Closed Drainage System With Double Lumen Tube

Abstract

A drainage tube for a closed liquid drainage system. The drainage system includes a catheter having a drainage eye adjacent its distal end for insertion into the body cavity of a patient and a drainage lumen extending from the drainage eye to the proximal end of the catheter, and a drainage receptacle for collecting the liquid. The drainage tube has a pair of lumens which are in communication adjacent the upstream and downstream ends of the tube. The lumens also communicate with the drainage lumen of the catheter adjacent the upstream end of the tube and with the receptacle adjacent the downstream end of the tube in order to drain liquid from the catheter to the receptacle and alleviate negative pressure which may develop in the system.

Description

The present invention relates to liquid drainage systems, and more particularly to a drainage tube for a closed drainage system.

Systems for draining liquid from a body cavity, such as the bladder, are well known. Conventionally, such systems have taken the form of a catheter which has its distal end inserted into the cavity such that its proximal end projects outwardly from the cavity, a drainage tube which has it upstream end connected to the proximal end of the catheter, and a drainage receptacle which is connected to the downstream end of the drainage tube. Thus, a liquid drains from the cavity through the catheter and drainage tube to the receptacle for collection.

Since the use of the drainage system poses the danger of introducing infection into the body cavity, it is desirable to maintain the system in a sterile condition. Accordingly, such systems are preferably of the closed type in order to prevent the admittance of air into the system during its use, since bacteria may enter the system with the air, and, by retrograde movement, the bacteria may enter the cavity with possible deleterious results to the patient's body. Although closed drainage systems are desirable, difficulties have been encountered in draining liquid from the body cavity to the receptacle in such a system. As a column of liquid drains from the catheter, a negative pressure may develop above the liquid column and cause the column to stop in the catheter or drainage tube thus preventing the column from draining into the receptacle. It has also been found that in urinary drainage systems the negative pressure may cause lesions to the bladder as the bladder collapses about the distal end of the catheter.

Ericson U.S. Pat. Nos. 3,419,009 and 3,429,314 disclose that filtered air may be introduced into the catheter to alleviate a negative pressure condition in the drainage system. Vaillancourt U.S. Pat. No. 3,583,401 shows a double lumen drainage tube utilized to break negative pressure in a drainage system.

DESCRIPTION OF THE DRAWINGS

FIG. 1 is a fragmentary side elevational view, taken partly in section and partly broken away, of a closed drainage system according to the present invention;

FIG. 2 is a fragmentary side elevational view, taken partly in section and partly broken away, of another embodiment of a drainage tube for the drainage system of FIG. 1;

FIG. 3 is a diagrammatic view of apparatus for determining the amount of negative pressure developed in a closed drainage system;

FIG. 4 is a diagrammatic view of apparatus for determining the amount of negative pressure developed in various configurations of a drainage system; and

FIG. 5 is a fragmentary diagrammatic view of a modified configuration of a drainage tube for the drainage system of FIG. 4.

DESCRIPTION OF THE PREFERRED EMBODIMENTS

Referring now to FIG. 1, there is shown a liquid drainage system, generally designated 10, including a catheter designated generally 12, a drainage tube designated generally 14, and a drainage receptacle designated generally 16. The catheter 12 has a drainage eye 18 adjacent the distal end 20 of the catheter, and a drainage lumen 22 extending from the drainage eye 18 to the proximal end 24 of the catheter. In use, the distal end 20 of the catheter is inserted into the body cavity of a patient, and liquid drains through the drainage eye 18 and the drainage lumen 22 for collection. If desired, the catheter may have a balloon 26 for retaining the catheter in the cavity, and the balloon may be inflated through a valve (not shown) in a side arm 28 of the catheter and through an inflation lumen 30 which communicates between the valve and the inside of the balloon 26.

The drainage tube 14 has a pair of lumens 32 and 34 which are in communication adjacent the upstream and downstream ends 36 and 38, respectively, of the tube 14. The upstream ends of the lumens 32 and 34 are also in communication with the drainage lumen 22 of the catheter 12. The upstream end 36 of the tube 14 may be secured in the proximal end 40 of a connector designated generally 42, and the distal end 44 of the connector 42 is received in the proximal end 24 of the catheter, such that communication is established between the lumens 32 and 34 and the drainage lumen 22 through a passageway 46 in the connector. Preferably, the downstream end 38 is secured in a drip chamber 48, and liquid passes from the downstream end of the tube into the drip chamber 48 and through an opening 50 into the interior of the drainage receptacle 16.

