Search Images Maps Play YouTube News Gmail Drive More »
Sign in
Screen reader users: click this link for accessible mode. Accessible mode has the same essential features but works better with your reader.

Patents

  1. Advanced Patent Search
Publication numberUS3889688 A
Publication typeGrant
Publication date17 Jun 1975
Filing date19 Dec 1973
Priority date19 Dec 1973
Publication numberUS 3889688 A, US 3889688A, US-A-3889688, US3889688 A, US3889688A
InventorsEamkaow Precha
Original AssigneeEamkaow Precha
Export CitationBiBTeX, EndNote, RefMan
External Links: USPTO, USPTO Assignment, Espacenet
Tracheostomy tube with novel retaining means
US 3889688 A
Abstract
A tracheostomy tube for insertion through the soft tissue of the neck and an opening in the tracheal wall, and having an inflatable cuff to seal the tube within the trachea as well as a second inflatable device surrounding the tube at a point closely adjacent the opening through which the tube passes on the inside of the trachea. The second device is inflatable to a diameter greater than the opening to prevent withdrawal of the tube until the second device has been deflated. An adjustable shield for securing the tube on the outside of the neck is also provided.
Images(1)
Previous page
Next page
Description  (OCR text may contain errors)

United States Patent [1 1 Eamkaow I 1 TRACIIEOSTOMY TUBE WITH NOVEL RETAINING MEANS [76] Inventor: Precha Eamkaow, 106 Revere Rd.,

Dewitt, NY. 13214 22 Filed: Dec. 19, 1973 21 A l. No.1 426,045

[52] US. Cl. 128/351 [51] Int. Cl A6lm 16/00 [58] Field of Search 128/1 R, 2 F, 129, 241,

128/246, 283, 344, 345, 348351, DIG. l6, DIG. 26, 341-343 1 1 June 17, 1975 Primary Exanziner-Richard A. Gaudet Assistant Examiner-Rick Opitz Attorney, Agent, or Firm-Charles S. McGuire [S7] ABSTRACT A tracheostomy tube for insertion through the soft tissue of the neck and an opening in the tracheal wall, and having an inflatable cuff to seal the tube within the trachea as well as a second inflatable device surrounding the tube at a point closely adjacent the opening through which the tube passes on the inside of the trachea. The second device is inflatable to a diameter greater than the opening to prevent withdrawal of the tube until the second device has been deflated. An adjustable shield for securing the tube on the outside of the neck is also provided.

8 Claims 3 Drawing Figures TRACHEOSTOMY TUBE WITH NOVEL RETAINING MEANS BACKGROUND OF THE INVENTION This invention relates to tracheostomy tubes and, more particularly, to novel and improved means of retaining such tubes in position with the trachea.

It is a common practice to create an artificial airway directly through the neck and into the trachea to per mit respiration without passing through the nose or mouth. An opening is made through the soft tissue of the neck and the tracheal wall through which a hollow tube is inserted to conduct air from the front of the neck directly into the trachea.

It is also common practice to provide means for sea]- ing the tube to the inner wall of the trachea to prevent leakage of air around the tube away from the lungs. That is, the sealing means are engaged between the outside of the tube and the inside of the trachea to provide a sealed passageway between the outer end of the tube and the lungs. A flange or shield is normally affixed to the outer end of the tube to prevent insertion past the desired point. The device may be secured in place by a cord tied around the patients neck from each side of the shield to prevent inadvertent dislodgement.

It has been found, however, that in tracheostomized patients with chronic wasting diseases, senility, mental problems, semicoma or coma, the tube sometimes is dislodged from the trachea accidentally or intentionally, resulting in serious respiratory insufficiency or death. Thus, conventional means of securing the tube in position are not satisfactory in such cases. Also, the cord around the patients neck may cause irritation and pain, as well as being unsanitary and interfering with circulation in patients who have undergone operative procedures on the neck.

The aforementioned means providing a seal between the tube and inner tracheal wall is commonly in the form of a cuff surrounding the tube which may be filled with air to lodge within the tracheal lumen. If the cuff remains inflated for a long period, exerting outward pressure on the trachea, stricture or necrosis of the tracheal lumen sometimes results. Deflation of the cuff, however, creates the possibility of dislodgement of the tube from the tracheal lumen.

It is a principal object of the present invention to provide a tracheostomy tube having novel and improved means for securing the tube within the trachea.

A further object is to provide a simple and effective structure forming an artificial airway through the throat and into the trachea which cannot be inadvertently withdrawn or inserted too far, and without tying a cord around the patients neck.

