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WO2017072812A1 - Tube d'intubation - Google Patents

Tube d'intubation Download PDF

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Publication number
WO2017072812A1
WO2017072812A1 PCT/JP2015/005383 JP2015005383W WO2017072812A1 WO 2017072812 A1 WO2017072812 A1 WO 2017072812A1 JP 2015005383 W JP2015005383 W JP 2015005383W WO 2017072812 A1 WO2017072812 A1 WO 2017072812A1
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WO
WIPO (PCT)
Prior art keywords
lumen
suction
tube
patient
tube body
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/JP2015/005383
Other languages
English (en)
Japanese (ja)
Inventor
竹澤　真吾
泰弘 橋本
一秋 宮田
秀一 米永
壮一郎 西釜
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.)
MEDICALSEED CO Ltd
Ulvac Kiko Inc
Original Assignee
MEDICALSEED CO Ltd
Ulvac Kiko Inc
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 MEDICALSEED CO Ltd, Ulvac Kiko Inc filed Critical MEDICALSEED CO Ltd
Priority to PCT/JP2015/005383 priority Critical patent/WO2017072812A1/fr
Priority to JP2017539388A priority patent/JPWO2017072812A1/ja
Publication of WO2017072812A1 publication Critical patent/WO2017072812A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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    • 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
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems

