CN108721748B - Tracheal catheter capable of reconstructing cough peak flow velocity - Google Patents
Tracheal catheter capable of reconstructing cough peak flow velocity Download PDFInfo
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- CN108721748B CN108721748B CN201810004441.7A CN201810004441A CN108721748B CN 108721748 B CN108721748 B CN 108721748B CN 201810004441 A CN201810004441 A CN 201810004441A CN 108721748 B CN108721748 B CN 108721748B
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/04—Tracheal tubes
- A61M16/0402—Special features for tracheal tubes not otherwise provided for
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
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Abstract
The invention discloses a tracheal catheter capable of reconstructing cough peak flow velocity, relates to the technical field of medical instruments, and aims to solve the problem that retentate on an air bag cannot be effectively removed during retention of the tracheal catheter in the prior art. The invention discloses a tracheal catheter capable of reconstructing the flow velocity of cough wind, which comprises: the tracheal catheter, the external air bag, the air bag catheter, the internal air bag, the inflation inlet, the inflation catheter, the air outlet, the sealed cavity and the air outlet; the tracheal tube comprises three separate cavities in total; wherein the inflation inlet is communicated with the air outlet through an inflation conduit; the sealed chamber comprises an air outlet on the inner wall and three air outlet holes on the outer wall, and the sealed chamber is wound on the outer wall of the tracheal catheter in an annular mode. According to the invention, airflow with a certain flow velocity is given through the inflation inlet, airflow with a certain flow velocity can be generated at all the three air outlet holes, the flow velocity of cough wind in a normal physiological state is achieved through adjustment, and the retentate on the inner air bag is impacted to the sound outlet by strong airflow impact force, so that the aim of reconstructing effective cough reflex of a human body is achieved.
Description
Technical Field
The invention relates to the field of medical instruments, in particular to a tracheal catheter capable of reconstructing cough peak flow velocity.
Background
The tracheal intubation is to place a special tracheal catheter into the trachea of a patient through the oral cavity or the nasal cavity. Is a technique for narcotizing in trachea and rescuing patients, and is the most effective means for keeping the upper respiratory tract unobstructed. Endotracheal or endobronchial tubes are a safety measure for maintaining pulmonary ventilation of a patient without spontaneous breathing by means of a ventilator via a tracheal tube.
However, the common tracheal tube can not clear the retention on the air sac clinically, and the tracheal tube with the subglottic suction function is left to clear the retention on the air sac, so that not only is the special tracheal tube prepared in advance and successfully left, but also a lot of complications occur clinically, the opening of the upper drainage tube of the tracheal tube is blocked by tracheal mucosa or sputum scab to cause ineffective clearing of the secretion, and then the cough reflex, the heart rate and the blood oxygen saturation change can be caused by overlarge pressure to cause the damage of the respiratory mucosa, and the incidence rate of the complications of the macroscopic respiratory hemorrhage caused by adopting the continuous subglottic suction technology (CASS technology) is 7.1% in the literature report, which causes the complication to be not widely used clinically.
Whereas for the most common airflow flushing techniques, i.e. two-person operation: one person rapidly extrudes the simple respirator, one person rapidly deflates and inflates the air bag, if the two persons are not matched, the retentate is prone to sliding into a deep respiratory tract, the airway pressure generated by extruding the simple respirator cannot be monitored, and the patient is prone to barotrauma and spontaneous respiration countermeasures due to overhigh airway pressure; especially for intractable hypoxemia patients, if the method of disconnecting the respirator and operating the simple respirator and the air bag by two persons is adopted to clear the retentate on the air bag, the mechanical ventilation and the low-concentration oxygen supply are interrupted for a longer time, so that the patients are in a more serious hypoxia state, and the repeated use of the simple respirator also increases the chance of cross infection.
Aiming at the existing technologies for removing the retention on the air bag, the technologies can not be generally popularized in clinic, and the main reasons are that the respiratory tract secretion can not be removed by simulating and reaching the effective cough peak flow rate under the physiological state of normal people, the risks of airway mucosa injury, bleeding and infection are increased, and the adverse reactions of patient such as choking cough, respiratory resistance and the like are increased.
