CA2102462C - Emergency resuscitation apparatus - Google Patents
Emergency resuscitation apparatus Download PDFInfo
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- CA2102462C CA2102462C CA002102462A CA2102462A CA2102462C CA 2102462 C CA2102462 C CA 2102462C CA 002102462 A CA002102462 A CA 002102462A CA 2102462 A CA2102462 A CA 2102462A CA 2102462 C CA2102462 C CA 2102462C
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- Canada
- Prior art keywords
- tube
- balloon
- endoesophageal
- respiration tube
- respiration
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M15/00—Inhalators
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/04—Tracheal tubes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/04—Tracheal tubes
- A61M16/0402—Special features for tracheal tubes not otherwise provided for
- A61M16/0409—Special features for tracheal tubes not otherwise provided for with mean for closing the oesophagus
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/04—Tracheal tubes
- A61M16/0434—Cuffs
- A61M16/0443—Special cuff-wall materials
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/04—Tracheal tubes
- A61M16/0434—Cuffs
- A61M16/0454—Redundant cuffs
- A61M16/0456—Redundant cuffs one cuff within another
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/04—Tracheal tubes
- A61M16/0434—Cuffs
- A61M16/0454—Redundant cuffs
- A61M16/0459—Redundant cuffs one cuff behind another
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/04—Tracheal tubes
- A61M16/0475—Tracheal tubes having openings in the tube
- A61M16/0477—Tracheal tubes having openings in the tube with incorporated means for delivering or removing fluids
- A61M16/0479—Tracheal tubes having openings in the tube with incorporated means for delivering or removing fluids above the cuff, e.g. giving access to the upper trachea
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/04—Tracheal tubes
- A61M16/0486—Multi-lumen tracheal tubes
Abstract
An emergency resuscitation endoesophageal airway comprises an arch-shaped respiration tube closed at a distal end but open at a proximal end. A first inflatable balloon of a rubber-like elastic material is attached to the respiration tube at a position close to its distal end thereof for closing the esophagus of a patient. A second inflatable balloon of a flexible synthetic resin is attached to the respiration tube at a location spaced from its proximal end for closing the pharynx of the patient. The respiration tube is provided with air holes between the first and second balloons, but rather nearer the second balloon, and the second balloon is so designed as to expand in both its longitudinal and radial directions to an extent much greater than the first balloon.
Description
Emergency_ Resuscitation Apparatus The present invention relates to an emergency resuscitation apparatus, and, more particularly, to an endo-esophageal airway for emE~rgency resuscitation, i.e. to be used for trying to achieve ari:ificial respiration on an emergency patient in a critical condition, while providing an artificial passage for flow of' air or oxygen to the lungs of the patient.
Up to now, artificial respiration has been employed widely to resuscitate an emergency patient in a critical condition. In most: cases, this is carried out by endotracheal intubation in which an endotracheal tube is inserted into the trachea of the patient through the mouth or nose of the patient and then connected to a resuscitator to introduce air or oxygen.
In the endotra~cheal intubation technique, it is primarily required to insert a laryngoscope into the cavity of the mouth to visualize the larynx. Then, a distal end of the endotracheal tube must bea quickly inserted into the trachea, while observing the: glottis under direct laryngoscopy. Thus, there is only a limited number of skilled persons who can adequately practice: controlled artificial lung ventilation by the endotracheal intubati.on method. In fact, in one country, the persons qualified to practice endotracheal intubation have been limited to those licensed to practice medical treatments, for example, medical doctors. Further, endotracheal intubation involves. technical difficulties when it is difficult to open the mouth of the patient or when the extension of the injured cervical spines endangers the patient in cases of cranial and cervical trauma. Since the regions between the innermost deb>ths of the pharynx and the larynx have a high risk of causing nervous reflexes, there is a danger that endotracheal intubation may cause side effects, such as arrhythmia, cardiac arrest, vomiting, laryngeal spasm, or the like when applied to a serious case whose respiratory function has been stopped.
A
Up to now, artificial respiration has been employed widely to resuscitate an emergency patient in a critical condition. In most: cases, this is carried out by endotracheal intubation in which an endotracheal tube is inserted into the trachea of the patient through the mouth or nose of the patient and then connected to a resuscitator to introduce air or oxygen.
In the endotra~cheal intubation technique, it is primarily required to insert a laryngoscope into the cavity of the mouth to visualize the larynx. Then, a distal end of the endotracheal tube must bea quickly inserted into the trachea, while observing the: glottis under direct laryngoscopy. Thus, there is only a limited number of skilled persons who can adequately practice: controlled artificial lung ventilation by the endotracheal intubati.on method. In fact, in one country, the persons qualified to practice endotracheal intubation have been limited to those licensed to practice medical treatments, for example, medical doctors. Further, endotracheal intubation involves. technical difficulties when it is difficult to open the mouth of the patient or when the extension of the injured cervical spines endangers the patient in cases of cranial and cervical trauma. Since the regions between the innermost deb>ths of the pharynx and the larynx have a high risk of causing nervous reflexes, there is a danger that endotracheal intubation may cause side effects, such as arrhythmia, cardiac arrest, vomiting, laryngeal spasm, or the like when applied to a serious case whose respiratory function has been stopped.
A
In addition, t:he ci:Liated epitheliums of the trachea are very fragile to trauma or stresses. For example, they are weak in resistance to pressure applied by a tube, a cuff, or a balloon, or can be burnt easily by inhalation of hot air in the vicinity of a fire. Recently, therefore, there has been a growing tendency to avoid breathing controls accomplished by inserting foreign :substances into such delicate and fragile tracheae for a lone period of time, as much as possible.
Recently, it has been proposed to use an esophageal obstructor airway ('EOA), because of the fact that a respiration tube closed at one end will in all probability be introduced into they esophagus through the pharynx by inserting it blindly through the mouth of the patient along a median line without perfox-ming overextension of the larynx.
