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WO2008122679A1 - Canule d'intubation fibroscopique - Google Patents

Canule d'intubation fibroscopique Download PDF

Info

Publication number
WO2008122679A1
WO2008122679A1 PCT/ES2007/000200 ES2007000200W WO2008122679A1 WO 2008122679 A1 WO2008122679 A1 WO 2008122679A1 ES 2007000200 W ES2007000200 W ES 2007000200W WO 2008122679 A1 WO2008122679 A1 WO 2008122679A1
Authority
WO
WIPO (PCT)
Prior art keywords
section
cannula
fibroscopic
intubation
proximal section
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/ES2007/000200
Other languages
English (en)
Spanish (es)
Inventor
Valentin Madrid Rondon
Andres Madrid Gonzalez
Pedro Salazar Salegui
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.)
AJL SA
Original Assignee
AJL SA
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 AJL SA filed Critical AJL SA
Priority to PCT/ES2007/000200 priority Critical patent/WO2008122679A1/fr
Publication of WO2008122679A1 publication Critical patent/WO2008122679A1/fr
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
    • A61M16/0488—Mouthpieces; Means for guiding, securing or introducing the tubes

Definitions

  • the present invention relates to a cannula used to facilitate the introduction of an endotracheal tube into the trachea of a patient with the help of a fibroscope.
  • the objective of the invention consists in the development of a cannula that has means that facilitate the guided introduction of the endotracheal tube and that these means are easily removable once the tube is completely inserted, in order to allow the cannula to exit of the mouth without the tube being affected by the cannula in the disassembly operation.
  • Endotracheal intubation consists in the introduction of an endotracheal tube into the patient's trachea, usually in order to increase the passage of air into the lungs to facilitate or allow the patient's breathing. Intubation requires great expertise by the medical staff to introduce the endotracheal tube through the patient's trachea and not through the esophagus, since this constitutes the most direct route from the mouth.
  • the endotracheal tube cannot be of hard material because it could cause damage to the throat and larynx, and is generally formed by a soft plastic that can bend and adapt in its path from the mouth into the trachea, however the Flexible character of the tube means that it is difficult to orient it from the outside to introduce it in the windpipe.
  • cannulas usually consists of short tubes of curved configuration that are introduced into the mouth and that, in addition to pressing the tongue down, collaborate in the introduction and guidance of the endotracheal tube towards
  • the trachea of the patient The trachea of the patient.
  • intubation is performed with the help of a fibroscope that allows the doctor to guide the positioning of
  • the cannula and the endotracheal tube Normally the fibroscope is introduced through the cannula until the trachea is detected, at which time the endotracheal tube is moved towards the end of the fibroscope until it is inserted into the trachea, then the fibroscope would be removed.
  • the invention patent US 4 338 930 refers to an air intubation cannula adapted to function as a guide for an endotracheal tube that has a proximal end of cylindrical configuration and a curved distal end open inferiorly that allows the passage of the endotracheal tube .
  • FIG. 1 Another closed type cannula is represented in the invention patent US 3 908 665, which shows a square tubular section in its entirety.
  • a closed cannula is also provided with a straight cylindrical section and a curved section of elliptical configuration.
  • the invention patent US 5 024 218 describes an open cannula configured by an elongated body that has a straight section at the end of which is a flat vertical portion, and which has a curved url of progressively decreasing width.
  • On the stretch straight there is a pair of flexible walls that define a quasi-tubular passage guide, and externally to these flexible walls rigid side walls are defined joined to the vertical flat portion that protects the instrument that is introduced by the flexible passage guide.
  • the patent of invention US 5 590 643 comprises an open curved distal part and a closed proximal part with an elliptical tubular shape in which a sleeve is mounted where upper and lower grooves parallel to each other are located defined that are intended to be bitten by the upper and lower teeth respectively of the patient for holding the cannula.
  • the invention patent US 4 054 135 describes a pharyngeal intubation cannula of tubular configuration that has a straight section finished in a fin at the proximal end and that has a curved section that shows a lateral access that allows the lateral exit of the Ia cannula with respect to the endotracheal tube already installed.
  • the tubular section is divided into two longitudinal sections joined by a joint, defining between them a lateral access that can be opened or closed after the rotation of said longitudinal sections around the joint.
  • the lateral access is sized to avoid, on the one hand, that the introduced endotracheal tube can exit and to facilitate on the other hand that the cannula can be detached from the tube, once it has been completely inserted, increasing the size of said lateral access by elastic deformation of the cannula itself.
