Connector valve assembly for endotracheal tubes

A connector valve assembly for admission of catheters through endotracheal tubes employs a connector body having a tracheal tube port, a respiratory tube port and an end portion adapted for insertion of a catheter through the body and through the tracheal tube for patient airway suctioning. An end cap on the end portion has an aperture with a ring seal for sealably engaging the catheter as it is inserted therethrough and has a check valve disposed inwardly of the ring seal toward the respiratory and tracheal tube ports. The end cap defines an air lock chamber for insertion of the catheter through the connector body without interrupting positive pressure ventilation of the patient.

This invention relates to medical tube connector devices and, in 
particular, to a connector assembly for endotracheal tubes utilizing a 
valve to limit air movement. 
BACKGROUND OF THE INVENTION 
During continuous mechanical ventilation of patients, a common clinical 
practice involves the use of positive end expiratory pressure (PEEP) 
wherein the ventilator provides a specific amount of pressure measured in 
centimeters of water pressure during the expiratory phase of ventilation. 
This "pressure breathing" tends to ventilate the entire lung system of the 
patient and to assist breathing of those with injuries or debilitating 
illnesses having labored or otherwise breathing difficulties. The slight 
positive pressure of the incoming air or gas to assist inhalation must be 
overcome during expiration and suitable valves and pressure regulators are 
emplaced in the ventilator to provide for expiration. 
During positive end expiratory pressure breathing, it is desirable not to 
interrupt the established routine of breathing during ventilation; 
however, virtually all patients on mechanical ventilation systems require 
frequent suctioning of the airways and lung organs to maintain proper 
bronchial hygiene to prevent even more serious illnesses such as bronchial 
pneumonia. 
Currently, when suctioning is required, the patient must be physically 
disconnected from the mechanical ventilation device because previous 
systems and connector devices have not permitted administering personnel 
to simultaneously maintain the pressurized system and suction through a 
catheter. 
In another common clinical procedure, an examination instrument known as a 
bronchofiberscope is inserted through the connector assembly and through 
the tracheal tube for visual inspection of the patient's lungs and 
bronchial passages. This inspection is often hampered because the patient 
is on pressurized mechanical ventilation and disconnection from the 
ventilator is ordinarily required prior to insertion of the 
bronchofiberscope. 
OBJECTS OF THE INVENTION 
The objects of the present invention are; to provide a connector valve 
assembly for maintaining positive end expiratory pressure in patients 
connected to a positive pressure ventilation system; to provide such a 
connector valve assembly in which a catheter or other small diameter 
tubular device can be inserted through a connector body and tracheal tube 
without loss of air pressure therein; to provide a connector valve 
assembly having a valve means including a ring seal and a one-way check 
valve therein cooperating to seal the connector body yet admit catheters 
and the like; to provide such a connector valve assembly having an air 
lock chamber between a ring seal and a check valve to maintain positive 
pressure within the connector body and tracheal tube; to provide such a 
connector valve assembly having a cap arrangement connectable thereto and 
defining an air lock chamber with a ring seal at one end and a check valve 
at another end portion, said cap arrangement being readily connectable to 
standard connector bodies; and to provide such a connector valve assembly 
which is sturdy and reliable in use, contains few moving parts, and is 
inexpensive to manufacture. 
Other objects and advantages of this invention will become apparent from 
the following description taken in connection with the accompanying 
drawings wherein are set forth, by way of illustration and example, 
certain embodiments of this invention.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT 
As required, a detailed embodiment of the present invention is disclosed 
herein, however, it is to be understood that the disclosed embodiment is 
merely exemplary of the invention which may be embodied in various forms. 
Therefore, specific structural and functional details disclosed herein are 
not to be interpreted as limiting, but merely as the basis for the claims 
and as a representative basis for teaching one skilled in the art to 
variously employ the present invention in virtually any appropriately 
detailed structure. 
Referring to the drawings in more detail: 
The reference numeral 1 generally indicates a connector valve assembly for 
admission of catheters and the like through endotracheal tubes and having 
a connector body 2 with a tracheal tube port 3, a respiratory tube port 4 
and an open end portion 5 for insertion of a catheter through the body 2 
and through a tracheal tube 6. 
A valve means 7 at the open end portion 5 opens and sealably engages the 
catheter and a check valve inwardly thereof opens to the valve body 
interior for insertion of the catheter into the body without opening the 
body to the outside atmosphere and causing loss of positive system 
pressure. 
In the illustrated example, the connector body 2 is substantially standard 
in configuration and comprises an elongate, tubular member having an outer 
wall 9 and an inner wall 10 defining a through bore. The illustrated 
tracheal tube port 3 is situated at the bottom of the body 2 and has 
spaced upper and lower flanges 12 and 13 with the lower flange 13 having a 
sloping surface 14 for snap fitting of an engagement ring portion 15 of a 
swivel adaptor 16. 
The tracheal tube coupling 18 has a lower insert end 19 and an upper 
reduction couple 20 insertable into the open end portion of the swivel 
adaptor 16. The exemplary reduction couple 20 may have an industry 
standard 15 mm. outside diameter with a one degree taper for a tight press 
fit. 
The endotracheal tube 6 has an upper connection end 21 and a lower, gas 
outlet end 22 associated with an expansible bladder or cuff 23 which is 
inflatable by means of an air line 24. 
