DE2535191A1 - Endotracheal respiration system with minimum dead space - having separate inhalation and exhalation lines and separate gas line - Google Patents

Endotracheal respiration system with minimum dead space - having separate inhalation and exhalation lines and separate gas line

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Publication number
DE2535191A1
DE2535191A1 DE19752535191 DE2535191A DE2535191A1 DE 2535191 A1 DE2535191 A1 DE 2535191A1 DE 19752535191 DE19752535191 DE 19752535191 DE 2535191 A DE2535191 A DE 2535191A DE 2535191 A1 DE2535191 A1 DE 2535191A1
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Germany
Prior art keywords
tube
line
dead space
endotracheal
inhalation
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Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
Application number
DE19752535191
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German (de)
Inventor
Ulrich Joachim Pfeiffer
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Individual
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Individual
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Priority to DE19752535191 priority Critical patent/DE2535191A1/en
Publication of DE2535191A1 publication Critical patent/DE2535191A1/en
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Classifications

    • 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
    • A61M16/042—Special features for tracheal tubes not otherwise provided for with separate conduits for in-and expiration gas, e.g. for limited dead volume

Abstract

The endotracheal respiration system minimises unused capacity in the lung; by having exhalation and inhalation lines which are separate in the endotracheal tube right up until they discharge into the trachea. Pref. a gas flow in a third line compensates for effective tube resistance from spontaneous exhalation. A connected circulatory system supplies fresh gas into the inhalation tube between the tube and the valve. The gas flow in the third line also builds up a pressure wave directly in front of the lungs during inhalation, so that combined with the exhalation resistance compensation the lungs can be more rapidly emptied. The system is especially designed for babies and small children.

Description

EIN ENDOTRACHEALES BEATMUNGSSYSTEM MIT MINIMALEM TOT RAUM Das System dient dazu, Totraum, Atemarbeit und- kraftaufwand auf ein Minimum zu reduzieren,- vorwiegend bei Früh-, Neugeborenen und Säuglingen bis zu einem Jahr. Darüberhinaus kann dieses Prinzip auch in der Kinder-und in der Erwachsenenanästhesie verwendet werden.AN ENDOTRACHEAL VENTILATION SYSTEM WITH MINIMUM DEAD SPACE The system serves to reduce dead space, breathing work and effort to a minimum, mainly in premature babies, newborns and infants up to one year old. Furthermore This principle can also be used in pediatric and adult anesthesia will.

Die bisher bekannten Systeme für Säuglinge haben alle den Nachteil eines, in Relation zum Atemzugvolumen gesetzt, großen Totraums, welcher dann durch Hyperventilation kompensiert werden muß.The previously known systems for infants all have the disadvantage a large dead space in relation to the tidal volume, which then passes through Hyperventilation needs to be compensated.

Da Säuglinge in kritischen Situationen aber wenig bereitschaft zu tieferen Atemzügen zeigen, sondern die Atemfrequenz erhöhen, kommt dies einer zusätzlichen vermehrten Totraumventilation gleich - ein "circulus vitiosus".Since infants in critical situations, however, little willingness to Show deeper breaths, but increase the breathing rate, this comes an additional increased dead space ventilation - a "vicious circle".

Ausserdem haben die heute gebräuchlichen Kindersysteme den Nachteil, daB sie keine ausreichende Kontrolle über eine adäquäte Lungenventilation liefern (Atemzugsvolumen, Druckamplituden, Gaszusammensetzung). Diese Oberwachungsfunktionen können nicht oder nur unzureichend erfüllt werden, da es sich hierbei um halboffene Systeme handelt. Eine entsprechende Oberwachung ist nur in einem Kreissystem (halbgeschlossen oder geschlossen) möglich. Zudem arbeitet ein Kreissystem wesentlich wirtschaftlicher, da es nur 1/3 - 1/4 des Gasflusses eines halboffenen Systems benötigt.In addition, the children's systems in use today have the disadvantage that they do not provide sufficient control over adequate lung ventilation (Tidal volume, pressure amplitudes, gas composition). These monitoring functions cannot be fulfilled or can only be insufficiently fulfilled, since these are half-open Systems acts. Appropriate monitoring is only possible in a circle system (semi-closed or closed) possible. In addition, a district system works much more economically, since it only takes 1/3 - 1/4 of the gas flow of a semi-open system.

