Apparatus for monitoring intra-abdominal pressure

• US 20040176703A1
• Filed: 03/04/2003
• Published: 09/09/2004
• Est. Priority Date: 03/04/2003
• Status: Active Grant

• Current Assignee: Convatec Incorporated (ConvaTec Group Plc)
• Original Assignee: Wolfe TORY Medical Incorporated
• Inventors: Wolfe, Timothy R., Christensen, Mark C., Denton, Marshall T., Croll, Perry W.
• Granted Patent: US 7,112,177 B2
• Time in Patent Office: Days
• US Class Current: 600/561
• CPC Class Codes: A61B 5/205 Determining bladder or urethral pressure
• CPC Class Codes: A61B 5/412 Detecting or monitoring sepsis

Abstract

An apparatus for monitoring intra-abdominal pressure in a medical patient includes a urinary catheter connected to a urine valve having selectable communication positions between a discharge end of the urinary catheter and either a drain or a fluid source. Preferably, the urine valve has a housing adapted to resist patient discomfort from body-valve contact. A plumbing structure desirably maintains fluid supply and drain conduits in a substantially parallel arrangement to assist routing those conduits between a patient'"'"'s legs. When the urine valve is oriented for communication with the fluid source, a syringe may be used to introduce a known quantity of fluid through the urine valve into the patient'"'"'s bladder where the fluid'"'"'s pressure can be measured. Desirably, a double check valve is included in a fluid supply path and arranged to permit repetitive operation of the syringe to introduce a bolus of fluid into the patient'"'"'s bladder.

Claims

1. An apparatus for measuring hydraulic pressure in the bladder of a medical patient whereby to infer intra-abdominal pressure, comprising:

a catheter adapted for draining urine from said patient;

a container of fluid;

a first fluid path comprising conduit disposed between said container and a drain portion of said catheter;

a fluid pump disposed to urge fluid flow through said first fluid path;

a pressure transducer arranged to measure a pressure of said fluid in said first fluid path; and

an automatic flow-control device actuated, at least in part, by fluid pressure effected by said fluid pump, said automatic flow-control device being disposed in said first fluid path and operable to permit flow of said fluid from said container toward said pump and to resist flow of said fluid from said pump toward said container.

2. The apparatus of claim 1, wherein:

said automatic flow-control device further comprises a portion adapted to permit flow of said fluid

through said first fluid path in a direction from said pump toward said catheter and to resist flow of said fluid in a direction from said pressure transducer toward said pump.

3. The apparatus of claim 1, wherein:

said automatic flow-control device comprises a double check valve; and

said fluid pump is disposed to effect a cyclic fluid pressure at a staging area between a first check valve portion and a second check valve portion of said double check valve.

4. The apparatus of claim 1, wherein:

said automatic flow-control device comprises a check-bypass valve; and

said fluid pump is configured to effect a cyclic fluid pressure at a staging area between a check valve seal and a bypass valve seal.

5. The apparatus of claim 4, wherein:

said fluid pump comprises a syringe; and

said check-bypass valve is adapted for attachment to a discharge end of said syringe.

6. The apparatus of claim 1, further comprising:

a urine valve configured to provide;

a first flow portion disposed in said first fluid path;

a second flow portion disposed in a second fluid path operable as a drain for fluid discharged from said catheter; and

a third flow portion disposed for fluid communication with a urine discharge end of said catheter;

wherein;

said urine valve is operable selectively to resist fluid flow between said third flow portion and said second flow portion.

7. The apparatus of claim 6, wherein:

said urine valve is operable selectively to resist fluid flow between said first flow portion and said third flow portion.

8. The apparatus of claim 6, wherein:

said first flow portion and said second flow portion of said urine valve provide a structure configured to permit connection to respective first and second substantially parallel conduits whereby to facilitate routing said substantially parallel conduits in a space between a patient'"'"'s legs.

9. The apparatus of claim 6, wherein:

said first flow portion, said second flow portion, and said third flow portion of said urine valve comprise substantially parallel conduit sections.

10. The apparatus of claim 6, wherein:

a connection structure is provided in fluid communication with each of said first flow portion, said second flow portion, and said third flow portion of said urine valve for connection of first, second, and third substantially parallel conduits thereto, whereby to facilitate routing said substantially parallel conduits in a space between a patient'"'"'s legs.

11. The apparatus of claim 6, wherein:

a body of said urine valve comprises a housing structured to resist imparting contact injury to a patient.

12. The apparatus of claim 11, wherein:

a flow path through said urine valve is selected by rotating a first valve structure with respect to a second valve structure.