Disclosure of Invention
The invention aims to provide a tracheal catheter capable of reconstructing cough peak flow velocity so as to solve the problem that retention on a tracheal catheter air bag in the prior art cannot be effectively eliminated.
In an embodiment of the present invention, there is provided an endotracheal tube for reconstructing peak cough flow rates, comprising. The tracheal catheter, the external air bag, the air bag catheter, the internal air bag, the inflation inlet, the inflation catheter, the air outlet, the sealed cavity and the air outlet; the endotracheal tube main part is made by the PVC material, and sealed cavity is made by the silica gel material.
The external air bag is arranged at the outer end of the tracheal catheter;
the inner air bag is arranged at the inner end of the tracheal catheter;
the balloon catheter communicates the outer balloon with the inner balloon, and the inner balloon is inflated by injecting gas into the outer balloon;
the inflation inlet is arranged at the outer end of the tracheal catheter;
the air outlet, the sealed cavity and the air outlet hole are arranged at the inner end of the tracheal catheter;
the inflation conduit is used for communicating the inflation inlet with the air outlet, and the air outlet generates airflow with a certain speed by injecting air into the inflation inlet;
furthermore, the shape of the inflation inlet is a cylindrical connection port which is changed from thin to thick;
furthermore, the cross section of the free part of the inflatable catheter is circular, the diameter of the inner cavity is 3mm, and the part of the inflatable catheter, which is combined with the tracheal catheter, is crescent;
further, the different parts of the cross-sectional area of the inner cavity of the inflation catheter are 7.065mm2；
The sealing cavity is made of a silica gel material;
further, the sealed chamber comprises an air outlet on the inner wall and three air outlet holes on the outer wall;
furthermore, the edge of the sealing chamber is 0.2cm away from the inner air bag, and the sealing chamber is annularly and hermetically wrapped around the air outlet and the tracheal catheter;
furthermore, the sealing cavity is a cylinder with the diameter being 0.2cm larger than the outer diameter of the tracheal catheter and the height being 0.5 cm;
the air outlet holes comprise three circular outlets, the diameters of the three circular outlets are 2mm, the openings are formed in the outer wall of the sealed cavity, and the total area of all the air outlet holes is 9.42mm2；
Furthermore, the three air outlet holes are respectively positioned on the arc back, the left upper side and the right upper side of the tracheal catheter, and the angles among the three air outlet holes are 120 degrees;
the tracheal tube comprises three separate cavities in total;
compared with the prior art, the tracheal catheter capable of reconstructing the peak flow rate of cough has the following advantages:
the external quick airflow is connected to the inflation inlet of the tracheal catheter, the airflow enters the interior of the tracheal catheter and a human body through the free part of the inflation catheter, and the inflation catheter is an independent cavity and must enter the sealed cavity through the air outlet, and the sealed cavity filled with the quick airflow is ejected from narrow air outlet holes in different directions to form strong airflow impact force, so that the cough peak flow rate under the physiological state of the human body is achieved, namely CPEF is more than 60L/min or 20 m/s, and therefore, the retentate accumulated on the periphery of the air bag is flushed to the oropharynx part and then the purpose of clearing the retentate on the air bag is achieved through the oral-nasal sputum suction operation. The method does not need to deflate the air bag of the tracheal catheter to remove the retentate on the air bag, thereby reducing the risk that the retentate falls into the deep respiratory tract; secondly, the complications of continuous attraction under the glottis are reduced: mucosal hemorrhage, blockage of a suction catheter, reverse infection of oropharyngeal fixed-value bacteria and regurgitation in the stomach; the patient with refractory hypoxemia does not need to disconnect a breathing machine or repeatedly use a simple respirator, so that cross infection is avoided; finally, the man-machine confrontation is reduced, and the pain of the patient is relieved. The most suitable way for clearing the foreign matters in the human airway is the rushing-out of the coughing air flow, and the way of suction or flushing the airway is not the most suitable way.