Esophageal obstruct:or ai~:-ways (EOA) are now employed in some countries, including Unii:ed Staten of America, Canada and Japan as an emergency re:auscitatian apparatus. Such an apparatus generally comprises a respiration tube having a closed distal end and proximal open end, and being provided with air holes in a~ midd7Le part of a side wall thereof. An inflatable balloon is arranged near the distal end of the respiration tube, a. slender elongated inflation tube is connected to the inflatable balloon, and a face-mask is fixed to the open end of the reaspiration tube.
The artificial lung ventilation is carried out in the following manner: Firstly, the distal end of the respiration tube is inserted into thsa low esophagus of a patient through the mouth. Then, the balloon is inflated by supplying air through the tube to brine it into close contact with the esophageal wall, and the face-mask is brought into close contact with the face of the patient. The open end of the respiration tube is connected to a. lung ventilator or a resuscitator to practice positive pressure artificial respiration on the patient. The air fed to EOA flows out of the respiration tube into the trachea through the air holes.
Since the esophagus is blocked by the balloon, the air does not flow into the stomach, but flows into the trachea via the pharynx and glottis, and then into the lungs of the patient.
The air in the lungs is 'then exhaled by releasing the pressure. This process ensures easy and rapid intubation, but it has to be assisted by an assistant to hold the mask in close contact with the face of the patient. In addition, the location of the di:atal end of the respiration tube put in the esophagus cannot be adjuated at will, which sometimes results in failure in obstruction by the inflated balloon. Further, it is difficult to maintain the close contact between the mask and the face of the' patient during transport in an ambulance.
To enable the prior art to be further described with the aid of a diagram the figures of the drawings will first be listed.
Fig. 1 is a plan vieaw of an endoesophageal airway for emergency resuscitation <according to an embodiment of the present invention;
Fig. 2 is a partial side view of the endoesophageal airway for emergency resuscitation of Fig. l;
Fig. 3 is a section view of an endoesophageal airway for emergency resuscitation, illustrating another embodiment of the present invention;
Fig. 4 is a pi.ctori<il view illustrating use of an endoesophageal airway for emergency resuscitation of the present invention, properly inserted into a patient; and Fig. 5 is a view of a prior art embodiment.
Figure 5 show; the :structure of laryngeal mask airways (LMA) that have been used in the United Kingdom. Such a laryngeal mask airway comprises a hollow respiration tube 101 like a short endotracheal. tube, a cushion mask 102 mounted on one open end of the. tube 101 and having an inflatable ring-like cushion 103 attached thereto, and means 105 for inflating the ring-like cushion 103. In use, the cushion 103 is deflated to minimize its volume and then inserted from the cavity of the mouth towards the larynx along the median line until the cushion 103 is stopped around the area between the pharynx and larynx. In this position, the cushion 103 is inflated by introducing a~ certain amount of air through the A
Recently, it has been proposed to use an esophageal obstructor airway ('EOA), because of the fact that a respiration tube closed at one end will in all probability be introduced into they esophagus through the pharynx by inserting it blindly through the mouth of the patient along a median line without perfox-ming overextension of the larynx.
Esophageal obstruct:or ai~:-ways (EOA) are now employed in some countries, including Unii:ed Staten of America, Canada and Japan as an emergency re:auscitatian apparatus. Such an apparatus generally comprises a respiration tube having a closed distal end and proximal open end, and being provided with air holes in a~ midd7Le part of a side wall thereof. An inflatable balloon is arranged near the distal end of the respiration tube, a. slender elongated inflation tube is connected to the inflatable balloon, and a face-mask is fixed to the open end of the reaspiration tube.
The artificial lung ventilation is carried out in the following manner: Firstly, the distal end of the respiration tube is inserted into thsa low esophagus of a patient through the mouth. Then, the balloon is inflated by supplying air through the tube to brine it into close contact with the esophageal wall, and the face-mask is brought into close contact with the face of the patient. The open end of the respiration tube is connected to a. lung ventilator or a resuscitator to practice positive pressure artificial respiration on the patient. The air fed to EOA flows out of the respiration tube into the trachea through the air holes.
Since the esophagus is blocked by the balloon, the air does not flow into the stomach, but flows into the trachea via the pharynx and glottis, and then into the lungs of the patient.
The air in the lungs is 'then exhaled by releasing the pressure. This process ensures easy and rapid intubation, but it has to be assisted by an assistant to hold the mask in close contact with the face of the patient. In addition, the location of the di:atal end of the respiration tube put in the esophagus cannot be adjuated at will, which sometimes results in failure in obstruction by the inflated balloon. Further, it is difficult to maintain the close contact between the mask and the face of the' patient during transport in an ambulance.
To enable the prior art to be further described with the aid of a diagram the figures of the drawings will first be listed.
Fig. 1 is a plan vieaw of an endoesophageal airway for emergency resuscitation <according to an embodiment of the present invention;
Fig. 2 is a partial side view of the endoesophageal airway for emergency resuscitation of Fig. l;
Fig. 3 is a section view of an endoesophageal airway for emergency resuscitation, illustrating another embodiment of the present invention;
Fig. 4 is a pi.ctori<il view illustrating use of an endoesophageal airway for emergency resuscitation of the present invention, properly inserted into a patient; and Fig. 5 is a view of a prior art embodiment.
Figure 5 show; the :structure of laryngeal mask airways (LMA) that have been used in the United Kingdom. Such a laryngeal mask airway comprises a hollow respiration tube 101 like a short endotracheal. tube, a cushion mask 102 mounted on one open end of the. tube 101 and having an inflatable ring-like cushion 103 attached thereto, and means 105 for inflating the ring-like cushion 103. In use, the cushion 103 is deflated to minimize its volume and then inserted from the cavity of the mouth towards the larynx along the median line until the cushion 103 is stopped around the area between the pharynx and larynx. In this position, the cushion 103 is inflated by introducing a~ certain amount of air through the A
inflating means 10~i and lbrought into close contact with the laryngeal opening, therelby closing the uppermost part of the esophagus and prevE:nting flow of air into the stomach. Under such a condition, t:he positive pressure artificial lung ventilation is accomplislZed through the opposite open end 104 of the respiration tube :101.