Ein neues Beatmungssystem für Kleinkinder muß also folgende Aufgaben erfüllen.A new ventilation system for infants must therefore do the following fulfill.

1. minimaler Totraum in Relation zu 2. minimalem Widerstand 3. optimale Oberwachungsmbglichkeiten bei Verwendung eines Kreissystems 4. Verwendung mit herkömmlichen Narkosegeräten und Respi ratoren 5. Einfachheit und gute Handhabung. 1. minimal dead space in relation to 2. minimal resistance 3. optimal Monitoring options when using a circular system 4. Use with conventional anesthesia machines and respirators 5. Simplicity and good handling.

Das Problem wurde gelöst, indem ein Endotrachealtubus mit Trennung von Inspirations- (1) und Exspirationsschenkel (2) bis zur Stimmritze gebaut wurde. Bei einem derartigen Tubus für Säuglinge mit einem Aussendurchmesser von 6 mm vereinigen sich die beiden Schenkel ca. 4 cm vor der Tubuspitze.The problem was solved by adding an endotracheal tube with separation from the inspiratory (1) and expiratory limbs (2) to the glottis. Combine with such a tube for babies with an outer diameter of 6 mm the two legs are approx. 4 cm in front of the tube tip.

Der Totraum dieses Tubus beträgt 1 ml. Die dritte Leitung (3) erfüllt bei Spontanatmung und künstlicher Beatmung verschiedene Funktionen.The dead space of this tube is 1 ml. The third line (3) fulfills different functions for spontaneous breathing and artificial ventilation.

A Bei Spontanatmung dient ein kontinuierlicher Gasfluß in Leitung (3) dazu, einen ebenso kontinuierlichen Frischgasfluß in Leitung (1) in Richtung des Exspirationsschenkels (2) umzulenken. Mittels eines Manometers wird dabei der Gasfluß in Leitung (3) so reguliert, daß an der Tubusspitze Druck = O herrscht. (Funktionsprinzip Venturi-Rohr. Wasserstrahl pumpe).A With spontaneous breathing, a continuous gas flow is used in the line (3) in addition, an equally continuous flow of fresh gas in line (1) in the direction of of the expiratory limb (2). The Gas flow in line (3) regulated so that pressure = 0 prevails at the tube tip. (Functional principle of Venturi tube. Water jet pump).

Würde der Gasfluß in Leitung (3) nicht bestehen, wird das Inspirationsgas in Leitung (1) zwar trotzdem in Leitung (2) umgelenkt, doch wird die Lunge durch den zur Umlenkung des Gasflusses in Leitung (2) notwendigen Druck leicht vorgebläht werden. Bei geringeren Gasflusses in Leitung (1), etwa bis zu 4 1/min., übersteigt der meßbare Druck am Tubusende jedoch nicht 1 cm H20, was ein Säugling durchaus für eine kürzere Zeitspanne tolerieren kann. Ein Fluß in Leitung (3) wäre also bei geringeren Flüssen in Leitung (1) nicht unbedingt notwendig. If the gas flow in line (3) would not exist, the inspiration gas in line (1) nevertheless diverted to line (2), but the lungs are through slightly pre-inflated the pressure required to divert the gas flow in line (2) will. At lower gas flow in line (1), up to about 4 1 / min., Exceeds the measurable pressure at the end of the tube, however, is not 1 cm H20, which an infant certainly does can tolerate for a shorter period of time. So a flow in line (3) would be at lower flows in line (1) are not absolutely necessary.

