U.S. patent number 3,638,655 [Application Number 05/037,462] was granted by the patent office on 1972-02-01 for intubation tubes.
Invention is credited to George O. Doherty.
United States Patent |
3,638,655 |
Doherty |
February 1, 1972 |
INTUBATION TUBES
Abstract
An intubation, endotracheal, or other tube having a tubular
portion provided with a bulbous cuff encirclingly disposed on its
distal end. The cuff is formed from an easily compressible or
distortable material which constantly seeks to revert to its
original shape, yet, when distorted, exerts pressure of small
magnitude on the distorting object. The cuff sealingwise engages
the walls of a patient's encircling tracheal lining. The cuff of
one embodiment is reduced in diameter at its center for
accommodation of the patient's vocal cords.
Inventors: |
Doherty; George O. (Missoula,
MT) |
Family
ID: |
21894483 |
Appl.
No.: |
05/037,462 |
Filed: |
May 18, 1970 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
Issue Date |
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628593 |
Apr 5, 1967 |
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Current U.S.
Class: |
128/207.15 |
Current CPC
Class: |
A61M
16/0447 (20140204); A61M 16/04 (20130101); A61M
25/04 (20130101); A61M 16/0445 (20140204); A61M
16/0443 (20140204) |
Current International
Class: |
A61M
25/04 (20060101); A61M 16/04 (20060101); A61M
25/02 (20060101); A61m 025/00 () |
Field of
Search: |
;128/145.5-145.8,147,201,208,222,239-242,245,341-343,348-351 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Rosenbaum; Charles F.
Parent Case Text
This application is a streamline continuation of application Ser.
No. 628,593, filed Apr. 5, 1967, now abandoned.
Claims
What is claimed is:
1. An intubation tube for establishing communication through and
for sealingwise engaging a body canal; said intubation tube
comprising a tubular portion adapted to telescopically fit within
said body canal; a bulbous cuff mounted on and encircling said
tubular portion; said cuff normally having a bulbous shape and
being formed from an elastic compressible material which when
compressed or distorted seeks to revert to its original
configuration; said cuff having an outer skin which is smooth and
substantially cavity free so as to prevent the passage of air
through said cuff; said cuff being free from communication with
means for inflating it; and said cuff being larger than said body
canal so that when confined within said canal it yieldably distorts
to the cross-sectional size and shape of said canal, thereby
forming a fluidtight seal between said tubular portion and said
canal.
2. An intubation tube according to claim 1 wherein said skin is a
thin covering surrounding said cuff.
3. An intubation tube according to claim 1 wherein said skin is
formed by the application of heat to the outer surface of said
cuff.
4. An intubation tube according to claim 1 wherein said tubular
portion includes at least one end which extends from said bulbous
cuff, said end being free for grasping and manipulation of said
tube.
5. An incubation tube according to claim 1 in which the cuff is
formed from a cellular material.
6. An intubation tube according to claim 1 in which the cuff is
formed from a trabeculated material.
7. An intubation tube according to claim 1 in which the cuff
possesses a spongy consistency.
8. An intubation tube according to claim 1 for use as an
endotracheal tube wherein the cuff is substantially circular in
transverse cross-sectional configuration concentric about the axis
of the tubular portion and of a diameter sufficient in size to
sealingwise engage a patient's tracheal lining caudad to the
larynx, and wherein the cuff is further elongated in longitudinal
cross-sectional configuration.
9. An intubation tube according to claim 1 for use as an
endotracheal tube wherein the cuff is adhesively secured to the
external surface of the tubular portion.
10. An intubation tube according to claim 1 for use as an
endotracheal tube wherein said tubular portion extends through a
longitudinally extending bore in said cuff, said bore being located
offcenter with respect to the outer periphery of said cuff, said
cuff being sized to engage a patient's tracheal lining caudad to
the larynx; said offcenter location of said bore permitting visual
inspection of said cuff, said tubular portion, and said larynx
during insertion of said endotracheal tube into a patient's
trachea.