Another object is to provide a tracheostomy tube having novel adjustment means for selectively affixing the outer shield at any desired point along the tube to compensate for different thicknesses of soft tissue between the outside of the neck and the trachea.

Other objects will in part be obvious and will in part appear hereinafter.

SUMMARY OF THE INVENTION balloons affixed around the outer periphery of the tube at spaced points thereon. One of the balloons is in the form of the usual tracheal cuff which expands to form a seal between the tube and the tracheal lumen. The second balloon is in the form of a flat collar which encircles the tube inside the trachea closely adjacent the opening, or stoma, through which tube extends. The second balloon does not engage the inside of the trachea, but inflates to a diameter larger than the tracheal stoma so that the tube cannot be withdrawn. Separate air lines are provided for inflating the first and second balloons.

A separate shield is provided for engaging the outer end of the tube adjacent the patients neck. An opening in the shield of about the same diameter as the tube allows the shield to be slid onto the tube until it engages the patients neck. Flexible straps on the shield are then tightened about the tube to secure the two in the proper relative position. The tube then can be neither withdrawn, until the balloons are deflated, nor inserted further, until the shield is re-adjusted. No strap or cord around the patients neck is necessary to retain the tube in position.

BRIEF DESCRIPTION OF THE FIGURES FIG. 1 is a side elevational view of a tracheostomy tube embodying the present invention shown in position in a patients neck and trachea which are shown in section;

FIG. 2 is a sectional view taken on the line 22 of FIG. 1; and

FIG. 3 is a front view of the outer end of the tube and adjustable shield.

DESCRIPTION OF THE PREFERRED EMBODIMENT A tracheostomy tube constructed according to a preferred form of the invention is shown in FIG. 1 as it would appear when in use. Hollow tube 10 extends from proximal end 12, on the outside of the patients throat, through openings made for such purpose in soft tissue 14 and tracheal wall 16, to distal end 18 directed downwardly within the tracheal tube. In accordance with usual medical nomenclature, the tubular portion of the trachea is hereinafter termed the tracheal lumen, and the opening in the tracheal wall through which tube 10 extends is referred to as the stoma.

The provision of tubes through the throat forming artificial airways to the trachea is well known, as are medical techniques for insertion of such tubes. A flexible plastic shaft having a tapered end extending out of end 18 of tube 10 is commonly provided to assist in inserting the tube into its final position. The flexible shaft is withdrawn from tube 10 after insertion. Since this technique is well known and forms no part of the present invention, the flexible shaft is not shown, and tube 10 is not shown prior to insertion into the trachea.

Tube 10 is bent between ends 12 and 18 so that it may extend inwardly, through the soft tissue and tracheal stoma, and then downwardly within the tracheal lumen. For convenience, the axis of the inwardly extending portion of the tube is labeled A-A, and the axis of the downwardly extending portion BB. The angle between the two axes is normally slightly greater than In order that the tube effectively serve its intended purpose, it is necessary to form a seal between the external surface of tube 10 and the tracheal lumen. It is conventional to accomplish this function by an inflatable device encircling the tube, commonly known as a tracheal cuff. Such an inflatable cuff is shown in FIG. 1, denoted by reference numeral 20 and connected by passageway 22 within the wall of tube to thin inflating tube 24. Thus, by injecting air through tube 24, cuff is inflated to engage the tracheal lumen and form the necessary seal after tube 10 is in its final position.

Cuff 20 is shown as an example of suitable means for providing the lumen seal. Other known means may be used, such as self-inflating cuffs, normally inflated cuffs which are forced to a deflated condition during insertion, and non-inflatable means such as the resilient flanges disclosed in US. Pat. No. 3,659,611. In addition to the conventional lumen sealing means, the present invention includes an inflatable device termed the stoma balloon and denoted by reference numeral 26. Passageway 28 through the inwardly extending portion of the wall of tube 10 connects stoma balloon 26 with inflating tube 30. Stoma balloon 26 encircles the portion of tube 10 on axis AA closely adjacent its intersection with axis B-B. In the disclosed form, balloon 26 forms a relatively flat collar about tube 10, being sealed thereto at points spaced along the tube by less than the longest radius of the balloon. Thus, after insertion of tube 10 with both cuff 20 and balloon 26 in the deflated condition, balloon 26 is positioned inside the trachea closely adjacent the tracheal stoma. Injection of air through tube 30 inflates stoma balloon 26 to a diameter larger than that of the tracheal stoma whereby tube 10 cannot be withdrawn until balloon 26 is deflated. Air pressure within both cuff 20 and balloon 26 is monitored in conventional fashion by small bladders 40.

