Abstract:
An improved endotracheal tube providing a built in suction channel for the removal of excessive secretions from the lumen of said tube and the tracheobronchial system is disclosed. Control valves for regulating the suction feature are also disclosed.

Description:
BACKGROUND OF THE INVENTION 
       [0001]    The technology described herein relates generally to endotracheal tubes used for intubating the trachea and like opening of human and animal bodies. 
         [0002]    During general anesthesia the gasses introduced through the endotracheal tube and the tube itself create irritation in the tracheobronchial system resulting in secretions that must be suction removed periodically by the anesthesiologist to clear the airway. 
         [0003]    In the current conventional system, this requires detaching the gas delivery apparatus from the end of the endotracheal tube so a smaller suction tube can be introduced and passed down the lumen of the endotracheal tube. When the suctioning is finished, the gas delivery apparatus must be reattached. Thus the flow of essential gasses to the patient is temporarily interrupted and some gasses undesirably escape into the operating room air breathed by the operating team, which can present a risk to the team personnel. Furthermore, the movement of the endotracheal tube and the insertion of yet another foreign object, the conventional suction tube itself, often stimulates involuntary patient muscle contractions and movements which can cause bleeding or otherwise interfere with surgical maneuvers. 
       BRIEF SUMMARY OF THE INVENTION 
       [0004]    The technology described herein improves upon existing endotracheal tubes by providing a built in suction channel whereby secretions that accumulate within the tube or beyond the distal end of the tube (the end positioned inside the patient) can be removed with minimal effort and minimal disruption of the gas delivery system. 
         [0005]    In an exemplary embodiment an improved endotracheal tube is comprised of an outer tube the diameter of which approximates the inner diameter of the passage to be intubated. A separate suction channel runs from the proximal end of the outer tube (the end of the tube outside of the patient) to the distal end of the tube. An opening at the distal end of the suction channel and periodic openings along the length of the channel allow fluids to be suctioned into the channel from the area past the distal end of the outer tube and from the area within the lumen of the outer tube. 
         [0006]    An extension tube in fluid communication with the suction channel extends outward from the proximal end of the outer tube. In an exemplary configuration the extension tube is connected to the inlet port of a valve means and the outlet port of the valve means is connected to an external suction apparatus commonly found in operating theatres. Both the endotracheal tube and the valves are intended to be single use devices. 
         [0007]    Two embodiments of valve means for regulating the flow of fluids through the suction channel are disclosed. One valve opens when an operator depresses a push button and the other opens when an operator turns a knob. Both valve examples are designed to automatically close when the operator releases them. Both valve examples have a suction bypass feature whereby when the suction feature is not in use, room air is sucked through a vent hole in the valve body and into the suction system. 
     
    
     
       BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWING 
         [0008]    The technology described herein will be better understood by reading the detailed description of the invention with reference to the accompanying drawing figures, in which like reference numerals denote similar structure and refer to like elements throughout, and in which: 
           [0009]      FIG. 1  is a perspective view of the improved endotracheal tube. 
           [0010]      FIG. 2  is a cross-sectional view of the endotracheal tube just below the cuff. 
           [0011]      FIG. 3  is a side view of the endotracheal tube just below the cuff. 
           [0012]      FIG. 4A  is a front view and  FIG. 4B  and  FIG. 4C  are side views of the first valve means. 
           [0013]      FIG. 5A  is a front cross-sectional view and  FIG. 5B  is a side cross-sectional view of the first valve means in its closed position. 
           [0014]      FIG. 5C  is a cross-sectional view of the stem component of the first valve means. 
           [0015]      FIG. 6A  is a front cross-sectional view and  FIG. 6B  is a side cross-sectional view of the first valve means in its open position. 
           [0016]      FIG. 7A  is a front view of the second valve means in its closed position. 
           [0017]      FIG. 7B  is a front cross-sectional view,  FIG. 7C  is a mid side cross-sectional view, and  FIG. 7D  is an end side cross-sectional view of the second valve means in its closed position. 
           [0018]      FIG. 8A  is a front view of the second valve means in its open position. 
           [0019]      FIG. 8B  is a front cross-sectional view,  FIG. 8C  is a mid side cross-sectional view and  FIG. 8D  is an end side cross-sectional view of the second valve means in its open position. 
