Adapter for localized treatment through a tracheal tube and method for use thereof

By interposing an adapter between the endotracheal or tracheal tube inserted to a patient and the ventilation and suction systems that are connected to the endotracheal tube, a catheter could be inserted via an input port built into the adapter so as to enable a medical personnel to provide localized treatments in the lungs of a patient without having to disconnect either one of the systems connected to the endotracheal tube. The adapter is configured to have a securing mechanism that allows the medical personnel to secure the medication catheter in place. A one way valve fitted to the apertured arm that forms the input port of the adapter prevents any back flow of fluid from the input port. The catheter is manufactured with calibration markings, most likely equally spaced, and a radiopaque line along its length to enhance the maneuvering and the positioning thereof in the patient so that the distal tip of the catheter could be accurately positioned to the desired location of the patient's tracheal/bronchial tree. As a result, the localized treatment such as the injection of a medicament is accurately provided to the appropriate location where the need is the greatest.

FIELD OF THE INVENTION

The present invention relates to the supplying of a medication and other fluids to a patient through either an endotracheal tube or a tracheal tube, and more specifically to the provisioning of an adapter to an endotracheal breathing circuit connected to the patient so that medication and/or other fluids such as oxygen may be provided to the lungs of the patient without having to disassemble the endotracheal breathing circuit.

BACKGROUND OF THE INVENTION

To enhance the breathing of a patient with a tracheal tube or an endotracheal tube, ventilation and suction systems are used. These systems are connected, by means of a connector, to the tracheal tube. (The term endotracheal tube henceforth should be taken to mean either an endotracheal tube or a tracheal tube.) The ventilation system provides ventilation to the patient while the suction system removes the fluids such as for example mucus secretions that accumulate in the trachea and the bronchi of the patient.

Oftentimes a patient connected to a tracheal tube has an acute lung injury. Consequently, medication must be provided to the patient. However, given that the endotracheal tube is connected in circuit with both the ventilator and the suction systems, prior to the instant invention, to supply medication to the patient, the systems, or at least one of the systems, connected to the patient's endotracheal tube has to be removed before medication may be supplied to the lungs of the patient. Needless to say, such removal and replacement of the ventilator and suction lines to the endotracheal tube is cumbersome, and oftentimes causes discomfort to the patient.

PCT publication WO95/08356 by the Assignee of the instant invention discloses the addition of an adapter in the ventilation circuit of the patient. The complete disclosure of the '356 publication is incorporated by reference to the disclosure of the instant application. The instant invention is an improvement of the adapter disclosed in the '356 publication. An alternative embodiment, as well as a method of using the same are also disclosed herein.

BRIEF DESCRIPTION OF THE PRESENT INVENTION

To ensure that a patient having an endotracheal tube inserted to his trachea is continuously connected to the ventilator and the suction system while medication is being provided, an adapter is interposed between the ventilator and the endotracheal tube of the patient. An input port is provided to the adapter so that a catheter that has calibration markings thereon and preferably a radiopaque line extending along its length is insertable to the adapter via the input port. To prevent back flow of fluids from the patient, fitted within the input port is a one way valve that opens only when the catheter is pressed thereagainst and subsequently passes therethrough. The input port, in conjunction with the adapter, would guide the catheter along the length of the endotracheal tube. The catheter is movable therealong until the distal end of the catheter extends beyond the distal end of the endotracheal tube.

With the aid of the equally spaced calibration markings and the radiopaque line along the catheter, the catheter may be accurately positioned to a desired location in the lungs of the patient. Once thus positioned, a medicament may be provided to the proximal end of the catheter, and be guided by the catheter to the desired location in the patient.

To regulate the length of the catheter inserted to the patient, a securing mechanism in the form of an internally threaded collar with extending fingers fitted thereto is threaded over the input port of the adapter, which in turn has at its upper arm an externally threaded portion that threadingly mates with the internal threads of the collar. When the collar is turned tightly on the arm of the input port, the fingers at the collar would compressively grasp the catheter, to thereby retain the catheter in place so that its distal end remains accurately positioned with respect to the desired location of the patient where the medication is to be supplied.

An alternative embodiment of the instant invention encompasses the incorporation of the adapter to the connector piece that acts as a junction for communicatively connecting the ventilator, the suction system and the endotracheal tube.

Instead of using the input catheter for supplying medication at the selected spot for the patient, the catheter may also be used for providing suction to a desired spot of the patient, by replacing the medicament supply means, such as for example a syringe or a medicament contained aerosol can, with a suction device. The suction device may be a part of the main suction provided to the endotracheal tube, or a distinct device that provides suction at the area where the tip of the catheter contacts.

In addition to using the catheter for supplying medicament to the patient and/or applying suction to a particular area such as for example the airways and/or lungs of the patient, other fluids or gases such as for example oxygen may be supplied through the catheter to the spot of the patient at the tip of the catheter, so that there is a high oxygenation directly at the desired patient location.