11. An intubation tube according to claim 1 for use as an
endotracheal tube wherein said cuff is provided intermediate its
ends with a diametrally reduced center portion which divides said
cuff into forward and rear cuff portions, said center portion being
sized to accommodate the patient's larynx; at least one of said
forward and rear cuff portions being larger than the patient's
trachea so that it yieldably distorts to the cross-sectional size
and shape of said trachea, the elasticity of said one cuff portion
causing it to expand outwardly against said trachea to form a
fluidtight seal therewith.
12. An intubation tube according to claim 11 wherein both of said
forward and rear cuff portions are larger than the patient's
trachea so as to fit snugly therein, thereby providing a fluidtight
seal above and below the patient's larynx when said center portion
is positioned within said trachea adjacent said larynx.
13. An intubation tube for establishing communication through and
for sealingwise engaging a body canal; said intubation tube
comprising a tubular portion adapted to telescopically fit within
said body canal; a bulbous cuff mounted on and encircling said
tubular portion; said cuff normally having a bulbous shape and
being formed from an elastic compressible material which when
compressed or distorted seeks to revert to its original
configuration; said cuff being elongated, having an enlarged
diameter intermediate its ends, having reduced diameters at its
ends, and normally having a rounded contour tapering toward said
ends from said enlarged diameter; said cuff being free from
communication with means for inflating it; and said enlarged
diameter being larger than said body canal so that when said cuff
is within said canal it yieldably distorts to the cross-sectional
size and shape of said canal.
Description
During surgical procedures it is often desirable to maintain
complete control over the patient's breathing. Heretofore, this has
been accomplished by administering oxygen and anesthetics to the
patient through an endotracheal tube inserted through the patient's
mouth and larynx and into the vestibular portion of the trachea.
These tubes externally carry inflatable rubber cuffs which are
inflated once the cuff has passed the larynx so as to form a
fluidtight seal between the encircling tracheal lining and the
outer surface of the tube. In this manner, any suitable gaseous
mixture can be passed into the patient's lungs.
The embracing inflatable cuffs, however, have not proved entirely
satisfactory for the foregoing purpose. In the first place, some
remotely located means must be provided for inflating the cuff once
it reaches the vestibular portion of the trachea and such means
usually involve a small flexible inflation tube which extends
loosely along the side of the larger cuff-carrying tube
interconnecting the cuff thereon with a small syringe-type bulb
located beyond the patient's mouth. These small tubes are a
nuisance and often interfere with the conduct of the operation.
Moreover, during emplacement, they obstruct the anesthesiologist's
view and often become twisted and tangled. On the other hand, if
the inflation tube is located internally of the endotracheal tube,
it can interfere with the insertion of instruments through the
latter tube. Secondly, conventional endotracheal tubes, because of
the nature of their construction, generally cannot be manufactured
at a cost which would permit their use on a disposable basis.
Consequently, they are reused after sterilization, but because the
cuffs are constructed of rubber they cannot be sterilized by steam
or other high-temperature methods. This increases the possibility
of transferring infections from one patient to another.
Among the several objects of the present invention may be noted the
provision of an intubation tube which can be inserted into an
enclosed channellike passage so as to form a fluidtight seal
therewith; the provision of an endotracheal tube having a cuff
which is compressed within the trachea so as to form a fluidtight
seal with the encircling tracheal lining; the provision of an
endotracheal tube which is simple in construction and economical to
manufacture; the provision of an endotracheal tube which is
completely disposable; the provision of an endotracheal tube which
is not easily dislodged through inadvertence once emplaced; and the
provision of an endotracheal tube which creates comparatively
little irritation when placed within a patient's trachea. Other
objects and features will be in part apparent and in part pointed
out hereinafter.
The invention accordingly comprises the constructions hereinafter
described, the scope of the invention being indicated in the
following claims.
In the accompanying drawings, in which several of various possible
embodiments of the invention are illustrated,
FIG. 1 is an elevational view of an endotracheal tube constructed
in accordance with and embodying the present invention;
FIG. 2 is a sectional view taken along line 2--2 of FIG. 1;
FIG. 3 is an elevational view of the endotracheal tube showing it
emplaced within the trachea of a patient illustrated in
phantom;
FIG. 4 is an elevational view of a modified form of endotracheal
tube forming part of the present invention;
FIG. 5 is a sectional view taken along line 5--5 of FIG. 4;
FIG. 6 is a fragmentary elevational view of another form of
endotracheal tube forming part of the present invention; and
FIG. 7 is a sectional view of the endotracheal tube of FIG. 6
emplaced within the trachea of a patient, the patient being
illustrated in phantom.
