AIRWAY ADJUNCT RESUSCITATION SYSTEMS AND METHODS

• US 20120029321A1
• Filed: 07/22/2011
• Published: 02/02/2012
• Est. Priority Date: 07/27/2010
• Status: Abandoned Application

• Current Assignee: Zoll Medical Corporation (Asahi Kasei Corporation)
• Original Assignee: Advanced Circulatory Systems, Inc. (Asahi Kasei Corporation)
• Inventors: Makaretz, Michael, Lurie, Keith, Krueger, Kurt, Voss, Greg, Metzger, Anja
• Application Number:
  US13/189,330
• Publication Number:
  US 20120029321A1
• Time in Patent Office: Days
• US Class Current: 600/301
• CPC Class Codes: A61B 5/08 Detecting, measuring or recording devices for evaluating the respiratory organs A61B5/0205 takes precedence
• CPC Class Codes: A61H 2201/107 Respiratory gas
• CPC Class Codes: A61H 31/004 Heart stimulation
• CPC Class Codes: A61M 16/0009 with sub-atmospheric pressure, e.g. during expiration
• CPC Class Codes: A61M 16/0012 by Venturi means
• CPC Class Codes: A61M 16/04 Tracheal tubes catheters in general A61M25/00
• CPC Class Codes: A61M 16/0409 with mean for closing the oesophagus
• CPC Class Codes: A61M 16/0415 with access means to the stomach
• CPC Class Codes: A61M 16/042 with separate conduits for in-and expiration gas, e.g. for limited dead volume
• CPC Class Codes: A61M 16/0443 Special cuff-wall materials A61M16/0481, A61M16/0422 take precedence
• CPC Class Codes: A61M 16/0445 Special cuff forms, e.g. undulated
• CPC Class Codes: A61M 16/0479 above the cuff, e.g. giving access to the upper trachea
• CPC Class Codes: A61M 16/0486 Multi-lumen tracheal tubes
• CPC Class Codes: A61M 16/0493 with means for protecting the tube from damage caused by the patient's teeth, e.g. bite block
• CPC Class Codes: A61M 16/20 Valves specially adapted to medical respiratory devices
• CPC Class Codes: A61M 16/208 Non-controlled one-way valves, e.g. exhalation, check, pop-off non-rebreathing valves
• 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 2202/0208 Oxygen
• CPC Class Codes: A61M 2205/3606 cooled
• CPC Class Codes: A61M 2230/005 : Parameter used as control input for the apparatus
• CPC Class Codes: A61M 2230/205 : partial oxygen pressure (P-O2)
• CPC Class Codes: A61M 2230/208 : pH-value
• CPC Class Codes: A61M 2230/30 : Blood pressure A61M2230/04 takes precedence
• CPC Class Codes: A61M 2230/432 : partial CO2 pressure (P-CO2)

Abstract

Embodiments of the present invention encompass systems and methods for administering intrathoracic pressure and cooling treatments to patients suffering from or at risk of developing heart failure, cardiac arrest, sepsis, shock, acute respiratory distress syndrome, polytrauma, head disease, elevated hepatic or portal vein pressures, bleeding during abdominal, head and neck surgery, or insufficient circulation during open heart surgery.

Claims

1. An airway adjunct resuscitation system for use during administration of a resuscitative procedure to a patient, the system comprising:

a support assembly defining an intrathoracic pressure monitoring lumen, a cooling fluid delivery lumen, a cooling fluid return lumen, and an orogastric lumen, wherein the orogastric lumen is adapted for use in removing gastric contents from the patient during administration of the resuscitative procedure to the patient;

a laryngeal cuff assembly coupled with the support assembly, wherein the laryngeal cuff assembly is positioned within the patient'"'"'s supraglottic airway at least in part by the support assembly, wherein the laryngeal cuff assembly at least partially isolates and seals a portion of the supraglottic airway of the patient, and wherein the laryngeal cuff assembly operates to assist in positioning a distal section of the intrathoracic pressure monitoring lumen in fluid communication with the patient'"'"'s trachea, during administration of the resuscitative procedure to the patient;

an esophageal cuff assembly coupled with the support assembly distal to the laryngeal cuff assembly, wherein the esophageal cuff assembly interfaces with the esophagus of the patient during administration of the resuscitative procedure to the patient; and

a fluid passage circuit defined at least in part by the esophageal cuff assembly and in fluid communication with the fluid delivery lumen and the fluid return lumen of the support assembly.

2. The airway adjunct resuscitation system according to claim 1, further comprising an intrathoracic pressure regulation mechanism in operative association with the support assembly, wherein the intrathoracic pressure regulation mechanism is adapted for use in regulating intrathoracic pressure within the patient.

3. The airway adjunct resuscitation system according to claim 2, wherein the intrathoracic pressure regulation mechanism comprises a member selected from the group consisting of an Impedance Threshold Device (ITD) mechanism and an Intrathoracic Pressure Regulator (ITPR) mechanism.

