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| United States Patent | 3,799,173 |
| Kamen | March 26, 1974 |
TRACHEAL TUBES
Abstract
A tracheal tube for use in intubating a trachea, and which embodies passageways and openings therein which are constituted and arranged in a manner particularly effective for the passage of suction catheters, and the like, therethrough into bronchi, and the like. The tube preferably embodies a cuff mounted on the end and sides thereof for effecting a seal between the tube and the trachea, and for protecting the trachea against injury. The cuff embodies resilient means for maintaining it in expanded position, and is contractible by means of a vacuum applied thereinto by a secondary tube mounted on the tracheal tube.
| Inventors: | Kamen; Jack M. (Gary, IN) |
| Appl. No.: | 05/237,897 |
| Filed: | March 24, 1972 |
| Current U.S. Class: | 128/207.15 ; 604/96.01 |
| Current International Class: | A61M 16/04 (20060101); A61M 25/10 (20060101); A61m 025/00 () |
| Field of Search: | 128/348,349R,349B,349BV,35R,351,239,246,325,344 |
| 2701559 | February 1955 | Cooper |
| 3292627 | December 1966 | Harautuneian |
| 2862498 | December 1958 | Weekes |
| 3640282 | February 1972 | Kamen et al. |
| 3211152 | October 1965 | Stern |
| 2548602 | April 1951 | Greenburg |
| 3638655 | February 1972 | Doherty |
Attorney, Agent or Firm:
I claim:
1. A tracheal tube comprising
a. an elongated tube having
1. a distal end portion having
a. an end wall,
2. a proximal end, and
3. a passageway extending longitudinally through said proximal end into said distal end portion,
b. said distal end portion
1. being narrower in width transversely to the length of said tube than the portion of said tube adjacent said distal end portion, and
2. having a transverse opening therein in communication with said passageway,
c. said transverse opening
1. being defined on one side by said end wall, and
2. extending from said end wall toward said proximal end, and d. a cuff
(1) mounted on and extending around the outer surface of said portion of said tube which is adjacent to said distal end portion, and also (2) mounted on and extending along the outer surface of said end wall outwardly of said opening, said cuff having means therein normally expanding said cuff away from both said outer surfaces.
2. A tracheal tube as defined in claim 1, and in which
a. said transverse opening extends through two opposite sides of said distal end portion,
b. said distal end portion includes two oppositely disposed side walls extending from said end wall toward said proximal end in spaced relation to each other,
c. said side walls define respective opposite sides of said opening, and
d. said cuff is mounted on and extends along the outer peripheral surface of said side walls outwardly of said opening.
3. A tracheal tube as defined in claim 2, and in which
a. said distal end portion extends along the longitudinal center line of said elongated tube.
4. A tracheal tube as defined in claim 3, and in which
a. said cuff has
1 a normal position wherein it is disposed in outwardly expanded position relative to said elongated tube, and
2 another position wherein it extends a lesser distance from said elongated tube than in said normal position, and
b. said cuff includes resilient means for normally yieldingly holding said cuff in said normal position.
5. A tracheal tube as defined in claim 3, and
a. in which said cuff comprises
1. a flxible cover mounted on
a. said portion of said elongated tube which is adjacent said distal end portion,
b. said side walls, and
c. said end wall, and
2. a resilient body portion
a. mounted in said cover, and
b. having
(1') normally an expanded position, wherein it is effective to hold a portion of said cover outwardly away from said portion and walls of said elongated tube, and
(2') a collapsed position, wherein the outer surface thereof is disposed closer to said elongated tube than in said expanded position to thereby permit said portion of said cover to assume a position closer to said elongated tube, and
b. which includes means connected to said cuff for creating and releasing a vacuum in said cover to thereby cause said body portion to move toward said collapsed and expanded positions, respectively.
BACKGROUND OF THE INVENTION
The present invention relates to tracheal tubes.
