U.S. patent application number 14/984649 was filed with the patent office on 2016-05-19 for tracheal tube positioning devices and methods.
The applicant listed for this patent is COVIDIEN LP. Invention is credited to Neville DeWitt Pierrat, Sarah Hayman, Hughie Keane, Olaf Lally, Roger Mecca, Sean Morris.
Application Number | 20160136374 14/984649 |
Document ID | / |
Family ID | 47596196 |
Filed Date | 2016-05-19 |
United States Patent
Application |
20160136374 |
Kind Code |
A1 |
Hayman; Sarah ; et
al. |
May 19, 2016 |
TRACHEAL TUBE POSITIONING DEVICES AND METHODS
Abstract
Various embodiments of tracheal tube assemblies disclosed herein
may include a tubular body having an open distal end for
ventilating a patient and a cuff disposed around the tubular body
above the open distal end. The cuff may be adapted to be inflated
to seal the cuff against a wall of a trachea of the patient. The
cuff may include a first portion that spaces the tubular body a
first distance from the tracheal wall when inflated and a second
portion that spaces the tubular body a second distance from the
tracheal wall when inflated. The second distance may be greater
than the first distance.
Inventors: |
Hayman; Sarah; (Boulder,
CO) ; DeWitt Pierrat; Neville; (Golden, CO) ;
Mecca; Roger; (Corona Del Mar, CA) ; Lally; Olaf;
(Galway, IE) ; Morris; Sean; (Co. Roscommon,
IE) ; Keane; Hughie; (Leitrim, IE) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
COVIDIEN LP |
Mansfield |
MA |
US |
|
|
Family ID: |
47596196 |
Appl. No.: |
14/984649 |
Filed: |
December 30, 2015 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
13193713 |
Jul 29, 2011 |
9242058 |
|
|
14984649 |
|
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|
Current U.S.
Class: |
128/207.15 |
Current CPC
Class: |
A61M 16/0486 20140204;
A61B 1/0623 20130101; A61M 25/1002 20130101; A61M 16/0404 20140204;
A61M 16/0463 20130101; A61M 16/0484 20140204; A61M 16/0459
20140204; A61M 2205/32 20130101; A61B 1/267 20130101; A61M 16/0443
20140204; A61M 2205/6063 20130101; A61M 16/0434 20130101; A61M
16/0445 20140204 |
International
Class: |
A61M 16/04 20060101
A61M016/04; A61B 1/267 20060101 A61B001/267 |
Claims
1. An airway system, comprising: a tracheal tube assembly having a
tubular body; a proximal collar region in a wall of a cuff and
configured to be attached to the tubular body of the tracheal tube
assembly; a distal collar region in the wall of the cuff and
configured to be attached to the tubular body of the tracheal tube
assembly; a first inflatable region disposed between the proximal
collar region and the distal collar region; and a second inflatable
region disposed between the proximal collar region and the distal
collar region, wherein the first inflatable region and the second
inflatable region are configured to be independently inflated to a
first inflation capacity and a second inflation capacity,
respectively, to seal against a wall of a patient's trachea.
2. The airway system of claim 1, wherein the first inflatable
region and the second inflatable region are disposed adjacent to
one another along a radial axis of the cuff configured to align
with a radial axis of the tubular body.
3. The airway system of claim 1, wherein the first inflatable
region and the second inflatable region are disposed adjacent to
one another along an axial axis of the cuff configured to align
with an axial axis of the tubular body.
4. The airway system of claim 1, comprising a third inflatable
region and a fourth inflatable region, each disposed between the
proximal collar region and the distal collar region, wherein the
first inflatable region, the second inflatable region, the third
inflatable region, and the fourth inflatable region are arranged in
successive radial positions.
5. The airway system of claim 1, comprising a substantially
continuous cuff membrane disposed about the first inflatable region
and the second inflatable region.
6. The airway system of claim 1, wherein the first inflatable
region and the second inflatable region have substantially
different inflation capacities.
7. The airway system of claim 1, wherein the proximal collar
region, the distal collar region, the first inflatable region, the
second inflatable region, or a combination thereof comprises
polyethylene terephthalate, low-density polyethylene, polyvinyl
chloride, silicone, neoprene, polyisoprene, polypropylene,
polyurethane, or a combination thereof.