The intubation of L1!~IA can be carried out with ease and rapidly when the patient is under anesthesia or unconsciousness. Also, :if it is easy to open the mouth of the patient because of deep <anesthesia, and if the patient shows no local nervous reflex but has spontaneous respiration, it is easy to perform they proper intubation, as the respiration tube can be thrust in properl~~r by confirming the location of the distal end thereof with i~he breath sounds coming through it.
However, such an apparatus involves technical difficulties for u~:e in emergency resuscitation. For example, it is difficult to locatsa the respiration tube in the proper position rapidly wren the respiratory function of the patient has been stopped fc>r somE~ reason ar other. Further, there is a fear of blockage of thEa airway when the cushion is inflated greatly. In addition, it. is difficult to bring the cushion into close contact with t:he laryngeal opening, because of the complex configuration of the pharynx. In the case of high positive pressure a~rtific:ial ventilation, the cushion cannot be brought into close contact with the laryngeal opening, thus making it difficult. to prevent the flow of air into the stomach, which in turn results in failure in artificial lung ventilation.
It is therefore an object of the present invention to provide an emergency resuscitation apparatus, i.e., an endoesophageal airway for- emergency resuscitation, that makes it possible to practice artificial lung ventilation easily, quickly and surely on a x>atient, even by a person who has no physician's license, to resuscitate the patient.
Another object of tree present invention is to provide an endoesophageal airway for emergency resuscitation, that can be used only by inserting a respiration tube into the esophagus A' without the use of a mask and insertion of a respiration tube into the trachea.
Still another object of the present invention is to provide an endoesophageal airway for emergency resuscitation, that makes it possible to adjust the depth of insertion of the respiration tube in the esophagus, as well as to prevent the flow of air into the stomach and the cavity of the mouth.
According to the present invention, these and other objects are achieved by providing an emergency resuscitation endoesophageal airway comprising: an arch-shaped respiration tube closed at a distal end and.open at a proximal end; a first inflatable balloon of a rubber-like elastic material attached to the tube at a position close to the distal end thereof for closing the esophagus of a patient; a second inflatable balloon of a flexible synthetic resin attached to the tube at a position spaced from the proximal end thereof for closing a pharynx of the patient; and first and second tubes for inflating said first and second balloons, wherein said respiration tube is provided with air holes between the first and second balloons, wherein said second inflatable balloon is so designed as to expand in both its longitudinal and radial directions to such an extent that it comes into light contact with the surrounding structures of the pharynx and cavity of mouth, and wherein the closed distal end of said respiration tube is slanted in the direction opposite to the curvature of respiration tube and is rounded.
Referring now to Figs. 1 and 2, there is shown an endoesophageal airway for emergency resuscitation according to an embodiment of the present invention, which comprises a respiration tube 1 having air holes or passages 4 provided therein; a first inflatable balloon 2 arranged at the side of a distal end of the respiration tube 1 for closing the esophagus; a second flexible and inflatable balloon 3 of a - 5a -synthetic resin arranged at the side of a proximal end of the respiration tube 1 for closing the pharynx; and inflating tubes 5 and 6 respectively connected to the first and second balloons 2 and 3. The respiration tube 1 is provided with the air holes 4 between the first and second balloons 2 and 3, but rather nearer the second balloon 3. The balloon 3 is so designed as to expand in both its longitudinal and radial directions to an extent ~anuch greater than the first balloon 2.
The respiration tube 1 is usually made of a synthetic material having good fle:~ibility and elasticity, and is in the form of an arch-shaped tube curved like a bow but straightened at a leading part including the first balloon 2, so that the endoesophageal airway may be easily inserted into the esophagus of a patient through the mouth. As a typical synthetic material for the respiration tube 1, there may be used materials such as non-rigid polyvinyl chloride, silicone rubber, or polyuret:hanes.
Respiration tube 1 has a main lumen 11 and is closed at its distal end but opened at its proximal end. Main lumen 11 is used to provide an ari~ificial airway for inhalation and exhalation of air or oxygen. To that end, respiration tube 1 is provided with tree plurality of air holes 4 each having a circular cross section and located between first and second balloons 2 and 3 but in i:he proximity of the balloon 3, whereby the main lumen 1.L communicates with the trachea through the air holes 4 when the endoesophageal airway for emergency resuscitation _-'is properly inserted into the esophagus of the patient"
A closed part 7 of i:he distal. end is slanted in the direction opposite to thEa curved direction of the respiration tube 1 and rounded to provide sharp corners. On the proximal end of the respiration tube 1 there is a connector 8, usually of a synthetic resin, having a connecting portion so that the endoesophageal airway can be connected directly to a manually operated resuscitator or an automatic resuscitator (not shown). To this end, the' connector 8 is generally designed to have an outer diameaer oj: 15 mm and a taper of 1/40, as used internationally.
The respiration tube: 1 is further provided with first and second small-sized lumen:> 12 and 1.3 in its side wall. The first lumen 12 comm,unicat:es at one end with the first balloon 2 through an opening formed in the wall of the respiration tube 1 and at its other e:nd is connected to the inflating tube _~_ through an opening provided in the wall of the tube 1 near its proximal end.
The second lumen 13 communicates at one end with the second balloon 3 and at :its other end with the inflating tube 5 6 through an opening formed in the wall of the tube 1.
The length and diameter of the tube 1 are generally determined according to physiques of patients, but the diameter of the tube 1 i:~ so determined as to have a diameter smaller than that of the esophagus to provide sufficient space for formation of an airway between them. However, there is no need for the tube 7_ to h<~ve precise measurements, as compared with the endotrache~al tube of the prior art. For practical use, it is sufficient to provide several respiration tubes that are different from one another in the distance between the first and second balloons, as each respiration tube can be used with more than one physique.