It is a primary object of the present invention to afford a novel tracheal tube.
Another object of the present invention is to enable a novel tracheal tube to be afforded which is particularly well adapted for use in selectively inserting other instruments, such as suction catheters, and the like, into desired position, such as, for example, into selected ones of a patient's bronchi, and the like.
Another object is to afford a novel tracheal tube embodying a leading or distal end for insertion into a patient, and in which the parts of the distal end are constituted and arranged in a novel and expeditious manner.
Tubes for insertion into a patient, such as, for example, tracheal tubes, catheters, enema tubes, and the like, heretofore known in the art, have had side openings therein for the passage of fluids therethrough into and out of the patient. However, insofar as is known, all such openings in such tubular members have heretofore been disposed in positions, such as, for example, that of the side opening shown in my earlier U.S. Letters Pat. No. 3,640,382, issued Feb. 8, 1972, wherein they were not well adapted for use in introducing suction catheters, and the like, into a patient because passage of the catheters through the openings would be obstructed or prevented by the portions of the tube adjacent to the openings, or the suction catheters would pass out of the openings at such an angle that they would impinge substantially directly against the tracheal wall and injure the latter, and the like. It is an important object of the present invention to afford a novel tracheal tube which overcomes such disadvantages of tracheal tubes heretofore known in the art.
Another object of the present invention is to afford a novel tracheal tube having side openings therein, which are constituted and arranged in a novel and expeditious manner effective to enable suction catheters, and the like, to be fed therethrough quickly and easily, and in a manner which is not injurious to a patient.
Tracheal tubes, as that term is used herein, may be of different types, such as, for example, orotracheal tubes, nasotracheal tubes and tracheostomy tubes. Also, such tubes may be flexible, the main body portion thereof being made of flexible material, such as, for example, rubber or a suitable plastic material, such as, polyethylene, or the like, or they may be stiff or rigid, being made of material such as stainless steel, or the like, the latter type of tubes being useful as tracheostomy tubes. The present invention is intended for use in the construction of all such tracheal tubes.
As is well known in the art, tracheal tubes have commonly been inserted into the trachea of a person for various purposes, such as, for example, to enable a person to breathe, or to enable intermittent positive pressure ventilation of the respiratory tract to be carried out. Often, it is highly important, particularly in such instances as when positive pressure ventilation of the respiratory tract is to be carried out, that an airtight or substantially airtight seal be provided between the tracheal tube and the trachea. Various attempts have been made theretofore to effect such seals between tracheal tubes and the trachea, such as, for example, by using large tubes which completely fill the trachea, or using cuffs which are mounted on the tubes and which are engageable with the trachea. The cuffed tubes heretofore known in the art have included tubes of the type shown in my aforementioned earlier issued U.S. Pat. No. 3,640,382, which have proven highly successful, and which comprise a cuff, embodying a flexible, air impervious cover disposed in surrounding relation to a portion of the tube and hermetically sealed thereto, and a porous resilient body portion made of suitable material, such as, for example, sponge rubber, mounted around the elongated tube, within the cover for yieldingly urging the cover outwardly away from the tube. An auxiliary tube extends into the cover of the cuffed tubes of the last mentioned type, in hermetically sealed relation thereto, and air may be withdrawn from the cover through the auxiliary tube to thereby cause the cuff to collapse to facilitate the insertion thereof into a trachea, after which the auxiliary tube may be opened to the atmosphere to thereby permit the cuff to expand into yielding, sealing engagement with the trachea.
Other cuffed tracheal tubes heretofore known in the art have included the type shown in the Stern U.S. Pat. No. 3,211,152, which issued Oct. 12, 1965, wherein the cuffs are in the form of elastic diaphragms or tubes mounted on the main tube in surrounding relation thereto, with the cuff normally, and when being inserted into the trachea being in uninflated or deflated condition. With such devices, after the intubation device has been inserted into the trachea, the cuff is inflated, like a balloon, by feeding air or other working fluid thereinto at a positive pressure to thereby expand the cuff into engagement with the inner wall of the trachea. It has been found that such devices have several inherent disadvantages, such as, for example, commonly causing injury to the trachea.