8. The airway system of claim 1, comprising a collar assembly
disposed on the tubular body below the cuff, wherein the collar
assembly comprises a first portion protruding radially away from
the tubular body a first distance and a second portion opposite the
first portion protruding radially away from the tubular body a
second distance that is greater than the first distance.
9. The airway system of claim 8, comprising an imaging device
disposed on the second portion of the collar assembly.
10. The airway system of claim 8, wherein the imaging device has a
field of view towards a distal end of the tubular body.
11. The air system of claim 8, wherein the imaging device is
disposed on a bottom surface of the collar assembly, wherein the
bottom surface faces towards a distal end of the tubular body.
12. The air system of claim 8, wherein the imaging device is
positioned below the first inflatable region, and wherein the first
inflation capacity of the first inflatable region is greater than
the second inflation capacity of the second inflatable region such
that the first inflatable region extends furthest away from the
tubular body when the first and second inflatable regions are
inflated.
13. The airway system of claim 1, wherein the tubular body includes
a first curved portion within the cuff and extending in a first
direction and a second curved portion below the cuff and extending
in a second direction opposite the first direction.
14. The airway system of claim 13, wherein portions of the tubular
body above and below the first and the second curved portions are
offset with respect to a portion of the tubular body
circumferentially surrounded by the cuff.
15. The air system of claim 1, wherein the cuff is a symmetrical
cuff.
16. The airway system of claim 1, wherein the cuff comprises a
honeycomb structure.
Description
CROSS REFERENCE TO RELATED APPLICATIONS
[0001] This application is a divisional of U.S. patent application
Ser. No. 13/193,713, entitled "TRACHEAL TUBE POSITIONING DEVICES
AND METHODS", filed Jul. 29, 2011, which is herein incorporated by
reference in its entirety for all purposes.
BACKGROUND
[0002] The present disclosure relates generally to medical devices
and, more particularly, to airway devices, such as tracheal
tubes.
[0003] This section is intended to introduce the reader to various
aspects of art that may be related to various aspects of the
present disclosure, which are described and/or claimed below. This
discussion is believed to be helpful in providing the reader with
background information to facilitate a better understanding of the
various aspects of the present disclosure. Accordingly, it should
be understood that these statements are to be read in this light,
and not as admissions of prior art.
[0004] In the course of treating a patient, a tube or other medical
device may be used to control the flow of air, food, fluids, or
other substances into the patient. For example, medical devices,
such as tracheal tubes, may be used to control the flow of air and
medicaments into or out of a patient's airway. In many instances,
it is desirable to provide a seal between the outside of the tube
or device and the interior of the passage in which the tube or
device is inserted. In this way, substances can only flow through
the passage via the tube or other medical device, allowing a
medical practitioner to maintain control over the type and amount
of substances flowing into and out of the patient. For example,
tracheal tubes may be used to control the flow of air or other
gases through a patient's trachea. Such tracheal tubes may include
endotracheal (ET) tubes, tracheostomy tubes, transtracheal tubes,
and so forth.
[0005] To seal these types of tracheal tubes, an inflatable cuff
may be provided. When inflated, the cuff generally expands into the
surrounding anatomy, for example, into the trachea to seal the
tracheal passage around the tube. Because the cuffs are generally
made from a relatively thin and flexible material, the cuffs may
inflate in such a way that the placement of the tubular body of the
tracheal tube within the patient's airway is subject to substantial
variations. For example, the cuffs may inflate to an irregular
shape such that one side of the cuff has a greater incidence of
wrinkles than another side of the cuff, and, accordingly, the
tracheal tube may be positioned off center with respect to a
central axis of the patient's trachea. In certain instances, such
as when auxiliary devices (e.g., imaging devices) are coupled to
the tracheal tube, it may be desirable to control the positioning
of the tubular body of the tracheal tube within the patient's
trachea. Accordingly, there remains a need in the art for improved
tracheal tubes and cuffs that enable proper patient ventilation
without the drawbacks associated with current designs.
