Abstract:
A disposable nasal air moisturizing device is removably attached to a nasal cannula to release a moisturizing liquid into a breathing gas and a patient&#39;s nasal airway. The intranasal sponges and moisturizing liquid prevents and treats both abrasions from the nasal cannula and excessive drying of the mucosa. This reduces the incidence of nosebleeds in patients using supplemental nasal oxygen.

Description:
CROSS-REFERENCE TO RELATED APPLICATION 
       [0001]    The present application claims the benefit of provisional application No. 62/163,262 (Attorney Docket No. 4827-703.101), filed on May 18, 2015, the full disclosure of which is incorporated herein by reference. 
     
    
     BACKGROUND OF THE INVENTION 
       [0002]    The invention relates generally to devices and methods for delivering moisture and/or other substances to the nasal passages concurrent with oxygen delivery using a nasal cannula, and more specifically to devices and methods for clipping or otherwise attaching a moisture saturation device onto a conventional nasal cannula. 
         [0003]    A conventional nasal cannula  10  ( FIG. 1 ) is a device used to deliver supplemental oxygen, air or other breathing gas mixture to a patient with respiratory, cardiac or hematologic disease. A conventional nasal cannula consists of a lightweight breathing tube  11  having two prongs  12  at one end. The two prongs are placed in the patient&#39;s nostrils to deliver the breathing gas. The other end of the tube is connected to a breathing gas supply, such as an oxygen tank or a wall connection in a hospital, via a flowmeter. The cannula may be attached to the patient by hooking the tube over the patient&#39;s ears. Typical adult nasal cannulas carry 1-5 liters of oxygen per minute while wider bore humidified nasal cannulas carry up to 60 liters of air/oxygen per minute. The nasal prongs typically contact the delicate mucosa of the nasal septum and turbinates, leading to ulceration 
         [0004]    The oxygen or air flowing from the gas source to the patient is usually very dry and can cause excessive drying of the mucosal membranes, discomfort, and in some cases ulceration of the nasal passage. Ulceration of the delicate nasal mucosa can cause nosebleed, or epistaxis which is especially serious in elderly patients who intentionally or unintentionally take medications or herbal supplements that thin their blood and impair normal blood clotting (aspirin, warfarin, apixaban eliquis, dabigatran etexilate pradaxa, edoxaban savaysa, rivaroxaban xarelto, fish oil, vitamin E, ginkgo, garlic capsules and others). Nasal ulcerations and bleeding in these patients can lead to respiratory problems, anemia and pain. 
         [0005]    To address the problem of excessive nasal drying, it is common to pass the breathing gas through a chamber containing water or other fluid to increase the moisture content of the gas prior to delivery to the patient. However, such devices are often only minimally effective and do not prevent the direct abrasive effects of the nasal prongs irritating the delicate nasal mucosa. 
         [0006]    U.S. Pat. No. 6,354,293 describes another approach to address the problem of dry nasal membranes. A humidifying element is placed retained under the user&#39;s nose, and oxygen or other gas is passed through the breathing humidifier into the users nostrils. The humidifying element is held between the nasal cannula and the nose, but is easily dislodged and can be dropped or lost, particularly with ambulatory patients. 
         [0007]    For these reasons, it would be desirable to provide a nasal air humidifying device which can be clipped or otherwise removably attached to a conventional nasal cannulas to enhance humidification of the breathing gas and avoid direct abrasion of the delicate nasal mucosa by the nasal prongs of supplemental oxygen. 
       SUMMARY OF THE INVENTION 
       [0008]    A nasal air moisturizing or humidifying device is configured to be securely and removably attached, typically clipped, over the oxygen delivery prongs of a conventional nasal cannula. The nasal air moisturizing device includes a sponge or other liquid-absorbable material configured to cover the prongs of the nasal cannula. The sponge will be saturated with saline or other a moisturizing fluid to continuously release moisture into the breathing gas being delivered to the patient. The sponge-like material will also provide an atraumatic interface with the nasal mucosa to avoid direct trauma and abrasion of the mucosa by the nasal prongs. 
         [0009]    In specific embodiments, the nasal air moisturizing device comprises a shell or frame body that carries saline or other moisturizing fluid which can be clipped or otherwise attached over the nasal cannula. The external shell or frame encloses a sponge for holding saline or other moistening fluid. The moisture absorbent sponge or other material is also carried in the shell and is configured (a) to be positioned over the nasal prongs of the conventional nasal cannula when the shell is attached to the breathing tube and (b) to receive moisturizing liquid and release the moisturizing liquid into breathing gas being delivered through the prongs by diffusion or capillary action. 