Other cuffed tubes heretofore known in the art have included tubes of the type shown in U.S. Letters Pat. No. 3,638,655, issued to George O. Doherty on Feb. 1, 1972, and which embodies a resilient, compressible cuff, which should be lubricated prior to insertion into a trachea and which, during insertion into the trachea, is compressed and expands in accordance with the size of the different portions of the trachea through which the cuff passes.
It is an object of the present invention to afford a novel tracheal tube which affords improvement over tracheal tubes heretofore known in the art.
A further object of the present invention is to afford a novel tracheal tube, which, while it employs some of the principles of the highly effective tracheal tube disclosed in my aforementioned U.S. Pat. No. 3,640,382, embodies improvements thereover.
Another object of the present invention is to afford a novel tracheal tube embodying a cuff which is mounted on the sides and the end of the tubular member in a novel and expeditious manner.
Yet another object of the present invention is to afford a novel tracheal tube embodying a cuff which is effective, in a novel and expeditious manner, to protect a trachea against injury by the distal end of the tube during insertion of the latter, and, also, while the tube remains disposed in such a trachea.
Another object of the present invention is to afford a novel tracheal tube of the aforementioned type which embodies a novel, resilient cuff, which is normally disposed in expanded position, but which may be effectively moved into a collapsed position for insertion into a trachea.
Another object of the present invention is to afford a novel tracheal tube which is practical and efficient in operation and which may be readily and economically produced commercially.
Other and further objects of the present invention will be apparent from the following description and claims and are illustrated in the accompanying drawings which, by way of illustration, show preferred embodiments of the present invention and the principles thereof and what I now consider to be the best mode in which I have contemplated applying these principles. Other embodiments of the invention embodying the same or equivalent principles may be used and structural changes may be made as desired by those skilled in the art without departing from the present invention and the purview of the appended claims.
DESCRIPTION OF THE DRAWINGS
In the drawings:
FIG. 1 is a fragmentary, side elevational view of a tracheal tube embodying the principles of the present invention;
FIG. 2 is a longitudinal sectional view taken substantially along the line 2--2 in FIG. 1, and showing the tracheal tube disposed in operative position in a trachea which is shown diagrammatically;
FIG. 3 is a side elevational view of the tracheal tube shown in FIG. 1, looking in the direction of FIG. 2, but showing the cuff on the tracheal tube in collapsed position;
FIG. 4 is a detail sectional view taken substantially along the line 4--4 in FIG. 2;
FIG. 5 is a detail sectional view taken substantially along the line 5--5 in FIG. 2;
FIG. 6 is a fragmentary, side elevational view of the distal end portion of a modified form of the present invention; and
FIG. 7 is an enlarged, detail sectional view taken substantially along the line 7--7 in FIG. 6, and showing the tracheal tube disposed in operative position in a trachea, which is shown diagrammatically, and also showing a suction catheter disposed in the tracheal tube and trachea.
DESCRIPTION OF THE EMBODIMENTS SHOWN HEREIN
A tracheal tube or intubation device 1, embodying the principles of the present invention, is shown in FIGS. 1-5 of the drawings to illustrate the presently preferred embodiment of the present invention.
The tracheal tube 1 embodies, in general, an elongated tube 2 having a cuff 3 mounted on one end portion thereof, with another tube 4 extending into the cuff 3 for a purpose which will be discussed in greater detail presently. The tube 2 may be of any suitable construction and is for the purpose of feeding air, or the like, into and out of the respiratory tract of a patient into whose trachea the tracheal tube or intubation device 1 has been inserted. Commonly, when the tracheal tube 1 is to be used as an endotracheal tube, such as, either an orotracheal or nasotracheal tube, the tube 2 thereof is preferably flexible and may be made of any suitable material such as, for example, rubber or a suitable plastic, such as polyethylene, or the like. However, in other instances, such as, for example, when the tracheal tube 1 is to be used as a tracheostomy tube, it may be desired to have the tube 2 thereof be rigid in construction and made of suitable material such as, for example, stainless steel, or the like.
