DE8908178U1 - Pharyngeal tube for insertion into the nose or throat - Google Patents

Description

G89041

Description Jürgen Ruß, Rudolf Schön, Dr. Christoph Scheldt

5300 Bonn

rharyngeaT-tube for insertion into nose or throat

The innovation concerns a pharyngological tube for insertion into the nose or throat up to approximately the epiglottis to keep the upper airways clear, with a curved, anatomically adapted shape made of soft rubber or the like and a length of approximately 9 to 17 cm, which is equipped with a possibly movable collar cuff in the area of the proximal end, and has at least one lumen running from the distal end to the proximal end of the tube with a diameter of approximately 5 to 15 mm and is possibly slightly widened in a funnel shape at the proximal end for the attachment of a breathing bag or the like.

During resuscitation measures, the upper airways of the

Patients should be kept free. Special pharyngeal tubes have been developed for this purpose, such as the Guedel oropharyngeal tube, which is inserted into the throat, or the so-called 3Q nasopharyngeal catheter according to Wendl, which is inserted through the nose.

Only in cases of severe clouding of consciousness, respiratory insufficiency or respiratory paralysis are ventilation tubes inserted into the throat, which are sealed against the tracheal wall with an inflatable cuff, thereby preventing aspiration of both vomit and fresh blood.

However, it is often necessary to supply additional oxygen to the patient during resuscitation. An endotracheal ventilation tube with an inflatable balloon cuff is known from DE-OS 23 08 400. A An additional suction catheter is passed through the ventilation tube in order to be able to suction during ventilation. This suction catheter is guided loosely inside the lumen of the ventilation tube. It is known from DE-PS 23 11 266 that

XQ In the case of an endotracheal tube with a balloon cuff, a second channel should be installed on the inner wall of the tube next to the open lumen for ventilation, which is however fully perforated and is used for suction. This second channel is not suitable for introducing oxygen, as this would become blocked within the large lumen of the tube and would not reach the site of action. The tube according to DE-PS 23 11 266 is inserted into the patient's trachea endobronchially, i.e. via the glottis.

In addition, two lumen suction catheters for insertion into the trachea and the bronchial system are known from DE-PS 36 08 943, in which the large lumen is used for suction and the small lumen running parallel to it is used to introduce medication under high pressure into the lungs.

In order to provide oxygen even when the patient is being ventilated using a

tracheal tube or, if the airways are kept clear, using a pharyngeal tube, it is known to insert a Schleich loosely into the corresponding tube from the proximal

3Q end, which lies loosely within the lumen of the tube. An oxygen supply device can then be connected to this supply tube. This loose connection of a tube for the oxygen supply to the pharyngeal tube has the disadvantage that this loose tube in

depending on its position is moved unintentionally, so that the hose hanging loosely inside the tube interferes with breathing. This hose for the oxygen supply is often stuck to the tube at the proximal end using a plaster to prevent its position

This is not satisfactory in any way.

Furthermore, a tracheal introduction tube with a spiral for fiber bronchoscopes in a double-lumen design is known. The large central lumen serves as an instrument channel through which the bronchoscope is introduced. This tube is basically orally with the help of a stylet and under anesthesia ; it can only remain with the patient for a short time - approx. maximum 20 minutes. For the oxygen supply, the tube is equipped with a second lumen on the outside, this oxygen channel is on the outer wall and can cause mucous membrane injuries. A nasal passage through this; introduction tube cannot be carried out because of the built-in metal spiral which increases stability.

The innovation is based on the task of enabling the oxygen supply to be perfect and defined even when using pharyngeal tubes, namely oropharyngeal tubes for insertion through the throat or nasopharyngeal tubes for insertion through the nose.

For this purpose, the invention proposes the further development of the known pharyngeal tubes according to Guedel or Wendl in such a way that a second lumen with a diameter of about 1 to 2 mm is provided within the tube in the wall. parallel to the first lumen from the proximal end to the distal end of the tube or at least from the proximal end over approximately two thirds of the length of the tube, so that between the proximal end and the collar cuff there is a continuous line to the small lumen

3Q breakthrough is formed in the area of the outer wall and through the breakthrough a

A tube that can be connected to the oxygen supply device for supplying oxygen is inserted into the small lumen towards the distal end and secured, e.g. glued.

With the innovative design of a pharyngeal tube,

integrated with a lumen, i.e. an extra channel for the

* Supply of oxygen, the oxygen supply is without

Interruption of the patient's ventilation is ensured.

