Endotracheal tube wih fibers optic illumination and viewing and auxiliary tube

• US 5,285,778 A
• Filed: 07/09/1992
• Issued: 02/15/1994
• Est. Priority Date: 04/19/1991
• Status: Expired due to Term

• Current Assignee: Mackin, Robert A.
• Original Assignee: Mackin, Robert A.
• Inventors: Mackin, Robert A.
• Primary Examiner(s): Burr, Edgar S.
• Assistant Examiner(s): Lewis, Aaron J.
• Application Number:
  US07/912,031
• Time in Patent Office: 586 Days
• Field of Search: 128/4-6, 128/11, 128/200.26, 128/207.14, 128/207.15
• US Class Current: 128/207.15
• CPC Class Codes: A61B 2090/306 using optical fibres
• CPC Class Codes: A61M 16/04 Tracheal tubes catheters in general A61M25/00
• CPC Class Codes: A61M 16/0404 with means for selective or partial lung respiration
• CPC Class Codes: A61M 16/0434 Cuffs
• CPC Class Codes: A61M 16/0488 Mouthpieces; Means for guiding, securing or introducing the tubes guiding or introducing with laryngoscopes A61B1/267; holding devices on the body A61M25/02

Abstract

An endotracheal tube includes a main tube having a proximal end portion and a distal end portion, an inflatable annular cuff disposed on the main tube in sealed relation thereto adjacent on the distal end portion. An inflation tube extends from the distal end portion into the cuff. A viewing lens is located on the distal end portion and optically coupled to a first optical fiber extending from the proximal end portion to the distal end portion. A viewing device is attached to a proximal end of the first optical fiber. An illumination port is located on the distal end portion coupled to a second optical fiber extending from the proximal end portion to the distal end portion. An illumination source is optically coupled to a proximal end of the second optical fiber. The extended insertion of the endotracheal tube and conditions of adjacent tissue can be viewed by means of the viewing device. A flushing tube extends from a flushing source adjacent to the proximal end portion to a flushing outlet port located at the distal end portion adjacent to the viewing lens to flush mucous away from the viewing lens. In one embodiment, an auxiliary tube extends through a sealable port in a wall of the proximal end portion and slides through the sealable port, through the main tube and out of the distal end portion thereof. The auxiliary tube includes fiber optic illumination and viewing elements on a distal end portion thereof and an inflatable annular cuff on the distal end portion thereof.

Claims

1. An endotracheal tube including means for lungs beyond the endotracheal tube during and/or after intubation continuous illumination and continuous viewing of the position of the endotracheal tube in the patient'"'"'s trachea and conditions of portions of the trachea and lungs beyond the distal end portion of the endotracheal tube without either disconnecting a ventilator from the endotracheal tube or inserting a bronchoscope or endoscope through the endotracheal tube, the endotracheal tube comprising in combination:

(a) a main tube having a proximal end portion and a distal end portion, an inflatable annular cuff being disposed on the main tube in sealed relation thereto adjacent to the distal end portion;

(b) an inflation tube extending from the proximal end portion into the cuff;

(c) integral means for avoiding problems in monitoring of the position of the endotracheal tube in a patient'"'"'s trachea and conditions of portions of the trachea and lungs beyond the distal end portion during and/or after intubation of the endotracheal tube caused by use of an endoscope or bronchoscope extending through the endotracheal tube, the integral means including

i. a viewing lens located on and directly attached to the distal end portion and optically coupled to a first optical fiber integral with the main tube and extending from the proximal end portion to the distal end portion,

ii. a viewing device attached to a proximal end of the first optical fiber, and

iii. an illumination port located in the distal end portion coupled to a second optical fiber integral with the main tube and extending from the proximal end portion to the distal end portion, a proximal end of the second optical fiber being optically coupled to an illumination source.

2. The endotracheal tube of claim 1 including a flushing tube extending from a flushing source adjacent to the proximal end portion to a flushing outlet port located at the distal end portion adjacent to the viewing lens to flush mucous away from the viewing lens.

3. The endotracheal tube of claim 2 including a sealable port in a wall of the proximal end portion and an auxiliary tube extending slidably through the sealable port, through the main tube and out of the distal end portion thereof, the auxiliary tube including fiber optic illumination and viewing means on a distal end portion thereof and an inflatable annular cuff on the distal end portion thereof.

4. A method of avoiding problems caused by use of an endoscope or bronchoscope in an endotracheal tube by using the endotracheal tube to visualize a patient'"'"'s trachea and conditions in the patient'"'"'s lungs without using an endoscope or bronchoscope, the method comprising the steps of:

(a) inserting a distal end portion of the endotracheal tube into a patient'"'"'s throat, the endotracheal tube having a proximal end portion and an inflatable annular cuff disposed on the endotracheal tube in sealed relation thereto adjacent to the distal end portion;

(b) illuminating the interior of the trachea as the distal end portion is inserted by means of an illumination port located on the distal end portion and coupled to a distal end of a first optical fiber integral with the endotracheal tube and extending from the proximal end portion to the distal end portion and an illumination source optically coupled to a proximal end of the first optical fiber;

(c) viewing the interior of the trachea as the distal end portion is inserted and viewing illuminated portions of the trachea and lungs beyond the distal end portion after the inserting by means of a viewing lens located on the distal end portion and optically coupled to a distal end of a second optical fiber integral with the endotracheal tube and extending from the proximal end portion to the distal end portion and a viewing device attached to a proximal end of the second optical fiber;

(d) inflating the cuff by pumping gas into an inflation tube extending from the proximal end portion into the cuff after the viewing of step (c) verifies that the distal end portion is properly located relative to the patient'"'"'s carina; and

(e) continuing to monitor the position of the endotracheal tube in a patient'"'"'s trachea and portions of the trachea and lungs beyond the distal end portion after intubation of the endotracheal tube by illuminating the portions of the trachea and lungs beyond the distal end portion by means of the illumination port, the first optical fiber, and the illumination source and by viewing the portions of the trachea and lungs beyond the distal end portion by means of the viewing lens, second optical fiber, and the viewing device,

wherein continuing illumination and viewing of the endotracheal tube in the patient'"'"'s trachea and conditions of portions of the trachea and lungs beyond the distal end portion area accomplished without disconnecting a ventilator from the endotracheal tube or inserting a bronchoscope or endoscope through the endotracheal tube.

5. The method of claim 4 including flushing mucous away from the viewing lens by means of a flushing tube extending from a flushing source adjacent to the proximal end portion to a flushing outlet port located at the distal end portion adjacent to the viewing lens.

6. The method of claim 5 including inserting an auxiliary tube slidably through a sealable port in a wall of the proximal end portion, through the main tube and out of the distal end portion thereof, the auxiliary tube including fiber optic illumination and viewing means on a distal end portion thereof and an inflatable annular cuff on the distal end portion thereof, and viewing the inside of a first main stem bronchus as the distal end portion of the auxiliary tube advances into the first main stem bronchus by means of the fiber optic illumination and viewing means until the cuff on the distal end portion of the auxiliary tube is properly located in the first main stem bronchus, and inflating the cuff on the distal end portion of the auxiliary tube to occlude the first main stem bronchus.

7. The method of claim 6 including ventilating a lung of the patient through a second main stem bronchus while the first main stem bronchus is occluded.