The respiratory tube port 4 joins the connector body 2 at a substantially 
angular relationship and has a passage therethrough (not shown) 
communicating with the through bore of the body tube for administering a 
gas, such as air or oxygen, through the tracheal tube 6 and into the 
patient's lungs. The respiratory tube port 4 has an end flange 26 and may 
be plain or include a swivel connector 27. 
The respiratory tube port 4 connects to a respiratory tube (not shown) 
which is in turn connected to a mechanical ventilator including an air or 
gas pump to provide a source of pressurized air for administration to a 
patient. This procedure, known as positive end expiratory pressure (PEEP) 
involves pressure breathing or reversal of ordinary breathing functions 
wherein the patient relaxes and the incoming pressurized air expands the 
diaphragm and causes the lungs to fill with the gas. Expiration is 
accomplished by positive contraction of the diaphragm sufficient to 
overcome the incoming air pressure and permit expiration. Normally the 
mechanical ventilating device (not shown) includes valves, regulators and 
the like. 
Patients on mechanical ventilation normally require frequent airway 
suctioning as through a suction catheter 29 to maintain the proper 
bronchial hygiene. Alternatively, examining instruments such as a 
bronchofiberscope (not shown) may be passed down the airway for visual 
examination of the patient's airway and lungs. Both the catheter and 
bronchofiberscope are long, slender, tubular devices and are commonly 
inserted through the endotracheal tube connector and endotracheal tube 6 
when emplaced. Particular problems are encountered with the positioning of 
the suction catheter 29 when the ventilation device provides pressurized 
air because entry of the catheter into the tube connector has heretofore 
caused positive pressure to be lost and the patient's blood oxygen supply 
to decrease drastically. 
Using the present invention, positive system pressure is not lost upon the 
insertion of the catheter 29 or bronchofiberscope through the connector 
body 2 and into the tracheal tube 6. In the illustrated example, the valve 
means 7 is associated with a cap arrangement 30 having an end wall 31 and 
a surrounding side wall 32. The cap arrangement 30 has a lower section 33 
joined thereto, also with a surrounding side wall 34 and having an 
inwardly directed flange providing an inner shoulder 35 which acts as a 
valve seat as described below. The side wall 34 forms a skirt sized to fit 
securely over the open end portion 5 and includes the valve means 7 as an 
assembly therewith. An end shoulder 36 confronts the inner shoulder 35 and 
a one-way check valve 38 is captured therebetween. 
In the illustrated example, the check valve 38 has a disc member 39 with a 
peripheral edge 40 and a central aperture portion 41. A flexible, rubbery 
valve flapper 42 is secured at one portion to the disc member 39 and has a 
flapper periphery overlying a portion of the inner shoulder 35 when 
thereagainst, whereby the inner shoulder 35 acts as a valve seat for the 
flapper 42. The positioning of the check valve 38 permits the flapper 42 
to swing open when the catheter 29 is routed through the connector body 2 
and to swing closed to a sealed position immediately upon withdrawal of 
the catheter 29 and held against the valve seat by greater than 
atmospheric or positive pressure. 
An aperture 45 extends axially through the end wall 31 and has a ring seal 
portion 46 formed therewith having an inside diameter sized for sealing 
engagement with the outside surface of the catheter 29. The ring seal 
portion 46 may be integral with the end wall 31 or may be a separate 
emplaced O-ring or the like suitably mounted within the end wall 31, as 
long as the ring seal portion 46 sealably engages the catheter wall and 
prevents loss of positive pressure air through the aperture 45. The side 
walls 32 and 33 generally define an air lock chamber for 48, FIG. 3, 
located between the first seal, the ring seal portion 46 and the second 
seal or check valve 38. A removable plug 49 comprises a shaft-mounted ball 
50 with an encircling seal flange 51 and secured to an upper tab portion 
52 joined to a tether 53 connected, as by molding, to end wall 31. The 
plug 49 is selectively insertable into the aperture 45 to close the air 
lock chamber 48 and removable therefrom to route the catheter 29 into the 
connector body 2. 
In use, the plug 49 is removed and the end of the catheter 29 inserted 
through the aperture 45 with the ring seal portion 46 sealing therearound. 
The catheter 29 is pushed quickly through the air lock chamber 48 and the 
check valve 38 and into the connector body 2. The catheter 29, 
bronchofiberscope or other similar device is then manipulated as desired 
by the doctor or health specialist to perform the necessary suctioning, 
inspection or the like. 
Upon completion of the suctioning or inspection, the catheter 29 is pulled 
outwardly of the tracheal tube 6 and connector body 2 whereupon the check 
valve 38 is no longer held open and the positive pressure within the 
connector body 2 administered by the mechanical ventilator pushes the 
flapper 42 to seal off the air lock member 48. The catheter 29 is then 
removed the remainder of the way through the aperture 45 and the plug 49 
fitted thereto upon completion. 
Throughout this entire procedure, the connector body 2 remains closed and 
no noticeable amount of air escapes to cause a drop in the positive 
pressure. 
It is to be understood that while one form of this invention has been 
illustrated and described, it is not to be limited to the specific form or 
arrangement of the parts herein described and shown, except insofar as 
such limitations are included in the following claims.