  • the cannula has, in correspondence with the lateral access, a sliding closure tab that remains inserted covering the lateral access preventing the endotracheal tube from exiting when it is introduced into the cannula, and that once removed leave the lateral access free for the exit of the cannula with respect to the tube already positioned.
  • the cannula must be rotated laterally, progressively freeing the tube through the lateral access, a situation that forces the tube to be held and partially removed to facilitate the lateral exit of the cannula partially inserted into the mouth.
  • This operation involves not only the axial displacement of the tube but also causes the distal part of the cannula to move laterally, partially obliterating the tube. This situation is aggravated when the cannula in its lateral movement is close to its complete extraction from the mouth, at which time a peak in the ventilation pressure is detected.
  • the cannula that constitutes the object of this invention satisfactorily solves the problem described above since, unlike the solutions described, the cannula is removed by elevation with respect to the endotracheal tube already installed without the need to axially move said tube and without causing any obstruction on the same.
  • the cannula guarantees a correct guidance of the endotracheal tube during its introduction, it is provided that the cannula incorporates a removable tongue that in its inserted position facilitates the guidance of the endotracheal tube, and that in
  • the cannula is formed by a body and by the removable tongue, in which the body comprises a straight proximal section and a curved distal section, in which the straight proximal section is topped at one end on a flat base. vertical and extends at its other end in the curved distal section and because the removable tongue is disposed in the proximal section of the body of the cannula and, specifically, in its lower face according to the position of intubation of the cannula, the tongue remaining Removable facing the patient's tongue.
  • the distal section shows a curved section open at the bottom and the proximal section has a first sector of internal and external section of semicircular shape that extends inferiorly and laterally in vertical skirts, and with a second sector located immediately after
  • the vertical flat base that shows the same internal section as the first sector, but which has a quadrangular external section in which the lateral faces of this second sector comprise part of the described skirts that extend superiorly ending in a horizontal face.
  • skirts in the vicinity of its lower edge, there are internally defined facing grooves that extend longitudinally and are conceived to accommodate by sliding the removable tongue that would thus be arranged covering the straight section of the cannula inferiorly and partially.
  • the removable tongue partially closes the cannula defining a tubular configuration of the straight section that facilitates the introduction and guidance of the endotracheal tube through the interior of the cannula.
  • the tongue consists of an elongated section provided with longitudinal lateral projections that are introduced into the grooves provided in the skirts of the straight section, and preferably having a front flange located at one end of said elongated section that facilitates the grip of the tongue for insertion or removal, as well as the elongated section can have its upper face curved for better guidance of the tube during its introduction.
  • the tongue could have some auxiliary element, such as a cord, that facilitates its extraction.
  • the longitudinal grooves of the body extend at their end in elbow grooves that constitute small recesses in the front face of the flat base, and on the other hand the longitudinal projections of the tongue also end in corresponding elbows located in correspondence. with the front flange, so that in the insertion position of the removable tongue in the body, the angled grooves receive the angled projections, the flange being in coplanar arrangement with the front face of the flat base.
  • This flat base is normally conceived with large dimensions to improve its handling during the extraction.
  • the quadrangular external shape of the second sector of the proximal section allows the cannula to be less sensitive against possible turns once it has been introduced into the mouth. It is envisaged that, preferably in this second sector, parallel ribs that define a space between them and between one of them and the rear face of the flat base that constitute different areas that the bite can bite are defined in their lateral and upper sides. Patient with their teeth. Depending on the area of the cannula that the patient bites, the cannula will be introduced to a greater or lesser extent in the mouth thereof.
  • the cannula can have a longitudinal mark, normally made with laser, that extends inside, both in the proximal section of the body and in the distal section of the body, which the fibroscope can follow during its introduction to facilitate correct guidance.
  • This longitudinal mark would be arranged in accordance with a midline of the body of the cannula.
  • the cannula can also incorporate an indelible mark, at the free edge of the distal section of the body, correspondingly corresponding to the longitudinal mark (the longitudinal mark is finished off at the end end in the indelible mark) to indicate to the doctor the position of the end of the cannula
