Medical multiple access low dead space anti-microbial aspirating/ventilating closed system improvements and methods

• US 5,730,123 A
• Filed: 04/21/1995
• Issued: 03/24/1998
• Est. Priority Date: 05/18/1994
• Status: Expired due to Term

• Current Assignee: Avent Incorporated (Avanos Medical, Inc.)
• Original Assignee: Ballard Medical Products (Kimberly-Clark Corporation)
• Inventors: Van Hooser, David Theron, Jensen, Billy M., Lambert, Richard C., Houghton, William R., Arambula, Gerry A., Stewart, Gene, Lorenzen, Rick D., Palmer, Darrel R.
• Primary Examiner(s): Asher, Kimberly L.
• Application Number:
  US08/426,362
• Time in Patent Office: 1,068 Days
• Field of Search: 128/200.26, 128/207.14-207.16, 128/DIG. 26, 128/911, 128/912, 604/93, 604/171, 604/187, 604/264
• US Class Current: 128/207.14
• CPC Class Codes: A61M 16/0463 combined with suction tubes, catheters or the like; Outside connections
• CPC Class Codes: A61M 16/0825 with ball-sockets
• CPC Class Codes: A61M 16/0833 T- or Y-type connectors, e.g. Y-piece
• CPC Class Codes: A61M 3/0201 Cassettes therefor
• CPC Class Codes: A61M 39/26 Valves closing automatically on disconnecting the line and opening on reconnection thereof check valves A61M39/24
• CPC Class Codes: Y10S 128/26 Cannula supporters
• CPC Class Codes: Y10S 128/912 Connections and closures for tubes delivering fluids to or from the body

Abstract

Apparatus and methods are disclosed by which a closed ventilating system accommodates multiple access to the respiratory system of an intubated medical patient without comprising the closed character of the system. Access to the respiratory system through one or more access sites of the closed system apparatus is provided at proximal adapter ports to ventilate the lungs of the patient with gas or gases, to aspirate secretions from the lungs, to oxygenate the lungs to eliminate or reduce residual co₂ therefrom, to visually inspect selected parts of the respiratory system, to sample sputum and gases, to sense parameters such as flow rates, pressure, and temperature, to flush with washing solution, and/or to administer medication, gases, and/or lavage.

Claims

1. A method for selectively providing a plurality of different types of respiratory therapies in combination with an endotracheal tube, said method comprising the steps of:

providing an adapter means adapted for connection to an end of an endotracheal tube, said adapter means comprising a pair of connection ports, at least one of said ports being adapted for connection to a ventilator means;

providing a plurality of interchangeable catheter cartridge means for providing any one of several desired types of respiratory therapies including;

first catheter cartridge means for aspirating fluids therethrough, adapted for connection to a source of vacuum, and comprising an aspirating catheter enclosed within a collapsible sheath, first connector means for selective, releasable fluid-tight connection to one of said ports of said adapter means, an integral wash chamber formed in said first connector means, liquid introduction means for carrying liquid directly from a liquid dispensing container into said integral wash chamber without passing through said adapter means, second connector means adapted for fluid-tight connection to a source of vacuum, and valve means in fluid communication with said aspirating catheter and operable to selectively place said aspirating catheter and an endotracheal tube in communication with a source of vacuum to effect aspiration of fluids therethrough; and

second catheter cartridge means for delivery of fluid through an endotracheal tube and comprising a fluid delivery catheter enclosed within a collapsible sheath, first connector means for selective, releasable fluid-tight connection to said one of said ports of said adapter means so as to be selectively interchangeable with said first catheter cartridge means, and second connector means for fluid-tight connection to a source of fluid to be delivered;

connecting one of said plurality of catheter cartridge means with said adapter means to form a first connection assembly; and

disconnecting said one of said plurality of catheter cartridge means from said adapter means and connecting another of said plurality of catheter cartridge means with said adapter means to form a second connection assembly.

2. A method as recited in claim 1, further including the steps of providing a third catheter cartridge means for providing an additional type of respiratory therapy and selectively connecting said third catheter cartridge means with said adaptor means.

3. A method as recited in claim 1, wherein said adapter means provides a non-swiveling connection to an endotracheal tube.

4. A method as recited in claim 1, wherein said adapter means is provided from one of a plurality of adapters, each sized for connection to a complementary sized endotracheal tube.

5. A method as recited in claim 1, wherein said adapter means comprises a Y-adapter having an elongated distal end adapted for press fit connection inside an end of an endotracheal tube.

6. A method as recited in claim 1, wherein said adapter means comprises a Y-adapter for connection to an end of an endotracheal tube, said Y-adapter including a distal fitting adapted for connection to an endotracheal tube, a first proximal fitting adapted for connection to a ventilator means, and a second proximal fitting, said first and second proximal fittings of said Y-adapter comprising said pair of connection ports of said adapter means.