BRIEF DESCRIPTION OF THE DRAWINGS
[0006] Advantages of the disclosed techniques may become apparent
upon reading the following detailed description and upon reference
to the drawings in which:
[0007] FIG. 1 is an elevational view of an endobronchial tube
including a cuff adapted to enable control over the positioning of
the endobronchial tube in a patient's trachea;
[0008] FIG. 2 is a cross-sectional view of the cuff shown in FIG. 1
illustrating segmentation of the cuff;
[0009] FIG. 3 is a cross-sectional view of a segmented cuff
including a first inflatable region and a second inflatable region
with different inflation capacities;
[0010] FIG. 4 is a cross-sectional view of a segmented cuff
including an outer membrane disposed thereon;
[0011] FIG. 5 is a perspective view of a tubular body having a cuff
mounted thereon and segmented in a honeycomb arrangement;
[0012] FIG. 6 illustrates a tracheal tube including a cuff having
portions with different inflated resting radii and a collar mounted
thereon;
[0013] FIG. 7 illustrates a tracheal tube including a curved
tubular body, a cuff having portions with different inflated
resting radii, and a collar mounted thereon; and
[0014] FIG. 8 illustrates a tracheal tube including a cuff having
portions with different wall thicknesses and a collar mounted
thereon.
DETAILED DESCRIPTION OF SPECIFIC EMBODIMENTS
[0015] One or more specific embodiments of the present techniques
will be described below. In an effort to provide a concise
description of these embodiments, not all features of an actual
implementation are described in the specification. It should be
appreciated that in the development of any such actual
implementation, as in any engineering or design project, numerous
implementation-specific decisions must be made to achieve the
developers' specific goals, such as compliance with system-related
and business-related constraints, which may vary from one
implementation to another. Moreover, it should be appreciated that
such a development effort might be complex and time consuming, but
would nevertheless be a routine undertaking of design, fabrication,
and manufacture for those of ordinary skill having the benefit of
this disclosure.
[0016] As described in detail below, provided herein are
embodiments of medical cuffs capable of efficiently sealing the
passage in which the cuff is inserted so that mechanical
ventilation can be used to introduce air, oxygen, other gases, or
medications into the lungs of a patient. The provided medical cuffs
may have one or more features that enable an operator to inflate
the cuff in a manner that enables control over the placement of a
mounting structure relative to an axial axis of a patient's airway.
For example, the medical cuffs provided herein may be used in
conjunction with a variety of suitable medical devices including a
tubular mounting structure on which the cuff is mounted during
assembly or manufacturing. That is, the disclosed medical cuffs may
be used in conjunction with an endotracheal tube, a tracheostomy
tube, an endobronchial tube, a circuit, an airway accessory, a
connector, an adapter, a filter, a humidifier, a nebulizer, a
prosthetic, and so forth. When mounted on a tubular body, features
of the provided cuffs may enable the operator to exhibit control
over the position of the tubular body within the patient's
airway.
[0017] For instance, in some embodiments, the cuff may include two
or more separately inflatable regions adapted to be inflated and
deflated as desired. In particular embodiments, the inflatable
regions may have different inflation capacities, and, when fully
inflated, the inflatable regions may position a tubular body of a
tracheal tube off-center with respect to a central axis of the
patient's trachea. The foregoing feature may be advantageous, for
example, in instances in which a collared device is positioned
below the cuff around the tubular body and protrudes farther
outward from the tubular body one side than the other. In these
instances, the side that protrudes farther outward may be aligned
with the portion of the cuff that has a greater inflation capacity
(e.g., volume) and, therefore, provides additional space within the
airway to accommodate the collar protrusion. In other instances,
however, the operator may desire the tubular body to be
substantially in line with respect to the central axis of the
patient's airway. In these embodiments, the inflatable regions may
be inflated to approximately the same inflation capacity.
[0018] In some embodiments described below, the tracheal tube on
which the medical cuff is mounted may be an endobronchial tube,
although these embodiments are not meant to limit the cuffs to
being mounted on this type of tracheal tube. Endobronchial tubes
are double-lumen tracheal tubes that facilitate an airtight seal in
the trachea and one stem of a patient's bronchus to allow
independent ventilation of one lung. Generally, an endobronchial
tube includes two tubes of unequal length that are attached to one
another. One tube terminates within the tracheal airway space,
i.e., the shorter tube has a distal end at a location similar to a
typical endotracheal tube. The other, longer, tube is configured to
extend past the shorter tube and into a left or right bronchial
stem. Both tubes define a passageway for transferring gases to and
from a patient.