       
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
       [0020]    In describing the preferred and other embodiments of the technology described herein, as illustrated in  FIGS. 1-8 , specific terminology is employed for the sake of clarity. The invention, however, is not intended to be limited to the specific terminology so selected, and it is to be understood that each specific element includes all technical equivalents that operate in a similar manner to accomplish similar functions. 
         [0021]    Referring now to  FIG. 1  and  FIG. 2 , illustrated therein is an embodiment of an improved endotracheal tube with intrinsic suction  1 . An outer tube  4  has an outer diameter that approximates the inner diameter of the passage to be intubated. A built in suction channel  2  runs through the outer tube. A plurality of a side hole  3  allows the movement of fluids from the outer tube lumen  15  into the suction channel lumen  14 . A suction extension tube  5  is in fluid communication with the suction channel  2  and extends beyond the outer tube  4 . An end cap  9  is used to close off the end of the suction extension tube  5  when the suction feature is not in use. A tether  8  attaches the end cap  9  to the extension tube  5 . 
         [0022]    An inflatable cuff  13  common to existing endotracheal tubes is positioned near the end of the tube. An air passageway  10 , a filler valve  12  and inflation extension tube  11  allows air to be pumped into the inflatable cuff  13 . A Murphy&#39;s Eye hole  7  is also common to existing endotracheal tubes and is positioned near the end of the outer tube  4 . A radiopaque strip  6  runs the length of the outer tube  4  underneath the suction channel  2 . 
         [0023]      FIG. 2  illustrates a cross-sectional view of the endotracheal tube just below the cuff. A plurality of side hole  3  allows fluids to be sucked from the outer tube lumen  15  into the suction channel lumen  14  when the suction feature is activated. 
         [0024]      FIG. 3  illustrates a side view from the concave side of the end of the endotracheal tube just below the cuff. An end hole  16  at the end of the suction channel  2  allows fluids to be sucked into the suction channel  2  from the area beyond the end of the tube. 
         [0025]    Referring now to  FIG. 4A , illustrated therein is a front view of the first valve means  19  for the regulation of the flow of fluids through the suction channel  2 . A fluid outlet port  20  and a fluid inlet port  21  extend outwards from the valve body  23 . A hose connected to a suction system commonly found in operating environments will slide over the outlet port  20 . The extension tube of the endotracheal tube&#39;s suction channel  2  will slide over the inlet port  21 . A plurality of a ridge  22  on the outlet and inlet ports create an airtight seal between the hoses and the ports. A vent hole  25  in the front of the valve body allows air from the surrounding room to be sucked into the suction system when the valve is in the closed position. An additional vent hole (not shown in this drawing) is also on the back side of the valve body. A push button  24  controls the operation of the valve. A stem  34  connects the push button to a sliding element within the valve body  23 . 
         [0026]      FIG. 4B  shows a side view of the first valve means  19  from the side facing the push button  24 . 
         [0027]      FIG. 4C  shows another side view of the first valve means  19  from the side opposite the push button. A vent hole  26  allows air to move in and out of the valve body  23 . This allows a reciprocatable element within the valve body to slide back and forth without creating a vacuum that could restrict the movement of the element. 
         [0028]      FIG. 5A  illustrates a cross-sectional view of the first valve means  19  showing the reciprocatable element  27  in its closed position. Two fluid passageways are disposed within the reciprocatable element  27 . A suction passageway  28  has one opening at the bottom of the reciprocatable element  27  and one opening at the top. A suction bypass passageway  29  has one opening at the top of the reciprocatable element  27  and two openings on the sides of the reciprocatable element  27 . A spring  31  keeps the valve in the closed position until an operator depresses the push button  24 . Silicone washers  33  provide airtight seals between the reciprocatable element  27  and both the inlet port  21  and the outlet port  20 . A plurality of a vent hole  26  on the side of the valve body  23  opposite the push button and a vent hole  32  on the side of the body (end plate) under the push button allow air to move into the space between the reciprocatable element  27  and the valve body  23  preventing a vacuum for forming that could restrict the movement of the reciprocatable element  27 . Grooves  35  in the stem  34  align with ridges  36  in the hole in the end plate through which the push button stem slides. The engagement of the grooves and ridges keep the stem  34  and reciprocatable element  27  from rotating out of alignment. A bumper block  30  prevents the reciprocatable element  27  from being pushed beyond the open position. The bumper block  30  has a hole in the middle of it to allow air to pass through it. 