Definitions

  • the present invention relates to an intubation tube that is inserted into a patient's airway.
  • the ventilator secures the airway, for example, by inserting an intubation tube into the patient's trachea.
  • Patent Document 1 describes a tracheal tube that can be connected to a ventilator. Such a tracheal tube is inserted into the trachea from the oral cavity, for example, and is placed in the trachea by a cuff.
  • Patent Document 2 describes an artificial respiration system capable of automatically sucking sputum even when a ventilator is attached.
  • the intubation tube included in this artificial respiration system is a multi-lumen tube in which a plurality of passages such as a passage for ventilation and a passage for suction of sputum are formed. By connecting with the device, it sucks sputum.
  • JP 09-108353 A Japanese Patent No. 5,503,094
  • an intubation tube for tracheal intubation is generally provided with a balloon (cuff) for indwelling the trachea. Since this balloon has a certain thickness in the radial direction of the tube, the gap between the bag that accumulates on the airway and the suction port for sucking it is separated. As a result, the soot may not be sucked efficiently.
  • an object of the present invention is to provide an intubation tube that can be ventilated by a ventilator and can efficiently suck sputum.
  • an intubation tube includes a tube body, a first lumen, a second lumen, a third lumen, and a balloon.
  • the tube body has an outer peripheral surface and is configured to be inserted into the patient's airway.
  • the first lumen is formed inside the tube body and is configured as a ventilation lumen connected to a ventilator.
  • the second lumen is formed inside the tube body so as to face a part of the outer peripheral surface, and is configured as a lumen for scissor suction connected to a scissor device.
  • the third lumen is configured as a lumen for air delivery formed inside the tube body.
  • the balloon is formed in an annular shape around the outer peripheral surface, communicates with the third lumen, and can be in close contact with the patient's airway in a state of being inflated by the air delivered from the third lumen. Composed. Further, in the inflated state, the balloon has a second region where the thickness of the first region facing the second lumen across the outer peripheral surface is opposite to the first region in the radial direction of the tube body. It is configured to be smaller than the thickness of the region.
  • the intubation tube since the first lumen for ventilation connected to the ventilator and the second lumen for sucking the sputum are provided, the sputum can be sucked with the ventilator attached. . Furthermore, since the thickness of the balloon is thin in the region facing the second lumen, the second lumen can be brought closer to the surface on the back side of the airway where the soot can be stored. Thereby, the opening part of a 2nd lumen and the surface of the back side of an airway can be brought close, and the suction
  • the balloon may be configured such that the thickness of the first region is not more than 0.5 times the thickness of the second region. As a result, it is possible to more efficiently suck the soot.
  • the second lumen may be opened at the distal end portion of the tube body or may be opened at the outer peripheral surface.
  • an intubation tube that can be ventilated by a ventilator and can efficiently suck sputum.
  • FIG. 1 It is a schematic block diagram which shows the artificial respiration system which concerns on the 1st Embodiment of this invention. It is a schematic block diagram of the sputum apparatus contained in the artificial respiration system of FIG. It is a block diagram which shows the internal structure of the said dredge apparatus. It is a schematic block diagram which shows the cover part of the container of the said dredge apparatus. It is a graph for demonstrating a patient's respiratory cycle, a vertical axis
  • shaft shows an airway pressure value and a horizontal axis shows time. It is a flowchart explaining operation
  • FIG. 12 is a cross-sectional view seen from the BB direction of FIG.
  • FIG. 12 is a cross-sectional view seen from the CC direction of FIG. It is sectional drawing which shows the front-end
  • FIG. 1 is a schematic configuration diagram showing an artificial respiration system according to the first embodiment of the present invention.
  • the artificial respiration system 1 according to the present embodiment includes an artificial respirator (artificial respiration unit) 2 and a sputum device 3.
  • the artificial respiration system 1 can perform an artificial respiration treatment on the patient P in a supine position, for example, with the artificial respirator 2.
  • the configuration of the ventilator 2 is not particularly limited, the ventilator 2 according to the present embodiment is applied to, for example, tracheal intubation.
  • a configuration example of the ventilator 2 will be described.
  • the ventilator 2 includes a main body 21, an inhalation circuit 22, an exhalation circuit 23, and a connection unit 24.
  • the ventilator 2 supplies the patient P with inspiratory gas having a predetermined oxygen concentration from the main body 21 via the inspiratory circuit 22 and exhausts the expiratory gas from the patient P via the expiratory circuit 23, so that the patient P It is possible to ventilate.