         [0010]    The frame typically comprises a rigid shell having an interior volume. The reservoir and the moisture absorbent material are usually disposed within the interior volume of the shell. The moisture absorbent material will usually comprise a sponge-like material or a gauze-like material and will includes two protrusions which extend outwardly through apertures in the shell. The two protrusions will extend outwardly through apertures in the shell and will have passages which are configured to be disposed over the prongs when the when the shell is attached to the nasal cannula. Typically, the sponge or other moisture absorbent material will be at least partially disposed within the shell with the protrusions extending outwardly from the shell so they can enter the patient&#39;s nose. 
         [0011]    The present invention also provides methods for establishing an interface between a nasal cannula and a patient&#39;s nasal mucosa. The method comprises providing a conventional nasal cannula of the type having prongs suitable without modification for placement in the nostrils of a patient for delivering a breathing gas to the patient. Such a conventional nasal cannula, when used without the methods and devices of the present invention, will suffer from the short comings discussed above. To overcome these shortcomings, and in n accordance with the present invention, a moisture absorbent material is placed around the prongs of the nasal cannula, and the prongs of the nasal cannula are positioned in the patient&#39;s nostril so that the moisture absorbent material provides a moisture permeable barrier between the prongs and mucosa of the patient&#39;s nostrils. As a breathing gas is delivered to the patient&#39;s nostrils through the prongs of the nasal cannula, the moisture is drawn from the intranasal sponges and nasal air is humidified. The moisture in the intranasal sponges is maintained by refilling the sponge or reservoir with saline or other moisturizing medical solution through the port on the top of the shell. 
         [0012]    In specific aspects of the methods, the moisture retaining sponges or other materials between the prongs and mucosa will inhibit and often eliminate abrasion of the nasal septum and nasal turbinates in addition to moisturizing the mucosa, and the methods are suitable for treating patients already suffering from septal ulceration and nosebleeds. The moisture absorbent material typically comprises a sponge or gauze body having protrusions, and the protrusions are typically placed over the prongs of the nasal cannula. The sponge body is then connected to the reservoir, and the protrusions are then inserted into the nostrils together with the nasal cannula. The methods may further comprise filling the reservoir with the moisturizing liquid after the nasal cannula has been placed on the patient. The reservoir is typically filled with a nasal saline solution and/or a bacteriostatic/bacteriocidal solution, and the reservoir may be replenished periodically without removing it from the patient. Moreover, the assembly of the shell, the moisture absorbent material, and the reservoir may be periodically replaced or exchanged without replacing the nasal cannula. 
         [0013]    Although the nasal air moisturizing devices of the present application are illustrated as integrated or monolithic devices without moving parts, it would also be possible to utilize spring-loaded or other articulated clips which could be removably secured over the nasal cannulas. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0014]      FIG. 1  illustrates a conventional nasal cannula in place with prongs in a patient&#39;s nose. 
           [0015]      FIG. 2  is a detailed view of the prongs of the conventional nasal cannula of  FIG. 1 . 
           [0016]      FIG. 3  is a top view of a nasal air humidifying device of the present invention. 
           [0017]      FIG. 4  is a front view of the nasal air humidifying device of the present invention. 
           [0018]      FIG. 5  is a back view of the nasal air humidifying device of the present invention. 
           [0019]      FIG. 6  is a side view of the nasal air humidifying device of the present invention. 
           [0020]      FIG. 7  is a cross-sectional view of the nasal air humidifying g device of the present invention taken along line  7 - 7  of  FIG. 4 . 
           [0021]      FIG. 8  illustrates the prongs of the conventional nasal cannula of  FIG. 1   present  in the patient&#39;s nostrils. 
           [0022]      FIG. 9  illustrates the nasal air humidifying device of the present invention covering the prongs of a conventional nasal cannula present in the patient&#39;s nostrils. 
       
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
       [0023]    A disposable device is described which clips or otherwise attaches onto a conventional, commercially available supplemental nasal oxygen cannula to moisturize the nasal mucosa as the patient breaths oxygen being delivered by the cannula. This device reduces/prevents nosebleeds associated with the use of supplemental oxygen. The device structure typically includes a sponge or other liquid absorbing material or mass and is designed to clip over the nasal prongs of a supplemental oxygen cannula. Common nasal saline solution or bacteriostatic/bactericidal solution can be used to moisturize the nasal sponges, and oxygen flowing through the nasal prongs carries the moisture from the sponge to the nasal membranes. In addition, the sponge typically covers the nasal prongs and releases or transfers the saline or other moisturizing liquid directly into the nasal air and further holds the prongs away from the nasal septum, minimizing or preventing ulceration of the delicate nasal mucosa. 
