Ajustment of endotracheal tube cuff filling

• US 20090229605A1
• Filed: 08/21/2006
• Published: 09/17/2009
• Est. Priority Date: 08/24/2005
• Status: Active Grant

• Current Assignee: Hospitech Respiration Ltd
• Original Assignee: Hospitech Respiration Ltd
• Inventors: Efrati, Shai, Deutsch, Israel
• Granted Patent: US 8,424,529 B2
• Time in Patent Office: Days
• US Class Current: 128/203.120
• CPC Class Codes: A61M 16/0003 Accessories therefor, e.g. sensors, vibrators, negative pressure
• CPC Class Codes: A61M 16/0051 with alarm devices
• CPC Class Codes: A61M 16/021 operated by electrical means A61M16/202 – A61M16/205 take precedence
• CPC Class Codes: A61M 16/022 Control means therefor
• CPC Class Codes: A61M 16/024 including calculation means, e.g. using a processor
• CPC Class Codes: A61M 16/04 Tracheal tubes catheters in general A61M25/00
• CPC Class Codes: A61M 16/0434 Cuffs
• CPC Class Codes: A61M 16/044 External cuff pressure control or supply, e.g. synchronisation with respiration
• CPC Class Codes: A61M 16/0463 combined with suction tubes, catheters or the like; Outside connections
• CPC Class Codes: A61M 2016/0027 pressure meter
• CPC Class Codes: A61M 2016/0413 with detectors of CO2 in exhaled gases
• CPC Class Codes: A61M 2205/15 Detection of leaks
• CPC Class Codes: A61M 2205/3303 Using a biosensor
• CPC Class Codes: A61M 2205/3306 Optical measuring means
• CPC Class Codes: A61M 2205/3317 Electromagnetic, inductive or dielectric measuring means
• CPC Class Codes: A61M 2205/3327 Measuring
• CPC Class Codes: A61M 2205/3334 Measuring or controlling the flow rate
• CPC Class Codes: A61M 2205/3344 Measuring or controlling pressure at the body treatment site
• CPC Class Codes: A61M 2205/3375 Acoustical, e.g. ultrasonic, measuring means
• CPC Class Codes: A61M 2205/702 automatically during use
• CPC Class Codes: A61M 2210/0618 : Nose
• CPC Class Codes: A61M 2230/432 : partial CO2 pressure (P-CO2)

Abstract

A method of intubating a subject is disclosed. The method comprises inserting an endotracheal tube into the tracheal airway of the subject; inflating a cuff associated with the endotracheal tube within the airway below the vocal cords; measuring a level of at least one measure being indicative of leakage of secretion past the cuff to the lungs; comparing the level of the measure with an optimal level of the measure; and adjusting inflation of the cuff based on the comparison so as to generally minimize leakage of secretion from above the cuff to the lungs, while minimizing pressure associated damages to the airway. The measure(s) can be carbon dioxide concentration, a proxy measure from which such concentration can be inferred, or the level of one or more additives delivered to a subject during intubation.

Claims

1-5. -5. (canceled)

6. A method of intubating a subject having an airway ending with lungs and vocal cords, comprising:

inserting an endotracheal tube into the airway;

inflating a cuff associated with said endotracheal tube within the airway below the vocal cords;

delivering a breathing gas and at least one identifiable additive through said endotracheal tube;

monitoring a level of said at least one identifiable additive at a monitoring location in the body of the subject; and

adjusting inflation of said cuff based on said monitoring so as to generally minimize leakage of secretion from above said cuff to the lungs, while minimizing pressure associated damages to the airway.

55. The method of claim 6, wherein said monitoring said level of said at least one identifiable additive comprises performing mass spectrometry.

56. The system of claim 6, wherein said measuring device comprises a mass spectrometer.

57. The system of claim 6, wherein said measuring device comprises a gas analyzer.

58. The method of claim 6, wherein said at least one identifiable additive is characterized by measurable electric properties.

61. The method of claim 6, wherein said at least one identifiable is characterized by measurable magnetic properties.

64. The method of claim 6, wherein said at least one identifiable is characterized by measurable optical properties.

67. The method of claim 6, wherein said at least one identifiable is characterized by measurable radiative properties.

70. The method of claim 6, wherein said at least one identifiable is characterized by measurable fluorescent properties.

73. The method of claim 6, wherein said at least one identifiable additive comprises at least one inert gas.

75. The method of claim 6, wherein said at least one identifiable additive comprises at least one colored gas.

76. The method of claim 6, wherein said at least one identifiable additive comprises at least one radioisotope.

7-15. -15. (canceled)

16. A system for intubating a subject having an airway ending with lungs, comprising:

an endotracheal tube, adapted to be inserted into the airway and being associated with a cuff capable of being inflated below the vocal cords;

a measuring device for measuring at least one measure being indicative of leakage of secretion from above said cuff to the lungs, said at least one measure being other than carbon dioxide concentration between said cuff and said vocal cords.

17. The system of claim 16, wherein said measuring device is designed and configured to signal when a level of said at least one measure exceeds an optimal level of said at least one measure.

25. The system of claim 17, further comprising an inflating device for adjusting inflation of said cuff based on signals received from said measuring device so as to generally minimize leakage of secretion from above said cuff to the lungs, while minimizing pressure associated damages to the airway.

26. The system of claim 17, wherein said measuring device comprises a display device for displaying said level of said at least one measure.

27. The system of claim 17, further comprising an alerting unit being in communication with said measuring device for producing an alert when said level of said at least one measure exceeds said optimal level.

28. The system of claim 25, wherein said inflating device is in communication with said measuring device, thereby forming therewith a closed loop control.

29. The system of claim 16, further comprising a measuring conduit extending from said measuring device to the airway above the cuff.

30. The system of claim 16, further comprising a suctioning device operative for suctioning secretions at a suctioning location in the airway above the cuff.

31. The system of claim 30, wherein said suctioning device is synchronized to operate intermittently with said measuring device.

32. The system of claim 30, further comprising a suctioning conduit extending from said suctioning device to said suctioning location.

33. The system of claim 16, further comprising a measuring and suctioning conduit, extending to said suctioning location, said a measuring and suctioning conduit being coupled to said measuring device and said suctioning device so as to facilitate said measuring and said suctioning at said location.

18-19. -19. (canceled)

20. A system for intubating a subject having an airway ending with lungs, comprising:

an endotracheal tube, adapted to be inserted into the airway and being associated with a cuff capable of being inflated below the vocal cords;

an additive delivering unit operatively associated with said endotracheal tube and configured to deliver at least one identifiable additive through said endotracheal tube; and

a measuring device for measuring a level of said at least one identifiable additive.

21. The system of claim 20, wherein said measuring device is designed and configured to signal when a level of said at least one identifiable additive exceeds an optimal level of said at least one identifiable additive.

22. The system of claim 20, wherein said endotracheal tube comprises an additive delivery conduit configured to deliver said at least one identifiable additive.

23. The system of claim 22, wherein said additive delivery conduit is disposed within a lumen of said endotracheal tube.

24. The system of claim 22, wherein said additive delivery conduit is externally coupled to or embedded in a wall of said endotracheal tube.

34-45. -45. (canceled)

46-47. -47. (canceled)

54. (canceled)

59-60. -60. (canceled)

62-63. -63. (canceled)

65-66. -66. (canceled)

68-69. -69. (canceled)

71-72. -72. (canceled)

74. (canceled)

77. (canceled)