Tracheal connector

Abstract

To provide a trachea tube connector capable of appropriately preventing a situation in which a subject's expired air is not discharged to the atmosphere sufficiently while improving the value of the subject's dynamic PEEP significantly.SOLUTION: A trachea tube connector 1 is connected to a respiration gas supply device and a tracheal tube 7 respectively. The trachea tube connector 1 includes a trachea tube connector body part 2 connected to the tracheal tube 7, a connector tube 3 connected to the trachea tube connector body part 2 and the respiration gas supply device, and a flow channel constriction mechanism 33 configured so as to constrict a respiration gas flow channel P. The trachea tube connector body part 2 includes a trachea tube port 20 connected to the trachea tube 7, an exhaust port 21 opposed to the trachea tube port 20 from which at least a subject's expired air is discharged, and a suction port 22 connected to the connector tube 3. The flow channel constriction mechanism 33 is disposed on the respiration gas flow channel P between the suction port 22 and the trachea tube port 20.SELECTED DRAWING: Figure 3

Description

Technical Field

[0001] The present disclosure relates to a tracheal connector. In particular, the present disclosure relates to a tracheal connector connected to a breathing gas supply device and a tracheal tube.

Background Art

[0002] Most patients (about 90%) who require mechanical ventilation management for 14 days or more after intubation undergo tracheotomy and then attempt to wean from the ventilator. It has been found that patients who were able to wean from the ventilator after tracheotomy have an improved long-term prognosis compared to patients who were dependent on the ventilator after tracheotomy. Specifically, there are also data such as the 3-year survival rate of patients who were able to wean from the ventilator after tracheotomy being 60%, while the 3-year survival rate of patients who were dependent on the ventilator was 30%. In addition, early weaning from the ventilator also contributes to a significant reduction in medical costs (about 1 / 6). Thus, it is preferable that patients after tracheotomy can be weaned from the ventilator early. The main reasons for the prolonged use of the ventilator are inappropriate gas exchange and reduced durability against an increased workload of breathing. In addition, in a conventional tracheal connector that connects a breathing gas supply device and a tracheal tube inserted into a patient's trachea, the positive pressure in the airway during the patient's exhalation (hereinafter referred to as dynamic end-expiratory pressure (PEEP)) becomes low. As a result, the patient's alveoli may collapse, and the duration of the patient's ventilator use may be prolonged. Therefore, if the expiratory positive pressure can be generated by improving the current tracheal connector, it is expected that alveolar collapse will be reduced and gas exchange will be improved. As a result, the end-expiratory lung volume increases and the workload of breathing (breathing effort) decreases, which may promote the patient's early weaning from the ventilator.

[0003] On the other hand, in the tracheal connector disclosed in Patent Document 1, in order to generate a certain value of dynamic PEEP, a part of the structure of the tracheal connector is devised. Specifically, a flow path narrowing mechanism having a through orifice is formed on the exhaust port side of the tracheal connector. Due to the flow path narrowing mechanism, the air flow (expiratory flow) of the patient's exhaled breath is less likely to be smoothly exhausted into the atmosphere, so the value of the patient's dynamic PEEP tends to increase easily. In this way, as the value of the patient's dynamic PEEP increases, alveolar collapse of the patient is preferably prevented, so the wearing period of the patient's ventilator may be shortened.

Prior Art Documents

Patent Documents

[0004]

Patent Document 1

Summary of the Invention

Problems to be Solved by the Invention

[0005] By the way, in the tracheal connector disclosed in Patent Document 1, since a flow path narrowing mechanism is formed on the exhaust port side of the tracheal connector, a situation is assumed in which sputum or the like mixed in the patient's exhaled breath blocks a part of the through orifice. In such a situation, since the expiratory flow is less likely to be exhausted into the atmosphere, while the value of the dynamic PEEP increases dramatically, there is a possibility that problems may occur in the patient's respiratory management. From the above viewpoint, there is room for further improvement of the tracheal connector.

[0006] An object of the present disclosure is to provide a tracheal connector capable of preferably preventing a situation in which the exhaled breath of a subject is not sufficiently exhausted into the atmosphere while dramatically improving the value of the dynamic PEEP of the subject.

