the upper wall of the trachea between two tracheal rings ( Figure 5) .
  • the selector (39) is set to position B and, operating the lever (38) , the perforation and traction element (21) is advanced along the tube (20) until the needle (22) exits which, like the tube (20) , reacquires a rectilinear configuration when exiting the tubular body (4) ( Figure 6) .
  • the tracheoscope (2) is extracted from the patient, the traction wire (23) released from the tube (20) , the tubular guide (19) and the tubular body (4) and the tracheostomy tube (25) is removed from the housing (45) ( Figure 9) .
  • the cap (46) of the gun (37) is rotated by about 30° in the direction indicated by the arrow C until one end of the housing (53) is positioned in correspondence to the slit (60) .
  • the cap (46) is uncoupled from the tubular body (43) and the cutting element (49) is moved from the rest position to the operating position by pushing the button (51) in the direction indicated by the arrow D.
  • the blade (50) is made to slide in the slit (60) and is advanced until cutting into the tubular body (4) with the inclined section (58) in correspondence to the groove (10) .
  • the blade (50) is arranged with the concave section (59) bridging the width of the tubular body (4) in such a way that, when pulling back the gun (37) and consequently the tracheoscope (2) to the outside, the tubular body (4) is cut longitudinally along the groove (10) .
  • the optical probe (12) is removed from the channel (11) to be reused and the cuff (18) is deflated.
  • the traction wire (23) is disengaged from the tubular guide (19) and the tube (20) , which preferably have longitudinal grooves (not illustrated) similar to the groove (10) to facilitate disengagement of the traction wire (23) .
  • the tracheoscope (2) is disconnected from the gun (37) and sent to an authorised waste disposal site.
  • the patient is intubated with the ventilation tube (61) which is connected to a ventilation device (71) and locked in proximity of the carinal bifurcation by inflating the cuff (62) ( Figure 9) .
  • the cone/cannula (33) is unscrewed from the cannula (27) to which the safety wire (36) was connected before starting the operations ( Figure 11) .
  • the safety wire (36) which is connected to the cannula (27) and runs outside the cannula (27) is used as remedy in the event of failure of the extraction manoeuvre, i.e. in the event that the tracheostomy tube (25) exist completely, since the end of the safety wire (36) exiting the mouth can be connected to the traction wire (23) forming a ring in such a way that the tracheostomy tube (25) can be reinserted.
  • the obturator (65) is inserted in the channel (29) of the cannula (27) and connected to a light source (not illustrated) , and the optical probe (12) is inserted in the channel (66) of the obturator (65) . Subsequently, the obturator (65) is rotated to move the cannula (27) from the cranial position ( Figure 12) to the caudal position ( Figure 13) .
  • the obturator (65) and the optical probe (12) are extracted from the cannula (27) and the cannula (27) locked on the outside by means of a retaining ring nut (72) of known type.
  • the tube (32) is connected to a pumping device (73) in such a way as to inflate the cuff (31) and lock the cannula (27) inside the trachea, the ventilation tube (61) is extracted ( Figure 14) and the cannula (27) connected to a ventilation device (71) .
  • the tube (61) is made to slide in the opposite direction along the groove (67) and, gradually while proceeding with extraction, it is separated from the tracheoscope (2) detaching the film (68) and severing the elastic rings (69) until positioning it as illustrated in Figure 9.
  • the form of implementation where the ventilation tube (61) is coupled to the tubular body (4) in such a way that it can be removed is particularly advantageous since it avoids separate insertion of the tracheoscope (2) and the ventilation tube (61) .
  • the apparatus (1) has many advantages for performing a percutaneous tracheostomy.
  • the fact that the needle (22) and then the traction wire (23) is introduced from the inside of the trachea to the outside is particularly advantageous, since in this way the tracheostomy can also be performed on very thick or short necks, given that no counterpressure needs to be exercised on the skin from the outside and hence the subcutaneous tissue planes are perforated radially, preventing the negative effect of misalignment of the subcutaneous planes.
  • the apparatus (1) allows carrying out perforation and insertion of the tracheostomy tube (25) with fewer manoeuvres compared to known techniques and hence the whole apparatus can be maintained in better hygienic conditions .
  • the tracheoscope (2) is made of a semi-rigid material and is preformed to better favour the anatomy of the trachea, it is less harmful to the patient during introduction into the trachea and allows carrying out the introduction manoeuvre in better safety conditions compared to the use of a rigid tracheoscope .
  • a further advantage is that the optical probe (12) can be inserted in the channel (11) and, during use, can be fixed into position inside the tracheoscope (2) .
  • This solution allows easier control over the endoscopic vision compared to a known solution where the endoscope is inserted in a rigid tracheoscope and must continually be positioned with respect to the rigid tracheoscope during execution of the stoma.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Pulmonology (AREA)
  • Animal Behavior & Ethology (AREA)
  • Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Public Health (AREA)
  • General Health & Medical Sciences (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Molecular Biology (AREA)
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  • Gastroenterology & Hepatology (AREA)
  • Emergency Medicine (AREA)
  • Anesthesiology (AREA)
  • Hematology (AREA)
  • Air Bags (AREA)
  • Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)
  • Endoscopes (AREA)