The closed dig>tal end of the tube 1 is usually formed as an integral part thereof" as shown in Fig. 1. Alternately, this closed distal end can be formed as a separate round end member having a configuration similar to that of Fig. 1 and serving as a stopper. In this case, the end member may be made of a material different from that of the tube 1 itself.
Further, the tube 1 may be provided with an insertion mark 15 between the second balloon 3 and the connecting portion of the tubes 1 whEare the inflating tubes 5 and 6 are connected to it, in order to facilitate a determination of the depth of insertion of the endoesophageal airway into the esophagus.
The first balloon 2 is arranged on the tube 1 near its closed distal end 7 for closing the esophagus, while the second balloon 3 is. arranged on the tube 1 at a position spaced from its proximal end for closing the pharynx.
The balloon 2 is usually made of a rubber-like elastic material, such as, for a};ample, natural rubber, synthetic rubber, or an elast.omer, in the form of a flexible tubular membrane. Typical synths~tic rubber includes isoprene rubber, silicone rubber, urethanes rubber, ethylene-propylene rubber, A
_8_ etc. Further, as t:he maiterial for the balloon 2, it is possible to use a non-rigid polyvinyl chloride, as it has relatively good expansib:ility. The flexible tubular membrane for the balloon 2 is attached to a peripheral portion of the tube 1 where the ltunen 12 opens, near the distal end thereof, and is hermetically fixed thereto so as to make gas communication between the balloon 2 and the lumen 12 through the opening of the latter. Thus, the balloon 2 is inflated like an air-sac by feeding air through the inflating tube 5 and the lumen 12, effect:ively hermetically closing the lower part of the esophagus.
The balloon 3 is made of a relatively soft synthetic resin, such as, for example, polyethylene, polyester, non-rigid polyvinyl chloride" silicone resin, polyurethane, etc.
in the form of a cylindrical soft membrane. The cylindrical membrane is attached neap_- the proximal end of the tube 1 and is hermetically fi~,:ed thE~reto to make fluid communication between the balloon 2 anti the lumen 13 through the opening of the latter. Thus, the balloon 3 i.s inflated like an air-sac by feeding air into the 7Lumen 13 through the tube 6. In this case, the balloon 3. is expanded in accordance with the complex configurations of t:he pharynx and is brought into light contact with the surrounding structures of the pharynx and the mouth, thereby hermetically closing the space between the mouth and the upper part of the pharynx. Since the balloon 3 is of a relatively soft :synthetic material, it is possible to inflate it at a relative7_y low pressure without putting excess pressure on the surroundp_ng structures of the pharynx and the mouth.
The balloon 3 is made of a soft material of which the rubber-like elasticity is: smaller than that of the first balloon 2 to prevent the surrounding pharyngeal structures from damage due to pressure applied by the balloon 3. Thus, if artificial lung ventilation is carried out under a certain pressure exceeding the contact force between the second balloon 3 and the surrounding pharyngeal structures, there is a fear that the second balloon 3 could be moved from its y, _ g _ original position by preasure in the esophagus. To solve this problem as well as to enaure good airtightness and fixing properties of the balloon 3, in the embodiment of Fig. 1 this balloon is so designed that it can be inflated in both its longitudinal and radial directions to an extent greater than the first balloon ~!.
The volume of the space between the second balloon 3 and the tube 1 is so deaermined that the balloon 3 is just filled up with air when a certa:in amount of air determined by the physique of the patient :is supplied to the balloon 3 at a pressure of 10 cmH20 or lower. In general, the amount of air sufficient to fill up then balloon 3 is 50 to 150 ml for adults, but 30 to E.0 ml iEor children.
The balloons ~;, 3 are respectively connected to the tubes 5 and 6 through they lumens 12, 13. The tubes 5 and 6 are usually made of a scynthei~ic material, such as non-rigid polyvinyl chloride, silicone rubber, a polyurethane, polyethylene, etc. Each tube 5, 6 is hermetically connected at one end to the lumens Z2 and 13 having openings formed between the balloon 3 and the connector 8. At its other end, each tube 5 or 6 is. conneacted to an air supply port 52 or 62.
In the vicinity of each of the tubes 5 and 6, there is a pilot inflatable balloon 51 or 61 to indicate the inflation of the balloon 2 or 3 indirectly.
In use, the tube 1 is correctly introduced into the esophagus E (Figures 4) from the mouth O of the patient by inserting it until the insertion mark has been reached to the level of the lips. During intubation, there is no fear of insertion of the tube 1 W to the trachea by mistake, since the arch-shaped tube 1 is straight at its leading end including the first balloon 2, and, since the closed distal end of the tube 1 is slanted in the direction opposite to the curvature of the tube 1 and is rounded.
Next, the balloons 2 and 3 are inflated by supplying air into the lumens 11 and 12 through the respective tubes 5 and 6. Thus, as shown in Fic~. 4, the balloon 2 hermetically closes the esophagus E, because of its rubber-like elasticity, 1~1 while the balloon 3 hermetically closes the pharynx P and the larynx L. In this case, the balloon 3 has been expanded sufficiently in both the longitudinal and radial directions and brought into light contact with the surrounding structures of the pharynx and the cavity of the mouth, thereby hermetically closing the space between the mouth and the upper part of the pharyn};. At the same time, the endoesophageal airway is prevented from axial movement by the second balloon 3.
Air is then fsad as .inhalant air from the resuscitator (not shown) to the lungs through the connector 8, the main lumen 11, passages 4 and the trachea. After this, the air fed to the patient is exhaled to the resuscitator in the reverse direction.