One-way valve means 52, such as a flap valve, as shown, may be secured to the tube 14 adjacent the upstream end of one lumen 32. The valve means 52 permits the passage of air from the one lumen 32 into the other lumen 34, while preventing the passage of liquid into the upstream end of the lumen 32. Thus, the valve means 52 directs the flow of liquid draining from the lumen 22 of the catheter into the lumen 34.

In operation, the liquid drains from the catheter through the lumen 34 into the drip chamber 48 and through the opening 50 into the interior of the drainage receptacle 16. Although the lumens of the tube 14 may have a range of diameter sizes which are practical for use in such a system, generally, the diameter of the lumen 34 is sufficiently small that the liquid may form into columns with a meniscus at its upper and lower ends as it passes through the lumen 34. When a column of liquid descends through the lumen 34 a negative pressure is developed above the column, and air is drawn upwardly through the lumen 32 and valve means 52 into the upstream end of the lumen 34, in order to break the negative pressure which has developed and prevent the column from "hanging up" in the tube. Hence, as air flows into the upstream end of the lumen 34, the liquid column continues its movement downwardly through the lumen 34 and into the drip chamber 48. Air in the interior of the drainage receptacle 16 and the drip chamber 48 serves as a source of air supply for movement of air upwardly through the lumen 32 to break the negative pressure in the lumen 34. As the liquid columns descend through the lumen 34, air passes downwardly through the lumen 34 back into the drip chamber 48 and interior of the drainage receptacle 16. Thus, air is recirculated through the drainage tube 14 as liquid drains through the lumen 34 in the closed system 10.

As noted previously, the purpose of a closed system is to maintain the system in a sterile condition and prevent harm to the patient, if at all possible. On the chance that bacteria has been introduced into the system, it is desirable to shorten the downstream end of the lumen 32 relative to the lumen 34, as shown, to aid in preventing the passage of urine and deposits into the downstream end of lumen 32, a possible source of bacteria which might be drawn toward the upstream end of the tube 14, or which might tend to clog the lumen 32.

Another embodiment of the drainage tube 14 for the system 10 is illustrated in FIG. 2, which also has a pair of lumens 32 and 34. However, in this embodiment the tube 14 includes a section 56 defining a portion 34' of the lumen 34 which extends upstream from the lumen 32. The section 56 has a plurality of apertures 58 which are disposed circumferentially around the section 56, and an air-pervious, fluid-impervious filter 60 covers the apertures 58. The filer 60 preferably has a porosity size of from 2-5 microns in order that it is also impermeable to passage of bacteria, and may be made of any suitable material, such as the material Pallflex, manufactured by the Pall Corporation. The connector 42 closes the upstream end 36 of the tube 14 and defines a continuation of the passageway 46 which contains a portion of the tube section having the filter 60. The upstream end of the tube section 56 is received in the connector passageway 46 with the outer wall of the section 56 engaged against the wall of the pasageway 46 to direct liquid from the catheter into the lumen portion 34'. The downstream end 38 of the tube 14 is received in the drip chamber 48, as described in connection with the drainage system shown in FIG. 1.

Thus, liquid is confined in the lumen portion 34' by the filter 60, while air is permitted to pass from the lumen 32 through the filter 60 and apertures 58 to break negative pressure which may develop in the lumen 34 and lumen portion 34'. During operation of the system, it is desired to maintain the tube 14 in a relatively vertical orientation to facilitate drainage through the lumen 34. However, a user may inadvertently form a loop in the tube, or a similar obstruction, which requires the liquid to flow in an upward direction prior to reaching the drainage receptacle. In such a case, a head of liquid must develop in the lower portion of the loop before the liquid flows around the loop and into the receptacle, causing a possible positive pressure in the lumen 34 between the loop and the catheter. However, the filter 60 also permits passage of air from the lumen portion 34' into the lumen 32 to break positive pressure which might otherwise develop in the lumen 34 and lumen portion 34'. Also, the bacteria-impermeable filter 60 prevents the introduction of bacteria into the upstream end of lumen 34 through the lumen 32 and apertures 58.