13. The apparatus of claim 12, said urine valve being actuated to select a fluid flow path by rotating a first portion of said housing with respect to a second portion of said housing.

14. The apparatus of claim 13, wherein:

said first portion and said second portion of said housing are sealed against infiltration by external contaminants.

15. The apparatus of claim 11, wherein:

said housing comprises smooth surfaces and rounded corners to resist formation of crevices in which contaminants might be shielded, whereby to facilitate cleaning fecal matter from an exterior surface of said housing.

16. The apparatus of claim 6, wherein:

said urine valve is structured as a gate valve.

17. The apparatus of claim 6, wherein:

a first aperture and a second aperture, each opening to portions of respective first and second flow paths through said valve, are disposed on a first surface; and

a valve core element comprises a second surface structured in cooperation with said first surface such that a third aperture disposed on said second surface can be aligned to form a leak resistant seal for fluid communication with either of said first and second apertures, said third aperture opening to a portion of a flow path in common to said first and said second flow paths.

18. The apparatus of claim 17, wherein said leak resistant seal comprises:

a first O-ring disposed on said first surface and arranged to encompass said first aperture; and

a second O-ring disposed on said first surface and arranged to encompass said first aperture and said second aperture.

19. The apparatus of claim 6, further comprising:

a structure carried on a housing of said urine valve adapted to provide visual indication of a currently selected flow path.

20. The apparatus of claim 6, in combination with:

a tray operable as a protective housing, said tray having blunt corners and areas of gradual transition in curvature whereby to resist injury to a patient arising from contact therewith, said protective housing defining a socket operable to space a structure received in said socket apart from a patient, said socket being structured to receive said urine valve.

21. The combination of claim 20, wherein:

said socket is configured to accommodate a discharge end portion of a structure associated with said catheter.

22. The combination of claim 21, wherein:

said socket is adapted to hold said discharge end portion in a preferred orientation whereby to assist a health care practitioner in inserting a needle into an aspiration port associated with said catheter.

23. An apparatus for measuring hydraulic pressure in the bladder of a medical patient, comprising:

a catheter adapted for draining urine from said patient;

a container of fluid;

a first fluid path between said container and a drain portion of said catheter;

a fluid pump disposed in said first fluid path;

a pressure transducer configured to measure a pressure of said fluid in said first fluid path at a location downstream of said pump; and

a multi-way valve comprising;

a first flow portion disposed in said first fluid path and arranged to receive fluid from said container;

a second flow portion disposed in a second fluid path configured as a drain for said catheter; and

a third flow portion disposed in said first fluid path for fluid communication with a urine discharge end of said catheter;

wherein;

said multi-way valve is operable selectively to resist fluid flow between said third flow portion and said second flow portion.

24. The apparatus of claim 23, said multi-way valve being configured to provide a streamlined plumbing arrangement to facilitate parallel routing of fluid conduits between said medical patient'"'"'s legs.

25. The apparatus of claim 24, wherein:

a urine draining lumen forming a flow path through said valve has a diameter in excess of about {fraction (3/16)} inches; and

a sealing element of said multi-way valve is structured to contain a dead volume of less than about 0.0006 cubic inches to reduce contaminant containment, whereby to resist infection transmission.

26. A method for measuring hydrostatic pressure in the bladder of a medical patient, comprising:

a) installing a urinary catheter in said patient to provide fluid communication in a first fluid path comprising a stretch between said bladder and a discharge portion of said catheter;

b) disposing an inlet port of a urine valve in fluid communication with said first fluid path, said urine valve comprising a drain orientation and a measure orientation, said drain orientation providing communication between said inlet port and a second fluid path directed from said urine valve toward a drain receptacle, said measure orientation providing communication between said inlet port and a third fluid path between said urine valve and a source of fluid;

c) connecting said source of fluid to a pump operable to urge a fluid along said third fluid path toward said catheter;

d) disposing a pressure transducer to measure pressure of fluid between said pump and said bladder;

e) placing said urine valve into said measure orientation and operating said pump to introduce a bolus of said fluid into said bladder;

f) using said pressure transducer to measure a hydrostatic pressure of said fluid; and

g) placing said urine valve into said drain orientation.

27. The method according to claim 26, wherein steps e) through g) are repeated in sequence as an intra-abdominal pressure measurement procedure is performed a plurality of instances that are spaced apart in time.

28. The method of claim 26, wherein operation of said pump in step e) comprises actuation of a syringe to cause cyclic pressure fluctuation at a staging area of an automatic valve arrangement operable to permit fluid flow from said fluid source toward said catheter and to resist fluid flow in a reverse direction.