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WO2016028239A1 - Tube pour intubation utilisé dans des interventions de trachéostomie - Google Patents

Tube pour intubation utilisé dans des interventions de trachéostomie Download PDF

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Publication number
WO2016028239A1
WO2016028239A1 PCT/TR2014/000290 TR2014000290W WO2016028239A1 WO 2016028239 A1 WO2016028239 A1 WO 2016028239A1 TR 2014000290 W TR2014000290 W TR 2014000290W WO 2016028239 A1 WO2016028239 A1 WO 2016028239A1
Authority
WO
WIPO (PCT)
Prior art keywords
intubation tube
fiber optic
camera
trachea
tracheostomy
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/TR2014/000290
Other languages
English (en)
Inventor
Mehmet Akif YAŞAR
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.)
Individual
Original Assignee
Individual
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 Individual filed Critical Individual
Priority to PCT/TR2014/000290 priority Critical patent/WO2016028239A1/fr
Publication of WO2016028239A1 publication Critical patent/WO2016028239A1/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
    • A61M16/0465—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
    • A61M16/0434—Cuffs
    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00002—Operational features of endoscopes
    • A61B1/00043—Operational features of endoscopes provided with output arrangements
    • A61B1/00045—Display arrangement
    • A61B1/00052—Display arrangement positioned at proximal end of the endoscope body
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/267—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the respiratory tract, e.g. laryngoscopes, bronchoscopes
    • 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
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/33—Controlling, regulating or measuring
    • A61M2205/3306—Optical measuring means
    • 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
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/50—General characteristics of the apparatus with microprocessors or computers
    • A61M2205/502—User interfaces, e.g. screens or keyboards