Devices for determining the amount of negative pressure developed in a drainage system are illustrated in FIGS. 3 and 4. In FIG. 3 a closed drainage system 110 is shown, including a container 170 retaining a source of liquid 172, a drainage tube 114 having two lumens 132 and 134, a conduit 174 communicating between the inside of the container 170 and the upstream end 136 of the tube 114, and a drainage receptacle 116, the interior of which communicates with the downstream end 138 of the drainage tube 114 through a drip chamber 148. The two lumens of the drainage tube 114 are in communication at the upstream and downstream ends 136 and 138 of the tube, and the tube 114 may have valve means 152, as previously described in connection with the system shown in FIG. 1. The container 170 is vented by a tube 176 to permit egress of liquid 172 from the container into the conduit 174 through an inlet opening 178 positioned in the container. Liquid drainage from the container may be started by siphoning the downstream end of the conduit 174. As liquid drains from the container 170 to the drainage receptacle 116 through the conduit 174 and drainage tube 114, negative pressure which develops in the system may be measured by a manometer 180 which is connected to the conduit 174 intermediate the upsream end 136 of the drainage tube 114 and the container 170.

FIG. 4 illustrates an apparatus which may be utilized to measure the negative and positive pressure in various configurations of a drainage system 210. The drainage system has a catheter 212 having its proximal end 224 connected to a connector 242 and communicating with one end of first and second tubes 282 and 284, respectively,, which are attached to the connector 242. The other end of first and second tubes 282 and 284 communicate with the interior of a drainage receptacle 216 through a drip chamber 248. The second tube 284 has first and second sections 286a and 286b, respectively, with one end 287 of the first section 286a communicating with the catheter, and with the other end 287' of the first section 286a being removably connected to one end of a flowmeter 288. The second section 286b of the tube 284 has one end 289 removably connected to the other end of the flowmeter 288, and its other end 289' positioned in the drip chamber 248. A manometer 280 is connected to the first section 286a of tube 284 intermediate its ends 287 and 287'. A pair of clamps 290a and 290b (shown in the released or open position) are positioned on the tube 284 to selectively open and close the sections 286a and b. The first clamp 290a is positioned on the first section 286a intermediate the connection of the manometer 280 to the tube section 286a and its end 287'. The second clamp 290b is positioned on the second section 286b intermediate the end 289 and the drip chamber 248. A balloon 292 containing a liquid is secured to the distal end 220 of the catheter 212 with the drainage eye 218 of the catheter being received in the interior of the balloon.

As the balloon 292 contracts, liquid drains through the catheter 212, the first tube 282, and the drip chamber 248 into the interior of the drainage receptacle 216. The manometer 280 measures the amount of negative pressure developed in the drainage system as the liquid drains from the balloon 292 to the drainage receptacle 216, and the flowmeter 288 is utilized to check for the passage of air in the system.

Measurements may be taken by the manometer 280 to determine the amount of negative or positive pressure developed in various configurations of the drainage system 210. First, the clamp 290bis closed, the end 287' of the first section 286a is connected to the upper end of flowmeter 288, the lower end of the flowmeter is removed from the tube section 286b, and the clamp 290a is opened. In this configuration, the catheter 212 and first tube 282 is vented to the atmosphere through the first tube section 286a and flowmeter. Second, both clamps 290a and b are opened with the end 287' of section 286a removed from the flowmeter 288, in order to vent the tube 282 through the first tube section 286a and vent the drip chamber 248 through the flowmeter 288 and the second tube section 286b. A second flowmeter (not shown) may be connected to the end 287' of section 286a, if desired. Third, the clamp 290a is closed and the clamp 290b opened with the end 287' of the first tube section 286a removed from the flowmeter 288, in order to vent the drip chamber 248 through the flowmeter 288 and second tube section 286b. The flowmeter 288 measures the flow of air venting the drip chamber 248. Fourth, both clamps 290a and b are opened and the end 287' of the first tube section 286a is connected to the upper end of the flowmeter 288. In this configuration the system 210 is closed, with liquid draining through the first tube 282 to the drainage receptacle 216, and with air recirculating from the drip chamber 248 through the tube 284 to the upstream end of the tube 282, in order to alleviate negative pressure developed in the system in a manner similar to the drainage system described in connection with FIG. 1. In this configuration the flowmeter 288 measures the flow of air passing from the drip chamber through the second tube 284. Fifth, both clamps 290a and b are closed to form a closed system. However, in this configuration the first tube 282 and drip chamber 248 are not vented, and air is not permitted to circulate from the drip chamber through the second tube 284 to the first tube 282.

