NASAL AIRWAY MANAGEMENT DEVICE
An airway management device including a hollow flexible tube. The tube defines a lumen extending between a proximal end and a distal end. The proximal end is configured to be coupled to a ventilator and/or anesthesia circuit. An opening is provided at or near the distal end to allow passage of air and/or anesthesia therethrough. The tube is configured to be expanded radially after insertion through a patient's nasopharyngeal passageway when the distal end of the tube is positioned proximate the patient's hypopharynx. The device may include an inflatable outer sleeve surrounding and extending along the length of the tube. When the outer sleeve is in a deflated state, the distal end of the tube may be inserted through a patient's nasopharyngeal passageway. When the distal end of the tube is positioned proximate the patient's hypopharynx, the outer sleeve may be inflated and expanded. The device may include an inflatable cuff attached at or near the distal end of the tube and including an opening fluidly coupled with the opening and lumen of the tube to allow passage of air and/or anesthesia therethrough. When in a deflated state, the inflatable cuff may be inserted through the patient's nasopharyngeal passageway. When in an inflated state, the inflatable cuff may expand to form a seal around the patient's supraglottic laryngeal inlet. An intermediate inflatable cuff having a larger diameter than other portions of the outer sleeve when inflated may be positioned along the length of the tube between the proximal and distal ends. The respective inflatable elements of the device may be concurrently or separately inflatable.
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This application claims priority to U.S. Provisional Application No. 61/412,943 filed Nov. 12, 2010, the entire contents of which are hereby incorporated by reference.
BACKGROUND1. Field of Invention
The invention relates generally to airway management devices and, more particularly, to a nasal airway management device with an inflatable outer sleeve.
2. Discussion of Related Art
Maintaining and securing a patient's airway and providing adequate ventilation when necessary are core principles to ensure oxygen delivery in all human beings. Controlling a patient's airway is the first and most important principle in basic life support and advanced cardiac life support algorithms. Humans cannot survive the interruption of oxygen delivery to the body for more than 5-10 minutes. This puts enormous pressure on ensuring timely and reliable means of airway control in emergency situations. Anesthetized patients, sedated patients, critically ill patients and coding patients, for example, often can not maintain an airway or adequately breath on their own and almost always require assisted ventilation. Accordingly, airway devices are typically placed in a patient's airway by trained professionals in order to assist with ventilation or to maintain and protect the airway. These devices may include, for example, oral and nasal airways, laryngeal mask airways (LMAs), and endotracheal tubes. These devices, however, have several disadvantages. For example, highly trained healthcare personnel and special instrumentation are typically required for the placement of advanced airway devices such as LMAs and endotracheal tubes. Moreover, sedation or general anesthesia are required during placement and use of LMAs and endotracheal tubes. Other devices such as, for example, nasal and oral airways and external face masks, while less invasive, nevertheless provide limited or no ability to provide assisted ventilation.
There is a need for quick, simple and reliable airway management device to provide airway control and assisted ventilation in, for example but not limited to, emergency situations.
SUMMARYIn an embodiment of the invention, an airway management device is provided. The airway management device according to an embodiment of the invention includes a hollow flexible tube. The tube defines a lumen extending between a proximal end and a distal end. The proximal end may be coupled to at least one of a ventilator and an anesthesia circuit. An opening is provided proximate the distal end of the tube to allow passage of air and/or anesthesia therethrough. The tube may be expanded radially after insertion through a patient's nasopharyngeal passageway when the distal end of the tube is positioned proximate the patient's hypopharynx.
According to an embodiment of the invention, the airway management device may also include an inflatable outer sleeve surrounding and extending along the length of the tube. When the outer sleeve is in a deflated state, the distal end of the tube may be inserted through a patient's nasopharyngeal passageway. When the distal end of the tube is positioned proximate the patient's hypopharynx, the outer sleeve may be inflated and expanded.
According to another embodiment, an inflatable cuff may be attached at or near the distal end of the tube. The inflatable cuff may define an opening fluidly coupled with the opening and lumen of the tube to allow passage of air and/or anesthesia therethrough. When in a deflated state, the inflatable cuff may be inserted through the patient's nasopharyngeal passageway. When in an inflated state, the inflatable cuff may expand to form a seal around the patient's supraglottic laryngeal inlet.
According to another embodiment, the device may include an intermediate inflatable cuff positioned along the length of the tube between the proximal and distal ends and having a larger diameter than other portions of the outer sleeve when inflated.
According to another embodiment, the respective inflatable elements of the device may be concurrently or separately inflatable.
Further features and advantages, as well as the structure and operation of various embodiments of the invention, are described in detail below with reference to the accompanying drawings.
