Combined laryngeal mask and reflectance oximeter

• US 5,282,464 A
• Filed: 11/23/1992
• Issued: 02/01/1994
• Est. Priority Date: 07/21/1992
• Status: Expired due to Term

• Current Assignee: Indian Ocean Medical Inc.
• Original Assignee: Archibald I. Brain
• Inventors: Brain, Archibald I. J.
• Primary Examiner(s): Fisher, J. Reed
• Assistant Examiner(s): Asher, Kimberly L.
• Application Number:
  US07/980,581
• Time in Patent Office: 435 Days
• Field of Search: 128/207.14, 128/204.22, 128/207.15, 128/205.23, 128/786, 128/787, 128/911, 128/912, 128/204.18, 128/633, 128/634, 128/664-666, 606/2, 606/14, 356/41
• US Class Current: 128/207.15
• CPC Class Codes: A61B 5/14552 Details of sensors specially adapted therefor
• 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 16/0445 Special cuff forms, e.g. undulated

Abstract

A reflectance oximeter is so mounted to the upstream or proximal side of a laryngeal mask as to face the posterior wall of the pharynx when the laryngeal mask has been positioned to perform its function of sealed, exclusive airway communication with the laryngeal inlet. Thus positioned, radiation from the oximeter can utilize local back-bone features as a reflector, for two-way passage of the radiation through tissue which characterizes the posterior wall of the pharynx. Moreover, the oximeter-observation region is within the body, so that ambient light has no degrading effect, and changes in oxygen saturation will be detected earlier than by use of any peripherally placed oximeter probe.

Claims

1. In combination, a laryngeal mask having a front side and a back side and means for establishing peripherally sealed engagement of said mask around the laryngeal inlet of a patient, with the front side facing into the laryngeal inlet and the back side facing the back wall of the pharynx, an elongate airway tube having a distal end which establishes a sealed passage through said mask between the back and front sides of said mask, and reflectance-oximeter probe means carried at the back side of said mask and oriented to radiate into and to sense radiation reflected from within a localized portion of the back wall of the pharynx.

2. The combination of claim 1, in which said mask comprises a plate via which said airway tube has sealed communication with said passage, and in which said plate includes a recess formation with said oximeter probe means carried in the recess formation.

3. The combination of claim 2, in which said oximeter probe means is removably carried in the recess formation.

4. The combination of claim 2, in which said oximeter probe means includes a flexible cable for establishing external electrical connection to source of excitation signals for oximeter-detected signals, and in which said airway tube has an elongate groove formation adapted to removably retain said cable.

5. The combination of claim 1, in which said means for establishing sealed mask engagement around the laryngeal inlet is an inflatable annular ring, and in which said oximeter probe means is carried by said mask at a location which, in plan view is radially within the annulus of said ring.

6. The combination of claim 1, in which said oximeter probe means is fixedly carried by the back side of said mask.

7. The combination of claim 1, in which said oximeter probe means is removably carried by the back side of said mask.

8. The combination of claim 1, in which said mask includes an inflatable cuff at the back side of the mask for development of distributed-area contact with the back wall of the pharynx, and in which said oximeter probe means is carried by said cuff within the region of cuff contact with the back wall of the pharynx.

9. The combination of claim 8, in which said means for establishing sealed mask engagement around the laryngeal inlet is an inflatable annular ring, and a single flexible tube for communicating inflation air is connected for concurrent inflation of said cuff and of said annular ring.

10. The combination of claim 1, in which said oximeter probe means includes a flexible cable for establishing external electrical connection to source of excitation signals for oximeter radiation and to a processor of oximeter-detected signals.

11. The combination of claim 10, in which said airway tube has an elongate local groove formation adapted to removably retain said cable.

12. The combination of claim 1, in which said oximeter probe means comprises an LED diode in spaced proximity to a photodetector diode.

13. The combination of claim 12, in which the spacing of said diodes is in the longitudinal direction of airway-tube connection to said mask.

14. The combination of claim 1, in which said oximeter probe means comprises plural spaced pairs of spaced diode elements, wherein each pair comprises an LED diode and a photodetector diode.

15. The combination of claim 14, wherein electronic circuitry is selectively and remotely switch-connected to one to the exclusion of other pairs of said plurality.

16. The combination of claim 1, in which said oximeter probe means comprises an array of spaced diodes wherein each of two opposite sides of an LED diode is flanked by a photodetector diode.

17. The combination of claim 16, wherein electronic circuitry is selectively and remotely switch-connected to one to the exclusion of said photodetector diodes while said circuitry is continuously connected to said LED diode.

18. In combination, a laryngeal mask comprising a plate having a front side and a back side and means including an inflatable annular ring peripherally connected to said plate in essentially a single plane for establishing peripherally sealed engagement of said mask around the laryngeal inlet of a patient, with the front side facing into the laryngeal inlet and the back side facing the back wall of the pharynx, the back side of said plate having a tubular airway inlet formation on an alignment which rises from said plane at an acute angle, an elongate airway tube having a distal end which establishes via said inlet formation a sealed passage through said mask between the back and front sides of said mask, and reflectance-oximeter probe means carried by the inlet formation of said mask and oriented to radiate into and to sense radiation reflected from within a localized portion of the back wall of the pharynx.