Referring now to Fi<~. 3, there is shown another embodiment of an endoesophageal airway for emergency resuscitation, further comprising a third inflatable balloon 9 of a rubber-like elastic material. The balloon 9 is attached to the respiration tube 1, covered with the second balloon 3, and communicating with main lumen 11 of the tube 1 through one or more holes 14 in tube 1. When the endoesophageal airway is supplied with air after properly inserting it into the esophagus of the patient,, the third balloon 9 is inflated by a part of the air blown into the lumen 1l of the tube 1, the air flowing into the balloon 9 through the holes 14. Thus, the previously inflated) second balloon 3 is additionally inflated in proportion to the internal pressure of the tube 1 and is brought into airtigrht and stationary contact with the surrounding pharyngeal structures to prevent the balloon 3 from slipping away from t:he surrounding pharyngeal structures.
In the embodiment o1: Fig. 3, the air is fed to the third balloon 9 through the lumen 11 and the holes 14 of the tube 1.
Alternately, the air hole: for introducing air into the balloon 9 can be constituted by a further small-sized lumen (not illustrated in the drawings) similar to the lumens 12 and 13 to control the inflation of the third balloon 9 as occasion demands. In this case, t:he further small-sized lumen opens at A
one end into the interior of the balloon 9 and at it other end is connected to an inflaiting tube (not shown) similar to the inflating tubes 5 and 6.
As will be understood from the above, the endoesophageal airway described has the following advantages:
(a) It is possible to ensure closure of the esophagus with the first balloon, because of the fact that it is of a rubber-like elastic: material. In addition, there is no fear of the flow of air into i~he esophagus, nor the backward flow of the contents of the si;.omach, because of the good airtightness between the first balloon and the surrounding pharyngeal structures.
(b) It is po:~sible to close the larynx without applying excess pressure on the surrounding laryngeal structures, even if the second balloon is inflated completely, because of the fact that the second balloon is of a soft synthetic membrane and has a size sufficieni:ly expandable in both its longitudinal and a~;:ial directions.
(c) It is po~csible to insert the respiration tube easily into the esophagus, without causing any risk of inserting it into the trachea by mistake, because the arch-shaped respiration tube i~; almo:~t straight at its leading end including the first. balloon, and i.ts closed distal end is slanted in the direction opposite to its curvature and is rounded.
(d) The respiration tube is surely introduced into the esophagus, even if it is blindly inserted into the pharynx through the mouth, thus making it possible to practice controlled artificial lung ventilation on a patient easily by closing the larynx and tree lower part of the esophagus with the first and second balloons. There is thus no need to have the assistance of any pet-son.
(e) Since the esophagus is expandable and has a higher adaptability to foreign substances than the trachea, the respiration tube is never required to have a precise diameter corresponding to physique: of the patient. The endoesophageal airway can thus be applied to various persons with different A
physiques by only roughly adjusting the distance between the first and second balloon: .
Although the preseni~ invention has been fully described in connection with the preferred embodiments thereof with reference to the accompanying drawings, it is to be noted that various changes and modifications are apparent to those skilled in the art. Such changes and modifications are to be understood as included within the scope of the present invention as defins~d by i~he appended claims unless they depart therefrom.
A
The intubation of L1!~IA can be carried out with ease and rapidly when the patient is under anesthesia or unconsciousness. Also, :if it is easy to open the mouth of the patient because of deep <anesthesia, and if the patient shows no local nervous reflex but has spontaneous respiration, it is easy to perform they proper intubation, as the respiration tube can be thrust in properl~~r by confirming the location of the distal end thereof with i~he breath sounds coming through it.
However, such an apparatus involves technical difficulties for u~:e in emergency resuscitation. For example, it is difficult to locatsa the respiration tube in the proper position rapidly wren the respiratory function of the patient has been stopped fc>r somE~ reason ar other. Further, there is a fear of blockage of thEa airway when the cushion is inflated greatly. In addition, it. is difficult to bring the cushion into close contact with t:he laryngeal opening, because of the complex configuration of the pharynx. In the case of high positive pressure a~rtific:ial ventilation, the cushion cannot be brought into close contact with the laryngeal opening, thus making it difficult. to prevent the flow of air into the stomach, which in turn results in failure in artificial lung ventilation.
It is therefore an object of the present invention to provide an emergency resuscitation apparatus, i.e., an endoesophageal airway for- emergency resuscitation, that makes it possible to practice artificial lung ventilation easily, quickly and surely on a x>atient, even by a person who has no physician's license, to resuscitate the patient.
Another object of tree present invention is to provide an endoesophageal airway for emergency resuscitation, that can be used only by inserting a respiration tube into the esophagus A' without the use of a mask and insertion of a respiration tube into the trachea.
Still another object of the present invention is to provide an endoesophageal airway for emergency resuscitation, that makes it possible to adjust the depth of insertion of the respiration tube in the esophagus, as well as to prevent the flow of air into the stomach and the cavity of the mouth.
According to the present invention, these and other objects are achieved by providing an emergency resuscitation endoesophageal airway comprising: an arch-shaped respiration tube closed at a distal end and.open at a proximal end; a first inflatable balloon of a rubber-like elastic material attached to the tube at a position close to the distal end thereof for closing the esophagus of a patient; a second inflatable balloon of a flexible synthetic resin attached to the tube at a position spaced from the proximal end thereof for closing a pharynx of the patient; and first and second tubes for inflating said first and second balloons, wherein said respiration tube is provided with air holes between the first and second balloons, wherein said second inflatable balloon is so designed as to expand in both its longitudinal and radial directions to such an extent that it comes into light contact with the surrounding structures of the pharynx and cavity of mouth, and wherein the closed distal end of said respiration tube is slanted in the direction opposite to the curvature of respiration tube and is rounded.
Referring now to Figs. 1 and 2, there is shown an endoesophageal airway for emergency resuscitation according to an embodiment of the present invention, which comprises a respiration tube 1 having air holes or passages 4 provided therein; a first inflatable balloon 2 arranged at the side of a distal end of the respiration tube 1 for closing the esophagus; a second flexible and inflatable balloon 3 of a - 5a -synthetic resin arranged at the side of a proximal end of the respiration tube 1 for closing the pharynx; and inflating tubes 5 and 6 respectively connected to the first and second balloons 2 and 3. The respiration tube 1 is provided with the air holes 4 between the first and second balloons 2 and 3, but rather nearer the second balloon 3. The balloon 3 is so designed as to expand in both its longitudinal and radial directions to an extent ~anuch greater than the first balloon 2.
