Abstract:
A tube for insertion into a trachea having a germicidal light source that is positioned above a cuff that holds the tube in place in the trachea. Activation of the germicidal light source causes an radiation emission that kills undesired bacteria that is fostered by the tube and the cuff, reducing the patient&#39;s risk of associated disease, and reducing the need for antibiotics.

Description:
FIELD OF THE INVENTION 
   This invention relates to tubes for medical use generally, and is more specifically related to a tube for insertion into a trachea that incorporates a germicidal light source. 
   BACKGROUND 
   Endotracheal and tracheostomy tubes are used to provide an airway in patients who do not have an adequate airway do due to medical conditions. An endotracheal tube is inserted through the mouth and larynx and into the trachea. Tracheostomy tubes are inserted through an incision just above the sternal notch. 
   With both types of tubes, an inflatable cuff is incorporated at the distal end of the tube that is present within the trachea. The cuff allows pressurization of the lungs during mechanical ventilation, and prevents aspiration of oral secretions and other contaminants into the lungs. The inflated cuff also helps secure the tube in position. A consequence of the inflated cuff is that secretions pool around the top of the cuff, where undesired bacteria may colonize. Microaspiration of these secretions around the cuff is a leading cause of ventilator-associated pneumonia in this patient population. 
   SUMMARY OF THE PRESENT INVENTION 
   The present invention is a tube for insertion into a trachea. A germicidal light source is present within the chamber. The chamber is substantially transparent to the germicidal light. Activation of the germicidal light source causes a radiation emission that kills the undesired bacteria reducing the risk of pneumonia associated with aspiration of the bacteria and as a consequence may reduce the need for administration of antibiotics. 

   
     SUMMARY OF THE DRAWINGS 
       FIG. 1  shows an embodiment of the endotracheal tube of the present invention. 
       FIG. 2  shows an embodiment of the tracheostomy tube of the present invention. 
       FIG. 3  shows an alternate embodiment of a tube according to the present invention. 
       FIG. 4  shows an endotracheal tube according to the present invention in position. 
       FIG. 5  is an isolation of a germicidal light emitting device. 
   

   DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS 
     FIG. 1  shows an endotracheal tube  2  according to the present invention. The endotracheal tube has a cuff  4  that is present on a portion of the tube. The upper end  6  of the endotracheal tube extends out of the mouth of the patient, while the lower end opens into the trachea. The cuff is positioned just above the opening  8  of the lower end. When the tube is inserted through the mouth and into the trachea, the cuff, being of a larger dimension than the remainder of the tube, is expanded to hold the tube in place by pressure against portions of the wall of the trachea contacted by the cuff. The cuff may be expanded by inflation with air or other gases through an air supply conduit  10 . 
   The tracheostomy tube  22  shown in  FIG. 2  has the same novel features and method of use as the endotracheal tube. The differences between the endotracheal tube of the preferred embodiment and the tracheostomy of the preferred embodiment are the same as the differences in the known endotracheal tubes and tracheostomy tubes. 
     FIG. 2  shows a tracheostomy tube  22  according to the present invention. The tracheostomy tube has a cuff  24  that is present on a portion of the tube. The upper end  26  of the tracheotomy tube extends out of an incision in the patient, while the lower end opens into the trachea. The cuff is positioned just above the opening  28  of the lower end. When the tube is inserted through the mouth and into the trachea, the cuff, being of a larger dimension than the remainder of the tube, is expanded to hold the tube in place by pressure against portions of the wall of the trachea contacted by the cuff. The cuff may be expanded by inflation with air or other gases through an air supply conduit  30 . 
   The tube of  FIGS. 1 and 2  has a chamber  12 ,  32  that is positioned just above the cuff. The chamber does not interfere with inflation and deflation of the cuff. A germicidal light source is present within the chamber. The chamber is preferred to be an annular member that completely surrounds the tube, with all surfaces of the chamber being smooth so as to facilitate insertion of the tube. The exterior surfaces of the chamber should not materially extend beyond the uninflated cuff, which facilitates insertion of the tube into the trachea. It is preferred that the extreme upper and extreme lower edges of the chamber are rounded or are otherwise tapered where the chamber joins the tube, so as to facilitate insertion and removal of the tube from the trachea. In summary, all of the exterior surfaces of the chamber should be smooth, with no sharp points or edges, including the edges where the chamber joins the tube. 
   The chamber is substantially transparent to the germicidal light. In the preferred embodiment, the germicidal light emits ultraviolet radiation, and particularly, the germicidal light emits ultraviolet C radiation (UVC), having a bandwidth that is consistent with UVC radiation. The UVC light source is contained within the chamber, and upon actuation, the chamber does not interfere with the transmission of UVC light to the exterior of the chamber. The UVC radiation is directed to, and acts upon, bacteria that are present and growing as a result of materials that are trapped within the trachea by the cuff and the tube. 
     FIG. 3  shows an additional embodiment of the endotracheal tube  62  according to the present invention. The endotracheal tube has a cuff  64  that is present on a portion of the tube. The upper end  66  of the endotracheal tube extends out of the mouth of the patient, while the lower end opens into the trachea. The cuff is positioned just above the opening  68  of the lower end. When the tube is inserted through the mouth and into the trachea, the cuff, being of a larger dimension than the remainder of the tube, is expanded to hold the tube in place by pressure against portions of the wall of the trachea contacted by the cuff. The cuff may be expanded by inflation with air or other gases through an air supply conduit  70 . 
   The tube of  FIG. 3  has a chamber  12 ,  32  has a ring of germicidal light emitting diodes (LEDs)  76 . The LEDs are preferred to emit radiation in the ultraviolet C band. The LEDs are positioned just above the cuff, and are preferred to form an annular ring around the tube. The LEDs may be covered with a substantially clear material, which both assists in mounting the LEDs, and provides a smooth surface. A substantially transparent shrink tubing may be used, or a non toxic clear resin may be used to mount and cover the LEDs. The LED configuration of  FIG. 3  may also be used in a tracheostomy tube. 
   In one embodiment, the chamber covering the LEDs of  FIG. 3  is formed by surrounding the LEDs and the portion of the tube in which the LEDs are mounted with a section of shrink wrap tubing. The substantially transparent shrink wrap tubing is heated, the shrink wrap tubing shrinks and covers the LEDs, providing a smooth surface, while also retaining the LEDs in position on the tube. 
   In a preferred embodiment, a conduit  14 , 34 , 74  is provided in the tube through which an electrical current passes to provide power to the UVC light source. In particular, it is preferred that the conduit is provided in a wall of the endotracheal tube, so that the conduit does not interfere with insertion or removal of the tube. Appropriate conductors, such as wires, may be located within the conduit, and provide the appropriate current to the UVC light source. It is preferred to use a low power germicidal light source, so as to reduce the likelihood of detrimental electrical shock to the patient, in the event that a malfunction of the device occurs. In particular, it is preferred to use a direct current power source, although an alternating current power source may be used. In another embodiment, a self-contained battery could be provided with the tube. Under normal circumstances, none of the conductors will contact the patient. 
   It is neither necessary nor desired for the germicidal light source to operate in a steady state, but rather, operation of the germicidal light source may be intermittent. An appropriate timing circuit may be provided to periodically operate the device. Intermittent operation reduces the undesired effects of, for example, UVC radiation, and further, reduces the power requirements for the device, particularly if the device is battery operated. The period of operation may be determined according to the power output of the germicidal light, and determined by empirical study.