  • the body of the cannula is held with one hand and pulled with the other of the tongue until it comes out completely without any limitation, at that time the endotracheal tube that can be turned slightly towards is released down by its outer section not introduced to facilitate the tilting and elevation of the cannula until its complete extraction from the mouth.
  • the endotracheal tube is not affected by any pressure from the cannula that could cause an obstruction and does not present any displacement.
  • Figure 1. Shows a perspective view of the cannula object of this invention.
  • Figure 2. Shows a front view of the cannula in which the endotracheal tube is inserted.
  • Figure 3. Shows a front view of the body of the cannula.
  • Figure 4.- Shows a plan view of the cannula.
  • Figure 5.- Shows a side view of the body of the cannula and a section according to the cutting plane A-A.
  • Figure 6. Shows a longitudinally sectioned view of the body of the cannula represented in the previous figure.
  • Figure 7.- Shows a perspective view of the tongue.
  • Figure 8. Shows a schematic view of the disassembly sequence of the cannula with respect to the endotracheal tube and its extraction from the mouth.
  • Figure 9. Shows a schematic view of the disassembly sequence of a cannula belonging to the state of the art with respect to the endotracheal tube, in which the disassembly is carried out laterally.
  • the intubation cannula comprises a body (1) formed by a proximal section (2) straight and a distal section (3) curved, in which the proximal section (2) is finished off. at one end on a vertical flat base (4) and extends at its other end in the curved distal section (3).
  • the distal section (3) is open downwards and the proximal section (2) has on its lower face corresponding to the intubation position of a removable tongue (5) that in its situation inserted in the body (1) defines a tubular configuration step (11) of the proximal section (2) that facilitates the guided introduction of the endotracheal tube (20), as observed in Figure 2, and in its location outside the body (1) corresponding to the representation of Figure 3, defines a proximal section (2) open inferiorly that allows the extraction of the body (1) in a vertical direction and outward of the mouth with respect to the endotracheal tube, which remains inserted without axial displacement.
  • the proximal section (2) has laterally some vertical skirts (7), on whose inner face and in the vicinity of its lower edge are defined internally facing grooves (6), represented in Figure 6, or in section AA of Figure 5, which extend longitudinally until it flows into the flat base (4), becoming guiding means and housing of the removable tongue (5).
  • the proximal section (2) has a first sector (2 ') of internal and external section of semicircular shape that extends inferiorly and laterally in the vertical skirts (7) and a second sector (2 ") located immediately after the vertical flat base (4) that shows the same internal section as the first sector (2), but which has a quadrangular external section, as observed in section AA of Figure 5, in which its lateral faces comprise the vertical skirts (7) that extend superiorly ending in a horizontal face (8).
  • parallel ribs (9) are defined on the lateral faces and horizontal face (8) of this second sector (2 ") that define spaces between them and between one of them and the rear face of The flat base (4) to position the patient's teeth once the cannula is introduced through its mouth.
  • Figure 7 shows the removable tongue (5) consisting of an elongated section (5 ') and a front flange (5 ") located at one end of said elongated section (5 ] ) that facilitates the grip of the removable tongue (5) for insertion or removal
  • the elongated section (5 ') shows longitudinal lateral projections (10) intended for insertion by sliding in the grooves (6) provided in the vertical skirts (7) and has its curved upper face for better guidance of the tube (20) during its introduction.
  • the grooves (6) of the body (1) extend in correspondence with the flat base (4) in elbow grooves (6 ! ) Represented in Figure 6, and the lateral projections (10) of the removable tongue (5) end in layered projections (10 ') represented in Figure 7, located in correspondence with the front flange (5 ") for accommodation in the elbow grooves (6') after the insertion of the removable tongue (5) into the body (1 ), so that the front flange (5 ") of the tongue (5) is in coplanar arrangement with the front face of the flat base (4).
  • the cannula has a longitudinal mark (21) inside it, represented in Figure 1, which follows the fibroscope during its travel. It is also provided that the cannula incorporates an indelible mark (for example in the form of an arrowhead), at the free edge of the distal section (3) of the body, correspondingly corresponding to the longitudinal mark.
  • an indelible mark for example in the form of an arrowhead
  • Figure 8 shows the sequence of how the cannula extraction object of this invention is carried out from the mouth and with respect to the endotracheal tube (20) exerting a vertical and outward movement of
  • the cannula without obliterating the tube which remains fixed without axial displacement.
  • Figure 9 shows the sequence of extraction of a cannula belonging to the state of the art, where the inconveniences that arise from the extraction in the lateral direction of the cannula, which involve the obliteration of the tube and the axial displacement of the tube are appreciated Regarding your initial position.