Drawings
FIG. 1 is a schematic view showing the structure of a tracheal catheter and a human body part when a conventional tracheal catheter is indwelling.
Fig. 2 is a schematic structural diagram of the present invention.
Fig. 3 is a cross-sectional view taken along line a-a of fig. 2.
Reference numerals:
1: the tracheal catheter 2: glottis 3: retentate
4: inner bag 5: the outer bag 6: air charging port
7: the inflation conduit 8: air outlet 9: sealed chamber
10: inner end of tracheal catheter 11: the air outlet 12: balloon catheter
13: outer end 14 of endotracheal tube: tracheal catheter lumen 15: inflatable catheter cavity
16: balloon catheter lumen
Detailed Description
In order to more clearly illustrate the objects, technical solutions and advantages of the present invention, the following will clearly and completely describe the technical solutions of the present invention with reference to the accompanying drawings. Based on the embodiments of the present invention, only a portion of the embodiments of the present invention should be considered as examples, and not all embodiments of the present invention should be considered as examples.
Fig. 1 is a schematic structural view of a tracheal catheter 1 and a human body part when the conventional tracheal catheter 1 is left.
As shown in fig. 1, during the indwelling period of the endotracheal tube 1, the inner balloon 4 is inflated and inflated for the purpose of sealing the airway around the endotracheal tube 1, which makes the space above the inner balloon 4 and below the glottis 2 dead space and prevents the flow of normal breathing and coughing gas.
Further, as shown in fig. 1, a large amount of retentate 3 exists above the inner balloon 4 and around the endotracheal tube 1, especially between the lacunae below the glottis 2, where oropharyngeal secretions and colonizing bacteria, and erroneously aspirated gastric contents accumulate to form a "mucus lake", and as the time for indwelling the endotracheal tube 1 is prolonged, the more retentate 3 accumulates; the swallowing and cough reflex and the respiratory cilia movement of the patient are weakened or disappeared when the trachea is intubated, and the air cavity is closed without air flow passing through due to the inflation state of the inner air bag 4, so that the retentate 3 cannot be removed in a cough form, and the incidence rate of Ventilator Associated Pneumonia (VAP) is increased.
Fig. 2 is a schematic structural diagram of an endotracheal tube capable of reconstructing a peak flow rate of cough according to the present invention, which includes an endotracheal tube 1, an inflation port 6, an inflation tube 7, an air outlet 8, a sealed chamber 9, and an air outlet 11; the main body of the tracheal catheter 1 is made of PVC material, and the sealing cavity 9 is made of silica gel material.
Fig. 3 is a schematic cross-sectional view taken along line a-a in fig. 2, and the endotracheal tube 1 includes three separate lumens, including an endotracheal tube lumen 14, an inflatable tube lumen 15, and a balloon tube lumen 16.
As shown in fig. 3, the cross section of the inflatable catheter 7 after entering the endotracheal tube 1 is crescent-shaped and is attached to the inner wall of the endotracheal tube 1, which can make the inner wall of the endotracheal tube cavity 14 smooth and smooth as well, and ensure that the sputum suction tube or the bronchofiberscope can operate through the endotracheal tube 1 smoothly as well.
As shown in figure 2, the external air sac 5 is communicated with the internal air sac 4 through the air sac guide tube 12, when the trachea is intubated, in order to prevent the air leakage of the respirator, avoid the aspiration and fix the trachea cannula, air is generally injected into the internal air sac 4 from the port of the external air sac 5 through the air sac guide tube 12 to cause the air sac to be inflated and expanded, and the pressure in the air sac is maintained at 25cmH2O～30cmH2And between O, the purpose of sealing the peripheral airway of the tracheal catheter 1 is achieved.
The shape of the inflation inlet 6 is a cylindrical connection port which is changed from thin to thick, so that the inflation inlet can be better connected with the oxygen therapy pipe in a sealing way and is not easy to loosen.