6. The airway adjunct resuscitation system according to claim 1, wherein the esophageal cuff assembly operates to provide a support against which the patient'"'"'s heart is compressed during administration of the resuscitative procedure, so as to increase efficiency of the resuscitative procedure.

7. The airway adjunct resuscitation system according to claim 1, wherein the esophageal cuff assembly operates to provide a cooling treatment to the patient.

8. The airway adjunct resuscitation system according to claim 1, wherein the esophageal cuff assembly operates to (i) assist in stabilizing the airway adjunct resuscitation system within the patient, (ii) provide a support against which the patient'"'"'s heart is compressed during administration of the resuscitative procedure so as to increase efficiency of the resuscitative procedure, and (iii) provide a cooling treatment to the patient.

12. The airway adjunct resuscitation system according to claim 1, wherein the support assembly defines an auxiliary lumen for use in monitoring a physiological parameter within the patient.

13. The airway adjunct resuscitation system according to claim 1, further comprising an intrathoracic pressure monitoring mechanism in fluid communication with the intrathoracic pressure monitoring lumen, wherein the intrathoracic pressure monitoring mechanism monitors pressure within the intrathoracic pressure monitoring lumen during administration of the resuscitative procedure to the patient.

19. The airway adjunct resuscitation system according to claim 1, wherein the esophageal cuff assembly defines an esophageal balloon and the gastric cuff assembly defines a gastric balloon that is separate or continuous from the esophageal balloon.

20. The airway adjunct resuscitation system according to claim 1, wherein the esophageal cuff assembly and the gastric cuff assembly are contiguous.

23. The airway adjunct resuscitation system according to claim 1, wherein the laryngeal cuff assembly comprises an elastomeric gel body that is shaped to interface with contours of the patient'"'"'s airway.

30. The airway adjunct resuscitation system according to claim 1, wherein the laryngeal cuff assembly comprises a laryngeal cuff balloon and the esophageal cuff assembly defines an esophageal cuff balloon, and wherein the laryngeal cuff balloon is contiguous with the esophageal cuff balloon, such that pressure, volume, or both can be redistributed between the laryngeal cuff balloon and the esophageal cuff balloon when pressure is applied to or released from the patient'"'"'s sternum during administration of the resuscitative procedure to the patient when the resuscitative procedure comprises administration of external chest compressions.

31. The airway adjunct resuscitation system according to claim 1, wherein the esophageal cuff assembly provides a platform against which the patient'"'"'s heart may be compressed during administration of the resuscitative procedure to the patient when the resuscitative procedure comprises administration of external chest compressions.

32. The airway adjunct resuscitation system according to claim 1, wherein the esophageal cuff assembly comprises a stimulation assembly.

45. The airway adjunct resuscitation system according to claim 1, wherein the esophageal cuff assembly comprises a heat conducting material.

46. The airway adjunct resuscitation system according to claim 1, wherein the esophageal cuff assembly comprises a non-compressible and non-expansible material that resists rupture during administration of the resuscitative procedure to the patient when the resuscitative procedure comprises administration of external chest compressions.

47. The airway adjunct resuscitation system according to claim 1, further comprising a physiological sensors.

48. The airway adjunct resuscitation system according to claim 1, further comprising a communication mechanism.

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51. A method of administering a resuscitative procedure to a patient, the method comprising:

engaging an airway adjunct resuscitation system with the patient, wherein the airway adjunct resuscitation system comprises;

a support assembly defining an intrathoracic pressure monitoring lumen;

an intrathoracic pressure monitoring mechanism in fluid communication with the intrathoracic pressure monitoring lumen;

a laryngeal cuff assembly coupled with the support assembly;

an esophageal cuff assembly coupled with the support assembly distal to the laryngeal cuff assembly; and

a gastric cuff assembly coupled with the support assembly distal to the esophageal cuff assembly;

positioning the laryngeal cuff assembly within the patient'"'"'s supraglottic airway;

positioning a distal section of the intrathoracic pressure monitoring lumen in fluid communication with the patient'"'"'s trachea;

isolating and sealing a portion of the supraglottic airway of the patient with the laryngeal cuff assembly;

placing the esophageal cuff assembly at the esophagus of the patient;

placing the gastric cuff assembly at the stomach of the patient, and

monitoring pressure within the intrathoracic pressure monitoring lumen with the intrathoracic pressure monitoring mechanism, so that the patient'"'"'s trachea is exposed to the monitored pressure within the intrathoracic pressure monitoring lumen.

56. The method according to claim 51, further comprising engaging a bite block mechanism of the airway adjunct resuscitation system with the patient'"'"'s mouth.

58. The method according to claim 51, further comprising monitoring a physiological parameter with a physiological sensor of the airway adjunct resuscitation system.