7. A method as recited in claim 6, wherein said first catheter cartridge means comprises a first catheter cartridge including said aspirating catheter enclosed within said collapsible sheath, a first connector for selective, releasable fluid-tight connection to said second proximal fitting of said Y-adapter, an integral wash chamber formed in said first connector surrounding a portion of said aspirating catheter, a liquid introduction assembly that carries liquid directly from a liquid dispensing container into said integral wash chamber without passing through said Y-adapter, a second connector adapted for fluid-tight connection to a source of vacuum, and said valve means.

8. A method as recited in claim 6, wherein said second catheter cartridge means comprises a second catheter cartridge including said fluid delivery catheter enclosed within said collapsible sheath, a first connector for selective, releasable fluid-tight connection to said second proximal fitting of said Y-adapter so as to be selectively interchangeable with said first catheter cartridge, and a second connector for said fluid-tight connection to a source of fluid to be delivered.

9. A method as recited in claim 1, wherein said liquid introduction means comprises tubing, connected directly to said first connector means, and proximal fitting means adapted for connection to said liquid dispensing container.

10. A method as recited in claim 9, wherein said proximal fitting means comprises valve means to seal said liquid introduction means when said liquid dispensing container is not attached thereto.

11. A method as recited in claim 1, wherein said second connector means of said second catheter cartridge means comprises a luer connection adapted for connection to a syringe.

12. A method as recited in claim 1, wherein said adapter means, said first catheter cartridge means, and said second catheter cartridge means are sized for use with an infant patient.

13. A method for selectively providing a plurality of different types of respiratory therapies in combination with an endotracheal tube, said method comprising the steps of:

providing adapter means adapted for connection to an end of an endotracheal tube, said adapter means comprising a pair of connection ports, at least one of said ports being adapted for connection to a ventilator means;

providing a plurality of interchangeable catheter cartridge means for providing any one of several desired types of respiratory therapies and adapted to be releasably and interchangeably connected to one of said ports, said plurality of catheter cartridge means including;

first catheter cartridge means for aspirating fluids therethrough and adapted for connection to a source of vacuum; and

second catheter cartridge means, selectively interchangeable with said first catheter cartridge, for delivering a fluid through an endotracheal tube;

connecting one of said plurality of catheter cartridge means with said adapter means to form a first connection assembly; and

disconnecting said one of said plurality of catheter cartridge means from said adapter means and connecting another of said plurality of catheter cartridge means with said adapter means to form a second connection assembly.

14. A method as recited in claim 13, wherein said adapter means comprises a Y-adapter for connection to an end of an endotracheal tube, said Y-adapter including a distal fitting adapted for connection to an endotracheal tube, a first proximal fitting adapted for connection to a ventilator means, and a second proximal fitting, said first and second proximal fittings of said Y-adapter comprising said pair of connection ports of said adapter means.

15. A method as recited in claim 14, wherein said first catheter cartridge means comprises a first catheter cartridge including an aspirating catheter enclosed within a collapsible sheath, a first connector for selective, releasable fluid-tight connection to said second proximal fitting of said Y-adapter, an integral wash chamber formed in said first connector surrounding a portion of said aspirating catheter, a liquid introduction assembly that carries liquid directly from a liquid dispensing container into said integral wash chamber without passing through said Y-adapter, a second connector adapted for fluid-tight connection to a source of vacuum, and valve means in fluid communication with said aspirating catheter and operable to selectively place said aspirating catheter and an endotracheal tube in communication with a source of vacuum to effect aspiration of fluids therethrough.

16. A method as recited in claim 15, wherein said second catheter cartridge means comprises a second catheter cartridge including a fluid delivery catheter enclosed within a collapsible sheath, a first connector for selective, releasable fluid-tight connection to said second proximal fitting of said Y-adapter so as to be selectively interchangeable with said first catheter cartridge, and a second connector for said fluid-tight connection to a source of fluid to be delivered.

17. A method as recited in claim 13, further including the step of providing a third catheter cartridge means for providing an additional type of respiratory therapy and selectively connecting said third catheter cartridge means with said adaptor means.

18. A method for selectively providing a plurality of different types of respiratory therapies in combination with an endotracheal tube, said method comprising the steps of:

providing a Y-adapter for connection to an end of an endotracheal tube, said Y-adapter comprising a distal fitting adapted for connection to an endotracheal tube, a first proximal fitting adapted for connection to a ventilator means, and a second proximal fitting;

providing a plurality of interchangeable catheter cartridges, each of which provides a desired types of respiratory therapy, said plurality of catheter cartridges including;

a first catheter cartridge adapted for connection to a source of vacuum comprising an aspirating catheter enclosed within a collapsible sheath, a first connector for selective, releasable fluid-tight connection to said second proximal fitting of said adapter means, an integral wash chamber formed in said first connector surrounding a portion of said aspirating catheter, a liquid introduction assembly that carries liquid directly from a liquid dispensing container into said integral wash chamber without passing through said Y-adapter, a second connector adapted for fluid-tight connection to a source of vacuum, and valve means in fluid communication with said aspirating catheter and operable to selectively place said aspirating catheter and an endotracheal tube in communication with a source of vacuum to effect aspiration of fluids therethrough; and

a second catheter cartridge for delivery of fluid through an endotracheal tube comprising a fluid delivery catheter enclosed within a collapsible sheath, a first connector for selective, releasable fluid-tight connection to said second proximal fitting of the Y-adapter so as to be selectively interchangeable with said first catheter cartridge, and a second connector for fluid-tight connection to a source of fluid to be delivered;

selectively connecting said first and second catheter cartridges with said Y-adapter in order to form one or more desired connection assemblies for providing said variety of respiratory therapies.