Definitions

  • the invention relates to an intubation tube used in tracheostomy practices.
  • the invention particularly relates to preventing complications that are likely to occur during tracheostomy process as intubation tube comprises a protective sheet, a fiber optic light, a camera and a shortened cuff.
  • Prior Art Tracheostomy is the process of forming a hole in front of the main trachea and providing a path for breathing or providing respiration support to the patient via a tube placed within this hole.
  • tracheostomy process it is possible to protect the structures in the upper respiratory tract, remove secretions, and supply more air and oxygen to the lungs. This process also assists in providing means of caring patients outside the intensive care unit.
  • tracheostomy practices it is possible to implement Surgical or Percutaneous dilatational tracheostomy (PDT).
  • PDT Percutaneous dilatational tracheostomy
  • anesthesia is applied to the patient during the process through preliminary preparations and monitorization.
  • PDT techniques are rather more preferred particularly in intensive care units.
  • the primary reasons for preferring PDT are minimal invasivity, cost-effectiveness, shorter process duration and no need for transferring the patient to the surgical room (reduced transport complications).
  • PDT process provides advantages, the principal problems experienced by all PTD processes defined until today are identification of the insertion site just at the beginning of the process, placement of needles or dilatators when applying the method and causing injuries in the esophagus by penetrating the posterior wall of the trachea or further during dilatation.
  • the risk of mortality is extremely low ( ⁇ 1 %).
  • some operations are applied to the patient simultaneously by a second person in order to verify the site of the installed cannula when performing PDT.
  • These operations are fiber optic bronchoscope, capnography, radiology or confirmation of spontaneous respiration.
  • the most common additional practice implemented during tracheostomy process is the fiber optic bronchoscopy. This operation has some advantages and disadvantages.
  • the advantages are confirmation of needle procedure, prevention of postoperative wall damages and prevention of accidental extubation.
  • the disadvantages are reduced ventilation/oxygenation, additional personnel requirement and increased cost/time.
  • Another operation that enables site identification is visualization of the needle in the anterior wall of the trachea with the fiber optic bronchoscope performed by a second person during air aspiration.
  • the reason for choosing fiber optic bronchoscope in the practice is to prevent possible damages by observing approach of the needle or the dilators to the posterior wall of the trachea.
  • fiber optic bronchoscope is a challenging practice which needs time to prepare and implement. Moreover, one more person to perform this practice is required in addition to the person performing tracheostomy.
  • a guide wire is introduced within the needle after aspiration process.
  • the guide wire is determinant for further processes. If the ventilation is applied under high pressure by means of a tube with its cuff air being deflated or especially ventilator (PEEP >10 CmH20), it affects treatment process in the lungs. In the prior art, on the other hand, preservation of ventilation and oxygenation cannot be achieved soundly.
  • the guide wire inserted through advancement within the needle then acts as a guide for the dilatation and tracheostomy cannula.
  • the needle is removed after insertion of the guide wire.
  • posterior/lateral walls of the trachea even the esophagus can be punctured, injured.
  • the operation is finalized by installing the tracheostomy cannula.
  • Another disadvantage of the prior art is that the intubation tube fails to cover the trachea completely as the cuff of the intubation tube is deflated and the tube is retracted. Therefore, the air directed to the lungs by the ventilator returns and is exhaled from the mouth, especially in the pressure ventilation practices.
  • the size of the cuffs available in the intubation tubes of the prior art varies in the range of 3.5-4.5 cm. However, this fact narrows the area desired to be used for tracheotomy. Moreover, aspiration of the intraoral fluid first to the trachea then to the lungs can be performed due to lowering of the cuff. This fact, on the other hand, increases the risk of infection in the lungs.
  • One of the patents available in the literature on this subject matter is the application No. US2010300448A1. In said application, the camera is positioned on the tracheostomy cannula of the invention.
  • the purpose of using camera here is to observe the damage that is likely to occur in the trachea wall as the cannula remains on the trachea for long time. This situation will only prevent the damages after tracheostomy and fails to prevent the damages that are likely to occur during said operation. Because, as the tracheostomy cannula is a cannula that remains installed on the trachea after the operation; the intubation tube of the invention is used during tracheostomy operation.
  • the present invention relates to an intubation tube used in the tracheostomy practices, which fulfills aforementioned requirements, eliminates all disadvantages and brings some additional advantages.
  • the primary objective of the invention is to obtain an intubation tube comprising a protective sheet on the lower and lateral walls of which a metal layer is placed after the cuff and has cross-section in the form of C.
  • the protective sheet acts as a barrier in front of the posterior wall and lateral walls of the trachea during tracheostomy operation when installing the needle and the dilatator, thus preventing possible damages. In this manner, said complications do not occur.
  • Another objective of the invention is to ensure safe identification of the application zone in the trachea by virtue of the detachable fiber optic light and camera available on the device. In this manner, tracheostomy operation is performed more securely, in shorter period and with lower cost.