The tube 2, shown in FIGS. 1-5, embodies a front end or distal end portion 5, which is somewhat U-shaped in construction, embodying a front wall 6 and two oppositely disposed side walls 7 and 8 projecting rearwardly from respective ends of the front wall 6 toward the priximal end 9 of the tube 2, FIG. 2. Preferably, the tube 2 is round in cross sectional shape and is uniform in cross sectional size, such as, for example, having an outside diameter in the nature of seven/one-sixteenth of an inch, throughout its length, rearwardly of the distal end portion 5. A passageway 10, which, preferably, is relatively large in size, such as, for example, having a diameter of five/sixteenth of an inch, extends through the tube 2 from the proximal end 9 thereof into the distal end portion 5 thereof.
The walls 6-8 of the distal end portion 5 of the tube 2 preferably are uniform in width, and preferably are substantially narrower in width than the remainder of the tube 2, such as, for example, having a width in the nature of one-half to three-fourths of the outside diameter of the remainder of the tube 2, and, preferably, in the nature of two-thirds thereof. An opening 11 extends transversely through the distal end portion 5, between the side walls 7 and 8 thereof. The upper side 12 and the lower side 13 of the opening 11, as viewed in FIG. 2, are defined by the inner faces of the side walls 7 and 8, respectively, and the front side 14 of the opening 11 is defined by the inner face of the front wall 6. The rear side 15 of the opening 11 preferably is disposed at the junction of the distal end portion 5 with the remainder of the tube 2. The inner face of each of the walls 6-8 preferably is flat in a direction perpendiculr to the length of the tube 2, as illustrated with respect to the side walls 7 and 8 in FIG. 5, or is convex inwardly, for a purpose which will be discussed in greater detail presently. Also, preferably, the walls 7 and 8 are spaced from each other the diameter of the passageway 10 so as to afford unobstructed communication between the passageway 10 and the opening 11.
The cuff 3, FIGS. 2 and 4, includes an air-impervious cover 16 and a body portion 17 disposed within the cover 16. The cuff 3 embodies a main portion 18, a front end portion 19 and a rear end portion 20, FIGS. 1 and 2, the end portions 19 and 20 being smaller in cross sectional size than the main portion 18, as will be discussed in greater detail presently.
The main portion 18 of the cuff 3 preferably is substantially elliptical in shape, in longitudinal cross section, when it is in fully expanded position, as shown in FIG. 1, and the body portion 17 and the cover portion 16 of the main portion 18 are disposed around a portion of the tube 2, in surrounding relation thereto, immediately adjacent and in rearwardly extending relation to the distal end portion 5. The portions of the cover 16 disposed around the main portion 18 and the rear end portion 20 of the cuff 3 are tubular in form, and the portion of the cover 16, which defines the rear end portion 20 of the cuff 3, is hermetically sealed to the outer surface of the tube 2 by suitable means, such as, for example, being vulcanized thereto or by a suitable cement such as rubber cement, or the like. In the preferred form of the intubation device 1 shown in the drawings, reinforcing rings 20' are mounted on the end portion 20 of the cuff 3 to insure the maintenance of an effective seal between the end portion 20 and the tube 2. The reinformcing rings 20' may be made of any suitable material such as rubber or a suitable plastic such as polyethylene amd may be secured to the outer face of the end portion 20 by suitable means such as vulcanization or a suitable cement.