It is therefore an objective of the present invention to provide an adapter that allows medication to be provided to a patient fitted with an endotracheal tube without having to disassemble the ventilator and/or the suction system that are connected to the endotracheal tube.

It is also an objective of the present invention to provide an adapter that allows localized suction or oxygenation to a desired area of the patient fitted with an endotracheal tube without having to disassemble the ventilator and/or the suction system that are connected to the endotracheal tube.

It is another objective of the present invention to provide an improved multi-purpose adapter.

It is yet another objective of the present invention to incorporate an adapter to the main connector that jointedly connects the ventilator circuit, the suction circuit and the endotracheal tube.

DETAILED DESCRIPTION OF THE PRESENT INVENTION

With reference toFIG. 1, an overall illustration of the interconnections of an endotracheal tube, a ventilator system, a suction system, and the instant invention adapter is shown. In particular, an endotracheal tube or a tracheal tube2is shown to be in communication with a ventilator4and a suction system6. The communications among endotracheal tube2, which is inserted into a patient (not shown for the sake of simplicity), ventilator4and suction system6are established by means of a junction connector8. As shown, junction connector8is cross shaped and has a first leg10, a second leg12and a third leg14. Additional legs, not shown, may also be incorporated to connector8.

Leg10is coupled to a suction catheter16by means of an appropriate coupler such as18. The other end of suction catheter16is connected to a control valve mechanism20, by way of a coupler22. Control valve mechanism20is connected to a vacuum line24, that in turn is connected to a conventional vacuum source usually built into the wall of the room of the patient. Enclosing suction catheter16is a protective sleeve25, which collapses when suction catheter16is inserted through endotracheal tube2to the trachea/bronchial tree of the patient for removing fluids collected thereat by way of suction.

Connected to leg14of junction connector8is a coupler26that is connected to the distal ends of two flexible conduits28and30. The respective proximal ends of conduits28and30are connected, by corresponding couplers32and34, to ventilator4. The combination of conduits28,30and ventilator4could be considered as a ventilator circuit that mechanically pumps and removes air to the patient. Such ventilator circuit for ventilating a patient is conventional.

Interposed between leg12of cross connector8and the proximal end36of endotracheal tube2is an aperture adapter38of the instant invention. As shown inFIG. 1, adapter38has an input port40that allows a medication catheter42to be inserted to endotracheal tube2so that its distal end44could be moved along the length of endotracheal tube2and eventually extended beyond tip46thereof. Medication catheter42can then be maneuvered to a desired location at the trachea/bronchial tree of the patient. Once positioned at the desired location, a medicament such as for example recombinant surfactant protein C (rSPC surfactant), also know as “venticute”, could be supplied to that desired location of the trachea/bronchial tree of the patient.

To enhance its movement along the length of endotracheal tube2and inside the patient, medication catheter42has along its length calibrated markings that allow a user to readily gauge the length of the catheter that has been inserted to the patient. To further enhance the maneuvering of medication catheter42, a radiopaque line is integrated along substantially its entire length.

FIG. 2provides an enlarged view of adapter38ofFIG. 1. In particular, adapter38has a main body45having a proximal end46that is matingly coupled to leg12of cross connector8. Distal end48of adapter38, on the other hand, is matingly coupled to connector36of endotracheal tube2. Adapter38is hollow so that a fluid path38is created along its length to enable free passage of suction catheter16, as well as bidirectional passage of air from the ventilator circuit.

At a side of body38there is fitted an apertured arm or extension52. Apertured arm52thus provides an input port to adapter38. Aperture54in arm52has a sufficient dimension to allow medication catheter42to pass therethrough. Arm52is incorporated or fitted to body38at an angle relative to the longitudinal axis of body45, so as to enable catheter42, once inserted to arm52, to pass therealong and be routed along the direction as indicated by directional arrow56.

Arm52has a top portion58that is externally threaded. An internally threaded collar60is threadingly mated to portion58of arm52. Collar60is moreover internally fitted with a number of fingers62, better shown inFIG. 3, that are compressible toward each other when collar60is threaded onto portion58. The relationship of fingers62with medication catheter42is such that once catheter42is inserted to arm52, upon collar60being fully threaded onto portion58, fingers62would compress in unison onto the outer surface of catheter42, without occluding catheter42, at the location where it makes contact with fingers62, so that catheter42is grasped by fingers62and be fixedly retained in position.

Further fitted to arm52is a one way valve64such as for example a duck bill valve. As shown by its enlarged planar view, one way valve64has a number of pliable flaps or portions64a–64nthat have sufficient elasticity so as to open just enough to enable catheter42to pass therethrough, and yet nonetheless would prevent any fluid in path50from flowing backwards out of arm52. Upon removal of catheter42from arm52, pliable portions64a–64nwould return to their respective original positions to act as a stop to prevent any back flow of fluids from the patient. For the illustration inFIG. 2, pliable portions64a–64ncould be considered to be opened along the direction into the paper.

FIG. 3is an alternative embodiment of the instant invention in which apertured arm52is integrated directly to cross connector8. Arm52is integrated to connector8at an appropriate angle so that catheter42could easily be inserted into endotracheal tube2. All components discussed above with reference to arm52inFIG. 2are present in the embodiment shown inFIG. 3.