Turning now to FIG. 3, tube 10 is retained on the outside of patients throat by shield 32, preferably constructed of somewhat flexible plastic. The shield is not directly attached to tube 10, but has a central opening of about the same diameter as the outside of tube 10 through which end 12 passes. Boss 34, formed integrally with shield 32, encircles this opening. Flexible straps 36 are affixed to opposite ends of collar 38 which partially encircles and extends outwardly from boss 34.

After insertion of tube 10 into the trachea stoma balloon 26 is inflated and the tube is pulled outwardly to insure that balloon 26 is firmly engaged against the tracheal wall around the stoma. Cuff 20 is then inflated to seal the trachea around tube 10. Shield 32 is placed over end 12 and slid along tube 10 until it engages the patients throat. Flexible straps 36 are then pulled tightly together and secured by any convenient means so that collar 38, being somewhat flexible, is deformed into frictional engagement with tube 10 to maintain shield 32 firmly in position thereon. For example, the straps may be merely tied either below or above the tube, or may be provided with cooperable engagement means such as mutually engageable notches in the edges of the straps, openings in one strap engageable by a projection on the other, etc.

Thus, the disclosed tube device may be secured firmly in place with neither undue discomfort to the patient nor the possibility of being dislodged. The stoma balloon in the disclosed embodiment is somewhat elongated in the vertical direction since its width is limited by the extent to which it can extend laterally of the tracheal lumen. The stoma balloon may take forms other than that of an inflatable device as long as it is movable between extended and retracted positions with respect to the outside of the tube. Such movement must, of course, be effected while the balloon, or equivalent retaining means, is within the trachea. Since the tracheal cuff is no longer used as a retaining means, it need be inflated only to the extent necessary to maintain the seal, thereby reducing the possibility of stricture or necrosis resulting from prolonged periods of tight engagement.

It is essential to maintain a seal around the tube in cases such as those where a respirator is connected to the outer end of the tube, to prevent air leakage, or where necessary to prevent aspiration; otherwise, inflation of cuff 20 may be omitted.

What is claimed is:

1. A tube device for introduction into the trachea to form an artificial airway through a patients throat, said device comprising, in combination:

a. a hollow tube having open ends and a bend intermediate of said ends to form portions lying along first and second linear, intersecting axes, said tube being constructed and arranged for insertion of one end thereof through a tracheal stoma and into the tracheal lumen with said first axis disposed generally coaxial with the tracheal lumen and said second axis extending through the stoma;

b. impermeable means attached to the portion of said tube lying along said first axis and inflatable from a retracted to an extended position to effect a seal between, said tube and lumen;

c. inflatable retaining means attached to the portion of said tube lying along said second axis closely adjacent said bend, and movable with respect thereto between retracted and extended positions, said tube and retaining means having a combined dimension laterally of said second axis when retracted allowing insertion of said tube and retaining means through the stoma, and a combined dimension laterally of said second axis when extended preventing withdrawal of said tube through the stoma;

(1. means for selectively inflating said impermeable means and said retaining means between said retracted and extended positions while inside the patients trachea; and

e. a shield substantially wider than the diameter of said tube, and adjustably positionable along the length of the portion of said tube lying along said second axis outside the stoma, whereby the tissue may be engaged between said retaining means and said shield to fix the position of said tube.

2. The invention according to claim 1 wherein said impermeable means comprise a selectively inflatable and deflatable tracheal cuff.

3. The invention according to claim 1 wherein said retaining means comprises an inflatable balloon sealed to said tube and connected by a closed passageway, through which air may pass to and from the interior of said balloon, to a tube for the passage of air to and from said balloon.

4. The invention according to claim 3 wherein said balloon is annular and is sealed to said tube around the periphery thereof at two positions spaced along said tube by a distance less than the radius of said balloon means, whereby the latter forms a relatively flat collar around said tube when inflated.

movable means comprise a pair of flexible straps.

8. The invention according to claim 7 wherein said flexible straps extend from opposite ends of a collar partially surrounding said opening and extending from one side of said shield, said collar being radially deformable into frictional engagement with said tube by tightening said straps.