63. The method according to claim 51, further comprising administering repeated chest compressions to the patient.

64. The method according to claim 51, wherein the intrathoracic pressure monitoring mechanism comprises a sequential valve system configured to administer no inspiratory resistance for a positive pressure ventilation, no expiratory resistance, an optional PEEP, or a preset or variable resistance to inflow of respiratory gases.

65. The method according to claim 51, wherein the intrathoracic pressure monitoring mechanism is configured to generate a continuous negative intrathoracic pressure with intermittent positive pressure ventilation.

66. The method according to claim 51, further comprising monitoring an end tidal CO₂ level in the patient with an end tidal CO₂ sensor of the airway adjunct resuscitation system, and adjusting the resuscitative procedure based on the end tidal CO₂ level.

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67. A method for treating a patient suffering from or at risk of developing a condition selected from the group consisting of heart failure, cardiac arrest, sepsis, shock, acute respiratory distress syndrome, polytrauma, head disease, elevated hepatic or portal vein pressures, bleeding during abdominal, head and neck surgery, and insufficient circulation during open heart surgery, the method comprising:

engaging an airway adjunct resuscitation system with the patient, wherein the airway adjunct resuscitation system comprises;

a support assembly defining an intrathoracic pressure monitoring lumen;

an intrathoracic pressure monitoring mechanism in fluid communication with the intrathoracic pressure monitoring lumen;

a laryngeal cuff assembly coupled with the support assembly;

an esophageal cuff assembly coupled with the support assembly distal to the laryngeal cuff assembly; and

a gastric cuff assembly coupled with the support assembly distal to the esophageal cuff assembly;

positioning the laryngeal cuff assembly within the patient'"'"'s supraglottic airway;

positioning a distal section of the intrathoracic pressure monitoring lumen in fluid communication with the patient'"'"'s trachea;

isolating and sealing a portion of the supraglottic airway of the patient with the laryngeal cuff assembly;

placing the esophageal cuff assembly at the esophagus of the patient;

placing the gastric cuff assembly at the stomach of the patient; and

monitoring pressure within the intrathoracic pressure monitoring lumen with the intrathoracic pressure monitoring mechanism, so that the patient'"'"'s trachea is exposed to the monitored pressure within the intrathoracic pressure monitoring lumen.

68. A method for treating a patient suffering from or at risk of developing low circulation, the method comprising:

engaging an airway adjunct resuscitation system with the patient, wherein the airway adjunct resuscitation system comprises;

a support assembly defining an intrathoracic pressure monitoring lumen;

an intrathoracic pressure monitoring mechanism in fluid communication with the intrathoracic pressure monitoring lumen;

a laryngeal cuff assembly coupled with the support assembly;

an esophageal cuff assembly coupled with the support assembly distal to the laryngeal cuff assembly; and

a gastric cuff assembly coupled with the support assembly distal to the esophageal cuff assembly;

positioning the laryngeal cuff assembly within the patient'"'"'s supraglottic airway;

positioning a distal section of the intrathoracic pressure monitoring lumen in fluid communication with the patient'"'"'s trachea;

isolating and sealing a portion of the supraglottic airway of the patient with the laryngeal cuff assembly;

placing the esophageal cuff assembly at the esophagus of the patient;

placing the gastric cuff assembly at the stomach of the patient; and

expanding the esophageal cuff assembly so as to anteriorly move the heart within the patient'"'"'s body;

administering of external chest compressions to the patient so as to compress the patient'"'"'s heart against the esophageal cuff assembly; and

monitoring pressure within the intrathoracic pressure monitoring lumen with the intrathoracic pressure monitoring mechanism, so that the patient'"'"'s trachea is exposed to the monitored pressure within the intrathoracic pressure monitoring lumen.

69. A method for providing a cooling treatment to a patient, the method comprising:

engaging an airway adjunct resuscitation system with the patient, wherein the airway adjunct resuscitation system comprises;

a support assembly defining an intrathoracic pressure monitoring lumen;

an intrathoracic pressure monitoring mechanism in fluid communication with the intrathoracic pressure monitoring lumen;

a laryngeal cuff assembly coupled with the support assembly;

an esophageal cuff assembly coupled with the support assembly distal to the laryngeal cuff assembly; and

a gastric cuff assembly coupled with the support assembly distal to the esophageal cuff assembly;

positioning the laryngeal cuff assembly within the patient'"'"'s supraglottic airway;

positioning a distal section of the intrathoracic pressure monitoring lumen in fluid communication with the patient'"'"'s trachea;

isolating and sealing a portion of the supraglottic airway of the patient with the laryngeal cuff assembly;

placing the esophageal cuff assembly at the esophagus of the patient;

placing the gastric cuff assembly at the stomach of the patient; and

introducing a cooling fluid into a member selected from the group consisting of the esophageal cuff assembly and the gastric cuff assembly.