The respiration tube 1 is usually made of a synthetic material having good fle:~ibility and elasticity, and is in the form of an arch-shaped tube curved like a bow but straightened at a leading part including the first balloon 2, so that the endoesophageal airway may be easily inserted into the esophagus of a patient through the mouth. As a typical synthetic material for the respiration tube 1, there may be used materials such as non-rigid polyvinyl chloride, silicone rubber, or polyuret:hanes.
Respiration tube 1 has a main lumen 11 and is closed at its distal end but opened at its proximal end. Main lumen 11 is used to provide an ari~ificial airway for inhalation and exhalation of air or oxygen. To that end, respiration tube 1 is provided with tree plurality of air holes 4 each having a circular cross section and located between first and second balloons 2 and 3 but in i:he proximity of the balloon 3, whereby the main lumen 1.L communicates with the trachea through the air holes 4 when the endoesophageal airway for emergency resuscitation _-'is properly inserted into the esophagus of the patient"
A closed part 7 of i:he distal. end is slanted in the direction opposite to thEa curved direction of the respiration tube 1 and rounded to provide sharp corners. On the proximal end of the respiration tube 1 there is a connector 8, usually of a synthetic resin, having a connecting portion so that the endoesophageal airway can be connected directly to a manually operated resuscitator or an automatic resuscitator (not shown). To this end, the' connector 8 is generally designed to have an outer diameaer oj: 15 mm and a taper of 1/40, as used internationally.
The respiration tube: 1 is further provided with first and second small-sized lumen:> 12 and 1.3 in its side wall. The first lumen 12 comm,unicat:es at one end with the first balloon 2 through an opening formed in the wall of the respiration tube 1 and at its other e:nd is connected to the inflating tube _~_ through an opening provided in the wall of the tube 1 near its proximal end.
The second lumen 13 communicates at one end with the second balloon 3 and at :its other end with the inflating tube 5 6 through an opening formed in the wall of the tube 1.
The length and diameter of the tube 1 are generally determined according to physiques of patients, but the diameter of the tube 1 i:~ so determined as to have a diameter smaller than that of the esophagus to provide sufficient space for formation of an airway between them. However, there is no need for the tube 7_ to h<~ve precise measurements, as compared with the endotrache~al tube of the prior art. For practical use, it is sufficient to provide several respiration tubes that are different from one another in the distance between the first and second balloons, as each respiration tube can be used with more than one physique.
The closed dig>tal end of the tube 1 is usually formed as an integral part thereof" as shown in Fig. 1. Alternately, this closed distal end can be formed as a separate round end member having a configuration similar to that of Fig. 1 and serving as a stopper. In this case, the end member may be made of a material different from that of the tube 1 itself.
Further, the tube 1 may be provided with an insertion mark 15 between the second balloon 3 and the connecting portion of the tubes 1 whEare the inflating tubes 5 and 6 are connected to it, in order to facilitate a determination of the depth of insertion of the endoesophageal airway into the esophagus.
The first balloon 2 is arranged on the tube 1 near its closed distal end 7 for closing the esophagus, while the second balloon 3 is. arranged on the tube 1 at a position spaced from its proximal end for closing the pharynx.
The balloon 2 is usually made of a rubber-like elastic material, such as, for a};ample, natural rubber, synthetic rubber, or an elast.omer, in the form of a flexible tubular membrane. Typical synths~tic rubber includes isoprene rubber, silicone rubber, urethanes rubber, ethylene-propylene rubber, A
_8_ etc. Further, as t:he maiterial for the balloon 2, it is possible to use a non-rigid polyvinyl chloride, as it has relatively good expansib:ility. The flexible tubular membrane for the balloon 2 is attached to a peripheral portion of the tube 1 where the ltunen 12 opens, near the distal end thereof, and is hermetically fixed thereto so as to make gas communication between the balloon 2 and the lumen 12 through the opening of the latter. Thus, the balloon 2 is inflated like an air-sac by feeding air through the inflating tube 5 and the lumen 12, effect:ively hermetically closing the lower part of the esophagus.
The balloon 3 is made of a relatively soft synthetic resin, such as, for example, polyethylene, polyester, non-rigid polyvinyl chloride" silicone resin, polyurethane, etc.
in the form of a cylindrical soft membrane. The cylindrical membrane is attached neap_- the proximal end of the tube 1 and is hermetically fi~,:ed thE~reto to make fluid communication between the balloon 2 anti the lumen 13 through the opening of the latter. Thus, the balloon 3 i.s inflated like an air-sac by feeding air into the 7Lumen 13 through the tube 6. In this case, the balloon 3. is expanded in accordance with the complex configurations of t:he pharynx and is brought into light contact with the surrounding structures of the pharynx and the mouth, thereby hermetically closing the space between the mouth and the upper part of the pharynx. Since the balloon 3 is of a relatively soft :synthetic material, it is possible to inflate it at a relative7_y low pressure without putting excess pressure on the surroundp_ng structures of the pharynx and the mouth.
The balloon 3 is made of a soft material of which the rubber-like elasticity is: smaller than that of the first balloon 2 to prevent the surrounding pharyngeal structures from damage due to pressure applied by the balloon 3. Thus, if artificial lung ventilation is carried out under a certain pressure exceeding the contact force between the second balloon 3 and the surrounding pharyngeal structures, there is a fear that the second balloon 3 could be moved from its y, _ g _ original position by preasure in the esophagus. To solve this problem as well as to enaure good airtightness and fixing properties of the balloon 3, in the embodiment of Fig. 1 this balloon is so designed that it can be inflated in both its longitudinal and radial directions to an extent greater than the first balloon ~!.