  • An objective of the invention is to ensure elimination of the need for fiber optic bronchoscope practice, which is performed simultaneously with the tracheostomy operation by virtue of the elements such as light and camera comprised thereon. In this manner, tracheostomy operation can be performed by only one person, without any need for an additional person to perform fiber optic bronchoscope operation.
  • Another objective of the invention is to avoid deterioration of oxygenation by ensuring continuity of ventilation as the intubation tube comprises shortened cuff.
  • the cuff contained in the intubation tube of the invention pressure can still be applied although the cuff is shortened.
  • aspiration in the stomach and mouth is prevented by virtue of the inflated cuff, thereby minimizing the risk of infections.
  • hypoxia or hypercarbia and complications that are likely to arise due to the same are also prevented.
  • the intubation tube used during tracheostomy operation comprises a protective sheet with C shaped cross section in the trachea end of said intubation tube, fiber optic light, camera and cuff with reduced diameter in order to diminish the complications that are likely to arise during the practice.
  • Figure-1 is the perspective view of intubation tube comprising the protective sheet.
  • Figure-2 is the view of the section of the intubation tube that enters into trachea.
  • Figure-3 is the general view of the camera-display system.
  • Figure-4 is the general view of the fiber optic light system.
  • Figure-5 is the general perspective view of the intubation tube.
  • Figure-6 is the view of the fiber optic and camera system comprising stop plate.
  • Figure-7 is the view of the fiber optic and camera system comprising stop gasket.
  • Figure-8 is the view of the cables passing through and entering into the intubation tube.
  • the drawings are not necessarily drawn to be scaled and details not necessary for understanding the present invention may have been neglected. Moreover, elements that are either substantially identical or have substantially identical functions are illustrated with identical numbers.
  • the invention comprises a protective sheet (20) with C shaped cross section in the trachea end (80) of said intubation tube (10) used during tracheostomy operation in order to reduce complications that are likely to arise during the practice.
  • the open end of said protective sheet (20) with C shaped cross section is positioned in such manner to face the anterior wall where needle will be inserted. In this manner; the damages that are likely to occur in the posterior and lateral walls during insertion of the substances such as needle, dilatator used when opening a hole in the anterior wall of the trachea, are prevented.
  • the periphery of said metal layer (21) is coated with a coating (22) made of a plastic material, thus forming the protective sheet (20). It can be used in both adult and pediatric patient group.
  • a detachable fiber optic light (40) and a camera (30) extending up to the trachea end (80) of the intubation tube (10) of the invention.
  • Said detachable fiber optic light (40) and camera (30) system can be reassembled to the disposable intubation tubes (10), after sterilization.
  • the cables (31 , 47) of said systems advance within the intubation tube (10) and are fixed in the intubation tube (10) trachea end (80).
  • Figure 3 illustrates a general view of the camera (30)-display (70) system.
  • the camera (30) is connected to a transfer cable (31) that transfers the displayed data.
  • Said transfer cable (31) enters into the intubation tube (10) from the transfer cable port (33) and extends within the intubation tube (10) ( Figure 8).
  • the end of the transfer cable (30) extending from the intubation tube (10) is connected to the display (70) by means of a jack (71). In this manner, imaging is ensured on the display (70) by means of the camera (30) during tracheostomy operation.
  • the display (70) to which the image captured by means of the fiber optic light (40) and camera (30) is transferred provides guidance to the person performing the tracheostomy operation in identification of the anterior wall of the trachea, in advancement of the needle, in insertion of the guide wire and during dilatation.
  • said camera (30) is the fiber optic light (40) enabling illumination of the medium.
  • Said fiber optic light (40) protrudes from the trachea end (80) of the intubation tube (10) and illuminates trachea.
  • illumination is ensured by means of a light source (46) available on the fiber optic cable (47).
  • the fiber optic cable (47) comprises thereon a power source (45) and one adapter (44).
  • the fiber optic cable (47) enters into the intubation tube (10) from fiber optic cable port (43) ( Figure 8).
  • Figure 6 and 7 illustrates a view of the fiber optic and camera (30) system comprising a stop plate (32) and a stop gasket (42).
  • Camera (30) and fiber optic light (40) system comprises stop plate (32) which enables fixation of the intubation tube (10) in the trachea end (80); is positioned on both the camera (30) and the fiber optic light (40). Moreover, it further comprises stop gasket (42) for fixation. These elements ensure fixation of the camera (30) and the fiber optic light (40).
  • Said camera (30) and fiber optic light (40) can be used for multiple times, if sterilized, as this system is detachable. However, as said camera (30) and fiber optic light (40) systems will constrict the inner diameter of the intubation tube (10), it is not preferred for children aged 12 and below.
  • Said intubation tube (10) comprises a cuff (50).
  • the length of said cuff (50) is reduced.
  • the length of the cuff (50), which is shortened, is 0.4-0.7 cm. In this manner, no air leaks occur when cuff is inflated and a large space for tracheostomy is provided.
  • the upper and lateral walls of the tube are removed starting from the bottom end of the cuff (50). That is to say, the intubation tube (10) does not pass through the cuff (50) and the intubation tube (10) is terminated at the point where cuff (50) starts.
  • the protective sheet (20) is extended through the cuff (50) up to the intubation tube (10) and is fixed thereto.
  • the intubation tube (10) of the invention further comprises a pilot balloon (62). There is an air cable (60) supplying air to said pilot balloon (62) and an air cable port (61 ) where said air cable enters into the intubation tube (10) ( Figure 8).