The foregoing and other features and advantages of the invention will be apparent from the following, more particular description of some example embodiments of the invention, as illustrated in the accompanying drawings. Unless otherwise indicated, the accompanying drawing figures are not to scale. Several embodiments of the invention will be described with respect to the following drawings, in which like reference numerals represent like features throughout the figures, and in which:
Some embodiments of the invention are discussed in detail below. In describing embodiments, specific terminology is employed for the sake of clarity. However, the invention is not intended to be limited to the specific terminology so selected. A person skilled in the relevant art will recognize that other equivalent components can be employed and other methods developed without departing from the broad concepts of the invention. All references cited herein are incorporated by reference as if each had been individually incorporated.
The tube 12, particularly the distal end 20, is configured for insertion through a patient's nostril N and nasopharyngeal passageway NP to a position in the laryngopharynx (or hypopharynx) LP (see
In some embodiments, the inflatable cuff 16 is attached at or near the distal end 20 of the tube 12 and may be arranged to be inflated and deflated via an inflation passage defined by a space between the inner surface of the outer sleeve 14 and the outer surface of the tube 12. The inflation passage may extend along the tube 12 and may be fluidly coupled to the inflatable cuff 16 to allow concurrent inflation and deflation of the outer sleeve 14 and the cuff 16. In some embodiments, discussed further below, a pilot tube 140 (see
The outer sleeve 14 and inflatable cuff 16 may include thin, flexible and compliant material such as, for example, PVC or polyurethane, although other materials are possible. When in a deflated state such as, for example, as shown in the embodiment depicted in
As shown in the embodiment depicted in
When PPV, CPAP, or PEEP is no longer needed, or if the patient should undergo unassisted spontaneous breathing trials such that simple maintenance the patency of the airway remains, the device 10 can be left in place with cuff 16 deflated and outer sleeve 14 either deflated or still inflated (if separately inflatable). In this case, the device 10 can serve as a conventional nasal airway. Nasal airways provide minimal stimulation to the patient and are extremely well tolerated compared to endotracheal tubes or LMAs. In addition the patient would be able to talk. At any time, the cuff 16 could be inflated again if there is a need to resume assisted ventilation.
As shown in the embodiment depicted in
The embodiments of the nasal airway management device may be useful and beneficial in various medical situations. For example, the device may be utilized for rescue ventilation in emergency situations to provide effective and reliable ventilation by nurses or other non-anesthesia trained personnel involved in the management of a coding patient before arrival of anesthesia or emergency rooms doctors and placement of an endotracheal tube. Additionally, the device may be utilized in the early postoperative period to prevent a patient's tongue and soft tissue from collapsing onto the pharynx and obstructing the patient's upper airway while also providing the ability to rapidly transition to PPV by inflating the cuff when a patient stops breathing due to over-sedation, muscle weakness or residual anesthetic effects.
The device may also be utilized in outpatient procedures requiring sedation. These procedures (e.g. colonoscopies, endoscopies, transesophageal echocardiograms) are done under anesthesia sedation with intravenous general anesthetics (e.g. propofol) or combination of narcotic with anxiolitic. One of the anesthetic goals of such a technique is to keep patients breathing on their own (spontaneous ventilation) while supplemental oxygen is provided via nasal cannula. Emergency situations arise when a patient is over-sedated and stops breathing. Effective use of the device in place of conventional nasal cannulas will dramatically improve safety, by allowing timely, effective and smooth transition to PPV in a case of anesthetic overdose and cessation of spontaneous ventilation. Similar use under general anesthesia may be provided.
While various embodiments of the present invention have been described above, it should be understood that they have been presented by way of example only, and not limitation. Thus, the breadth and scope of the present invention should not be limited by any of the above-described embodiments, but should instead be defined only in accordance with the following claims and their equivalents.
Claims
1. An airway management device, comprising:
- a hollow flexible tube defining a lumen extending between a proximal end and a distal end, wherein the proximal end is configured to be coupled to at least one of a ventilator and an anesthesia circuit, wherein an opening is provided proximate the distal end to allow passage of air and/or anesthesia therethrough, and wherein the tube is configured to be expanded radially after insertion through a patient's nasopharyngeal passageway when the distal end of the tube is positioned proximate the patient's hypopharynx.
2. The airway management device according to claim 1, further comprising:
- an inflatable outer sleeve surrounding and extending along a length of the tube, wherein, when the outer sleeve is in a deflated state, the distal end of the tube is configured to be inserted through a patient's nasopharyngeal passageway, and wherein, when the distal end of the tube is positioned proximate the patient's hypopharynx, the outer sleeve is configured to be inflated and expanded.
3. The airway management device according to claim 2, further comprising:
- an inflatable cuff attached at or near the distal end of the tube, wherein the inflatable cuff defines an opening fluidly coupled with the opening and lumen of the tube to allow passage of air and/or anesthesia therethrough, wherein, when in a deflated state, the inflatable cuff is configured to be inserted through the patient's nasopharyngeal passageway, and wherein, when in an inflated state, the inflatable cuff is configured to expand to form a seal around the patient's supraglottic laryngeal inlet.