Abstract

Cette invention se rapporte à un appareil (1) et à un procédé permettant de réaliser une trachéotomie percutanée et dans lesquels un trachéoscope tubulaire (2) pourvu d'un dispositif d'éclairage (14) et d'un dispositif d'inspection optique (12) est inséré partiellement dans la trachée et contient un élément de perforation et de traction coulissant. Cet élément de perforation et de traction (21) sort à l'aide d'un dispositif de guidage (19, 20) de l'une des extrémités du trachéoscope tubulaire (2) afin de perforer un espace intra-annulaire de la trachée de l'intérieur vers l'extérieur.
PCT/IT2001/000457 2000-09-05 2001-09-04 Appareil et procede pour realiser une tracheotomie percutanee Ceased WO2002020077A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU2001292217A AU2001292217A1 (en) 2000-09-05 2001-09-04 Apparatus and method for performing percutaneous tracheostomy

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
ITBO2000A000510 2000-09-05
IT2000BO000510A ITBO20000510A1 (it) 2000-09-05 2000-09-05 Apparecchiatura e metodo per la realizzazione di tracheostomia

Publications (1)

Publication Number Publication Date
WO2002020077A1 true WO2002020077A1 (fr) 2002-03-14

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PCT/IT2001/000457 Ceased WO2002020077A1 (fr) 2000-09-05 2001-09-04 Appareil et procede pour realiser une tracheotomie percutanee

Country Status (3)

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AU (1) AU2001292217A1 (fr)
IT (1) ITBO20000510A1 (fr)
WO (1) WO2002020077A1 (fr)

Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2005032632A1 (fr) * 2003-09-30 2005-04-14 Tracoe Medical Gmbh Dispositif de realisation d'une tracheotomie
DE102005006276A1 (de) * 2005-02-10 2006-08-17 Tracoe Medical Gmbh Führungshilfe zur Einführung von Sonden in oder durch luftgefüllte Hohlräume
EP2465563A1 (fr) * 2010-12-14 2012-06-20 Gimac di Maccagnan Giorgio Dispositif de trachéotomie
CN105126224A (zh) * 2015-08-26 2015-12-09 山东颐和医疗科技有限公司 多功能供氧给药管及利用其的气管插管和电子供氧给药器
US20200030561A1 (en) * 2017-04-07 2020-01-30 Hamad Medical Corporation Kits and methods for retrograde percutaneous dilational tracheostomy
RU2818748C1 (ru) * 2023-03-14 2024-05-03 Государственное бюджетное учреждение здравоохранения "Научно-исследовательский институт - краевая клиническая больница N 1 имени профессора С.В. Очаповского" Министерства здравоохранения Краснодарского края (ГБУЗ "НИИ-ККБ N 1 им. проф. Очаповского" Минздрава Краснодарского края) Способ выполнения дилатационной трахеостомии
WO2024107739A3 (fr) * 2022-11-14 2024-07-25 Chmayssani Mohamad Dispositifs et procédés pour effectuer une trachéotomie

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4444185A (en) * 1981-08-19 1984-04-24 Shugar Martin A Fiberoptic tracheotomy method
WO1995032017A1 (fr) * 1994-05-23 1995-11-30 Mallinckrodt Medical, Inc. Appareil pour pratiquer une tracheotomie translaryngienne

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4444185A (en) * 1981-08-19 1984-04-24 Shugar Martin A Fiberoptic tracheotomy method
WO1995032017A1 (fr) * 1994-05-23 1995-11-30 Mallinckrodt Medical, Inc. Appareil pour pratiquer une tracheotomie translaryngienne

Cited By (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2005032632A1 (fr) * 2003-09-30 2005-04-14 Tracoe Medical Gmbh Dispositif de realisation d'une tracheotomie
DE102005006276A1 (de) * 2005-02-10 2006-08-17 Tracoe Medical Gmbh Führungshilfe zur Einführung von Sonden in oder durch luftgefüllte Hohlräume
EP2465563A1 (fr) * 2010-12-14 2012-06-20 Gimac di Maccagnan Giorgio Dispositif de trachéotomie
WO2012080897A3 (fr) * 2010-12-14 2012-08-09 Gimac Di Maccagnan Giorgio Dispositif de trachéotomie
US9155856B2 (en) 2010-12-14 2015-10-13 Gimac Di Maccagnan Giorgio Tracheotomy device
CN105126224A (zh) * 2015-08-26 2015-12-09 山东颐和医疗科技有限公司 多功能供氧给药管及利用其的气管插管和电子供氧给药器
CN105126224B (zh) * 2015-08-26 2018-05-29 山东颐和医疗科技有限公司 多功能供氧给药管及利用其的气管插管和电子供氧给药器
US20200030561A1 (en) * 2017-04-07 2020-01-30 Hamad Medical Corporation Kits and methods for retrograde percutaneous dilational tracheostomy
WO2024107739A3 (fr) * 2022-11-14 2024-07-25 Chmayssani Mohamad Dispositifs et procédés pour effectuer une trachéotomie
RU2818748C1 (ru) * 2023-03-14 2024-05-03 Государственное бюджетное учреждение здравоохранения "Научно-исследовательский институт - краевая клиническая больница N 1 имени профессора С.В. Очаповского" Министерства здравоохранения Краснодарского края (ГБУЗ "НИИ-ККБ N 1 им. проф. Очаповского" Минздрава Краснодарского края) Способ выполнения дилатационной трахеостомии

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ITBO20000510A0 (it) 2000-09-05
AU2001292217A1 (en) 2002-03-22
ITBO20000510A1 (it) 2002-03-05

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