Landscapes

  • Health & Medical Sciences (AREA)
  • Pulmonology (AREA)
  • Biomedical Technology (AREA)
  • Emergency Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Anesthesiology (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)
  • Otolaryngology (AREA)
  • Surgical Instruments (AREA)

Abstract

L'invention concerne un tube pour intubation (10) qui comprend une couche de protection (20) présentant une section transversale en forme de C dans l'extrémité trachée (80) dudit tube pour intubation (10) utilisé au cours d'une intervention de trachéotomie pour réduire des complications susceptibles de se produire pendant l'intervention, une lampe à fibre optique (40), une caméra (30) et un ballonnet (50) de longueur raccourcie.
PCT/TR2014/000290 2014-08-20 2014-08-20 Tube pour intubation utilisé dans des interventions de trachéostomie Ceased WO2016028239A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PCT/TR2014/000290 WO2016028239A1 (fr) 2014-08-20 2014-08-20 Tube pour intubation utilisé dans des interventions de trachéostomie

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/TR2014/000290 WO2016028239A1 (fr) 2014-08-20 2014-08-20 Tube pour intubation utilisé dans des interventions de trachéostomie

Publications (1)

Publication Number Publication Date
WO2016028239A1 true WO2016028239A1 (fr) 2016-02-25

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Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/TR2014/000290 Ceased WO2016028239A1 (fr) 2014-08-20 2014-08-20 Tube pour intubation utilisé dans des interventions de trachéostomie

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Citations (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0836860A2 (fr) * 1996-10-16 1998-04-22 Smiths Industries Public Limited Company Dispositifs trachéaux
WO2005049122A1 (fr) * 2003-11-24 2005-06-02 George Mireas Tube endotracheal a protection pour la trachee
DE102004026316B3 (de) * 2004-05-26 2005-06-23 Dollner, Ralph, Dr. Endotrachealtubus
WO2007017447A2 (fr) * 2005-08-05 2007-02-15 H.S. Hospital Service S.P.A. Dispositif de tracheotomie
WO2009019734A2 (fr) * 2007-08-06 2009-02-12 Medical Service S.R.L. Tube endotrachéal
US20100300448A1 (en) 2009-05-28 2010-12-02 Kenowski Michael A Tracheostomy Tube
US20110275895A1 (en) * 2004-02-10 2011-11-10 Mackin Robert A Endotracheal tube with camera and illuminator at distal end
US20120088971A1 (en) 2008-03-19 2012-04-12 Hanu Surgical Devices Llc ROTICAM: An Orotracheal Guide with Camera
US20120259173A1 (en) * 2011-04-05 2012-10-11 Nellcor Puritan Bennett Llc Visualization device and holder for use with a tracheal tube
WO2012160585A1 (fr) * 2011-05-25 2012-11-29 Giuseppe Servillo Tube orotrachéal pour intervention de trachéotomie

Patent Citations (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0836860A2 (fr) * 1996-10-16 1998-04-22 Smiths Industries Public Limited Company Dispositifs trachéaux
WO2005049122A1 (fr) * 2003-11-24 2005-06-02 George Mireas Tube endotracheal a protection pour la trachee
US20110275895A1 (en) * 2004-02-10 2011-11-10 Mackin Robert A Endotracheal tube with camera and illuminator at distal end
DE102004026316B3 (de) * 2004-05-26 2005-06-23 Dollner, Ralph, Dr. Endotrachealtubus
WO2007017447A2 (fr) * 2005-08-05 2007-02-15 H.S. Hospital Service S.P.A. Dispositif de tracheotomie
WO2009019734A2 (fr) * 2007-08-06 2009-02-12 Medical Service S.R.L. Tube endotrachéal
US20120088971A1 (en) 2008-03-19 2012-04-12 Hanu Surgical Devices Llc ROTICAM: An Orotracheal Guide with Camera
US20100300448A1 (en) 2009-05-28 2010-12-02 Kenowski Michael A Tracheostomy Tube
US20120259173A1 (en) * 2011-04-05 2012-10-11 Nellcor Puritan Bennett Llc Visualization device and holder for use with a tracheal tube
WO2012160585A1 (fr) * 2011-05-25 2012-11-29 Giuseppe Servillo Tube orotrachéal pour intervention de trachéotomie

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