Thanks to the inventive design of the pharyngeal tube, in which the lumen used for oxygen supply opens at the distal end, an oxygen saturation of 100% is achieved when treating the patient. According to the invention, dead space ventilation is prevented and 100 % oxygen saturation is achieved through throat breathing. The internal second lumen also does not hinder the introduction of the tube.

In the oropharyngeal tube, the exit cross-section at the distal end is approximately perpendicular to the length of the tube. In order to ensure the best possible oxygen transfer, achieve, it is now planned that the Oropharyngeal tube, the outlet opening of the small lumen is formed at the distal in the area of the lower cross-sectional area determined by the bend of the tube, i.e. preferably where the distal end in the pharynx exposed.

In the case of the nasopharyngeal tube, however, the distal end is bevelled in cross-section, as this also

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According to the new regulations, the outlet opening of the small Lumens should be positioned at the distal end in the area of the beginning of the bevel of the tube end so that oxygen can be properly introduced into the trachea.

With funnel-shaped extended proximal end

developed naso-pharyngeal tubes, the second small lumen in the area of the proximal end can also end within the tube at the transition of the large lumen to the funnel-shaped expansion and flow into the latter.

The innovation is illustrated below with examples of implementation

the drawing in detail. The drawing shows

-7-Figure 1 a nasopharyngeal tube with

Oxygen supply channel introduced into the patient

Figure 2 an oropharyngeal tube with oxygen supply channel is inserted into the patient

Figure 3 a nasopharyngeal tube in perspective view

Figure 4 Cross section through the entrance area of the tube

according to Figure -3 in enlarged view

Figure 5 an oropharyngeal tube in perspective Figure 6 shows the distal end of a tube Oropharyngeal tube.

Figure 7 Cross section through the exit area of the tube according to Figure 3 in enlargement

Figure 8 Variant of the exit area according to Figure 7 of the Tube according to Figure 3 Figure 9 Cross section through an oropharyngeal tube According to Figure 1, the nasopharyngeal tube 1 is

nasal cavity of a patient, with the tip of the tube, i.e. the distal end 10, passing the uvula and ending proximal to the epiglottis. The tube is

2Q preformed in a curved shape to adapt to the anatomy of the throat. At the proximal end of the tube, a collar cuff 2, made of rubber for example, is attached to the tube, which can be moved on the tube and which locks the tube 1 in the correct position to prevent it from being pushed too far into the The tube 1 is designed with two parallel continuous lumens, both of which are located within the tube, ^ie within the circular cross-sectional circumference. The main lumen 12, the

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coaxially continuous, is used for ventilation. The second lumen, with a much smaller cross-section, forms the oxygen supply channel. In addition, the pharyngeal tube is equipped with a supply tube 3 for oxygen, which a hole 4 in the smaller of the two lumens. The tube 1 and the hose 3 including the collar cuff 2 form a handy unit, whereby the hose 3 is fixed in the tube 1, for example glued or welded in, so that it cannot be removed even in the event of unwanted IQ stress. The patient can can now breathe freely and undisturbed through the nasopharyngeal tube, namely its main lumen 12, while at the same time oxygen can be supplied through the secondary lumen via tube 3.

Figure 2 shows the use of the oropharyngeal tube

The Guedel tube is shown analogously, which is inserted through the mouth and throat for free ventilation. This tube is also inserted only with its distal end 10 to about

2Q proximal to the epiglottis. The distal end has a cross-section that is approximately perpendicular to the tube extension. The tube is pre-bent along its length to match the anatomy of the pharynx so that it fits well and securely. At the proximal end, the Oropharyngeal tube 1 has a reinforced neck that is bite-resistant. At the distal end on the entry side, the tube is designed with a collar cuff 2 that is intended to prevent it from slipping into the throat. This cuff 2 is firmly connected to the tube 1.

__ According to the invention, the tube 1 is designed with two parallel, continuous internal lumens, with the main lumen 12 used for ventilation running coaxially to the longitudinal extension and longitudinal axis of the tube 1. In addition to the main lumen 12, which is used for ventilation, a smaller, continuous secondary lumen is designed in parallel in the tube 1, into which the hose 3 for supplying oxygen is inserted and secured. The secondary lumen has a significantly smaller passage cross-section.

