Bronchial blocker endotracheal apparatus

• US 5,588,424 A
• Filed: 06/28/1995
• Issued: 12/31/1996
• Est. Priority Date: 06/28/1995
• Status: Expired due to Fees

• Current Assignee: Cleveland Clinic Foundation
• Original Assignee: Cleveland Clinic Foundation
• Inventors: Insler, Steven R., Kraenzler, Erik J.
• Primary Examiner(s): Millin, V.
• Assistant Examiner(s): SRIVASTAVA, VIRENDRA KUMAR
• Application Number:
  US08/495,823
• Time in Patent Office: 552 Days
• Field of Search: 128/207.15, 128/207.14, 128/200.26, 604/99, 604/101
• US Class Current: 128/207.15
• 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 16/0459 one cuff behind another
• CPC Class Codes: A61M 16/0484 at the distal end
• CPC Class Codes: A61M 16/0486 Multi-lumen tracheal tubes
• CPC Class Codes: A61M 25/1011 Multiple balloon catheters

Abstract

An endotracheal tube (12) ventilates air from the lungs of a patient when inserted into the trachea. A second flexible tube (14) is closely joined to the endotracheal tube (12) in a side-by-side relation. The second flexible tube (14) slidably receives a catheter or endobronchial blocker (16) which has an inflatable cuff (32). The cuff (32) is maneuvered into the right or left bronchus of the patient by sliding and rotating the catheter or bronchial blocker (16) into a position to occlude the selected bronchus. A tracheal cuff (18) is disposed around the endotracheal tube (12) and the second flexible tube (14). When inflated, the tracheal cuff (18) engages the walls of the trachea to reduce passage of air and to secure the position of the endotracheal tube (12).

Claims

1. An endotracheal apparatus for insertion through the mouth and into the trachea of a patient for ventilating one lung and blocking the other lung comprising:

a first elongated flexible tube having an external wall portion, a proximal end and a distal end, the distal end being positioned in the trachea when in use and adapted for ventilating air;

a second elongated flexible tube, separate from the first tube, having a proximal end and a distal end, an external wall portion of the second elongated flexible tube being closely joined in a side-by-side relation to said external wall portion of the first elongated flexible tube, the second elongated flexible tube for receiving an endobrochial blocker;

a first inflatable and deflatable cuff extending about the first and second elongated flexible tubes toward the distal ends of the first and second tubes, the first inflatable and deflatable cuff being positioned and operable when inflated to engage the trachea;

an endobronchial blocker comprising an elongated catheter having a proximal end and a distal end, being slidably receivable in the second elongated flexible tube, the elongated catheter having an inflatable and deflatable cuff disposed about the distal end of the elongated catheter; and

,

an air passage defined in a wall of the first elongated flexible tube and terminating within the first inflatable and deflatable cuff.

2. The endotracheal apparatus as set forth in claim 1 wherein the distal ends of the first and second elongated tubes are angled relative to an axial direction.

3. The endotracheal apparatus as set forth in claim 1 wherein the first elongated tube includes an opening located between the distal end of the first elongated tube and the first inflatable and deflatable cuff, the opening allowing air to enter the first elongated tube.

4. The endotracheal apparatus as set forth in claim 1 wherein the second elongated tube has a diameter which is smaller than a diameter of the first elongated tube.

5. The endotracheal apparatus as set forth in claim 1 wherein the first and second elongated tubes are joined in contact.

6. The endotracheal apparatus as set forth in claim 1 further including a valve in fluid communication with the air passage for supplying air to and removing air from the first inflatable and deflatable cuff.

7. The endotracheal apparatus as set forth in claim 1 wherein the distal end of the elongated catheter is capable of extending beyond the distal end of the second elongated flexible tube and is directable by rotation into a selected bronchus.

8. The endotracheal apparatus as set forth in claim 1 further including a means to inflate and deflate the inflatable and deflatable cuff of the elongated catheter.

9. The endotracheal apparatus as set forth in claim 1 wherein the first and second elongated flexible tubes comprise a polyvinyl chloride material.

19. The endotracheal apparatus as set forth in claim 1 wherein the endobronchial blocker is rotatable in and removable from the second elongated flexible tube.

10. An endotracheal apparatus for insertion through the mouth and into the trachea of a patient for ventilating at least one lung comprising:

a first flexible tube having a sufficient length to extend from the mouth to a position near the carina of the trachea, the first flexible tube being adapted to communicate air;

a second flexible tube separate from the first flexible tube and having a length substantially equal to he length of the first flexible tube, the second flexible tube having a portion of an outer surface wall closely joined in a side-by-side relation with a portion of an outer surface wall of the first flexible tube, the second flexible tube being adapted to slidably receive an elongated instrument;

and,

an elongated instrument having a bronchial blocking cuff sealed to a distal end of the elongated instrument, the elongated instrument being slidably received into the second flexible tube such that the distal end extends beyond a distal end of the second flexible tube and into the selected bronchus.

11. The endotracheal apparatus as set forth in claim 10 further including an inflatable and deflatable cuff sealed around both the first and second flexible tubes at a position to engage the trachea when the first and second flexible tubes are at the position near the carina and the inflatable and deflatable cuff is inflated;

and,

an air passage associated with one of the first and second flexible tubes, the air passage being adapted to communicate air to and from the inflatable and deflatable cuff.

12. The endotracheal apparatus as set forth in claim 11 further including a means to inflate and deflate the bronchial blocking cuff.

13. The endotracheal apparatus as set forth in claim 10 wherein the first and second flexible tubes are comprised of a polyvinyl chloride material.

14. The endotracheal apparatus as set forth in claim 10 wherein the first flexible tube has a diameter which is larger than a diameter of the second flexible tube.

15. The endotracheal apparatus as set forth in claim 10 further including a cuff inflator including a valve in fluid communication to the air passage to selectively inflate and deflate the inflatable and deflatable cuff.

20. The endotracheal apparatus as set forth in claim 11 wherein the catheter is rotatable in and removable from the second flexible tube.

16. A method of using an endotracheal apparatus for ventilating one lung and blocking the other lung of a patient comprising the steps of:

providing separate first and second flexible tubes closely joined in a side-by-side relation along their external walls, each of the first and second flexible tubes having a length sufficient to extend from the patient'"'"'s mouth and into the patient'"'"'s trachea, the second flexible tube being configured to receive an elongated catheter having a bronchial blocking cuff;

inserting the first and second flexible tubes through the mouth and into the trachea with a distal end of the first and second flexible tubes being at a position near the carina;

providing an elongated catheter having a bronchial blocking cuff disposed toward a distal end of the catheter;

inserting the distal end of the elongated catheter into the second flexible tube and maneuvering the bronchial blocking cuff into a bronchus; and

,

inflating the bronchial blocking cuff to occlude the bronchus.

17. The method of using an endotracheal apparatus as set forth in claim 16 further including securing the position of the first and second flexible tubes relative to the trachea.

18. The method of using an endotracheal apparatus as set forth in claim 16 further including while inserted in the second flexible tube, rotating the elongated catheter into a selected bronchus.