The amount of negative pressure developed in the system 210 for the above configurations of the system is thus determined by the manometer 280, and the flowmeter 288 is used to determine whether air passes through the tube sections 286a and b. It should be noted that if the flowmeter 288 only has the capability of measuring the flow of air in a single direction, the manner in which it is connected to the system is determined by the expected direction of air flow through the tube sections 286a and b.

The first tube 282 may be placed in various orientations in order to determine the effect of these orientations upon drainage in the system 210. For example, the tube 282 may be placed in a vertical configuration or in a loop 294, as shown in FIG. 4, or it may be placed in a descending spiral 296, as shown in FIG. 5.

The foregoing detailed description is given for clearness of understanding only, and no unnecessary limitations should be understood therefrom, as modifications will be obvious to those skilled in the art.

Claims

I claim:

1. A closed system for drainage of liquid from a cavity comprising a tubular conduit having a single liquid inlet opening insertable into the cavity and a downwardly extending section, a drainage receptacle in a position to receive liquid from said conduit, the downwardly extending section including a drainage tube having two lumens which are in communication at the upstream end of the tube and adjacent the downstream end of the tube, one-way valve means adjacent the upstream end of one of said lumens for permitting the passage of liquid into the one lumen, said valve means comprising a flap valve.

2. A closed system for drainage of liquid from a body cavity comprising a tubular conduit having a single liquid inlet opening insertable into the cavity and a downwardly extending section, and a drainage receptacle in a position to receive liquid from said conduit, the downwardly extending section including a drainage tube having two lumens which are in communication at the upstream end of the tube and adjacent the downstream end of the tube, said drainage tube including a section defining a portion of one of said lumens which extends upstream from the other of the lumens, said section having a plurality of apertures disposed circumferentially around the section, and including a filter covering said apertures, said filter being pervious to air to permit passage of air between the lumens to alleviate negative or positive pressure in said one lumen and impervious to liquid to prevent passage of liquid from the one lumen.

3. In a closed system for draining liquid from a body cavity, including a catheter having a drainage eye adjacent its distal end and a drainage lumen extending from the drainage eye to the proximal end of the catheter, and a drainage receptacle for collecting the liquid, a drainage tube having a pair of lumens which are in communication adjacent the upstream and downstream end of the tube, with said lumens communicating with the drainage lumen of the catheter adjacent the upstream end of the tube and communicating with the drainage receptacle adjacent the downstream end of the tube to drain liquid from the catheter to the drainage receptacle and alleviate negative pressure developed in the system, one-way valve means adjacent the upstream end of one of said lumens for permitting the passage of air from the one lumen into the other of said lumens and preventing the passage of liquid into the one lumen, said valve means comprising a flap valve.

4. In a closed system for draining liquid from a body cavity, including a catheter having a drainage eye adjacent its distal end and a drainage lumen extending from the drainage eye to the proximal end of the catheter, and a drainage receptacle for collecting the liquid, a drainage tube having a pair of lumens which are in communication adjacent the upstream and downstream end of the tube, with said lumens communicating with the drainage lumen of the catheter adjacent the upstream end of the tube and communicating with the drainage receptacle adjacent the downstream end of the tube to drain liquid from the catheter to the drainage receptacle and alleviate negative pressure developed in the system, said drainage tube including a section defining a portion of one of said lumens which extends upstream from the other of the lumens, said section having a plurality of apertures disposed circumferentially around the section, and including a filter covering said apertures, said filter being pervious to air to permit passage of air between the lumens and impervious to liquid to prevent passage of liquid from the one lumen.

5. The drainage system of claim 4 including a connector which closes the upstream end of said tube, said connector having a passageway to receive an end portion of the tube section and communicating between the lumen extension and the drainage lumen of the catheter.