A multilumen tracheal tube or catheter is disclosed. The tube has a plurality of suction lumens, each having a suction port. A rotatable suction port collar is provided. The suction port collar has an inlet and an outlet. The collar overlaps each suction port and is capable of selectively occluding a number of the suction ports while enabling unimpeded passage between a remainder of the ports and the outlet.

BACKGROUND

The present invention relates to a tracheal tube used for mechanical ventilation of a hospital patient, by insertion of the tube into the trachea of the patient. In particular, the present invention relates to a tracheal tube having means for irrigating and/or evacuating contaminated secretions accumulating above the tracheal tube cuff and thereby reducing the risk of such contaminated secretions entering the lungs of the patient.

Tracheal intubation involves the insertion of a tubular device, known as a tracheal tube, into the trachea of a patient. The tracheal tube passes through the trachea and terminates at a position above the carina, anterior to a position between the second and fourth thoracic vertebrate. Gases may then be introduced through the tracheal tube and into the lungs of the patient.

The primary purposes of tracheal intubation, are to mechanically ventilate the patient's lungs, when a disease prevents the patient from normal, breathing induced ventilation, or to apply anesthetic gases during surgical intervention. In order to create enough air pressure to accomplish such mechanical ventilation and to prevent escape of gases past the tube, it is necessary to seal the passageway around the tracheal tube. A seal may be produced by the use of an inflatable cuff formed integrally with and surrounding the tracheal tube. When the tracheal tube has been introduced into the patient's trachea, the inflatable cuff will normally be located about 3 to 5 centimeters above the carina and within the tube-like trachea.

The inflatable cuff is then inflated so as to engage the wall of the trachea and thereby seal the trachea and prevent gases being introduced through the tracheal tube from simply backing up around the tube. While treatment of this sort has proved successful for patients having chronic or acute respiratory diseases, there is a constant risk of several complications.

In particular, many patients receiving tracheal intubation develop pneumonia, resulting from an infection of the lungs, possibly induced by contaminated, pooled secretions entering the trachea and the lungs after bypassing the epiglottis during intubation. The epiglottis normally operates as a valve which selectively closes the entry into the trachea and lungs, to prevent the introduction of secretions and particulate matter. However, when a tracheal tube is in place, the epiglottis is held in an open position, and secretions which would normally be directed away from the trachea and into the digestive system, instead follow the path of the tracheal tube and pool above the inflatable cuff of the tracheal tube.

The greatest risk of such infectious secretions reaching the lungs is upon the cessation of mechanical ventilation. In particular, when the need for tracheal intubation ends, the inflatable cuff of the tracheal tube is deflated so that the tracheal tube may be withdrawn from the patient. The infectious secretions which have pooled above the inflatable cuff are then released and are free to flow into the lungs, where bronchitis or pneumonia may rapidly develop. There is also the risk of the infectious secretions reaching the lungs while intubated, by aspiration of the secretions past the tracheal tube cuff.

To overcome these risks, it is known in the prior art to combine a single lumen suction tube with a tracheal tube. The suction tube is joined to the tracheal tube in a suitable manner, the end of the suction tube terminating at a position above the inflatable cuff. The suction tube provides means for suction or evacuation of any pooled secretions which accumulate in the trachea above the inflatable cuff. However, such prior art devices have the disadvantage that use of a single lumen for the suction tube often causes direct suction to be exerted on the tracheal mucosa which may then result in damage to the mucosa.

U.S. Pat. No. 4,840,173 to Porter III, describes an endotracheal tube having a single lumen suction tube merged thereto. In particular, this patent describes a device wherein the suction tube is laminated to the outside of the ventilation tube, so that the suction tube terminates at a position just above the inflatable cuff. The suction tube includes multiple openings which may be used to evacuate secretions which pool above the inflatable cuff. In addition, the inflatable cuff includes a section immediately adjacent to the end of the suction tube that is less flexible than the rest of the inflatable cuff, to insure that the flexible material of the inflatable cuff is not sucked up against the suction tube openings. The endotracheal tube described in the Porter III patent has the disadvantages noted above, that the single lumen suction tube may exert suction on the tracheal mucosa and thereby cause damage to the mucosa. Further, the Porter III device is of a relatively complex design, requiring difficult processing, resulting in expensive production.

U.S. Pat. No. 5,143,062, issued to Peckham, discloses an endotracheal tube comprising a double lumen through which air may be circulated, creating an indirect gentle suction through a suction eye communicating with the distal ends of the lumens, and located at a position proximal to the inflation cuff. This design, however, does not provide adequate suction necessary for aspirating secretions and is easily occluded.

The above noted patent references fail to adequately address the suctioning of secretions which have pooled above the inflatable cuff in a manner that is sufficient to accomplish the task but is not so strong so as to cause damage to the mucosa. Moreover, these references and other conventional endotracheal and tracheal tubes lack the ability to suction these secretions, even when a patient is turned according to nationally instituted decubitus prevention protocols. That is, they fail to provide alternative suction capabilities in the event the patient is turned or in the event the desired suction lumen is occluded by secretions.