The volume of the space between the second balloon 3 and the tube 1 is so deaermined that the balloon 3 is just filled up with air when a certa:in amount of air determined by the physique of the patient :is supplied to the balloon 3 at a pressure of 10 cmH20 or lower. In general, the amount of air sufficient to fill up then balloon 3 is 50 to 150 ml for adults, but 30 to E.0 ml iEor children.
The balloons ~;, 3 are respectively connected to the tubes 5 and 6 through they lumens 12, 13. The tubes 5 and 6 are usually made of a scynthei~ic material, such as non-rigid polyvinyl chloride, silicone rubber, a polyurethane, polyethylene, etc. Each tube 5, 6 is hermetically connected at one end to the lumens Z2 and 13 having openings formed between the balloon 3 and the connector 8. At its other end, each tube 5 or 6 is. conneacted to an air supply port 52 or 62.
In the vicinity of each of the tubes 5 and 6, there is a pilot inflatable balloon 51 or 61 to indicate the inflation of the balloon 2 or 3 indirectly.
In use, the tube 1 is correctly introduced into the esophagus E (Figures 4) from the mouth O of the patient by inserting it until the insertion mark has been reached to the level of the lips. During intubation, there is no fear of insertion of the tube 1 W to the trachea by mistake, since the arch-shaped tube 1 is straight at its leading end including the first balloon 2, and, since the closed distal end of the tube 1 is slanted in the direction opposite to the curvature of the tube 1 and is rounded.
Next, the balloons 2 and 3 are inflated by supplying air into the lumens 11 and 12 through the respective tubes 5 and 6. Thus, as shown in Fic~. 4, the balloon 2 hermetically closes the esophagus E, because of its rubber-like elasticity, 1~1 while the balloon 3 hermetically closes the pharynx P and the larynx L. In this case, the balloon 3 has been expanded sufficiently in both the longitudinal and radial directions and brought into light contact with the surrounding structures of the pharynx and the cavity of the mouth, thereby hermetically closing the space between the mouth and the upper part of the pharyn};. At the same time, the endoesophageal airway is prevented from axial movement by the second balloon 3.
Air is then fsad as .inhalant air from the resuscitator (not shown) to the lungs through the connector 8, the main lumen 11, passages 4 and the trachea. After this, the air fed to the patient is exhaled to the resuscitator in the reverse direction.
Referring now to Fi<~. 3, there is shown another embodiment of an endoesophageal airway for emergency resuscitation, further comprising a third inflatable balloon 9 of a rubber-like elastic material. The balloon 9 is attached to the respiration tube 1, covered with the second balloon 3, and communicating with main lumen 11 of the tube 1 through one or more holes 14 in tube 1. When the endoesophageal airway is supplied with air after properly inserting it into the esophagus of the patient,, the third balloon 9 is inflated by a part of the air blown into the lumen 1l of the tube 1, the air flowing into the balloon 9 through the holes 14. Thus, the previously inflated) second balloon 3 is additionally inflated in proportion to the internal pressure of the tube 1 and is brought into airtigrht and stationary contact with the surrounding pharyngeal structures to prevent the balloon 3 from slipping away from t:he surrounding pharyngeal structures.
In the embodiment o1: Fig. 3, the air is fed to the third balloon 9 through the lumen 11 and the holes 14 of the tube 1.
Alternately, the air hole: for introducing air into the balloon 9 can be constituted by a further small-sized lumen (not illustrated in the drawings) similar to the lumens 12 and 13 to control the inflation of the third balloon 9 as occasion demands. In this case, t:he further small-sized lumen opens at A
one end into the interior of the balloon 9 and at it other end is connected to an inflaiting tube (not shown) similar to the inflating tubes 5 and 6.
As will be understood from the above, the endoesophageal airway described has the following advantages:
(a) It is possible to ensure closure of the esophagus with the first balloon, because of the fact that it is of a rubber-like elastic: material. In addition, there is no fear of the flow of air into i~he esophagus, nor the backward flow of the contents of the si;.omach, because of the good airtightness between the first balloon and the surrounding pharyngeal structures.
(b) It is po:~sible to close the larynx without applying excess pressure on the surrounding laryngeal structures, even if the second balloon is inflated completely, because of the fact that the second balloon is of a soft synthetic membrane and has a size sufficieni:ly expandable in both its longitudinal and a~;:ial directions.
(c) It is po~csible to insert the respiration tube easily into the esophagus, without causing any risk of inserting it into the trachea by mistake, because the arch-shaped respiration tube i~; almo:~t straight at its leading end including the first. balloon, and i.ts closed distal end is slanted in the direction opposite to its curvature and is rounded.
(d) The respiration tube is surely introduced into the esophagus, even if it is blindly inserted into the pharynx through the mouth, thus making it possible to practice controlled artificial lung ventilation on a patient easily by closing the larynx and tree lower part of the esophagus with the first and second balloons. There is thus no need to have the assistance of any pet-son.
(e) Since the esophagus is expandable and has a higher adaptability to foreign substances than the trachea, the respiration tube is never required to have a precise diameter corresponding to physique: of the patient. The endoesophageal airway can thus be applied to various persons with different A
physiques by only roughly adjusting the distance between the first and second balloon: .
Although the preseni~ invention has been fully described in connection with the preferred embodiments thereof with reference to the accompanying drawings, it is to be noted that various changes and modifications are apparent to those skilled in the art. Such changes and modifications are to be understood as included within the scope of the present invention as defins~d by i~he appended claims unless they depart therefrom.