19. A method as recited in claim 18, further including the steps of connecting one of said catheter cartridges with said Y-adapter in order to provide a first connection assembly, disconnecting said catheter cartridges from said Y-adapter and then connecting another of said catheter cartridges with said Y-adapter in order to provide a second connection assembly.

20. A method as recited in claim 18, wherein said Y-adapter includes a third proximal fitting and wherein said first and second catheter cartridges are connected to said Y-adapter simultaneously to thereby provide said variety of respiratory therapies.

21. A method as recited in claim 18, further including the steps of providing a third catheter cartridge which provides an additional type of respiratory therapy and selectively connecting said third catheter cartridge with said Y-adapter.

22. An apparatus for selectively providing a plurality of different types of respiratory therapies in combination with an endotracheal tube, said apparatus comprising:

adapter means adapted for connection to an end of an endotracheal tube, said adapter means comprising a pair of connection ports, at least one of said ports being adapted for connection to a ventilator means; and

a plurality of interchangeable catheter cartridge means for providing any one of several desired types of respiratory therapies and adapted to be releasibly and interchangeably connected to one of said ports, said plurality of catheter cartridge means comprising;

first catheter cartridge means for aspirating fluids therethrough, adapted for connection to a source of vacuum, and comprising an aspirating catheter enclosed within a collapsible sheath, first connector means for selective, releasable fluid-tight connection to one of said ports of said adapter means, an integral wash chamber formed in said first connector means, liquid introduction means for carrying liquid directly from a liquid dispensing container into said integral wash chamber without passing through said adapter means, second connector means adapted for fluid-tight connection to a source of vacuum, and valve means in fluid communication with said aspirating catheter and operable to selectively place said aspirating catheter and an endotracheal tube in communication with a source of vacuum to effect aspiration of fluids therethrough; and

second catheter cartridge means for delivering a fluid through an endotracheal tube and comprising a fluid delivery catheter enclosed within a collapsible sheath, first connector means for selective, releasable fluid-tight connection to said one of said ports of said adapter means so as to be selectively interchangeable with said first catheter cartridge means, and second connector means for fluid-tight connection to a source of fluid to be delivered,

wherein said apparatus in a first arrangement of parts for providing aspiration of fluids comprises said first catheter cartridge means releasably connected to said adapter means, and

wherein said apparatus in a second arrangement of parts for delivering a fluid through an endotracheal tube comprises said second catheter cartridge means releasably connected to said adapter means.

23. An apparatus as recited in claim 22, further including a third catheter cartridge means for providing an additional type of respiratory therapy, wherein said apparatus in a third arrangement of parts for providing said additional type of respiratory therapy comprises said third catheter cartridge means releasably connected to said adaptor means.

24. An apparatus as recited in claim 22, wherein said apparatus in an alternative arrangement of parts for selectively providing said aspiration of fluids and said delivery of a fluid through an endotracheal tube comprises said first and second catheter cartridge means being connected to said adaptor means simultaneously.

25. An apparatus as recited in claim 22, wherein said adaptor means comprises a Y-adaptor including a distal fitting adapted for connection to an endotracheal tube, a first proximal fitting adapted for connection to a ventilator means, and a second proximal fitting, said first and second proximal fittings of said Y-adaptor comprising said pair of connection ports of said adaptor means.

26. An apparatus as recited in claim 25, wherein said Y-adaptor includes a third proximal fitting adapted for connection to one of said plurality of interchangeable catheter cartridge means.

27. An apparatus for selectively providing a plurality of different types of respiratory therapies in combination with an endotracheal tube, said apparatus comprising:

adapter means adapted for connection to an end of an endotracheal tube, said adapter means comprising a pair of connection ports, at least one of said ports being adapted for connection to a ventilator means; and

a plurality of interchangeable catheter cartridge means for providing any one of several desired types of respiratory therapies and adapted to be releasibly and interchangeably connected to one of said ports, said plurality of catheter cartridge means comprising;

first catheter cartridge means for aspirating fluids therethrough and adapted for connection to a source of vacuum; and

second catheter cartridge means, selectively interchangeable with said first catheter cartridge, for delivering a fluid through an endotracheal tube,

wherein said apparatus in a first arrangement of parts for providing aspiration of fluids comprises said first catheter cartridge means releasably connected to said adapter means, and

wherein said apparatus in a second arrangement of parts for delivering a fluid through an endotracheal tube comprises said second catheter cartridge means releasably connected to said adapter means.