As the background devices fail to disclose a tracheal tube and suction catheter system having these structural characteristics, the need for such a device is apparent. The instant invention addresses this by providing a multilumen tracheal tube and suction catheter system comprising a device that enables the surgical team to direct suctioning to any number of lumens within the tracheal tube.

SUMMARY OF THE INVENTION

The present invention improves upon a tracheal tube. In one embodiment, a tube having a first wall and a second wall concentric to the first wall is provided. The first wall surrounds and defines a ventilation lumen which is adjacent to a first surface. The first wall may be attached at a second surface to a first surface of the second wall at a plurality of partitions. This enables a plurality of suction lumens to be defined by the second surface of the first wall, the first surface of the second wall, and surfaces of adjacent partitions. Each suction lumen would have a suction port formed through a portion of the second wall. A suction port collar having an inlet and an outlet is also provided. The collar surrounds the tube and overlaps the suction ports. The collar is selectively positionable so as to enable fluid communication between the inlet and at least one suction port while occluding any remaining suction port. The outlet of the suction port would be adapted to connect to a suction source.

In some embodiments, the suction port collar is rotatable about the tube. In other embodiments a guide may be provided. Such a guide may be coupled to the tube and disposed over each suction port, the guide would have openings aligned with each suction port, and the suction port collar would be rotationally attached to the guide. The collar may be configured as a cylindrical ring having an inner diameter, an outer diameter, and a tubular conduit affixed substantially normal to a plane tangential to the outer diameter.

The inlet to the collar is at that end of the conduit coincident with the inner diameter, and the outlet is at the opposite end of the conduit. The inlet may be capable of aligning with only a single suction port at any one point in time, a multiple of such suction ports, or no suction port.

In another embodiment, a tracheal tube having a plurality of suction lumens, each suction lumen having a suction port; and a suction port collar may be provided. The suction port collar may have an outlet and an inlet. The collar may overlap each suction port, a portion of the collar selectively occluding a number of the ports while enabling unimpeded passage between a remainder of the ports and the outlet. Such a tube may contain a ventilation lumen as well as suction lumens which are radially disposed about an outer diameter of the ventilation lumen. Each suction lumen may have an inlet and an outlet, the outlet corresponding to at least one of the suction ports. Such a tube may be provided with an inflatable cuff sealed to and surrounding the tube at a distal end adapted to seal the trachea of a patient. Each suction lumen would have an inlet port proximal to the inflatable cuff and terminate at one of the suction ports distal from the inflatable cuff.

Other objects, advantages and applications of the present invention will be made clear by the following detailed description of a preferred embodiment of the invention and the accompanying drawings wherein reference numerals refer to like or equivalent structures.

DETAILED DESCRIPTION

Reference will now be made to the drawings in which the various elements of the present invention will be given numeral designations and in which the invention will be discussed so as to enable one skilled in the art to make and use the invention. It is to be understood that the following description is only exemplary of the principles of the present invention, and should not be viewed as narrowing the pending claims. Those skilled in the art will appreciate that aspects of the various embodiments discussed may be interchanged and modified without departing from the scope and spirit of the invention.

Referring toFIG. 1, a tracheal tube12is depicted extending through the mouth14and the trachea16of the upper respiratory system of patient10. The tracheal tube10terminates in a distal end18well above the point20at the first bifurcation of trachea16into the right lung22through the right mainstem bronchus24and into the left lung26through the left mainstem bronchus28. Typical sub-branchings of the mainstem bronchus are shown inFIG. 1for illustrative purposes in relation to the sub-branching of left mainstem bronchus24into left lung26.

The distal end18of tracheal tube12is provided with a balloon30which, when inflated, engages the walls of trachea16to facilitate mechanical ventilation of patient lo through a connector32coupled to a standard tracheal tube adapter34at the proximal end36of tracheal tube12. As would be understood by those of skill in the art, air from the ventilating apparatus for patient10enters tracheal tube12through one leg of the connector32, and correspondingly, air is returned to the ventilating apparatus from patient10through a second leg of the connector.

Looking now toFIG. 2, a more detailed view of the tracheal tube12may be had. This view depicts the tube12in a straightened configuration. A collar38is positioned on the tube12. The collar38rotates about the cannula and provides the user or medical personnel with an ability to select functionalities as explained in greater detail below. An inlet port40or a plurality of such inlet ports40is provided at desirable locations along the tube12. In some embodiments, such inlet ports40are located above the balloon30, i.e., between the balloon30and the proximal end36. In other embodiments, a inlet port or inlet ports40are located below the balloon30, i.e., between the balloon30and the distal end18. Some embodiments may have inlet ports on each side of the balloon30.