Further, the inflation inlet 6 is communicated with the air outlet 8 through an inflation conduit 7, and air is injected from the inflation inlet 6 to enable air flow to be flushed out from the air outlet 8; clinically, a 15L/min (250 ml/sec) oxygen flow can be connected to the inflation port 6 by central oxygen supply, since the cross-sectional area of the lumen of the inflation catheter 7 is 7.065mm2Therefore, theoretically, the gas flow velocity of the gas outlet 8 can reach 35.39 m/s, and high-speed gas flow is formed preliminarily.
In addition, the round hollow conduit of the free part of the air charging conduit 7 is made of PVC material, and the hard material is prevented from being deformed by the oppression of a patient or foreign matters, so that the smoothness of the air charging conduit 7 is effectively maintained.
9 edges of sealed chamber and inside gasbag 4 are 0.2cm apart from nearest, and the effective air current impact force not only can be guaranteed to closely the air current, thoroughly clears away retentate 3 on the gasbag, can fix the air current direction moreover from the 2 directions of the deepest flow direction glottis of closed cavity, more accords with air current direction and sputum clearance mode under the human physiological state.
In addition, the sealing chamber 9 is a cylinder with a diameter of 0.2cm larger than the outer diameter of the tracheal catheter 1 and a height of 0.5cm, which is equivalent to the increase of 0.2cm in the inner diameter based on the 7.5 # tracheal catheter 1 (outer diameter of 1.13cm) which is most commonly used, namely, the inner diameter of the catheter at the sealing chamber 9 is 1.33cm, and because the expanding support airway adjacent to the inner air sac 4 exists, the catheter at the sealing chamber 9 has almost no stress on the mucosa of the surrounding airway.
The air outlet holes 11 are respectively positioned on the arc back, the left upper side and the right upper side of the tracheal catheter 1, and the angles between the air outlet holes are 120 degrees; clinically, a semi-lying position or a 30-degree lying position is generally recommended for a mechanically ventilated patient, and due to the gravity principle, more retentate 3 on the air bag is accumulated on the periphery of the inner air bag 4, so that in order to ensure an effective clearing effect, the patient can be horizontally placed so as to flush out the retentate 3 during operation; secondly, the design scheme of the angles of the three air outlet holes 11 can ensure that the air flow can generate certain air flow impact force in different directions on the periphery of the tracheal catheter 1, so that the purpose of comprehensively removing the retentate 3 on the periphery of the tracheal catheter 1 and the mucosa of the air passage is achieved.
The method comprises the following specific steps: the sealing chamber 9 is annularly and hermetically wrapped around the air outlet 8 and the tracheal catheter 1, when high-speed airflow of 35.39 m/s is formed in the embodiment and enters the sealing chamber 9 through the air outlet 8, the sealing chamber 9 is filled with the high-speed airflow, and the risk that the air outlet 11 is blocked by sputum is effectively prevented; because the sealed chamber 9 comprises three air outlet holes 11 (all round openings with the diameter of 2mm), the sum of the areas of the air outlet holes is 9.42mm2Therefore, the three outlet holes 11 can generate 26.54 m/s high-speed airflow finally. When a human body coughs normally, the expiratory speed can reach 10 m/s, and the expiratory airflow can reach 28 m/s in severe coughs, which is equivalent to ten-level wind power, so that the high-speed airflow can be endured by the airway and can effectively remove airway secretions. The study of the high-heart-rate and Qinxingzhi proves that the CPEF value is more than or equal to 60L/min (for an endotracheal tube with the indwelling diameter of 8mm, the expiratory flow rate is about 20 m/s), the tube drawing success rate of the patient is high, and the cough capability of the patient is good. Therefore, the high-speed airflow of 26.54 m/s can effectively flush the retentate 3 accumulated on the periphery of the air bag to the oropharynx part, and then achieve the purpose of clearing the retentate 3 on the air bag through the operation of oronasal sputum suction.
Finally, in order to prevent the stimulation of airflow drying and humidity cooling to airway mucosa and ensure the smooth implementation, the oxygen can be heated and humidified to ensure that the temperature reaches 37 ℃ and the humidity reaches 100 percent.