The front end portion 19 of the cuff 3, like the main portion 18 thereof embodies a portion of the body portion 17 and of the cover 16. It is substantially U-shaped, having a front end portion 21 disposed in covering relation to the front wall 6 of the distal end portion 5 of the tube 2, and two legs 22 and 23 projecting rearwardly from the front end portion 21 in covering relation to the outer faces of the side walls 7 and 8 of the distal end portion 5, respectively. The front end portion 19 of the cuff 3 preferably is relatively narrow in width, preferably being of such width that it will just cover the outer peripheral face of the distal end portion 5 of the tube 2. The portion of the cover 16 disposed on the distal end portio 5 of the tube 2 is hermetically sealed by suitable means, such as vulcanization or cement, or the like, along its respective longitudinal edges 24 and 25, FIG. 5, to respective sides of the distal end portion 5 along a line 26, FIG. 3, which extends along the sides 12-14 of the opening 11 and terminates at its rear ends, at respective ends of a line 27, FIG. 3, along which the front edge of the portion of the cover portion 16 of the main portion 18 of the cuff 3 is similarly hermetically sealed to the outer surface of the corresponding side of the tube 2 between the legs 22 and 23 of the front end portion 19 of the cuff 3.
The cover 16 is flexible and may be made of any suitable material, such as, for example, latex rubber or a suitable plastic sheet material, such as, polyethylene, or the like. Preferably, it also is elastic for reasons which will be discussed in greater detail presently, and, of course, under such circumstances it would be made of a suitable elastic material such as the aforementioned latex rubber.
The body portion 17 of the cuff 3 affords a resilient mass which preferably completely fills the cover 16 forwardly of the end portion 20 thereof and, when the intubation device 1 is disposed in normal inoperative position, outside the trachea, preferably is effective to yieldingly hold the cover 16 in fully expanded position, as shown in FIG. 1. The body portion 10 may be made of any suitable resilient material, but, preferably, is made of a sponge-like resilient material having a multitude of interstices spread therethrough, such as, for example, sponge rubber or a suitable resilient plastic material, such as, for example, foamed polyurethane, or the like, for a purpose which will be discussed in greater detail presently.
The tube 4 has one end portion 28, FIG. 2, extending into the cuff 3. As shown in the drawings, the tube 4 extends along the tube 2, preferably, the tube 4 is formed integrally with the tube 2 and terminates in a free end portion 29 which extends outwardly beyond the proximal end 9 of the tube 2. However, as will be appreciated by those skilled in the art, the tube 4 may be formed separately from the tube 2 and inserted into the cuff 3 in a suitable manner without departing from the purview of the broader aspects of the present invention.
In the intubation device 1 shown in the drawings, wherein the tube 4 extends along the tube 2, FIG. 2, the tube 4 extends through the end portion 20 of the cuff 3, and the portion of the cover 16, which affords the end portion 20, is hermetically sealed to the tube 4 in the same manner as it is so sealed to the tube 2. With this construction, it will be seen that when the tube 4 is open to the atmosphere throughout its length, and the intubation device 1 is disposed outside of a trachea, the body portion 17 is effective to yieldingly hold the cover 16 in fully outwardly extended position, as shown in FIG. 1. However, by the application of a vacuum to the end portion 29 of the tube 4, air may be withdrawn from within the cover 16 through the tube 4 to thereby afford a partial vacuum within the cuff 3 and cause the main portion 18 and the front end portion 19 thereof to collapse from the position shown in FIG. 1 to a position such as that shown in FIG. 3, because of the imbalance between the pressure within the cover 16 and the atmospheric pressure exteriorly thereof. It will be seen that by making the body portion 17 of the cuff 3 of a resilient material having interstices therein, such as, for example, the aforementioned foam rubber or foamed polyurethane, as in my aforementioned U.S. Pat. No. 3,640,282, the withdrawal of air from within the cover 16 may be substantially uniform throughout the entire area between the end portion 20 and the front end of the cuff 3, so as to effect a substantially complete collapse of all portions of the cover 9 forwardly of the end portion 20 thereof.