Landscapes

  • Health & Medical Sciences (AREA)
  • Pulmonology (AREA)
  • Biomedical Technology (AREA)
  • Emergency Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Anesthesiology (AREA)
  • Otolaryngology (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)
  • Infusion, Injection, And Reservoir Apparatuses (AREA)

Abstract

L'invention concerne une canule dont le corps est formé d'une section proximale (2) droite et d'une section distale (3) ouverte vers le bas. Selon l'invention, la section proximale (2) présente dans sa face inférieure une languette extractible (5) qui, lorsqu'elle est insérée dans le corps (1), définit une configuration tubulaire de la section proximale (2) facilitant l'introduction guidée du tube endotrachéal (2) et qui, lorsqu'elle est située à l'extérieur du corps (1), définit une section proximale (2) ouverte dans sa partie inférieure, permettant l'extraction du corps (1) dans le sens vertical et vers l'extérieur de la bouche par rapport au tube endotrachéal (20) qui reste introduit de manière fixe sans déplacement axial.
PCT/ES2007/000200 2007-04-10 2007-04-10 Canule d'intubation fibroscopique Ceased WO2008122679A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PCT/ES2007/000200 WO2008122679A1 (fr) 2007-04-10 2007-04-10 Canule d'intubation fibroscopique

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/ES2007/000200 WO2008122679A1 (fr) 2007-04-10 2007-04-10 Canule d'intubation fibroscopique

Publications (1)

Publication Number Publication Date
WO2008122679A1 true WO2008122679A1 (fr) 2008-10-16

Family

ID=39830504

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/ES2007/000200 Ceased WO2008122679A1 (fr) 2007-04-10 2007-04-10 Canule d'intubation fibroscopique

Country Status (1)

Country Link
WO (1) WO2008122679A1 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7866313B2 (en) 2007-01-02 2011-01-11 Isen Innovations, Llc Oral airways that facilitate tracheal intubation
WO2013033390A1 (fr) * 2011-08-30 2013-03-07 Zhao pei-shan Canule oropharyngée

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3908665A (en) * 1974-05-20 1975-09-30 John A Moses Oro-pharyngeal airway
US4054135A (en) * 1976-07-23 1977-10-18 Berman Robert A Intubating pharyngeal airway
US4338930A (en) * 1980-09-08 1982-07-13 Tudor Williams R Airway intubator
US20050016531A1 (en) * 2003-06-10 2005-01-27 Norikata Takuma Airway

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3908665A (en) * 1974-05-20 1975-09-30 John A Moses Oro-pharyngeal airway
US4054135A (en) * 1976-07-23 1977-10-18 Berman Robert A Intubating pharyngeal airway
US4338930A (en) * 1980-09-08 1982-07-13 Tudor Williams R Airway intubator
US20050016531A1 (en) * 2003-06-10 2005-01-27 Norikata Takuma Airway

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7866313B2 (en) 2007-01-02 2011-01-11 Isen Innovations, Llc Oral airways that facilitate tracheal intubation
US7866314B2 (en) 2007-01-02 2011-01-11 Isen Innovations, Llc Method of tracheal intubation
WO2013033390A1 (fr) * 2011-08-30 2013-03-07 Zhao pei-shan Canule oropharyngée

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