[0019] While the total diameter of an endobronchial tube may be
larger than that of a single lumen endotracheal tube, the diameter
of each individual lumen of the endobronchial tube is relatively
smaller than that of a single lumen endotracheal tube. Such a shift
in diameter may be challenging for physicians during placement of
an endobronchial tube. Because the endobronchial tube involves not
only correct intubation within the trachea but also correct
placement of the bronchial lumen within a left or right bronchial
stem, physicians may use visualizing devices, such as
bronchoscopes, to aid in the placement of the bronchial tube.
However, commercial bronchoscopes are generally sized and shaped to
be used in conjunction with the relatively larger lumen of a
single-lumen endotracheal tube. As such, the bronchoscopes may not
fit easily within either lumen of a double-lumen endobronchial
tube.
[0020] The systems and devices provided herein offer an approach to
overcoming these drawbacks by enabling clinicians to couple a
visualization device to existing endobronchial tubes to facilitate
better visualization of the endobronchial tube placement. For
example, by enabling the clinician to inflate one portion of a
disclosed cuff to a different volumetric capacity than another
portion of the cuff, an imaging device may be accommodated in the
patient's airway. That is, some embodiments may employ an imaging
device, such as a camera mounted on a collar configured to be
placed about a tubular body of the endobronchial tube, in
conjunction with the disclosed cuffs to facilitate visualization of
portions of a patient's airway. In particular embodiments, these
features may be advantageous for use with dual-lumen endobronchial
tubes during initial placement of the tubes in the patient's
airway, when the patient is moved during a period of prolonged
intubation, and periodically during a medical procedure.
[0021] The tracheal tubes, as provided herein, may be disposable
rather than reusable, capable of conveying gas to and from the
patient, capable of providing separate ventilation channels to the
tracheal space and to an individual lung, and capable of enabling
control over the positioning of the tracheal tube about a central
axis of the airway. It should be noted that the provided tracheal
tubes and methods of operating the tracheal tubes may be used in
conjunction with auxiliary devices, such as airway accessories,
ventilators, humidifiers, and so forth, which may cooperate with
the tracheal tubes to maintain airflow to and from the lungs of the
patient. For instance, the tracheal tubes may be placed in the
trachea and coupled to a ventilator to protect the airway from
possible obstruction or occlusion in emergency situations, such as
when a patient experiences cardiac or respiratory arrest. For
further example, the tracheal tubes may be coupled to an adapter or
connector that is configured to cooperate with control circuitry to
activate valving that controls the airflow to and from the patient
during inspiration and expiration.
[0022] Again, although the embodiments illustrated and described
herein are discussed in the context of endotracheal tubes such as
endobronchial tubes, it should be noted that presently contemplated
embodiments may include the disclosed cuffs mounted on any portion
of a variety of suitable airway devices. For example, the disclosed
medical cuffs may be utilized in conjunction with a tracheostomy
tube, a Broncho-Cath.TM. tube, a specialty tube, or any other
airway device with a main ventilation lumen. Furthermore, as used
herein, the term "tracheal tube" may include an endotracheal tube,
a tracheostomy tube, a Broncho-Cath.TM. tube, a bronchoblocking
tube, a specialty tube, or any other airway device.
[0023] Turning now to the drawings, FIG. 1 is an elevational view
of an exemplary tracheal tube 10 configured to be placed in a
patient's bronchial stem in accordance with aspects of the present
disclosure. The tracheal tube 10 includes a central tubular body 12
with a tracheal ventilation lumen 14 and a bronchial ventilation
lumen 16. The tracheal lumen terminates at a tracheal lumen distal
end 18 while the bronchial lumen terminates in a bronchial lumen
distal end 20. Furthermore, the tracheal tube 10 may include a
tracheal lumen proximal end 22 and a bronchial lumen proximal end
24. As shown, the tracheal ventilation lumen 14 and a bronchial
ventilation lumen 16 may be attached to one another over a portion
of the tubular body 12 and may separate at their respective
proximal ends 22 and 24 and distal ends 18 and 20. The tubular body
12 may include a divider 26 that divides the tracheal ventilation
lumen 14 and bronchial ventilation lumen 16 and serves as a shared
wall between them.