With the intubation device 1 constructed in the aforementioned manner, when it is desired to insert it into a trachea, such as the trachea 30 diagrammatically shown in FIGS. 2-4, a partial vacuum may be applied to the end portion 29 of the tube 4 to thereby cause the cuff 3 to move from its normal expanded position shown in FIG. 1 to a collpased position such as that shown in FIG. 3. While maintaining the vacuum on the tube 4, the tracheal tube 1 may be inserted into a trachea, such as the trachea 30, the cuff being disposed in the aforementioned collapsed position to thereby facilitate such insertion. Thereafter, when the tracheal tube 1 has been inserted into the desired position in the trachea 30, the vacuum on the tube 4 may be released to thereby permit the cover 16 to be expanded outwardly by the yielding expansion of the resilient body member 17, the expansion of the cover from the collapsed position being to a position wherein it is yieldingly held by the body portion 17 in engagement with the inner wall 31 of the trachea 30, such as shown in FIGS. 2 and 4. Such expansion, it will be seen, is caused by the resiliency of the body portion 17 and is a direct result of the volumetric expansion thereof.
This is to be distinguished from the expansion of the aforementioned cuffs heretofore known in the art, which cuffs are expanded by the application of a positive pressure, by the introduction of air or other working fluid thereinto under pressure.
Although it is of little or no importance whether the cover 16 is wrinkled when the cuff 3 is in fully collapsed position, as shown in FIG. 3, and it is not essential or an absolute requirement that no wrinkles be formed in the cover 16 when the cuff 3 is disposed in operative engagement with the trachea, such as is shown in FIG. 2, it is preferred that no such wrinkles be present when the cuff 3 is in operative engagement with the trachea. Therefore, to insure against such wrinkles, we prefer that the cover 16 be made of a suitable elastic material such as, for example, the aforementioned latex rubber, which is stretched by the expansion of the body portion 17.
As will be appreciated by those skilled in the art, the size of the cuff 3 in its normal, fully expanded state, as shown in FIG. 1, and the characteristics of the cover 16 and the body portion 17 are factors in the determination of the pressure with which the cuff 3 presses outwardly on a trachea, such as the trachea 30 when it is disposed in operative engagement with the inner wall 31 of such a trachea. Preferably, the size of the cuff 3 and the characteristics of the cover 16 and the body portion 17 are such that the outward pressure of the cuff 3 on a trachea is no greater than 25 centimeters of water, when the intubation device 1 is in normal operative position in the trachea and the cuff 3 is in effective sealing engagement with the latter.
However, as will be appreciated by those skilled in the art, this is set forth merely by way of illustration of the preferred embodiment of the present invention and not by way of limitation, and variations in the size and characteristics of the cuff 3 may be made by those skilled in the art without departing from the purview of the present invention.
It will be seen that the cuff 3 embodied in the intubation device 1 shown in FIGS. 1-5 of the drawings, not only affords an effective means for sealing the intubuation device 1 against leakage therepast in the trachea, but it affords effective protection against injury to the trachea during insertion of the intubation device into the trachea. Whereas, insofar as is known, cuffs on tracheal tubes heretofore known in the art always have been disposed in rearwardly spaced relation to the front or distal end of such tracheal tubes, the cuff 3, including both the cover portion 16 and the body portion 17 thereof, not only extends around the tube 2, rearwardly of the distal end portion 5 thereof, but also extends around the outer peripheral surface of the distal end portion 5 in covering relation thereto. Thus, even in collapsed position, as shown in FIG. 3, the cuff 3 affords an effective pad for preventing injury to the trachea by engagement of the front end portion of the tube 2 therewith, and is particularly effective to prevent injury to such a trachea by the direct impingement of the front end of the tracheal tube 1 against a portion of the trachea, both during insertion of the tracheal tube 1 into the trachea and during the time that the tracheal tube 1 remains in the trachea. In addition, the intubation device 1, shown in FIGS. 1-5, affords a novel and effective tracheal tube, the construction of which is such that other instruments, such as suction catheters, and the like, may be readily, selectively inserted therethrough into various positions in a patient, as will be discussed in greater detail hereinafter.