4. The airway management device according to claim 3, wherein a space between an outer surface of the tube and an inner surface of the outer sleeve defines an inflation passage extending along the tube and fluidly coupled to the inflatable cuff to allow concurrent inflation and deflation of the outer sleeve and the inflatable cuff.
5. The airway management device according to claim 5, wherein the outer sleeve further comprises an intermediate inflatable cuff portion disposed between the proximal and distal ends, wherein the intermediate inflatable cuff portion is configured to have a larger diameter than other portions of the outer sleeve when inflated, and wherein, when positioned in the patient's oropharynx and inflated, the intermediate inflatable cuff portion of the outer sleeve is configured to secure the tube therein and prevent the tube from sliding back into the nasopharyngeal passageway.
6. The airway management device according to claim 3, further comprising a pilot tube extending along the length of the tube.
8. The airway management device according to claim 6, wherein the pilot tube is fluidly coupled to the inflatable cuff and to a space between an outer surface of the tube and an inner surface of the outer sleeve to allow concurrent inflation and deflation of the inflatable cuff and the outer sleeve.
9. The airway management device according to claim 8, further comprising an intermediate inflatable cuff provided on the outer sleeve between the proximal and distal ends, wherein the intermediate inflatable cuff is configured to have a larger diameter than the outer sleeve when inflated, and wherein, when positioned in the patient's oropharynx and inflated, the intermediate inflatable cuff is configured to secure the tube therein and prevent the tube from sliding back into the nasopharyngeal passageway.
10. The airway management device according to claim 9, wherein the intermediate inflatable cuff is fluidly coupled to at least one of the pilot tube and a space between the outer surface of the tube and the inner surface of the outer sleeve to allow concurrent inflation and deflation of the outer sleeve, the inflatable cuff, and the intermediate inflatable cuff.
11. The airway management device according to claim 9, wherein the intermediate inflatable cuff is fluidly coupled to a second pilot tube to allow inflation and deflation of the intermediate inflatable cuff separate from the outer sleeve and the inflatable cuff.
12. The airway management device according to claim 6, wherein the pilot tube is fluidly coupled to the inflatable cuff to allow inflation and deflation of the inflatable cuff separate from the outer sleeve.
13. The airway management device according to claim 12, further comprising an intermediate inflatable cuff provided on the outer sleeve between the proximal and distal ends, wherein the intermediate inflatable cuff is configured to have a larger diameter than the outer sleeve when inflated, and wherein, when positioned in the patient's oropharynx and inflated, the intermediate inflatable cuff is configured to secure the tube therein and prevent the tube from sliding back into the nasopharyngeal passageway.
14. The airway management device according to claim 13, wherein the intermediate inflatable cuff is fluidly coupled to a space between the outer surface of the tube and the inner surface of the outer sleeve to allow concurrent inflation and deflation of the outer sleeve and the intermediate inflatable cuff.
15. The airway management device according to claim 13, wherein the intermediate inflatable cuff is fluidly coupled to at least one of the pilot tube and the inflatable cuff to allow concurrent inflation and deflation of the inflatable cuff and the intermediate inflatable cuff.
16. The airway management device according to claim 13, wherein the intermediate inflatable cuff is fluidly coupled to a second pilot tube to allow inflation and deflation of the intermediate inflatable cuff separate from the outer sleeve and the inflatable cuff.
17. The airway management device according to claim 2, further comprising an intermediate inflatable cuff provided on the outer sleeve between the proximal and distal ends, wherein the intermediate inflatable cuff is configured to have a larger diameter than the outer sleeve when inflated, and wherein, when positioned in the patient's oropharynx and inflated, the intermediate inflatable cuff is configured to secure the tube therein and prevent the tube from sliding back into the nasopharyngeal passageway.
18. The airway management device according to claim 17, wherein a space between an outer surface of the tube and an inner surface of the outer sleeve defines an inflation passage extending along the tube and fluidly coupled to the intermediate inflatable cuff to allow concurrent inflation and deflation of the outer sleeve and the intermediate inflatable cuff.
19. The airway management device according to claim 17, further comprising a pilot tube extending along the length of the tube.
20. The airway management device according to claim 19, wherein the intermediate inflatable cuff is fluidly coupled to the pilot tube to allow inflation and deflation of the intermediate inflatable cuff separate from the outer sleeve.
21. The airway management device according to claim 1, further comprising a plurality of pilot tubes extending along a length of the tube and configured to radially expand the tube when inflated.
22. The airway management device according to claim 21, wherein the pilot tubes spiral along the length of the tube, wherein, when the pilot tubes are inflated, the length of the tube increases.
Type: Application
Filed: Mar 22, 2011
Publication Date: May 17, 2012
Applicant: The Johns Hopkins University (Baltimore, MD)
Inventor: Viachaslau M. Barodka (Baltimore, MD)
Application Number: 13/053,785
International Classification: A61M 16/01 (20060101); A61M 16/00 (20060101);