Corresponding reference characters indicate corresponding parts
throughout the several views of the drawings.
Referring now to the drawings, 2 designates an endotracheal tube
including a tubular portion 4 having a distal end 6 and a proximal
end 8. Tubular portion 4 is preferably formed from a flexible
relatively soft synthetic or natural material. Embracing tubular
portion 4 at its distal end 6 is a bulbous cuff 10 having a
substantially circular transverse cross-sectional shape and a
somewhat elongated or elliptical longitudinal cross-sectional
configuration. Cuff 10 is provided with a central bore 12, the
walls of which snugly embrace and are preferably adhesively secured
to the external surface of tubular portion 4.
Cuff 10 is formed from a spongy rubber, plastic, or other natural
or synthetic material having a trabeculated or cellular
consistency. The material is easily compressed, but once compressed
seeks to revert to its original configuration. The exact choice of
material is not critical, the significant factor being that it
compresses or distorts under forces of relatively small magnitude,
but when these forces are removed it readily reverts to its
original shape. This cuff material can be formed or molded in any
conventional manner, and, if desired, it can be provided with a
smooth cavity-free outer surface. This can be accomplished by the
application of heat, by coating with a plastic or latex, or by
actually using a covering of thin latex or thin plastic within
which the foamy or spongy material is flowed, extruded, or
otherwise introduced.
Referring now to FIG. 3, endotracheal tube 2 is emplaced merely by
inserting its distal end into the patient's mouth 14 and larynx 16
and insinuating cuff 10 through the narrow laryngeal orifice formed
by the vocal cords 18. The surface of cuff 10 is first coated with
a suitable lubricant such as xylocaine jelly which has anesthetic
properties to lessen irritation upon placement. Distal end 6 is
then passed through the patient's mouth 14 and larynx 16 until cuff
10 engages vocal cords 18 of larynx 16, whereupon the
anesthesiologist, by manipulating proximal end 8, urges tube 2
still further inwardly. This causes cuff 10 to contract or deform
to the cross-sectional shape of the patient's laryngeal orifice.
Tube 2 is urged further inwardly, causing cuff 10 to glide past
vocal cords 18. Once beyond vocal cords 18, cuff 10 reexpands,
seeking to revert to its original size within the vestibular
portion 20 of the patient's trachea 22 and in so doing engages the
encircling tracheal lining, assuming the cross-sectional shape
thereof and forming a fluidtight seal therewith. Inasmuch as the
foamed or spongy material from which cuff 10 is formed deforms
under forces of small magnitude, the restricted portion of the
larynx 16 is not in anyway injured or subject to significant
irritation. Similarly, once in vestibular portion 20 of trachea 22,
cuff 10 exerts a slight substantially uniform pressure on the
encircling tracheal lining, forming an adequate seal therewith, but
does not in anyway annoy it.
Endotracheal tube 2, including tubular portion 4 and bulbous cuff
10 can be produced by means of an inexpensive manufacturing
operation requiring little skilled labor or expensive production
machinery. Consequently, it can be sold at a price which would
justify its use on a disposable basis. Nevertheless, it can be
sterilized in a manner similar to conventional inflatable cuff-type
endotracheal tubes and, therefore, can be used for more than one
operation or other surgical procedure.
As will be seen from FIGS. 4 and 5, it is possible to provide a
modified endotracheal tube 30 also including a tubular portion 32
and a bulbous cuff 34, the latter of which can be formed from any
of the materials previously discussed in conjunction with cuff 10.
Cuff 34, however, is provided with a longitudinally extending bore
36 located offcenter with respect to the outer periphery of cuff 34
so that when the distal end of tubular portion 32 is fitted into
bore 36 and adhesively secured to the walls thereof, cuff 34 will
be disposed eccentrically on tubular portion 32. At the opposite or
proximal end of tubular portion 32, a stripe 38 or other suitable
indicia is inscribed to indicate the circumferential portion on
tubular portion 32 where the outward radial protuberance of cuff 34
is smallest.