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Figure 3 shows a schematic perspective view of the nasopharyngeal tube 1 from Figure 1. The distal end 10 is bevelled. As can be seen from the associated enlarged cross-sectional detail of the proximal end according to Figure 4, the tube 1 is designed with the large lumen 12 that runs from the proximal end 11 to the distal end 10 and is coaxial with the longitudinal extension of the tube, and the small lumen 13 that runs parallel to this on one side in the wall. The proximal end region of the

Tube 1 is widened in a funnel shape in order to

breathing bag or the like to the lumen 12. Below the funnel-shaped widening, the collar cuff 2 sits on the tube 1 and can be pushed back and forth in the direction of the arrow S. Between the collar cuff 2 and proximal end 11 in the wall 15 is the opening 4 which forms an opening to the lumen 13. Through this opening 4, the tube 3 with the end 32 for the supply of oxygen is inserted into the lumen 13 in the direction of the distal end and is also secured within the lumen 13. It is It is also possible to fix the hose 3 to the tube on the outer wall by means of another cuff pushed on from the outside. A connection 31 for the oxygen supply is provided at the free end of the hose 3.

At the distal end, the small lumen 13 of the nasopharyngeal tube opens as shown in Figure 3 where the bevelled cross-section begins, i.e. practically above the outlet opening of the large lumen 12, see enlarged

Detailed cross section according to Figure 7.

It is also possible to end the small lumen 13 at the distal end area within the tube end, as shown in Figure 8 in a detailed cross-section, so that it passes over the large lumen 12 and merges with it at the end 10.

In the oropharyngeal tube shown in Figure 5, the two lumens 12 and 13 are parallel to each other from the distal

to the proximal end of the tube 1. The small lumen 13 is in the outer wall in the lateral area of the curved tube, as shown in Figure 5, or in the lower area, i.e. along the longest surface line of the tube, see Figure 6, The lumen 13 ending at the proximal end 11 is connected here to the supply tube 3 for the oxygen, whereby the latter is preferably inserted into the lumen 13 and secured therein. The opening 4 here corresponds to the inlet opening of the lumen 13 at the proximal end �P of the tube. IQ The nasopharyngeal ¹ !-tube according to Figure 3 or the Oropharyngeal tubes according to Figure 5 are designed as a new two-lumen device and, together with the supply tube 3 for the oxygen, form a single device that enables free breathing and oxygen supply.

Figure 9 shows a nasopharyngeal tube in cross section (longitudinal)

with a funnel-shaped, extended proximal end region (la) equipped with two parallel continuous lumens 12, 13. The ventilation The main lumen is guided centrally axially in longitudinal extension through the curved tube 1 from the proximal end 11 to the distal end 10 and is also widened in a funnel shape 12a at the proximal end. The small lumen 13 used for oxygen supply is parallel to the main lumen 12 within the

Tube is formed in the area of the wall 15 and extends from

distal end 10 to the funnel-shaped extension 12a and ends here. The connection for the hose for the oxygen supply is made through the opening 4 in the outer wall of the tube. The hose for the oxygen supply 1st 1n not shown in Figure 9.

Claims (2)

G89041 Protection claims Pharyngeal tube for insertion into the throat or nose up to approximately the epiglottis to keep the upper airways clear with a pre-curved anatomically adapted shape made of soft rubber or the like and a length of approximately 9 to 17 cm ^&ugr; is equipped with a possibly movable collar cuff in the area of the proximal end and has at least one lumen with a diameter of about 2.5 to 15 mm that runs through from the distal end to the proximal end of the tube and is optionally slightly widened in a funnel shape at the proximal end for attaching a breathing bag or the like, characterized in that within the tube in the wall (15) there is a second lumen (13) with a diameter of about 1 to &aacgr; mm parallel to the first lumen (12) from the proximal end (11) to the distal end (10) of the tube or at least starting from the proximal end, is designed to run approximately over two thirds of the length of the tube, that between the proximal end (10) and the collar cuff (2) a breakthrough (4) extending through to the small lumen (13) is formed in the area of the outer wall and through which Breakthrough (4) with a Oxygen supply device connectable tube (3) for supplying oxygen into the small lumen (13) is inserted in the direction of the distal end and secured, e.g. glued in. 2. Pharyngeal tube for insertion into the throat according to claim 1, in which the tube ends at the distal end approximately perpendicular to the longitudinal extension, characterized in that the outlet opening of the small lumen 35 (i3) is formed _{at the} distal end of the tube in the region of the lower cross-sectional area predetermined by the j bend of the tube. -2- Pharyngeal tube for insertion into the nose according to claim 1, in which the tube is bevelled at the distal end, characterized in that the outlet opening of the small lumen (1?) is arranged at the distal end in the region of the beginning of the bevel of the tube end. Pharyngeal tube for insertion ^into the nose according to claim 1 or 3, in which the proximal end is widened in a funnel shape, characterized in that the inlet opening of the small lumen (13) is located in the region of the proximal end of the tube within the tube at the transition of the large lumen (12) to the funnel-shaped widening.