  • the ventilator 2 is configured to be able to detect the spontaneous breathing of the patient P. More specifically, the ventilator 2 is configured to be able to detect the spontaneous breathing of the patient P as a trigger and start inspiration in synchronization therewith.
  • the trigger generally includes a pressure trigger and a flow trigger. A pressure trigger is recognized by the point at which the pressure in the circuit decreases as the patient inhales.
  • a flow trigger is recognized by the point at which steady flow in the circuit has decreased due to patient inspiration.
  • the sensitivity of the trigger is configured to be adjustable, but is set to an appropriate sensitivity so that, for example, a slight fluctuation of the circuit caused by patient movement or the like is not recognized as the trigger.
  • the main body 21 may have a blower inside.
  • the blower takes in oxygen and air from an oxygen source (not shown), for example, and sends oxygen gas having a predetermined concentration and pressure to the intake circuit 22 via an intake valve or the like.
  • the expiratory gas discharged from the expiratory circuit 23 is discharged into the atmosphere via an expiratory valve or the like.
  • the main body 21 may further include a reservoir tank or the like.
  • the oxygen gas pressurized by a blower or the like can be stored in the reservoir tank, and the oxygen gas can be delivered more smoothly.
  • the connecting portion 24 has a tubular structure configured as a so-called Y piece. That is, the connection part 24 has one end part connected to the insertion part 44 inserted into the patient's airway, and two branched other end parts respectively connected to the inspiratory circuit 22 and the expiratory circuit 23. In the pipe line connected to the intake circuit 22 of the connection part 24, for example, a filter for preventing infection may be disposed.
  • the ventilator 2 may include a support 25 that bundles the inhalation circuit 22 and the exhalation circuit 23 and supports them in a predetermined position.
  • the ventilator 2 may have a display unit 26 connected to the main body 2.
  • the display part 26 is comprised, for example with a touchscreen display etc., and is comprised so that input operation, such as display of the patient P's respiration state, selection of ventilation mode, etc., is possible.
  • the ventilator 2 may appropriately include an alarm device that reports an abnormality in the respiratory state of the patient P, a nebulizer that humidifies the airway of the patient P, and the like.
  • the artificial respiration system 1 includes a sputum device 3 and is configured to be able to automatically perform sputum suction treatment for, for example, a serious patient P that cannot spontaneously breathe.
  • a sputum device 3 configured to be able to automatically perform sputum suction treatment for, for example, a serious patient P that cannot spontaneously breathe.
  • FIG. 2 and 3 are diagrams showing the dredge apparatus 3 according to the present embodiment
  • FIG. 2 is a schematic configuration diagram
  • FIG. 3 is a block diagram showing the internal configuration.
  • the scissor device 3 includes a suction line 4, a switching unit 5, and a control unit 6, and is configured so that the control unit 6 can control the suction of the sputum by the suction line 4. Further, the switching unit 5, the control unit 6, and a part of the suction line 4 are disposed inside the housing 30 of the scissor device 3.
  • the suction line 4 includes a suction port 41, a suction tube 42, a housing part 43, and an insertion part 44. That is, the suction line 4 is capable of sucking sputum generated in the patient's airway from the suction port 41, and configured to suck the sputum from the suction tube 42 to the housing portion 43.
  • the insertion unit 44 has an intubation tube (tracheal tube) 440 that is inserted into the patient's airway via the oral cavity, as will be described later.
  • the suction port 41 opens at the distal end portion of the intubation tube 440, for example.
  • the suction tube 42 is connected between the suction port 41 and the accommodating portion 43 and is disposed so as to penetrate the housing 30.
  • the suction tube 42 is configured to communicate with the suction port 41 by being connected to the insertion portion 44.
  • a suction path is formed inside the suction tube 42 (not shown).
  • the suction path constitutes the lumen of the kite when sucking the kite. That is, one end of the suction path is connected to the suction port 41 via the intubation tube 440, and the other end is connected to the housing portion 43.
  • the suction tube 42 is configured to be deformable, for example, a polyurethane catheter tube or the like.
  • the suction tube 42 may be a single lumen tube in which only a suction path is formed, or may be a double lumen tube as necessary.
  • the suction tube 42 may be configured to be replaceable. In other words, the used suction tube 42 is removed from the intubation tube 440 and the housing portion 43, and a new suction tube 42 can be connected to the intubation tube 440 and the housing portion 43. Thereby, the suction tube 42 can be exchanged as necessary, and the sanitary treatment can be performed more hygienically.