Endotracheal tube 30 is manipulated through the patient's larynx
and into the trachea in a manner similar to endotracheal tube 2.
Inasmuch as cuff 34 is located eccentrically on tubular portion 32,
the anesthesiologist can rotate tubular portion 32 so that the
circumferential portion of cuff 34 having the smallest radial
projection with respect to tubular portion 32 is presented along
the anesthesiologist's line of sight. The actual location of this
portion can be readily ascertained by observing stripe 38.
Consequently, tubular portion 32 can be rotated to bring cuff 34
into a position wherein cuff 34 and tubular portion 32 are held in
such a manner within the patient's larynx that the visual
obstruction caused thereby is reduced to an absolute minimum. This
construction affords the anesthesiologist proper inspection of cuff
34 and tubular portion 32 as well as the patient's larynx as cuff
34 is manipulated through the latter.
The eccentric disposition of cuff 34 necessarily guides the distal
end of tubular portion 32 into an eccentrically located position
within the patient's trachea. This is of no consequence from the
standpoint of administering anesthetics. However, once emplaced,
endotracheal tube 30 can be rotated so that its distal end is
disposed offcenter in any desired direction. Accordingly,
instruments such as probing suction catheters which are generally
passed through endotracheal tubes can more easily be directed to
whatever quarter the operator desires to perform more intensive
work.
Referring now to FIGS. 6 and 7, it is possible to provide another
modified endotracheal tube 40 also including a tubular portion 42
and a bulbous cuff 44, the latter of which is formed from any of
the resilient materials previously discussed in conjunction with
cuff 10. Cuff 44, however, possesses a diametrally reduced center
portion 46 defined by gently sloping surfaces 48 which lend an
hourglass appearance thereto. Cuff 44 is divided into forward and
rear cuff portions 50, 52, by reduced center portion 46.
Endotracheal tube 40 is emplaced by smearing cuff 44 with a
suitable lubricant and then advancing the distal end of tubular
portion 42 through the patient's mouth 14 and larynx 16. Eventually
forward cuff portion 50 will encounter the restricted laryngeal
orifice formed by vocal cords 18. A slight forward or inward thrust
will, however, compress forward cuff portion 50 allowing it to
glide past vocal cords 18 and into the vestibular portion 20 of
trachea 22. Rear cuff portion 52, on the other hand, remains
proximal to vocal cords 18 so that gently sloping surfaces 48 are
embraced by vocal cords 18 which form the restricted laryngeal
orifice. Thus, diametrally reduced portion 46 accommodates the
patient's vocal cords 18 so that irritation is reduced to an
absolute minimum during the course of the operation. Nevertheless,
a fluidtight seal is formed by the snugness of the fit above and
below the vocal cords 18 as well as in the area of vocal cords 18
themselves. Consequently, a compressive, yet contoured, fit is
achieved through the use of a suitable resilient material and this
contoured fit greatly aids in preventing endotracheal tube 40 from
becoming dislodged.
Whereas the cuffs of conventional endotracheal tubes are passed
through the larynx in a deflated condition and are subsequently
inflated in the trachea by means of suitable inflating devices,
cuffs 10, 34, and 44 of tubes 2, 30, and 40, respectively, are
merely eased through and compressed by the larynx itself. Once
beyond the larynx, they reexpand by virtue of their own natural
resiliency and thereby engage the encircling tracheal lining
forming a fluidtight seal therewith. Consequently, no remotely
located inflating devices are necessary to enable cuffs 10, 34, or
44 to achieve a proper seal.
It should be understood that endotracheal tubes 2, 30, 40, can be
employed in numerous other situations where it is desired to
temporarily seal a tube within an enclosed channel, such as
intubation of other body canals, joining two tubes of unequal
diametral size, etc.
In view of the above, it will be seen that the several objects of
the invention are achieved and other advantageous results
attained.
As various changes could be made in the above constructions without
departing from the scope of the invention, it is intended that all
matter contained in the above description or shown in the
accompanying drawings shall be interpreted as illustrative and not
in a limiting sense.
* * * * *