[0024] The tracheal lumen proximal end 22 and a bronchial lumen
proximal end 24 may be outfitted with separate connectors that may
be attached to a ventilation device 28 during operation. The
ventilation device 28 may include a suitable controller (e.g., a
processor-based control system) so that a clinician may direct
airflow to and from both the tracheal ventilation lumen 14 and
bronchial ventilation lumen 16. In other embodiments, either the
tracheal ventilation lumen 14 or the bronchial ventilation lumen 16
may be blocked or otherwise closed such that only one of the two
lumens of the tracheal tube 10 is operational. The tracheal lumen
distal end 18 of ventilation lumen 14 terminates in an opening 30
and may be placed in a patient's trachea during operation to
maintain airflow to and from the patient's lungs. A Murphy's eye 32
may optionally be present and may be located on the ventilation
lumen 14 opposite the opening 30 to prevent airway occlusion when
the tracheal tube assembly 10 is improperly placed within the
patient's trachea.
[0025] As illustrated, a tracheal cuff 34 may encircle the tubular
body 12 and be inflated to seal against the walls of a body cavity
(e.g., a trachea). To that end, the cuff 34 has a proximal shoulder
region 35 and a distal shoulder region 37 that facilitate
attachment of the cuff 34 to the tubular body 12. Further, the
illustrated cuff 34 is a segmented cuff including partitions 36
that divide the cuff 34 into a first segment 38, a second segment
40, a third segment 42, and a fourth segment 44. Each of the
segments may be adapted to be separately inflated to a different
volumetric capacity by the operator. For example, in the depicted
embodiment, for illustration purposes, a single port 46 is shown
coupling the cuff 34 to an inflation lumen 48 terminating in an
inflation tube 50 connected to an inflation pilot balloon and valve
assembly 52. However, in further embodiments, a separate inflation
lumen may be provided for each segment or a valving arrangement may
be provided to enable fewer inflation lumens to be employed.
Nevertheless, the foregoing feature enables an operator to control
the degree of inflation of the cuff at different radial locations
around the circumference of the cuff 34.
[0026] By enabling the operator to control the inflation volumes
present at different locations about the circumference of the cuff
34, the illustrated embodiment provides the operator a way to
control the alignment of the tubular body 12 with respect to an
axial axis 54 (e.g., of a patient's airway) at different positions
along a radial axis 56 or a circumferential axis 58. For example,
the operator may shift the location of the divider 26 along the
radial axis 56 within a patient's airway to move the tubular body
12 closer to one side of the tracheal wall or another. For further
example, in some embodiments, the operator may inflate or deflate
the segments of the cuff 34 to position the divider 26 in a
position that is substantially aligned with a central axial axis of
the patient's airway, thereby centering the tracheal tube 10 in the
patient's airway. Indeed, the segmented cuff 34 enables the
operator to position the tubular body 12 within the patient's
airway at any desired location along the radial and circumferential
axes 56 and 58.
[0027] It should be noted that the tracheal ventilation lumen 14
may also include a suction lumen (not shown) that extends from a
location on the tracheal tube 10 positioned outside the body when
in use to a location on the tubular body 12 that terminates in a
port located proximally to cuff 34 through which secretions may be
aspirated. Further, bronchial ventilation lumen 16 is longer than
tracheal ventilation lumen 14 and includes a distal portion 60 that
extends past the tracheal lumen distal end 18. The bronchial
ventilation lumen 16 may include a bronchial inflation cuff 62 that
is configured to seal against the walls of a patient's bronchial
stem. The cuff 62 may be inflated via a port 64 coupled to an
inflation lumen 66 terminating in an inflation tube 68 connected to
an inflation pilot balloon and valve assembly 70.
[0028] The tubular body 12 and the cuff 34 may be formed from
materials having desirable mechanical properties (e.g., puncture
resistance, pin hole resistance, tensile strength, and so forth)
and desirable chemical properties (e.g., biocompatibility).
Further, in one embodiment, the walls of the cuff 34 or the cuff 62
may be made of a polyurethane (e.g., Dow Pellethane.RTM. 2363-80A)
having suitable mechanical and chemical properties. In other
embodiments, the walls of the cuff 34 or the cuff 62 may be made of
silicone or a suitable polyvinyl chloride (PVC). In certain
embodiments, the cuff 34 or the cuff 62 may be generally sized and
shaped as a high volume, low pressure cuff that may be designed to
be inflated to pressures between approximately 15 cm H.sub.2O and
30 cm H.sub.2O. Further, bronchial cuff 62 may be a different color
or include other identifying markings that allow a user to
differentiate between the tracheal cuff 34 and the bronchial cuff
62. Still further, the tracheal cuff 34 and/or the bronchial cuff
62 may be any suitable size or shape, including, but not limited
to, tapered or ribbed cuffs.