A modified form of my intubation tube is shown in FIGS. 6 and 7, and parts which are the same as parts shown in FIGS. 1-5 are indicated by the same reference numerals as used in FIGS. 1-5, and parts which are similar but have been substituted for parts of the preferred form of my invention shown in FIGS. 1-5 are indicated by the same reference numerals with the suffix a added thereto. All of the changes made in the modified form of my invention over the preferred form as shown are embodied in the cuff 3a attached to the tube 2.
The tracheal tube or intubation device 1a shown in FIGS. 6 and 7 is the same in construction and mode of operation as the tracheal tube shown in FIGS. 1-5, except that the front end portion 32 of the cuff 3a terminates on the tube 2 adjacent to, but rearwardly of the distal end 5 thereof, and like the rear end portion 20 of the cuff 3 comprises merely a portion of the cover 16a, which is hermetically sealed by suitable means, such as, for example, vulcanization or cement to the outer surface of the tube 2. A reinforcing ring 33, like the reinforcing ring 20' on the rear end portion 20, preferably is mounted on the end portion 32 of the cuff 3a to insure the maintenance of an effective seal between the end portion 32 and the tube 2.
Thus, the cuff 3a of the tracheal tube 1a, unlike the cuff 3 of the tracheal tube 1, does not extend across the distal end portion 5 of the tube 2 in covering relation thereto. However, the distal end portion 5 of the tube 2, shown in FIGS. 6 and 7, which projects forwardly from the front end portion 32 of the cuff 3a, is identical in construction and in positioning relative to the remainder of the tube 2 as in the tracheal tube 1 shown in FIGS. 1-5.
The tracheal tube 1a may be inserted into and then sealingly engaged with a trachea in the same manner as heretofore discussed with respect to the tracheal tube 1, by collapsing the cuff 3a, inserting the tracheal tube 1a into the desired position in the trachea, and then permitting the cuff 3a to expand into sealing engagement with the latter. This, it will be seen, affords a highly effective and practical tracheal tube for enabling a person to breathe, or to enable intermittent positive pressure ventilation of the respiratory tract to be carried out.
However, the tracheal tube 1a has another important advantage over tracheal tubes heretofore known in the art, as does the tracheal tube 1 as will now be discussed. Thus, oftentimes it is desirable or necessary to withdraw liquid, such as mucus from cavities within a patient, such as, for example, from within the bronchi of the patient. This commonly is done by inserting suitable suction tubes, such as suction catheters heretofore well known in the art, through the trachea into the desired position. In the past, this commonly has been done by passing the suction catheter directly through the trachea, or by passing it through a tracheal tube which is completely open at the front or inner end thereof. This often is difficult procedure, particularly when it is necessary to selectively insert the suction catheter into a particular position, such as, for example, into the left or right bronchus. The present invention, both in the form shown in FIGS. 1-5 and in the form shown in FIGS. 6 and 7, affords a novel tracheal tube which is highly effective in assisting in such insertion of another instrument, such as suction catheter, into desired position in a patient.