Means for Solving the Problems

[0007] The tracheal connector according to one aspect of the present disclosure is connected to a respiratory gas supply device configured to supply respiratory gas to a subject and a tracheal tube inserted into the trachea of the subject, respectively. A tracheal connector main body connected to the tracheal tube, A connector tube connected to the tracheal connector main body and the breathing gas supply device, A flow path narrowing mechanism configured to narrow the breathing gas flow path through which the breathing gas flows, and is provided with. The tracheal connector main body is A tracheal port connected to the tracheal tube, An exhaust port that faces the tracheal port and through which at least the exhaled breath of the subject is discharged, An intake port connected to the connector tube, and has. The flow path narrowing mechanism is provided on the breathing gas flow path between the intake port and the tracheal port.

[0008] According to the above configuration, since the flow path narrowing mechanism configured to narrow the breathing gas flow path is arranged on the breathing gas flow path between the intake port and the tracheal port, the flow of the breathing gas supplied from the breathing gas supply device (hereinafter, the intake flow) is restricted by the flow path narrowing mechanism. Further, the intake flow that has passed through the flow path narrowing mechanism collides with the flow of the exhaled breath of the subject (hereinafter, the exhaled flow) that has passed through the tracheal port, thereby forming a turbulent flow region around the tracheal port. For this reason, it becomes difficult for the exhaled flow to flow smoothly toward the exhaust port side, so the pressure around the tracheal port increases. As a result, the value of dynamic PEEP (positive end-expiratory pressure) jumps. Further, since the flow path narrowing mechanism is not provided on the exhaust port side, a situation in which the exhaled breath of the subject is not sufficiently discharged into the atmosphere due to the flow path narrowing mechanism is preferably prevented. Therefore, it is possible to provide a tracheal connector that can preferably prevent a situation in which the exhaled breath of the subject is not sufficiently discharged into the atmosphere while significantly improving the value of the dynamic PEEP of the subject.

Effect of the Invention

[0009] According to the present disclosure, it is possible to provide a tracheal connector that can preferably prevent a situation in which the exhaled breath of the subject is not sufficiently discharged into the atmosphere while dramatically improving the value of the dynamic PEEP of the subject.

Brief Description of the Drawings

[0010] [Figure 1] FIG. 8 is a perspective view showing a state in which the tracheal connector according to an embodiment of the present disclosure is attached to a patient. [Figure 2] It is a perspective view of a tracheal connector. [Diagram 3] FIG. 14 is a view showing a longitudinal section of the tracheal connector main body portion. [Figure 4] FIG. 17 is a plan view of a flow path narrowing mechanism provided in a connector tube.

Modes for Carrying Out the Invention

[0011] The tracheal connector 1 according to an embodiment of the present disclosure (hereinafter, this embodiment) will be described below with reference to the drawings. FIG. 1 is a perspective view showing a state in which the tracheal connector 1 according to this embodiment is attached to a patient U (subject). FIG. 2 is a perspective view of the tracheal connector 1. As shown in FIG. 1, the patient U is a patient who requires respiratory support after tracheotomy. In particular, the trachea of the patient U has been tracheotomized, and a tracheal tube 7 (see FIG. 2) is inserted into the trachea. The respiratory gas (for example, oxygen gas) supplied from the respiratory gas supplier 5 is sent into the trachea of the patient U through the tracheal connector 1 and the tracheal tube 7. On the other hand, the exhaled breath containing carbon dioxide discharged from the lungs of the patient U is discharged into the atmosphere through the tracheal tube 7 and the exhalation port 21.

[0012] As shown in FIG. 1, the respiratory gas supplier 5 is connected to the tracheal connector 1. The respiratory gas supplier 5 is configured to supply respiratory gas to the patient U. The respiratory gas supplier 5 includes a gas supplier main body 8 configured to supply respiratory gas to the patient U through the tracheal connector 1, and a gas tube 6 connected to the gas supplier main body 8.