[0029] In addition, in some embodiments, to assist in proper
placement of the tube 10, one or more imaging devices may be placed
at any appropriate location along the length of the tube 10. For
example, an imaging assembly having a collar that is adapted to
encircle the tubular body 12 in a location below the cuff 34 may be
provided. The collar may include a portion that extends outward a
greater distance from the tubular body on one side than another to
accommodate a camera that is provided for visualization of the
patient's anatomy. For example, such visualization may be desirable
as the double lumen tracheal tube 10 is inserted into the patient,
when the patient has been moved into an alternate position, or at
any other suitable time while the patient is intubated. In these
embodiments, the segmented cuff 34 that enables the operator to
adjust the position of the tubular body 12 within the patient's
airway may be particularly advantageous. That is, it may be
desirable to position the protruding camera below a segment of the
cuff that is overinflated as compared to an opposite cuff segment
that is underinflated since this arrangement may allow additional
space to accommodate the camera.
[0030] During operation of the illustrated airway device, the
tracheal tube 10 is inserted into the trachea of a patient and
positioned within the left or right bronchial stem, and the
tracheal cuff 34 and bronchial cuff 62 are inflated to the desired
volumetric capacities to isolate the appropriate airway structures
and position the tubular body 12 in the desired location. In
embodiments in which an imaging assembly, such as a collared
assembly including an imaging device, is coupled to the tubular
body 12, the imaging device may guide tube placement. In other
embodiments, to assist in proper placement of the tube 10, X-ray
visible markings 72 may be placed at any appropriate location. For
example, the markings 72 may outline a bronchial distal opening 74
or a side eye 76. In some embodiments, one or more of the disclosed
visualization features (e.g., a collared imaging assembly, x-ray
markings, and so forth) may be associated with the tracheal cuff 34
and/or the bronchial cuff 62. For instance, in some embodiments, it
may be desirable to visualize the bronchial cuff 62, for example,
during placement of the tracheal tube 10 in the patient's bronchial
stem.
[0031] FIG. 2 is a cross-sectional view taken along line 2-2 of
FIG. 1 illustrating features of the segmented cuff 34 in more
detail. As shown, the illustrated cuff 34 includes a first
inflatable region 78, a second inflatable region 80, a third
inflatable region 82, and a fourth inflatable region 84. In
accordance with a presently disclosed embodiment, each of the
inflatable regions is adapted to be inflated and deflated
independently. That is, the pressure of each inflatable region may
be separately adjusted by an operator in order to position the
tubular body 12 within the patient's airway in the desired
location.
[0032] In the embodiment of FIG. 2, four inflatable regions 78, 80,
82, and 84 extending lengthwise along the length of the tubular
body 12 are illustrated. However, in other embodiments, features of
the two or more inflatable regions of the illustrated cuff 34 may
be subject to considerable variations in quantity, size, shape, and
placement based on the given application. As such, features such as
the cuff 34 may have configurations other than those illustrated
that are within the scope of the disclosed cuffs. For example, FIG.
3 illustrates a cross-sectional view of a cuff 86 including
inflatable regions having substantially different inflation
capacities. That is, the illustrated cuff 86 includes a first
inflatable region 88 having a first inflation capacity and a second
inflatable region 90 having a second inflation capacity that is
less than the first inflation capacity. Although the illustrated
view shows each of the regions 88 and 90 inflated to its full
respective capacity, here again, the volumes of the regions may be
independently adjusted to position the tubular body 12 in the
desired location within the patient's airway.
[0033] It should be noted that based on the intended use of the
cuff, a different arrangement or quantity of inflatable regions may
be provided. For example, in instances in which the cuff is coupled
to an endotracheal tube, and the user desires the tubular body to
be substantially centered within the patient's trachea, the cuff 34
of FIG. 2 may be chosen, and the inflatable regions may be filled
to approximately the same volume with minor variations as necessary
to achieve a substantially centered tubular body. However, in
instances in which the cuff is coupled to an endobronchial tube
including a collared camera assembly, the user may desire the
tubular body to be off-center with respect to a central axis of the
patient's trachea. In these embodiments, the cuff 86 of FIG. 3 may
be utilized since the different inflation capacities of the
inflatable regions may more easily provide the desired
positioning.