Sowohl der Tubus mit Leitung (3) als auch ein vereinfachter Tubus (ohne Leitung (3)) kann an ein Kreissystem angeschlossen werden, aber auch im halboffenen System benutzt werden. Der Anschluß an ein Kreissystem setzt natürlich geringe Ventilwiderstände voraus; außerdem sollten die Ventile (1) und (E) möglichst nahe am Patienten sein, um so eine exspiratorische Kompression oder eine inspiratorische Dekompression der Gassäulen in den Schläuchen (ia) und (2a) - was einer Totraumvergrößerung entsprechen würde - auf ein Minimum zu reduzieren. Um diese Möglichkeit schließlich ganz auszuschalten, wird die Frischgaszuleitung zwischen Inspirationsleitung des Tubus (1) und Inspirationsventil (1) des Kreisystems gelegt. Somit wird auch ein fortwährender Gasfluß durch Leitung (1) und Leitung (2) - ein Spüleffekt - gewährleistet. Um eine gute alveoläre Ventilation sicherzustellen, reicht ein Frischgaszustrom in Höhe des Atem-Minuten-Volumens aus. Both the tube with cable (3) and a simplified tube (without line (3)) can be connected to a circle system, but also in a semi-open one System can be used. The connection to a circuit system naturally sets low valve resistances in advance; In addition, the valves (1) and (E) should be as close as possible be on the patient for an expiratory compression or an inspiratory one Decompression of the gas columns in the hoses (ia) and (2a) - which increases the dead space would correspond - reduce to a minimum. To this possibility after all completely, the fresh gas supply line between the inspiration line of the The tube (1) and inspiration valve (1) of the circuit system are placed. Thus also becomes a continuous gas flow through line (1) and line (2) - a flushing effect - guaranteed. A supply of fresh gas is sufficient to ensure good alveolar ventilation equal to the breath-minute volume.

B Mit beiden Tuben (mit und ohne Leitung (3)) kann manuell beatmet werden, sowohl im halbgeschlossenen Kreissystem als auch im halboffenen.B Both tubes (with and without line (3)) can be used for manual ventilation both in the semi-closed circle system and in the semi-open.

C Maschinelle Beatmung ist ebenso mit als auch ohne Leitung (3) möglich.C Mechanical ventilation is also possible with and without a line (3).

Ohne Leitung (3) (verschlossen), kann man mit allen herkömmlichen Respiratoren mit positivem oder positivnegativem Druck beatmen. Without line (3) (closed), you can use all conventional Ventilate respirators with positive or positive negative pressure.

Mit Leitung (3) läßt sich der Tubus bis jetzt nur an den Loosco-Infant-Ventilator anschließen. Der Vorteil der Koppelung dieses Gerätes mit dem Tubus liegt darin, daß bei der Inspiration durch Verschließen von Leitung (2) durch das Gerät mittels des Gasflusses aus den Leitungen (1) und (3) eine Druckwelle direkt vor der Lunge aufgebaut wird, bei der Exspiration durch den von Leitung (3) erzeugten Unterdruck der Widerstand des Tubus Kompensiert und somit die Lungenentleerung beschleunigt werden kann. Zusätzlich zum minimalen Totraum erreicht man damit eine optimale Ventilation. Up to now the tube (3) can only be connected to the Loosco Infant fan connect. The advantage of coupling this device with the tube is that that during inspiration by closing line (2) through the device by means of of the gas flow from lines (1) and (3) a pressure wave directly in front of the lungs is built up during expiration by the negative pressure generated by line (3) the resistance of the tube compensates and thus accelerates the emptying of the lungs can be. In addition to the minimal dead space, optimal ventilation is achieved.

Claims (4)