  • the housing part 43 includes a container 431 and a negative pressure source 432.
  • the container 431 accommodates the soot sucked through the suction tube 42 and is maintained at a negative pressure.
  • the container 431 includes a lid 433 connected to the suction tube 42 and the negative pressure source 432.
  • the negative pressure source 432 is configured by, for example, a diaphragm type vacuum pump or the like, and an intake port is connected to the container 431. Thereby, the container 431 can maintain the inside at a predetermined negative pressure.
  • the predetermined negative pressure is not particularly limited, but is, for example, ⁇ 700 mmHg (about ⁇ 93.3 kPa) or more and ⁇ 100 mmHg (about ⁇ 13.3 kPa) or less, and further ⁇ 500 mmHg (about ⁇ 66.7 kPa). Above -300 mmHg (about -40.0 kPa). These pressure values are all gauge pressures.
  • the configuration of the negative pressure source 432 is not limited to the above, and other vacuum pumps or the like can be used.
  • the container 431 is configured to be replaceable in the present embodiment. Thereby, since it can replace
  • the container 431 is composed of, for example, a flexible soft bag.
  • a product made of a synthetic resin such as polypropylene resin, polyethylene resin, or nylon resin can be used.
  • the container 431 can be manufactured at a low cost compared to a container made of glass or the like, and the cost due to replacement can be suppressed. Further, at the time of replacement, the container 431 is pressed from the outside so that the air in the container 431 can be removed and discarded, which can contribute to the reduction of waste.
  • FIG. 4 is a schematic configuration diagram showing the lid 433 of the container 431 according to the present embodiment.
  • the lid 433 has a soot removal port 434 connected to the suction tube 42 and an intake port 435 connected to the intake port of the negative pressure source 432.
  • a check valve 436 is disposed in the soot removal port 434.
  • the check valve 436 is configured to allow the inflow of soot from the suction tube 42 to the container 431 and prevent the backflow from the container 431 to the suction tube 42.
  • the configuration of the check valve 436 is not particularly limited, and for example, a swing type can be used.
  • the check valve 436 is configured to be opened when pressure is applied from the suction tube 42 into the container 431.
  • the suction port 41 is at atmospheric pressure, and the inside of the container 431 is maintained at a negative pressure.
  • pressure is applied from the suction port 41 side into the container 431, and the check valve 436 is opened.
  • the connection between the container 431 and the negative pressure source 432 is released, and further, pressure is applied from the inside of the container 431 to the outside by pressing or the like for air removal.
  • the check valve 436 is closed, and it is possible to prevent re-inflow of air into the container 431.
  • the valve opening pressure of the check valve 436 can be set as appropriate so that the above opening and closing is possible.
  • a filter 437 is disposed in the intake port 435.
  • a membrane filter having a pore diameter of about 0.45 to 0.8 ⁇ m, for example, made of cellulose acetate can be employed.
  • Such a filter 437 is configured to allow air to communicate, for example, when no liquid adheres, and to block air communication when the liquid adheres.
  • the negative pressure source 432 can inhale the air in the container 431 via the filter 437 during operation of the dredge device 3.
  • the air in the container 431 can be removed through the filter 437 by pressing the container 431 or the like.
  • the accommodating part 43 may further include a pressure sensor 438 arranged so as to be able to measure the pressure in the container 431.
  • the pressure sensor 438 is disposed between the negative pressure source 432 and the container 431 in which a negative pressure similar to that in the container 431 is maintained, for example.
  • the configuration of the pressure sensor 438 is not particularly limited, and is configured by, for example, a diaphragm gauge.
  • the pressure sensor 438 enables the negative pressure source 432 to be driven to maintain the pressure in the container 431 below a predetermined value when the pressure in the container 431 has risen above the predetermined value due to suction or the like.
  • the switching unit 5 is configured to be switchable between a first state in which the suction port 41 and the storage unit 43 are communicated with each other and a second state in which the suction port 41 and the storage unit 43 are blocked.
  • the switching unit 5 includes a clamp 51 that can open and close the suction tube 42.
  • the clamp 51 includes, for example, a fixed member 51a and a movable member 51b that are disposed with the suction tube 42 interposed therebetween.
  • the fixed member 51a and the movable member 51b are arranged to face each other so as to maintain the shape of the suction tube 42 as a tube, and the suction path in the suction tube 42 is opened.
  • the movable member 51b moves toward the fixed member 51a, the suction tube 42 is deformed so as to be crushed in the radial direction. Thereby, the opposing surfaces in the suction tube 42 come into contact with each other, and the suction path is closed.