[0034] Still further, in some embodiments, it may be desirable to
reduce or eliminate the possibility of contact between the
patient's airway and the interfaces disposed between the inflatable
regions. To that end, one or more features may be provided that
minimize such contact. For example, the embodiment of FIG. 4
illustrates a cuff 92 having a first inflatable region 94 and a
second inflatable region 96 that are connected to one another at
interfaces 98 and 100. A membrane 102 is disposed about the
circumference of the cuff 92 to encircle the first inflatable
region 94, the second inflatable region 96, and the interfaces 98
and 100. In certain instances, the foregoing feature may offer
advantages over designs without a membrane. For example, in some
embodiments, the membrane 102 may reduce the likelihood of grooves
or creases forming in the cuff 92 in the areas around the
interfaces 98 and 100 as the cuff is inflated to seal against a
wall of a patient's airway.
[0035] As noted above, the cuffs of presently disclosed embodiments
may take on various forms having a variety of arrangements of
inflatable regions. For example, embodiments of the cuffs may have
any combination of any quantity of vertically, horizontally, or
angularly disposed inflatable regions. More specifically, in one
embodiment illustrated in FIG. 5, a perspective view of a cuff 104
having a honeycomb structure and being mounted on a tubular body
106 is shown. In this embodiment, inflatable regions 108 and 110
are coupled to a proximal collar region 112 of the cuff 104, and
inflatable regions 114 and 116 are coupled to a distal collar
region 118 of the cuff 104. Here again, each inflatable region is
configured to be inflated and deflated independently, for example,
via separate inflation lumens. That is, in this embodiment,
inflatable region 108 is inflated via inflation lumen 120
terminating in notch 122, inflatable region 110 is inflated via
inflation lumen 124 terminating in notch 126, inflatable region 114
is inflated via inflation lumen 128 terminating in notch 130, and
inflatable region 116 is inflated via inflation lumen 132
terminating in notch 134. However, in other embodiments, fewer
lumens may be provided and one or more valving mechanisms may be
employed to utilize the lumens to selectively inflate or deflate
each of the inflatable regions.
[0036] FIGS. 6-8 illustrate further embodiments of the presently
disclosed cuffs during operation in conjunction with imaging
assemblies disposed about tubular bodies within a patient's airway.
In particular, FIG. 6 illustrates an asymmetrical cuff 136 disposed
about a tubular body 138 and inflated within a patient's trachea
140. A collar assembly 142 is also mounted on the tubular body 138
below the cuff 136. The collar assembly 142 includes an imaging
device 144 disposed in a first portion 146 of the assembly opposite
a second portion 148 of the assembly. As illustrated, the first
portion 146 of the assembly protrudes outward from the tubular body
138 a first distance 150 that is greater than a second distance 152
that the second portion 148 of the assembly protrudes outward from
the tubular body 138. The foregoing structure of the collar
assembly 142 may accommodate the imaging device 144 and its
associated electronics.
[0037] In some embodiments, the asymmetrical cuff 136 may include
one or more features that enable the tubular body 138 to be
positioned within the trachea 140 in a desired location with
respect to a central axis 154 of the trachea 140. For example, the
illustrated cuff 136 includes a proximal shoulder region 156 and a
distal shoulder region 157 that couple to a first wall portion 158
that inflates to seal against a first side 160 of the tracheal
wall. Similarly, a second wall portion 162 is disposed between the
collar regions 156 and 157 and inflates to seal against a second
side 164 of the tracheal wall. When the cuff 136 is inflated, a
resting radius 166 of the second wall portion 162 is greater than a
resting radius 168 of the first wall portion 158. That is, the
distance that the second wall portion 162 extends outward from the
tubular body 138 is greater than the distance that the first wall
portion 158 extends outward from the tubular body 138.
[0038] The foregoing feature enables the operator to adjust the
position of a central axis 170 of the tubular body 138 with respect
to the central axis 154 of the patient's trachea 140. For example,
when fully inflated as shown in FIG. 6, the tubular body 138 is
off-center with respect to the central axis 154 of the patient's
trachea 140. This may be advantageous in embodiments in which the
collar 142 is mounted on the tubular body 138 because the first
portion 146 of the collar assembly 142 may be aligned underneath
the second portion 162 of the cuff 136, where additional space is
provided to accommodate the distance 150 that the collar assembly
protrudes outward from the tubular body 138.