Claims (9)
1. A tracheal catheter capable of reconstructing the peak flow velocity of cough is characterized by comprising a tracheal catheter, an external air bag, an air bag catheter, an internal air bag, an inflation inlet, an inflation catheter, an air outlet, a sealed cavity and an air outlet hole;
the tracheal tube comprises three separate cavities in total;
the external air bag is communicated with the internal air bag through an air bag conduit, and the internal air bag is inflated and expanded by injecting air from the external air bag;
the inflation inlet is communicated with the air outlet through an inflation conduit, and air is injected from the inflation inlet to enable air flow to be flushed out from the air outlet;
the sealed chamber is annularly and hermetically wrapped around the air outlet and the tracheal catheter and comprises three air outlet holes on the outer wall;
the three air outlets are respectively positioned on the arc back, the upper left side and the upper right side of the tracheal catheter, when external quick air flow is connected to the inflation inlet, the quick air flow enters the sealed cavity through the inflation catheter and the air outlet, is full of the sealed cavity and is sprayed out from the three air outlets to form strong air flow impact force, and the cough peak flow rate under the physiological state of a human body is achieved.
2. The endotracheal tube according to claim 1, wherein the inflation port is a tapered cylindrical mouthpiece.
3. The endotracheal tube according to claim 1, characterized in that the free portion of the inflation tube has a circular cross-section and the portion associated with the endotracheal tube has a crescent shape.
4. The endotracheal tube according to claim 3, characterized in that the cross sectional area of the lumen is equal in different portions of the inflatable tube.
5. The endotracheal tube according to claim 1, wherein the sealed chamber is formed from a silicone material.
6. The endotracheal tube of claim 5, wherein the sealed chamber edge is closest to the inner cuff by a distance of 0.2 cm.
7. The endotracheal tube according to claim 5, wherein the sealed chamber is a cylinder having a diameter greater than 0.2cm of the outer diameter of the endotracheal tube and a height of 0.5 cm.
8. The endotracheal tube of claim 1, wherein the three gas exit holes are three circular side holes.
9. The endotracheal tube of claim 8, wherein the three circular side holes are all 120 degrees apart.
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| Application Number | Priority Date | Filing Date | Title |
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| CN201810004441.7A CN108721748B (en) | 2018-01-03 | 2018-01-03 | Tracheal catheter capable of reconstructing cough peak flow velocity |
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| Application Number | Priority Date | Filing Date | Title |
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| CN201810004441.7A CN108721748B (en) | 2018-01-03 | 2018-01-03 | Tracheal catheter capable of reconstructing cough peak flow velocity |
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| CN108721748A CN108721748A (en) | 2018-11-02 |
| CN108721748B true CN108721748B (en) | 2021-04-23 |
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Citations (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN201888978U (en) * | 2010-11-24 | 2011-07-06 | 中国人民解放军第三军医大学第二附属医院 | Novel tracheal catheter |
| CN202751663U (en) * | 2012-06-07 | 2013-02-27 | 吴联籽 | Multifunction adjustable tracheal catheter |
| CN204073016U (en) * | 2014-09-10 | 2015-01-07 | 南通市第一人民医院 | A kind of multilumen tracheal catheter |
| CN105288811A (en) * | 2009-07-31 | 2016-02-03 | 阿文特公司 | Subglottic suctioning system |
Family Cites Families (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US7913693B2 (en) * | 2006-11-10 | 2011-03-29 | Nellcor Puritan Bennett Llc | Method and apparatus for preventing occlusion of a tracheal tube suction lumen |
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- 2018-01-03 CN CN201810004441.7A patent/CN108721748B/en active Active
Patent Citations (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN105288811A (en) * | 2009-07-31 | 2016-02-03 | 阿文特公司 | Subglottic suctioning system |
| CN201888978U (en) * | 2010-11-24 | 2011-07-06 | 中国人民解放军第三军医大学第二附属医院 | Novel tracheal catheter |
| CN202751663U (en) * | 2012-06-07 | 2013-02-27 | 吴联籽 | Multifunction adjustable tracheal catheter |
| CN204073016U (en) * | 2014-09-10 | 2015-01-07 | 南通市第一人民医院 | A kind of multilumen tracheal catheter |
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