  • a solenoid can be used to drive the movable member 51b.
  • a 1st and 2nd state can be switched rapidly.
  • actuators such as a cylinder, for the drive of the movable member 51b.
  • the suction path between the clamp 51 and the container 431 is maintained at the same negative pressure as in the container 431.
  • the control unit 6 is typically configured by a CPU (Central Processing Unit) or an MPU (Micro-Processing Unit).
  • the control unit 6 executes a predetermined process by executing a program or the like stored in a memory (not shown).
  • the control unit 6 causes the switching unit 5 to transition between the first state and the second state at a constant suction cycle that is different from the breathing cycle of the patient, and during each suction cycle, the suction time is 1 second or less.
  • the switching unit 5 can be held in the first state.
  • the suction time can be a time during which suction is not detected as a trigger for spontaneous breathing by the ventilator 2, specifically 1 second or less, for example, 0.1 second or more and less than 0.3 second. can do.
  • the suction cycle corresponds to a time obtained by combining the suction time for performing suction and the time for which suction is stopped.
  • the suction cycle may be longer or shorter than the breathing cycle, and can be set as appropriate according to the state of occurrence of wrinkles of the patient, the state of spontaneous breathing, and the like.
  • the suction cycle is 1 second or more and 60 minutes or less, and 1 second or more and 10 seconds or less. When there is no spontaneous breathing of the patient, the suction cycle is set to 10 seconds or less, so that the sputum can be sucked before a large amount of sputum occurs.
  • FIG. 5 is a graph for explaining a patient's respiratory cycle, where the vertical axis indicates the airway pressure value and the horizontal axis indicates time.
  • the airway pressure is increasing, indicating that it is during inspiration.
  • the airway pressure is reduced, indicating that the time of expiration is being reached.
  • the “breathing cycle” here refers to the time from the start of inspiration to the start of the next inspiration, and is indicated by the period indicated by C in FIG.
  • a patient who has difficulty in spontaneous breathing is forcedly ventilated by the respiratory cycle set by the ventilator 2.
  • FIG. 6 is a flowchart for explaining the operation of the control unit 6 (the dredge device 3). Hereinafter, the operation of the control unit 6 will be described with reference to FIG.
  • the dredge device 3 is activated and the negative pressure source 432 is driven (ST1).
  • the switching unit 5 is in the second state in which the suction tube 42 is closed by the clamp 51, and air communication between the suction port 41 and the housing unit 43 is blocked.
  • the control unit 6 determines whether or not the pressure in the container 431 is less than a predetermined value based on the output of the pressure sensor 438 (ST2).
  • the “predetermined value” of the pressure in the container 431 is, for example, ⁇ 400 mmHg (about ⁇ 53.3 kPa, gauge pressure). If it is determined that the pressure in the container 431 is equal to or higher than the predetermined value (No in ST2), the negative pressure source 432 is further driven to make a similar determination again (ST2).
  • the control unit 6 opens the suction tube 42 with the clamp 51 and switches the switching unit 5 to the first state (ST3). ).
  • the pressure of the suction port 41 is substantially equal to the atmospheric pressure
  • the pressure in the container 431 of the accommodating portion 43 is a negative pressure less than a predetermined value. Therefore, a pressure difference is generated in the suction line 2 due to the opening between the suction port 41 and the accommodating portion 43. Therefore, according to this step, the switching unit 5 can be held in the first state, and the soot can be aspirated rapidly from the suction port 41 to the accommodation unit 43 via the suction tube 42.
  • control unit 6 may temporarily stop driving the negative pressure source 432. At this time, since the switching unit 5 is in the second state, the pressure in the container 431 can be maintained below a predetermined value even if the driving of the negative pressure source 432 is stopped.
  • the control unit 6 determines whether or not a predetermined suction time has elapsed since the switching unit 5 was switched to the first state (ST4).
  • the suction time is 0.2 seconds.
  • the control unit 6 switches the switching unit 5 to the second state (ST5).
  • control unit 6 determines whether or not a time corresponding to a predetermined suction cycle has elapsed since the switching unit 5 was switched to the first state (ST6).
  • the suction cycle is 5 seconds.
  • the controller 6 may drive the negative pressure source 432 even during the repetition of the suction cycles of ST3 to ST6.
  • the control unit 6 can drive the negative pressure source 432 only when a predetermined condition is satisfied, thereby suppressing power consumption due to the driving of the negative pressure source 432 and ensuring quietness. It is also possible to reduce the burden.