FIG. 4illustrates an alterative embodiment of the adapter of the instant invention in which a guide means in the form of an elbow or a chute internal of the adapter housing is provided for guiding the catheter towards the center of the housing when the catheter is inserted to the adapter. Except for the adapter and the guide means internal thereof, all components which are the same or function the same as previously discussed are designated with the same numbers.

In particular, adapter70of theFIG. 4embodiment could be considered as a connector means that has a main body72. Although shown as a somewhat gradually increasing diameter cylindrical body, it should be appreciated that body72of adapter70could in fact be configured to have different shapes. As was the case with the previously discussed adapter, distal end74of housing72is used to mate with an endotracheal tube while the proximal end76of housing72is connectable to a suction catheter. As was the case in the embodiment shown inFIG. 2, aperture arm52provides an input port to adapter70.

However, for the embodiment as shown inFIG. 4, a guide means in the form of an elbow78is integrated to the interior surface of housing72so as to extend from aperture arm52. Elbow78is configured such that it provides a surface that guides catheter42into body72in such a way that once inserted beyond the mouth of elbow78, as indicated at80, further extension of catheter42would move catheter42into and substantially along the longitudinal axis of housing72, so as to enhance the insertion of catheter42to the endotracheal tube. Elbow78therefore acts as a means to enhance the insertion and guide the movement of catheter42into adapter70and then the endotracheal tube. Needless to say, it also enhances the insertion of the catheter to the desired area of the lungs of the patient along the direction indicated by arrow56.

In operation, medication catheter42, which is enveloped by a protective sleeve66as shown inFIG. 2, is inserted to aperture arm52by way of collar60, which has an opening, not shown, that matches aperture54of arm52. As the distal tip44of catheter42makes contact with the pliable fingers64a–64nof fitting64, it pushes the pliable fingers64in a direction toward connector8so that an opening is formed to enable catheter42to pass therethrough. By reading the calibrated markings along catheter42, the length of catheter42that is being inserted to arm52, and subsequently to endotracheal tube2, is readily determined. And with the length of catheters42and the combined distances or lengths of arm52, connector8or body45(theFIG. 2adapter), and endotracheal tube2known, the user can readily determined when distal tip44of catheter42is extended beyond tip46of tracheostomy tube2.

Further, with the radiopaque line incorporated along substantially its entire length, catheter42could be readily maneuvered to precisely position its distal tip44to the appropriate location in the lung of the patient. Thereafter, a medicament container such as for example a syringe is inserted to the input68at the proximal end of catheter42. By pushing in the plunger of the syringe, the medicament such as for example the venticute as mentioned previously is squirt into catheter42and conveyed therealong to output, at distal tip44, to the desired location in the lung of the patient. Thus, given that the medicament is applied to substantially the desired precise location, a smaller dose of the medicament would achieve the same result as the larger doses in the prior art. Moreover, the medicament is concentrated in the particular area of need and therefore would act more quickly as compared to the prior art methods of non-localized application of the medicament.

Although catheter42as disclosed above has been described as a guide for inputting medicament to a desired location of the lungs of a patient, the fact that catheter42, in most instances, is smaller in diameter and easier to maneuver than suction catheter16means that catheter42could be more accurately placed and positioned adjacent to a desired area in the tracheal/bronchial tree of a patient. Catheter42could also be used for suctioning a particular location in the bronchial tree of the patient. This is done either by configuring another flexible conduit from ventilator4that is matable with input68of catheter42. An alternative is to have a suction device, independent of ventilator4, that has an output that is matable with input68at the proximal end of catheter42to apply a suction force to catheter42for suctioning fluid collected at the selected area of the bronchial tree of the patient. This dual use of catheter42, i.e., suctioning as well as providing medicament to the desired area of the patient, could be done with the same catheter. For example, it could very well be that it is desirable to suction out whatever fluid that has been collected in a certain area of the lungs of the patient before medicament is supplied thereto. The fact that the same catheter could be used for both functions means that there is only need to insert a single catheter into the lung of the patient. The fact that catheter42has calibrated markings along its length and a radio opaque line along the length thereof means that it could be readily maneuvered to the desired location for application of either the medicament or suction.

In addition to the application of medicament and suction, catheter44could also be used for a number of other things, if the application of a certain desired result is aimed at a precise location in the lungs of the patient. For example, in place of a medicament, oxygen may be fed by means of the catheter to the desired site, so that a high or concentrated oxygenation may be applied to the chosen site at the lungs of the patient in order to achieve faster result. An oxygen supply may be provided by an oxygen flow meter that has an output which is configured to fit to input68of catheter42.

Inasmuch as the present invention is subject to many variations, modifications and changes in detail, it is intended that all matter described throughout this specification and shown in the accompanying drawings be interpreted as illustrative only and not in a limiting sense. Accordingly, it is intended that the invention be limited only by the spirit and scope of the hereto appended claims.