Patent Citations
Cited PatentFiling datePublication dateApplicantTitle
US2457244 *22 Jun 194328 Dec 1948Otis F LamsonMedical appliance for control of enemata
US2586940 *30 Oct 194726 Feb 1952Albert E GrahamSurgical appliance
US3693624 *2 Oct 196926 Sep 1972Donald P ShileyTracheotomy tube
Referenced by
Citing PatentFiling datePublication dateApplicantTitle
US4090518 *12 Aug 197623 May 1978Elam James OEsophago-pharyngeal airway
US4180076 *13 Jan 197825 Dec 1979Betancourt Victor MNasogastric catheters
US4235239 *15 Sep 197825 Nov 1980Elam James OCuffed endotrachael tube and method
US4341210 *30 Jun 198027 Jul 1982Elam James OCuffed endotracheal tube and method
US4449523 *13 Sep 198222 May 1984Implant Technologies, Inc.Talking tracheostomy tube
US4489723 *26 Mar 198425 Dec 1984Elliot SimonsSwimming apparatus
US4573460 *15 May 19844 Mar 1986Implant TechnologiesTalking tracheostomy tube
US4633864 *22 Oct 19846 Jan 1987Dacomed CorporationSpeaking endotracheal tube
US4649913 *8 Jul 198517 Mar 1987Smiths Industries Public Limited CompanyTracheostomy tube assemblies
US4791920 *21 Aug 198620 Dec 1988Dario FauzaTracheostomy cannula
US4817598 *8 Jun 19874 Apr 1989Portex, Inc.Tracheostomy tube with ring pull removable inner cannula
US5038777 *14 Mar 199113 Aug 1991Dunn Margarette TEndotracheal device
US6394093 *13 May 199928 May 2002Scott LethiNasopharyngeal airway with inflatable cuff
US661230527 Apr 20012 Sep 2003Dario O. FauzaIntegral balloon tracheostomy tube
US6971382 *24 May 20046 Dec 2005Albert M CorsoTrachea tube method and device
US72079725 Sep 200124 Apr 2007Flodin BjoernDevice for fixing a tube member
US7328702 *21 Apr 200412 Feb 2008Smiths Group PlcTracheostomy device
US746216219 Jul 20049 Dec 2008Broncus Technologies, Inc.Antiproliferative devices for maintaining patency of surgically created channels in a body organ
US765426418 Jul 20062 Feb 2010Nellcor Puritan Bennett LlcMedical tube including an inflatable cuff having a notched collar
US770871219 Jul 20044 May 2010Broncus Technologies, Inc.Methods and devices for maintaining patency of surgically created channels in a body organ
US781559019 Jul 200419 Oct 2010Broncus Technologies, Inc.Devices for maintaining patency of surgically created channels in tissue
US800274018 Jan 200623 Aug 2011Broncus Technologies, Inc.Devices for maintaining patency of surgically created channels in tissue
US809629915 Dec 200917 Jan 2012Nellcor Puritan Bennett LlcMedical tube including an inflatable cuff having a notched collar
US830868218 Jan 200613 Nov 2012Broncus Medical Inc.Devices for maintaining patency of surgically created channels in tissue
US83136878 Sep 200820 Nov 2012Kimberly-Clark Worldwide, Inc.Method of making an improved balloon cuff tracheostomy tube
US84091675 Oct 20062 Apr 2013Broncus Medical IncDevices for delivering substances through an extra-anatomic opening created in an airway
US8607795 *8 Sep 200817 Dec 2013Kimberly-Clark Worldwide, Inc.Balloon cuff tracheostomy tube
US86087244 Nov 201017 Dec 2013Broncus Medical Inc.Devices for delivering substances through an extra-anatomic opening created in an airway
US870903413 May 201129 Apr 2014Broncus Medical Inc.Methods and devices for diagnosing, monitoring, or treating medical conditions through an opening through an airway wall
US878440016 May 201222 Jul 2014Broncus Medical Inc.Devices for delivering substances through an extra-anatomic opening created in an airway
US20130047993 *31 Aug 201128 Feb 2013Nellcor Puritan Bennett LlcTracheal tube having a flange with a variable volume
DE4401904A1 *24 Jan 199427 Jul 1995Matthias HechtBlocking seal for trachea cannula
EP0106780A1 *9 Sep 198325 Apr 1984Implant Technologies, Inc.Talking tracheostomy tube
EP0238515A1 *21 Aug 198630 Sep 1987Fauza Dario De OliveiraTracheostomy cannula.
WO2001083015A1 *27 Apr 20018 Nov 2001Dario O FauzaIntegral balloon tracheostomy tube
WO2002024272A1 *5 Sep 200128 Mar 2002Bjoern FlodinA device for fixing a tube member
WO2004096331A2 *21 Apr 200411 Nov 2004Gostelow ThomasTracheostomy device
Classifications
U.S. Classification128/207.15
International ClassificationA61M16/04
Cooperative ClassificationA61M16/0465, A61M16/0497
European ClassificationA61M16/04E