         [0024]    A major benefit of the device of the present invention is its compatibility with existing medical equipment. The ability to continue use of a familiar nasal cannula design improves compliance and reduces the financial burden of purchasing completely new oxygen delivery devices. The reservoir of the device may be filled with sterile normal saline solution, typically available in hospitals, nursing homes and pharmacies. 
         [0025]    Bacteriostatic or bactericidal solution can also be used to fill the reservoir, if the clinical condition of the patient warrants. 
         [0026]    The learning curve of use is short. Families and healthcare workers can understand the easy clip-on properties of this device, and can successfully use it almost immediately. 
         [0027]    The device is made as a simple shell with a slot or clip at the bottom, and there is only one way that the nasal oxygen can be inserted into the device, and that immediately creates a firm or tight seal. 
         [0028]    The device is disposable to reduce bacterial/viral/fungal contamination. 
         [0029]    Referring now to the drawings,  FIG. 2  shows more detail of a conventional nasal cannula  10  of the type that can be used with the devices and methods of the present invention. In particular, the conventional nasal cannula  10  includes a breathing tube  11  and has an internal lumen  13  which receives a flow of oxygen or other breathing gas from a breathing gas source, such as a pressure bottle or a wall connector. The internal lumen  13 , in turn, opens to lumens  14  formed through the prongs  12  which are received in the patient&#39;s nostrils, as better seen in  FIG. 8  which will be described later. 
         [0030]    Referring now to  FIGS. 3-7 , a nasal air humidifying device  16  constructed in accordance with the principles of the present invention comprises a shell  18  defining an interior space  20  ( FIG. 7 ). The shell  18  may be formed from a soft or hard plastic or other conventional medical device material, typically by molding or thermal forming. A moisture absorbent material  22  ( FIG. 7 ), typically a sponge, gauze, or other conventional medical material used to absorb medical grade solutions, is present within the interior  20  of the shell  18  and includes a pair of protrusions  24  which extend outwardly from the shell through apertures  25  formed in a front surface of the shell. A slot  28  is formed in a lower portion of a back wall of the shell, as best seen in  FIGS. 5, 6 and 7 , to accommodate the breathing tube  11  when the prongs  12  are placed into and through passages  36  in the protrusions  24 . 
         [0031]    Referring now to  FIGS. 8 and 9 , the nasal cannula  10  without benefit of the present invention ( FIG. 8 ) may be placed in a patient&#39;s nostrils so that one prong  12  enters the right nostril NR and the other prong enters the left nostril NL. The prongs are exposed within the nasal cavity and rub against the mucosa of the septum S and turbinates T. As discussed above, such unprotected rubbing can abrade and damage the mucosal surfaces of the nasal cavity. In addition, the air entering the nostrils is dry and can have the other deleterious effects described above. The shell  18  has right and left sidewalls  26  and  27 , respectively, so that the shell will usually define a complete enclosure for the moisture absorbent material  22  except for (1) a port  32  ( FIG. 7 ) with a cover  34  that allows for liquid introduction into the moisture absorbent material  22  and (2) apertures  25  and  29  ( FIG. 7 ) that allow the protrusions  24  to extend outwardly from the shell  18 . 
         [0032]    The shell  18  thus encloses moisture absorbent material  22  to define a reservoir region in its interior so that the moisturizing liquid can be introduced through port  32  into the reservoir region where it is absorbed by the moisture absorptive material. The moisturizing liquid will distribute through the moisturizing absorbent material  22  and is able to travel upward through the protrusions  24  and into the patient&#39;s nostrils by capillary action. In this way, moisture which is carried into and released from the protrusions  12  will help humidify the breathing gas and moisturize the mucosal surfaces within the patient&#39;s nostrils as the otherwise dry air is introduced through the prongs  12 . 
         [0033]    As shown in  FIG. 9 , the breathing tube  11  has been inserted through the slot  28  of the nasal air humidifying device  16 . More specifically, the breathing tube  11  is inserted through the slot  28  of the shell  18  so that the prongs  12  pass through the apertures  25  and  29  and through the passages  36  of the protrusions  24 . After placement into the nostrils NL and NR, the protrusions  24  directly engage the surfaces of the turbinates TL and TR as well as the septum S, where they act both as a protective barrier to inhibit abrasion and to deliver moisture to humidify the air being delivered to the patient.