U.S. patent number 3,851,650 [Application Number 05/260,085] was granted by the patent office on 1974-12-03 for closed drainage system with double lumen tube.
This patent grant is currently assigned to The Kendall Company. Invention is credited to Phillip H. Darling.
United States Patent |
3,851,650 |
Darling |
December 3, 1974 |
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.
Inventors: |
Darling; Phillip H. (Elm Grove,
WI) |
Assignee: |
The Kendall Company (Boston,
MA)
|
Family
ID: |
22987708 |
Appl.
No.: |
05/260,085 |
Filed: |
June 6, 1972 |
Current U.S.
Class: |
604/129;
604/920 |
Current CPC
Class: |
A61M
25/10186 (20131105); A61M 25/10 (20130101); A61M
25/00 (20130101); A61F 5/441 (20130101); A61M
25/10185 (20131105) |
Current International
Class: |
A61F
5/441 (20060101); A61M 25/00 (20060101); A61M
25/10 (20060101); A61m 027/00 () |
Field of
Search: |
;128/275,276,DIG.25,348-350 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Truluck; Dalton L.
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.
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.
* * * * *