  • the control unit 6 may monitor whether or not the pressure in the container 431 is less than a predetermined value by the pressure sensor 438, and may drive the negative pressure source 432 only when the pressure becomes a predetermined value or more. The monitoring of the pressure may be performed constantly during the driving of the saddle device 3 or may be performed at a predetermined timing.
  • the control unit 6 may monitor periodically at a cycle different from the suction cycle, for example, monitor at the timing when the switching unit 5 is switched to the second state. .
  • the control unit 6 may drive the negative pressure source 432 at a constant cycle without monitoring the pressure in the container 431.
  • the control unit 6 may drive the negative pressure source 432 when the switching unit 5 of ST5 is switched to the second state.
  • control unit 6 since the control unit 6 according to the present embodiment can perform suction at a constant suction cycle, suction can be performed automatically, and the burden on nurses and the like can be greatly reduced.
  • suction time short malfunction of the ventilator can be prevented even if the suction is periodically performed at a period different from the patient's breathing period.
  • suction cycle it is possible to avoid a state in which a large amount of sputum is generated, and to reduce the risk that ventilation by the ventilator 2 is hindered. Therefore, according to the scissor device 2, sputum can be sucked automatically and safely even when the ventilator can detect spontaneous breathing.
  • a configuration for monitoring the respiratory state of the patient can be eliminated.
  • the structure of an apparatus can be simplified and the introduction cost of the dredge apparatus 2 can be suppressed.
  • the accommodating portion 43 of the suction line 4 has the pressure sensor 438 for monitoring the pressure in the container 431.
  • the pressure sensor may not be provided.
  • the vacuum pump that maintains the accommodating portion 431 at a negative pressure may be constantly operated, and the operation and the stop may be repeated at a predetermined timing.
  • the sputum apparatus 3 may have the communication part 7 comprised so that reception of the signal output from the ventilator 2 was possible.
  • the reception method may be wired communication or wireless communication.
  • the communication unit 7 may receive information about the patient's respiratory cycle output from the ventilator 2.
  • the information about the respiratory cycle may include information about the length of the respiratory cycle, or information about the timing of expiration and / or inspiration.
  • the control unit 6 can adjust at least one of the suction cycle and the suction time based on the information about the breathing cycle.
  • the sputum device 3 may not be connected to a ventilator.
  • a suction port may be formed in a tube placed in a trachea different from the tracheal intubation tube connected to the ventilator.
  • the suction method by the control unit 6 is not limited to the method shown in the above operation example.
  • the control unit 6 may perform switching to the first state a plurality of times in each suction cycle.
  • the suction time can be, for example, 0.2 seconds or less, and further 0.1 seconds or less.
  • the scissor device 3 can be attached to the ventilator 2 via the insertion portion 44.
  • the insertion portion 44 is configured as an intubation tube 440 that is inserted into an airway such as a patient's trachea.
  • a tracheal intubation tube to be inserted into a patient's trachea is connected to the ventilator.
  • the tracheal intubation tube includes at least a lumen formed for patient ventilation and is placed in the trachea by a balloon (cuff).
  • an intubation tube that can be ventilated by a ventilator and can efficiently suction sputum is provided.
  • FIG. 8 is a perspective view showing the configuration of the intubation tube 440.
  • the intubation tube 440 includes a tube body 447, a connection portion 446, a first lumen 441, a second lumen 442, a third lumen 443, and a balloon 445.
  • the intubation tube 440 is configured as a so-called triple lumen tube in which a first lumen 441, a second lumen 442, and a third lumen 443 are formed inside a tube body 447.
  • the intubation tube 440 is configured by connecting a connecting portion 446 and a tube main body 447 to form a curved tube as a whole. That is, the connecting portion 446 includes the first end 440 a of the intubation tube 440, and the tube body 447 includes the second end 440 b of the intubation tube 440.
  • the tube body 447 is configured to be inserted into the patient's airway.
  • the tube body 447 is typically inserted into the patient's trachea, but may be inserted into the bronchus, for example.
  • the tube body 447 is formed of a material such as polyvinyl chloride, polyurethane, stainless steel, natural rubber, or silicone rubber.
  • the airway here shall mean the whole respiratory organ, the tube main body 447 is typically inserted in a trachea.
  • the tube body 447 has an outer peripheral surface 447s.
  • the outer peripheral surface 447s can constitute a continuous smooth curved surface.
  • FIG. 9 is a cross-sectional view showing a configuration including the first end portion 440a of the connection portion 446, and is a view seen from the direction AA of FIG.