19. The combination of claim 18, in which said inlet formation includes a recess formation with said oximeter probe means carried in the recess formation.

20. The combination of claim 18, in which said oximeter probe means is fixedly carried by said inlet formation.

21. The combination of claim 18, in which said oximeter probe means is removably carried by said inlet formation.

22. The combination of claim 21, in which said oximeter probe means is mounted to the convex surface of a cylindrically arcuate shell configurated for compliantly stressed retaining engagement to said tubular inlet formation.

23. The combination of claim 18, in which said mask includes an inflatable cuff at the back side of the mask and engaged to said inlet formation for development of distributed-area contact with the back wall of the pharynx, and in which said oximeter probe means is carried by said cuff within the region of inflated-cuff contact with the back wall of the pharynx.

24. The combination of claim 23, in which a single flexible tube is connected for communicating inflation air for concurrent inflation of said cuff and of said annular ring.

25. An artificial airway device to facilitate a patient'"'"'s lung ventilation, comprising an airway tube, an evacuation tube, and a laryngeal mask at one end of said tubes, said mask including a first inflatable-cuff formation of flexible material in a generally elliptical configuration extending from a proximal end to a distal end and in generally a single plane which is inclined to the axis of the airway tube at the distal end of the airway tube, a second inflatable-cuff formation carried by said mask on the posterior side of said plane, said mask being configured upon inflation of said cuff formations (1) to form a seal of said airway tube solely around the circumference of the laryngeal inlet and (2) to establish a cushioning action via said second cuff formation between the posterior side of said mask and the posterior wall of the pharynx, the distal end of said first cuff formation being configured for entry into and insertional location of said device by engagement with the oesophagus at the upper sphinctral region of the oesophagus when the mask is positioned for sealing the airway tube to the laryngeal inlet, said evacuation tube having an open distal end centrally within and axially short of the distal end of said first cuff formation, inflation-passage means communicating with both said inflatable cuff formations for selective inflation/deflation operation of said cuff formations;

said cuff formations, upon inflation via said inflation-passage means, sealing said airway tube for communication solely with the laryngeal inlet, sealing said evacuation tube solely to the sphinctral region; and

reflectance-oximeter probe means carried by said second cuff formation and oriented to radiate into and to sense radiation reflected from within a localized portion of the posterior wall of the pharynx.

26. The artificial airway device of claim 25, in which said airway tube is relatively rigid and curved to follow the airway of a patient.

27. An artificial airway device to facilitate a patient'"'"'s lung ventilation, comprising an airway tube, an evacuation tube, and a laryngeal mask at one end of said tubes, said mask being of generally elliptical configuration extending from a proximal end to a distal end and in generally a single plane, said configuration being adapted for support by and around the laryngeal inlet and orienting the distal end of the airway tube at an angle to said plane and in substantial alignment with the axis of the laryngeal inlet when supported by and around the laryngeal inlet, the distal end of said mask having a first cuff formation configured for entry into and insertional location of said device by engagement with the upper sphinctral region of the oesophagus when the mask is Positioned for airway-tube alignment with the axis of the oesophagus inlet, said evacuation tube having an open distal end centrally within and axially short of the distal end of said first cuff formation, a second inflatable-cuff formation carried by said mask on the posterior side of said plane, inflation-passage means communicating with both said cuff formations, and reflectance-oximeter probe means carried by said second cuff formation and oriented to radiate into and to sense radiation reflected from within a localized portion of the posterior wall of the pharynx.

28. An artificial airway device to facilitate a patient'"'"'s lung ventilation, comprising an airway tube, a suction tube, and a laryngeal mask at one end of said tubes, said mask having a proximal end and a distal end and being configured to form a seal of said airway tube solely around the circumference of the patient'"'"'s laryngeal inlet, said distal end being configured for entry into and insertional location of said device at the entrance of the upper sphinctral region of the oesophagus when said Mask is positioned for sealing the airway tube to the laryngeal inlet, said evacuation tube having an open distal end centrally within but axially short of the distal end of said mask, and the distal end of said mask including a first inflatable flexible cuff formation for peripherally sealed engagement of the upper sphinctral region to the distal end of said evacuation tube, thus exposing a passage via said mask for airway-tube communication solely with the laryngeal inlet on the anterior side of said mask, while exposing the posterior side of said mask to the posterior wall of the pharynx, a second inflatable-cuff formation carried by the posterior side of said mask for inflated engagement to the posterior wall of the pharynx, inflation-passage means communicating with both said cuff formations, and reflectance-oximeter probe means carried by said second cuff formation and oriented to radiate into and to sense radiation reflected from within a localized portion of the posterior wall of the pharynx.