For this purpose, using either the tracheal tube 1a or the tracheal tube 1, the tracheal tube may be inserted into a trachea into a desired position, such as, for example, the position shown for the tracheal tube la in FIG. 7 for the insertion of a suction catheter into one of the bronchi of a patient. In this position of the tracheal tube 1a, the distal end 5 of the tube 2 is disposed in closely adjacent relation to the junction 34 between the left bronchus 35 and the right bronchus 36, and is disposed in uniplanar relation to the plane of separation between the bronchi 35 and 36. With the tracheal tube 1a thus positioned, a suitable suction tube, such as, for example, the suction catheter 37, shown in FIG. 7, may be inserted longitudinally through the tube 2 from the proximal end 9 into the distal end portion 5 thereof. From that position, the operator may readily manipulate the tube 37 so that it may be further advanced through tthe upper or lower side of the opening 11 in the distal end portion 5, as viewed in FIG. 7, into the right bronchus 36 or the left bronchus 35, respectively. The front end portions of such suction tubes used for this purpose, such as, for example, the front end portion 38 of the tube 37, commonly are preset at an angle relative to the adjacent portion of the tubes, in the manner illustrated in FIG. 7. With the suction catheter so constructed, it will be seen that the front end portion 38 may be readily inserted through the tube 2 in such position, that when it enters the distal end 5 of the tube 2 it automatically is guided thereby into the desired bronchus 35 or 36.
It will be seen that with the distal end 5 of the tube 2 constituted and arranged in the manner disclosed herein, no obstruction is afforded thereby to the passage of an instrument, such as the suction catheter 37, laterally outwardly through the opening 11. It will be remembered that the inner faces of the walls 6-8 of the distal end 5 of the tube 2 preferably are perpendicular, in a lateral direction, to the longitudinal center line of the distal end portion 5, or are convex inwardly. With such construction, no obstruction is afforded on the distal end 5 to catch the front end of an instrument, such as the tube 37, and obstruct or interfere with the passage thereof laterally outwardly through the opening 11, and, in fact, the inner faces of the walls 6-8 act as guide surfaces for guiding the front end portions of suction tubes, and the like, such as, for example, the front end 38 of the tube 37, outwardly through the opening 11 in the proper direction.
Thus it will be seen that the tracheal tube 1a, shown in FIGS. 6 and 7, afford a novel tracheal tube which may be quickly and easily disposed in operative position in a trachea, or the like, in sealing engagement therewith, for the passage of air, or the like, therethrough, and which also affords a novel and practical device for effectively assisting in the selective positioning of other instruments, such as, for example, suction catheters in or beyond the trachea.
Similarly, it will be seen that the tracheal tube 1 shown in FIGS. 1-5 of the drawings, has the same advantages of construction and mode of operation as the tracheal tube 1a, and, in addition, embodies a cuff which protects against contact betwen the distal end 5 of the tracheal tube 1 and the trachea, which would be injurious to the latter, both during the insertion of the tracheal tube 1 into the trachea, and during the time that it is so positioned in the trachea.
It will be appreciated by those skilled in the art that although the opening 11 in the distal end portion 5 of the tube 2 in each of the tracheal tubes 1 and 1a is shown as extending completely through the distal end portion 5, this is merely by way of illustration of the preferred construction of the tracheal tubes 1 and 1a, and not by way of limitation, and, if desired, the opening 11, which is in communication with the passageway 10 may be only in one side of the distal end 5 of the tube 2 of either of the tracheal tubes 1 or 1a without departing from the purview of the broader aspects of the present invention. In that event, I prefer to afford a stripe or other indicia, not shown, on the proximal end portion of the tubes 2, with the stripe, or the like, positioned so as to indicate to the operator the direction in which the opening in the distal end of the tube is facing.
From the foregoing it will be seen that the present invention affords a novel intubation device embodying a cuff which is constituted and arranged in a novel and expeditious manner.
Also, it will be seen that the present invention affords a novel intubation device for use in tracheae wherein the parts thereof are constituted and arranged in a novel and expeditious manner effective to afford a device for effectively assisting in the insertion of other instruments, such as, for example, suction catheters, and the like, into a patient.
Thus, while I have illustrated and described the preferred embodiments of my invention, it is to be understood that these are capable of variation and modification, and I therefore do not wish to be limited to the precise details set forth, but desire to avail myself of such changes and alterations as fall within the purview of the following claims.
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