  • the connection portion 446 includes a suction tube connection portion 448 and a balloon expansion port 449.
  • the suction tube connection portion 448 and the balloon expansion port 449 are disposed on the outer peripheral surface of the connection portion 446.
  • One end of the tube main body 447 is fitted into the connection portion 446 as shown in FIG.
  • the suction tube connecting portion 448 is connected to the suction tube 42, and a second lumen 442 is formed therein.
  • the second lumen 442 is formed inside the connection portion 446 and the tube main body 447, and is configured as a lumen (tube) for suctioning the rod connected to the rod device 3.
  • the second lumen 442 is connected to the suction path of the suction tube 42, and is formed from the suction tube connecting portion 448 to the suction port 41 through the tube body 447.
  • a third lumen 443 is formed in the balloon expansion port 449.
  • the balloon expansion port 449 includes a valve 449a for inserting a syringe barrel which is arranged at the distal end portion and injects air (see FIG. 8).
  • the third lumen 443 is connected to a delivery port 443a of a balloon 445, which will be described later, and is continuously formed from the delivery port 443a to the balloon expansion port 449 through the tube body 447.
  • the first lumen 441 is formed inside the connection portion 446 and the tube main body 447, and is configured to penetrate between the first and second end portions 440a and 440b. That is, the first lumen 441 is a ventilation lumen (tube) connected to the ventilator 2 via the connection portion 446 and communicates with the patient's airway. As a result, the pressure in the first lumen 441 becomes equal to the airway pressure.
  • FIG. 10 is a perspective view of the tube main body 447, and shows a state cut at L1 in FIG. 8 for explanation.
  • the first lumen 441, the second lumen 442, and the third lumen 443 are formed in the tube body 447 in parallel.
  • the tube body 447 having such a shape can be easily manufactured by extrusion molding or the like.
  • the second lumen 442 is formed to face a part of the outer peripheral surface 447s of the tube main body 447.
  • the portion of the outer peripheral surface 447s that the tube body 447 faces is a portion that faces the back side of the patient's airway when inserted into the patient's airway.
  • FIG. 11 is a bottom view showing the distal end portion (second end portion 440b) of the tube main body 447
  • FIG. 12 is a cross-sectional view seen from the BB direction of FIG. FIG. 12 shows a state where the balloon 445 is inflated.
  • the balloon 445 is formed in an annular shape around the outer peripheral surface 447 s, communicates with the third lumen 443, and is inflated by the air delivered from the third lumen 443, so that the patient's airway It is comprised so that it can closely_contact
  • the annular balloon 445 is formed eccentric from the axis of the tube main body 447 in the expanded state. That is, in the balloon 445, the thickness D1 of the first region 445a facing the second lumen 442 across the outer peripheral surface 447s has a second region 445b opposite to the first region 445a in the radial direction of the tube body 447. Is configured to be smaller than the thickness D2.
  • the “thickness” of the balloon 445 is a thickness along the radial direction of the tube main body 447.
  • the thickness D1 of the first region 445a may be at least a slight thickness, and may be configured to be 0.5 times or less the thickness D2 of the second region 445b, for example.
  • FIG. 13 is a cross-sectional view seen from the CC direction of FIG. 11 and shows the second end 440b which is the tip of the tube main body 447.
  • the second lumen 442 opens at the second end 440b, that is, the tip of the tube body 447.
  • This opening is configured as the suction port 41 of the suction line 4 described in the first embodiment. Since the second lumen 442 is formed so as to face a part of the outer peripheral surface 447s as described above, the second lumen 442 is configured along, for example, the back side of the airway when the tube body 447 is inserted into the patient's airway. obtain. For this reason, the suction port 41 also opens near the back side in the airway.
  • the first region 445a of the balloon 445 of the present embodiment is a region facing the second lumen 442, and can be in close contact with the dorsal surface of the patient's airway.
  • the suction port 41 that is the opening of the second lumen 442 can be brought close to the surface on the back side of the airway.
  • the suction port 41 can be brought closer to the stored soot, and the soot can be efficiently sucked.
  • a tracheal intubation tube that can be ventilated by the ventilator 2 and that can efficiently suction sputum.
  • the second lumen 442 may open to the outer peripheral surface 447 s. That is, the tip of the second lumen 442 may be closed, and the suction port 41 may be formed on the outer peripheral surface 447s. Since the second lumen 442 is configured along the dorsal side of the airway when inserted into the patient's airway, as described above, when the suction port 41 is also inserted into the patient's airway, the airway It is comprised so that it may oppose the back