As shown inFIG. 3, the tube12is configured as a cannula with a plurality of internal lumens that extend at least partially along the length of the tube12. In theFIG. 3example, a ventilation lumen42is provided at the center of the tube12. Surrounding the ventilation lumen42are a plurality of lumens, including at least one suction lumen44. Many embodiments, such as theFIG. 3embodiment contain a plurality of such suction lumens44arranged radially about the ventilation lumen42. A first wall46separates the ventilation lumen42from the suction lumen44. In this embodiment, a second wall48forms the exterior wall of the tube12. A plurality of partitions50are provided to separate each suction lumen44from one another. Each of these walls and partitions may be created via extrusion of the material comprising the tube through an appropriate die during formation of the tube12and as such may effectively be considered as a single component having a plurality of lumens situated therein. In any event, the placement of lumens in a tracheal tube is a process that would be understood by those of skill in the art

As seen inFIG. 3, additional lumens, such as an inflation lumen52and an irrigation lumen54may be provided. The inflation lumen52connects the balloon30to some means capable of inflating the balloon, thus keeping the tracheal tube12adequately sealed and positioned desirably within the trachea16. An irrigation lumen54may also be provided to enable medical personnel to introduce a lavage solution or to medicate the patient10. In some embodiments, one or more of the suction lumens44may alternatively be used as irrigation lumens. The collar38is provided with an outlet56which leads to a suction source (not shown). A guide58may also be provided within which the collar38is allowed to rotate.

Turning toFIG. 4, a partial cutaway view depicting the internal configuration of one embodiment of the collar38is shown. It may be seen that a plurality of suction lumens44are shown radially disposed about the ventilation lumen42. The suction lumens44, in this embodiment, three such lumens extend substantially around the entire cannula with the exception of a region containing the inflation lumen52. Each suction lumen44contains a suction port60that extends through the tube wall or second wall48. The collar38contains a passage or conduit62connecting the outlet56to an inlet64. Rotating the collar38about the tube12enables the user or medical personnel to selectively align the inlet64within the collar38with a specific suction port6o within a specific suction lumen44. Of course each suction lumen44is provided with an inlet port40as described above as well as a suction port60. By rotating the collar into the desired position, the user or medical personnel is provided with a selectable means with which to suction fluids from the patient10.

The inlet64within the collar38may be configured so that it accesses more than one suction lumen44simultaneously. One manner with which to accommodate this configuration would be to place the suction ports60of adjacent lumens44proximate to the partitions50between the lumens44. Alternatively, the partition50may be eliminated at the intersection of the adjacent suction ports60. In any event, if the inlet64has access to more than one suction lumen44at a time, suction on more than one lumen may take place. Furthermore, the collar38may be capable of occluding all suction ports60. This would effectively eliminate any suctioning capabilities.

Looking finally toFIG. 5, a partial cutaway view normal to theFIG. 4view depicts the internal configuration of one embodiment of the collar38for additional clarity. This view depicts the tube12, the ventilation lumen42, one suction lumen44separated from the ventilation lumen by the first wall46and bounded on the opposite side by second wall48. One of the partitions50is depicted as well. The suction port60may be clearly seen as forming a passage through the second wall48. In this view, the inlet64of the collar38is not aligned with the suction port60of lumen44, therefore flow or suctioning would be prevented. It should be easy to envision that appropriate rotation of the tubular component forming the passage or conduit62to the suction port60would enable suctioning.

In this FIG., details with respect to the guide58as well as the collar38may be seen. In some embodiments, the guide58is secured to the tube12such that rotational movement of the guide with respect to the tube is prevented. Appropriate measures should be taken to ensure that the collar38is capable of rotation with respect to the guide58. For example, a flanged interface66between the two components may be used. Such an interface should be fluid tight so as not to enable air leakage into the system when suctioning or to have fluid leakage from the system to the environment. As such, those skilled in the art would understand and be capable of providing an appropriate fluid tight seal to these areas.

During use, the collar38would be rotated to the desired suction lumen44. An indicator68, for example, such as the one depicted inFIG. 3may be provided. An indicator would enable a user to appropriately align the passage or conduit62with a specific suction lumen. As such, an indicator may be provided which corresponds to each suction lumen. In lieu or in addition, the collar38may be made to incrementally click, lock, or snap into each suctioning position as well as a non-suctioning position. This may be accomplished by any number of means known to those with skill in the art. As can be seen from the FIGs., each suction lumen44may be used bi-directionally, that is, each suction lumen may be used to introduce a fluid into the patient. Some such fluids may comprise medicaments, lavage to clean the lumen or the patient's trachea, as well as other fluids.

As used herein and in the claims, the term “comprising” is inclusive or open-ended and does not exclude additional unrecited elements, compositional components, or method steps.

While various patents have been incorporated herein by reference, to the extent there is any inconsistency between incorporated material and that of the written specification, the written specification shall control. In addition, while the invention has been described in detail with respect to specific embodiments thereof, it will be apparent to those skilled in the art that various alterations, modifications and other changes may be made to the invention without departing from the spirit and scope of the present invention. It is therefore intended that the claims cover all such modifications, alterations and other changes encompassed by the appended claims.