SCHUTZANSPROCHEPROTECTION APPROACH 1. J Endotracheales Beatmungssystem mit minimalem Totraum raumdadurch gekennzeichnet, daß Inspirations-(1) und Exspirationsleitung (2) im endotrachealen Tubus bis zur Einmündung in die Luftröhre getrennt sind.1. J Endotracheal ventilation system with minimal dead space characterized in that inspiration (1) and expiration line (2) in the endotracheal The tube is separated to the point where it joins the trachea. 2. Endotracheales Beatmungssystem mit minimalem Totraum, dadurch gekennzeichnet, daß durch einen Gasfluß in einer dritten Leitung (3) bei Spontanatmung der exspiratorisch wirksame Tubuswiderstand kompensiert werden kann. 2. Endotracheal ventilation system with minimal dead space, thereby characterized in that by a gas flow in a third line (3) during spontaneous breathing the expiratory effective tube resistance can be compensated. 3. Endotracheales Beatmungssystem mit minimalem Totraum, dadurch gekennzeichnet, daß durch einen Gasfluß in einer dritten Leitung (3) bei Beatmung inspiratorisch eine Druckwelle unmittelbar vor der Lunge aufgebaut, exspiratorisch der Tubuswiderstand kompensiert und somit die Lunge schneller entleert werden kann. 3. Endotracheal ventilation system with minimal dead space, thereby characterized in that by a gas flow in a third line (3) during ventilation inspiratory a pressure wave built up directly in front of the lungs, expiratory the tube resistance is compensated and thus the lungs can be emptied more quickly. 4. Endotracheales Beatmungssystem mit minimalem Totraum, dadurch gekennzeichnet, daß bei einem damit verbundenen Kreissystem die Frischgaszuführung (F) in den Inspirationsschlauch (la) zwischen Tubus und Ventil (1) mündet. 4. Endotracheal ventilation system with minimal dead space, thereby characterized in that the fresh gas supply in an associated circular system (F) opens into the inspiration tube (la) between the tube and valve (1). Leerseite eiBlank page egg
DE19752535191 1975-08-07 1975-08-07 Endotracheal respiration system with minimum dead space - having separate inhalation and exhalation lines and separate gas line Pending DE2535191A1 (en)

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Cited By (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0499718A1 (en) * 1991-02-18 1992-08-26 Gambro Ab Set of tubes intended for peritoneal dialysis
DE4221931C1 (en) * 1992-07-03 1993-07-08 Harald Dr. 8521 Moehrendorf De Mang
WO2000013730A1 (en) * 1998-09-02 2000-03-16 Flodin Bjoern A device for supplying inhalation gas to and removing exhalation gas from a patient
DE10123278C1 (en) * 2001-05-10 2002-06-13 Univ Hamburg Breathing device used in intensive care or during anesthesia comprises a respirator, an outlet, an inhalation tube, a twin-channel endotracheal tube, flow meters, pressure meters, and an evaluation device
EP1814620A1 (en) * 2004-11-19 2007-08-08 Saturn Biomedical Systems Inc. Secretion clearing ventilation catheter and airway management system
US8025059B2 (en) 2003-04-30 2011-09-27 Hajo Reissman Respiratory device comprising a double lumen endotracheal tube

Cited By (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0499718A1 (en) * 1991-02-18 1992-08-26 Gambro Ab Set of tubes intended for peritoneal dialysis
DE4221931C1 (en) * 1992-07-03 1993-07-08 Harald Dr. 8521 Moehrendorf De Mang
WO1994001157A1 (en) * 1992-07-03 1994-01-20 Harald Mang Tracheal or tracheotomy tube and breathing installations fitted therewith
WO2000013730A1 (en) * 1998-09-02 2000-03-16 Flodin Bjoern A device for supplying inhalation gas to and removing exhalation gas from a patient
US6634360B1 (en) 1998-09-02 2003-10-21 Flodin Bjoern Device for supplying inhalation gas to and removing exhalation gas from a patient
DE10123278C1 (en) * 2001-05-10 2002-06-13 Univ Hamburg Breathing device used in intensive care or during anesthesia comprises a respirator, an outlet, an inhalation tube, a twin-channel endotracheal tube, flow meters, pressure meters, and an evaluation device
WO2002089885A2 (en) 2001-05-10 2002-11-14 Universität Hamburg Device for artificial respiration with an endotracheal tube
US7481222B2 (en) 2001-05-10 2009-01-27 Hajo Reissmann Device for artificial respiration with an endotracheal tube
US8025059B2 (en) 2003-04-30 2011-09-27 Hajo Reissman Respiratory device comprising a double lumen endotracheal tube
EP1814620A1 (en) * 2004-11-19 2007-08-08 Saturn Biomedical Systems Inc. Secretion clearing ventilation catheter and airway management system
EP1814620A4 (en) * 2004-11-19 2010-06-30 Saturn Biomedical Systems Inc Secretion clearing ventilation catheter and airway management system

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