         [0029]      FIG. 5B  illustrates a side mid-cross-sectional view of the valve means  19  in its closed position. The suction bypass passageway  29  is in fluid communication with the outlet port  20  and the two side vent holes  25  on each side of the valve body  23 . 
         [0030]      FIG. 5C  illustrates a mid-cross-sectional view of the stem  34  connecting the push button with the reciprocatable element. Grooves in the stem  35  align with ridges attached to the valve body. 
         [0031]      FIG. 6A  illustrates a front cross-sectional view of the first valve means  19  with the push button depressed and the reciprocatable element  27  in its open position. In this position the suction passageway  28  is in fluid communication with the inlet port  21  and the outlet port  20  and the suction feature is activated. 
         [0032]      FIG. 6B  illustrates a side mid-cross-sectional view of the valve means  19  in its open position. 
         [0033]      FIG. 7A  illustrates a front view of a second valve means  40  in its closed position. This valve utilizes a rotatable knob  41  to turn a rotatable element disposed within the valve body  44 . A knob stem  49  connects the rotatable knob  41  to the rotatable element. An inlet port  21  and an outlet port  20  extend outward from the valve body  44 . A vent hole  43  represented in this drawing as a dotted line is positioned on the back of the valve body  44 . 
         [0034]      FIG. 7B  illustrates a cross-sectional view of the valve means  40  in its closed position exposing a rotatable element  50 . A fluid passageway  48  is disposed within the rotatable element  50 . A spring anchor block  45  is attached to the valve body  44  and a spring attachment post  51  is attached to the rotatable element  50 . A spring not shown in this figure connects the anchor block  45  and attachment post  51  and keeps the rotatable element  50  in its closed position when the suction feature is not needed. A stop block (not shown in this figure) attached to the valve body keeps the attachment post  51  and rotatable element  50  from moving beyond the valves closed position and within the ninety degree rotation arc. The spring anchor block  45  and the stop block also serve as spacers between the end of the rotatable element and the body end plate  47  which encloses the inner components of the valve  40 . 
         [0035]      FIG. 7C  illustrates a side mid-cross-sectional view of the second valve means  40  in its closed position. This view illustrates that the fluid passageway  48  is comprised of two separate passageways joined together and has three openings. In this closed position one opening is in fluid communication with the outlet port  20  and another one is in fluid communication with the back vent hole  43 . A silicone washer  33  forms an airtight seal between the rotatable element  50  and the outlet port  20 . 
         [0036]      FIG. 7D  illustrates a side view of the second valve means  40  without the endplate and the knob. A spring  52  is attached to the spring anchor block  45  and to the spring attachment post  51 . A stop block  46  keeps the attachment post  51  and the rotatable element  50  from moving beyond the valve&#39;s closed position. 
         [0037]      FIG. 8A  illustrates a front view of the second valve means  40  shown in  FIG. 7A  where its knob  41  has been rotated ninety degrees from its closed position into its open position. 
         [0038]      FIG. 8B  illustrates a front cross-sectional view of the second valve means  40  shown in  FIG. 7B  where the rotatable element  50  and knob  41  have been rotated ninety degrees into in its open position. In this position one of the openings of the fluid passageway  48  is in fluid communication with the outlet port  20  and one of the openings is in fluid communication with the inlet port  21 . 
         [0039]      FIG. 8C  illustrates a side mid-cross-sectional view of the second valve means  40  in its open position. 
         [0040]      FIG. 8D  illustrates a side view of the second valve means  40  without the endplate and the knob where an operator has rotated the rotatable element  50  ninety degrees into its open position. The spring anchor block  45  also functions as a stop block and keeps the rotatable element from moving past its open position. The spring  52  is compressed in this position and it will force the rotatable element  50  back into its closed position when the operator releases the knob. 
         [0041]    Having thus described exemplary embodiments of the technology described herein, it should be noted by those skilled in the art that the within disclosures are exemplary only, and that various other alternatives, adaptations, and modifications may be made within the scope of the technology described herein. Accordingly, the technology described herein is not limited to the specific embodiments illustrated herein, but is limited only by the following claims.