A
Claims (10)
1. An emergency resuscitation endoesophageal airway comprising:
an arch-shaped respiration tube closed at a distal end and open at a proximal end;
a first inflatable balloon of a rubber-like elastic material attached to the tube at a position close to the distal end thereof for closing the esophagus of a patient;
a second inflatable balloon of a flexible synthetic resin attached to the tube at a position spaced from the proximal end thereof for closing a pharynx of the patient; and first and second tubes for inflating said first and second balloons, wherein said respiration tube is provided with air holes between the first and second balloons, wherein said second inflatable balloon is so designed as to expand in both its longitudinal and radial directions to such an extent that it comes into light contact with the surrounding structures of the pharynx and cavity of mouth, and wherein the closed distal end of said respiration tube is slanted in the direction opposite to the curvature of respiration tube and is rounded.
an arch-shaped respiration tube closed at a distal end and open at a proximal end;
a first inflatable balloon of a rubber-like elastic material attached to the tube at a position close to the distal end thereof for closing the esophagus of a patient;
a second inflatable balloon of a flexible synthetic resin attached to the tube at a position spaced from the proximal end thereof for closing a pharynx of the patient; and first and second tubes for inflating said first and second balloons, wherein said respiration tube is provided with air holes between the first and second balloons, wherein said second inflatable balloon is so designed as to expand in both its longitudinal and radial directions to such an extent that it comes into light contact with the surrounding structures of the pharynx and cavity of mouth, and wherein the closed distal end of said respiration tube is slanted in the direction opposite to the curvature of respiration tube and is rounded.
2. The emergency resuscitation endoesophageal airway claimed in claim 1, wherein the second balloon is such that it can be filled with a predetermined amount of air supplied thereto at a pressure of 10 cmH2O or lower through the second inflating tube.
3. The emergency resuscitation endoesophageal airway claimed in claim 1, further comprising a third inflatable balloon of a rubber-like elastic material attached to the respiration tube but within the second inflatable balloon and communicating with a lumen of the respiration tube through one or more holes provided therein, whereby, when air is introduced with pressure into the lumen of said respiration tube, the third balloon is inflated radially to such an extent that the previously inflated second balloon is additionally inflated and brought into airtight and stationary contact with the surrounding pharyngeal structures to prevent the balloon from slipping away from the surrounding pharyngeal structures.
4. The emergency resuscitation endoesophageal airway claimed in claim 1, wherein said arch-shaped respiration tube is straightened at a leading portion thereof from the distal end thereof to the portion for attachment of the first balloon.
5. The emergency resuscitation endoesophageal airway claimed in claim 1, wherein said respiration tube is provided with an insertion mark between the second balloon and the portion of the tube where said inflating tubes are connected to opposite to the curvature of said respiration tube.
6. The emergency resuscitation endoesophageal airway according to claim 1, wherein said respiration tube is made of a synthetic material selected from the group consisting of non-rigid polyvinyl chloride, silicone rubber and polyurethanes.
7. The emergency resuscitation endoesophageal airway according to claim 1, wherein said respiration tube has first and second small-sized lumens provided in a side wall thereof, said first small-sized lumen being communicated at one end thereof with said first inflatable balloon through an opening formed in the wall of the respiration tube and at the other end connected to an inflating tube through an opening provided in the wall of the respiration tube near the proximal end thereof, said second small-sized lumen is communicated at one end thereof with said second inflatable balloon and at the other end to the inflating tube through an opening formed in the wall of the respiration tube.
8. The emergency resuscitation endoesophageal airway according to claim 1, wherein the first inflatable balloon is made of an elastic material selected from the group consisting of natural rubber, synthetic rubber, elastomers, and non-rigid polyvinyl chloride.
9. The emergency resuscitation endoesophageal airway according to claim 8, wherein the first inflatable balloon is made of a synthetic rubber selected from the group consisting of isoprene rubber, silicone rubber, urethane rubber and ethylenepropylene rubber.
10. The emergency resuscitation endoesophageal airway according to claim 1, wherein the second inflatable balloon is made of a relatively soft synthetic resin selected from the group consisting of polyethylene, polyester, non-rigid polyvinyl chloride, silicone resin and polyurethane.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP4-322521 | 1992-11-06 | ||
| JP4322521A JP2779992B2 (en) | 1992-11-06 | 1992-11-06 | Emergency resuscitation esophageal airway |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CA2102462A1 CA2102462A1 (en) | 1994-05-07 |
| CA2102462C true CA2102462C (en) | 2004-06-15 |
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Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA002102462A Expired - Fee Related CA2102462C (en) | 1992-11-06 | 1993-11-04 | Emergency resuscitation apparatus |
Country Status (7)
| Country | Link |
|---|---|
| US (1) | US5392774A (en) |
| EP (1) | EP0596517B1 (en) |
| JP (1) | JP2779992B2 (en) |
| KR (1) | KR100298516B1 (en) |
| CN (1) | CN1102414C (en) |
| CA (1) | CA2102462C (en) |
| DE (1) | DE69327768T2 (en) |
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-
1992
- 1992-11-06 JP JP4322521A patent/JP2779992B2/en not_active Expired - Lifetime
-
1993
- 1993-11-04 CA CA002102462A patent/CA2102462C/en not_active Expired - Fee Related
- 1993-11-05 US US08/148,912 patent/US5392774A/en not_active Expired - Lifetime
- 1993-11-05 EP EP93117969A patent/EP0596517B1/en not_active Expired - Lifetime
- 1993-11-05 DE DE69327768T patent/DE69327768T2/en not_active Expired - Fee Related
- 1993-11-06 KR KR1019930023522A patent/KR100298516B1/en not_active IP Right Cessation
- 1993-11-06 CN CN93112703A patent/CN1102414C/en not_active Expired - Fee Related
Also Published As
| Publication number | Publication date |
|---|---|
| JP2779992B2 (en) | 1998-07-23 |
| DE69327768D1 (en) | 2000-03-09 |
| DE69327768T2 (en) | 2000-06-21 |
| US5392774A (en) | 1995-02-28 |
| KR940011017A (en) | 1994-06-20 |
| JPH06142205A (en) | 1994-05-24 |
| EP0596517A1 (en) | 1994-05-11 |
| KR100298516B1 (en) | 2001-10-22 |
| CA2102462A1 (en) | 1994-05-07 |
| EP0596517B1 (en) | 2000-02-02 |
| CN1088458A (en) | 1994-06-29 |
| CN1102414C (en) | 2003-03-05 |
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