[0039] Further, it should be noted that in some embodiments, one or
more indicators may be provided for the purpose of indicating to an
operator which portion of the asymmetrical cuff is adapted to
inflate to a larger resting radius and which portion is adapted to
inflate to a smaller resting radius. For example, in the
illustrated embodiment, indicators 172 and 174 are provided to
indicate to a user that the portion 162 is capable of being
inflated to a larger resting radius than portion 158. The
indicators 172 and 174 may be of any quantity or type, including
text, image, ink, chemical, or topographic markers. Indeed, the
indicators 172 and 174 may take any form previously disclosed in
U.S. Pat. No. 8,381,730, filed Jan. 29, 2009, which is hereby
incorporated by reference. For instance, the indicators may be
identified via touch, for example, in embodiments in which the
indicators take the form of raised protrusions. Still further, the
indicators 172 and 174 may be combined with any of the other
presently disclosed embodiments to indicate to a user which
portions of the adjustable cuffs correspond to which features
(e.g., which segments correspond to which inflation
capacities).
[0040] FIG. 7 illustrates a symmetrical cuff 190 having a proximal
shoulder region 184 and a distal shoulder region 186 and being
disposed about a tubular body 178 and inflated within the patient's
trachea 140. It should be noted that in certain embodiments, the
shoulder regions 184 and 186 may be inverted or non-inverted,
depending on the given application. For example, in some
embodiments, when the shoulder regions 184 and 186 are inverted,
the length of the portion of the tubular body 178 that is disposed
between the shoulder regions 184 and 186 may be shorter than the
length of the portion of the tubular body 178 that is disposed
between the shoulder regions 184 and 186 when the shoulder regions
184 and 186 are not inverted.
[0041] In the illustrated embodiment, the collar assembly 142 is
also mounted on the tubular body 178 below the cuff 190. As before,
the collar assembly 142 includes the imaging device 144 disposed in
the first portion 146 of the assembly that protrudes outward from
the tubular body 178 a greater distance than the second portion 148
of the assembly. In this embodiment, however, the tubular body 178
includes a first curved portion 180 and a second curved portion 182
that accommodate the protruding first portion 146 of the collar
assembly 142.
[0042] In this embodiment, when the cuff 190 is inflated, the
portion of the tubular body 178 that is distal to the curved
portion 182 is offset with respect to the portion of the tubular
body 178 that is disposed between curved portion 180 and the curved
portion 182. Accordingly, a distance 192 from the tubular body 178
to a first portion 193 of the tracheal wall is greater than a
distance 194 from tubular body 178 to a second portion 195 of the
tracheal wall. As such, in this embodiment, the protruding portion
146 of the collar assembly 142 is accommodated by providing curved
portions 180 and 182 in the tubular body 178.
[0043] Still further, FIG. 8 illustrates another embodiment of a
cuff 196 disposed about the tubular body 138 and inflated within
the patient's trachea 140. The collar assembly 142 is also mounted
on the tubular body 138 below the cuff 196. As before, the first
portion 146 of the collar assembly 142 protrudes outward from the
tubular body 138 a greater distance than the second portion 148 of
the assembly. However, in this embodiment, the wall thickness of
the cuff 196 is variable about its circumference to facilitate
offsetting of the central axis 170 of the tubular body 138 with
respect to the central axis 154 of the patient's trachea when the
cuff 196 is inflated.
[0044] The illustrated cuff 196 includes a first wall portion 198
having a first thickness 200 that is greater than a second
thickness 202 of a second wall portion 204. Accordingly, when the
cuff 196 is inflated as shown, a resting radius 206 of the wall
portion 198 is less than a resting radius 208 of wall portion 204.
The foregoing feature of the cuff 196 may allow for accommodation
of the protruding portion 146 of the collar assembly 142 below the
portion 204 of the cuff 196 with the larger resting radius 208.
[0045] While the disclosure may be susceptible to various
modifications and alternative forms, specific embodiments have been
shown by way of example in the drawings and have been described in
detail herein. However, it should be understood that the
embodiments provided herein are not intended to be limited to the
particular forms disclosed. Rather, the various embodiments may
cover all modifications, equivalents, and alternatives falling
within the spirit and scope of the disclosure as defined by the
following appended claims.
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