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  • Health & Medical Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Engineering & Computer Science (AREA)
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  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
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  • External Artificial Organs (AREA)

Abstract

Dans un aspect, l'invention concerne un tube d'intubation comprenant un corps de tube, une première lumière, une deuxième lumière, une troisième lumière et un ballonnet. Le corps de tube comporte une surface périphérique externe et est configuré de sorte à pouvoir être inséré dans les voies respiratoires d'un patient. La première lumière est formée à l'intérieur du corps de tube et est configurée sous la forme d'une lumière de ventilation à raccorder à un respirateur artificiel. La deuxième lumière est formée à l'intérieur du corps de tube de sorte à faire face à une partie de la surface périphérique externe, et elle est configurée sous la forme d'une lumière d'aspiration d'expectoration à raccorder à un dispositif d'expectoration. La troisième lumière est configurée sous la forme d'une lumière de transmission d'air formée à l'intérieur du corps de tube. Le ballonnet est formé annulaire autour de la surface périphérique externe, il est raccordé à la troisième lumière et est configuré de sorte à pouvoir adhérer étroitement aux voies respiratoires du patient lorsqu'il se trouve dans un état déployé provoqué par l'air transmis par la troisième lumière. Ce ballonnet est configuré de sorte que, dans l'état déployé, l'épaisseur d'une première zone faisant face à la deuxième lumière, avec la surface périphérique externe interposée entre elles, soit inférieure à l'épaisseur d'une deuxième zone opposée à la première dans le sens radial du corps de tube.
PCT/JP2015/005383 2015-10-27 2015-10-27 Tube d'intubation Ceased WO2017072812A1 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
PCT/JP2015/005383 WO2017072812A1 (fr) 2015-10-27 2015-10-27 Tube d'intubation
JP2017539388A JPWO2017072812A1 (ja) 2015-10-27 2015-10-27 挿管チューブ

Applications Claiming Priority (1)

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PCT/JP2015/005383 WO2017072812A1 (fr) 2015-10-27 2015-10-27 Tube d'intubation

Publications (1)

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WO2017072812A1 true WO2017072812A1 (fr) 2017-05-04

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PCT/JP2015/005383 Ceased WO2017072812A1 (fr) 2015-10-27 2015-10-27 Tube d'intubation

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JP (1) JPWO2017072812A1 (fr)
WO (1) WO2017072812A1 (fr)

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CN108721744A (zh) * 2018-06-14 2018-11-02 黄鹏飞 一种静音式呼吸机
JP2020044121A (ja) * 2018-09-19 2020-03-26 泉工医科工業株式会社 カフ付き気管チューブ
CN110975023A (zh) * 2019-12-14 2020-04-10 高孟翠 一种内科护理吸痰装置
WO2020092423A1 (fr) * 2018-10-30 2020-05-07 Horzewski Michael J Tube de distribution et procédés de transport de particules dans le système respiratoire
WO2020125030A1 (fr) * 2018-12-17 2020-06-25 江苏人冠医疗科技有限公司 Système de perfusion et de recirculation de gaz pour chirurgie laparoscopique
CN112169123A (zh) * 2020-10-29 2021-01-05 重庆市人民医院 气管导管

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WO2012087837A1 (fr) * 2010-12-21 2012-06-28 C. R. Bard, Inc. Tube endotrachéal ayant un manchon évidé, une ou plusieurs ouvertures d'aspiration agencées dans celui-ci, et/ou un manchon ayant des raidisseurs et procédé de fabrication et/ou d'utilisation de celui-ci

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GB1040425A (en) * 1962-12-26 1966-08-24 Raymond Pesty Improvements in or relating to surgical devices for use in tracheotomy
US4840173A (en) * 1988-02-22 1989-06-20 Porter Iii John W Endotracheal tube combination
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CN108721744A (zh) * 2018-06-14 2018-11-02 黄鹏飞 一种静音式呼吸机
CN108721744B (zh) * 2018-06-14 2021-05-18 深圳市华医安全医疗科技有限公司 一种静音式呼吸机
JP2020044121A (ja) * 2018-09-19 2020-03-26 泉工医科工業株式会社 カフ付き気管チューブ
WO2020092423A1 (fr) * 2018-10-30 2020-05-07 Horzewski Michael J Tube de distribution et procédés de transport de particules dans le système respiratoire
CN113365584A (zh) * 2018-10-30 2021-09-07 帕格尼亚医疗公司 用于将颗粒输送到呼吸系统的递送导管和方法
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WO2020125030A1 (fr) * 2018-12-17 2020-06-25 江苏人冠医疗科技有限公司 Système de perfusion et de recirculation de gaz pour chirurgie laparoscopique
CN110975023A (zh) * 2019-12-14 2020-04-10 高孟翠 一种内科护理吸痰装置
CN112169123A (zh) * 2020-10-29 2021-01-05 重庆市人民医院 气管导管

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