[0013] As shown in FIGS. 1 and 2, the tracheal connector 1 is connected to the gas tube 6 of the breathing gas supply device 5 and the tracheal tube 7, respectively. The tracheal connector 1 has a tracheal connector main body 2 and a connector tube 3. The tracheal connector main body 2 is connected to the tracheal tube 7 and has a tracheal port 20, an exhaust port 21, and an intake port 22. The tracheal port 20 is connected to the tracheal tube 7. The exhaust port 21 faces the tracheal port 20. The exhaled air discharged from the patient U and passing through the tracheal tube 7 is discharged to the outside from the exhaust port 21 through the tracheal port 20. The intake port 22 is connected to the connector tube 3. The breathing gas output from the breathing gas supply device 5 is sent into the trachea of the patient U through the intake port 22 and the tracheal port 20 and then through the tracheal tube 7. Also, a part of the breathing gas is discharged to the outside from the exhaust port 21.

[0014] The tracheal connector main body 2 further has an exhaust side tube portion 26 and an intake side tube portion 27. The exhaust side tube portion 26 extends between the tracheal port 20 and the exhaust port 21. The intake side tube portion 27 is connected to the exhaust side tube portion 26 and has an intake port 22. The intake side tube portion 27 and the exhaust side tube portion 26 may be integrally formed.

[0015] The intake side tube portion 27 is obliquely connected to the exhaust side tube portion 26. Specifically, as shown in FIG. 3, the axial direction A1 of the exhaust side tube portion 26 extends obliquely with respect to the axial direction A2 of the intake side tube portion 27. The angle θ between the axial direction A1 and the axial direction A2 is, for example, within the range of 35° to 55°. Also, the internal space of the intake side tube portion 27 and the internal space of the exhaust side tube portion 26 communicate with each other, and a breathing gas flow path P through which the breathing gas flows is formed by the two mutually communicating internal spaces.

[0016] The connector tube 3 is connected to the tracheal connector main body 2 and the gas tube 6 of the breathing gas supply device 5. As shown in FIG. 2, the connector tube 3 has a first connection end 31, a second connection end 32, and a tube main body 36. The first connection end 31 is connected to the intake port 22. The second connection end 32 is located on the opposite side to the first connection end 31 and is connected to the gas tube 6 of the breathing gas supply device 5 (see FIG. 1). The tube main body 36 extends between the first connection end 31 and the second connection end 32 and is formed in a bellows shape.

[0017] As shown in FIG. 3 , the first connecting end 31 is provided with a flow path narrowing mechanism 33. The flow path narrowing mechanism 33 is configured to narrow the respiratory gas flow path P through which respiratory gas flows. The flow path narrowing mechanism 33 has a closing plate 34 configured to block a part of the opening of the first connecting end 31, and a through orifice 35 formed in the closing plate 34. The closing plate 34 may be formed integrally with the first connecting end 31. The closing plate 34 blocks the passage of the flow of respiratory gas supplied from the respiratory gas supplier 5 (hereinafter referred to as the inhalation flow F2), while the through orifice 35 allows the inhalation flow F2 to pass. In this way, the respiratory gas flow path P can be narrowed by the closing plate 34 and the through orifice 35.

[0018] 4, the closing plate 34 and the through orifice 35 are formed in a circular shape in a plan view. A center point O1 of the closing plate 34 and a center point O2 of the through orifice 35 may be substantially coincident. The ratio of the surface area of the closing plate 34 to the cross-sectional area of the flow path of the connector tube 3 at the first connection end 31 may be, for example, within a range of 75% to 90%. For example, when the ratio of the surface area of the closing plate 34 to the cross-sectional area of the flow path is 75%, the ratio of the opening area of the through orifice to the cross-sectional area of the flow path is 25%. In this case, since the cross-sectional area of the flow path is four times the opening area of the through orifice, the radius r1 of the through orifice 35 is 1 / 2 of the cross-sectional radius r of the flow path.

[0019] In addition, when the ratio of the surface area of the closing plate 34 to the cross-sectional area of the flow path is 75% to 90%, the narrowing rate of the breathing gas flow path P achieved by the flow path narrowing mechanism 33 is also within the range of 75% to 90%. That is, when the ratio of the surface area of the closing plate 34 to the cross-sectional area of the flow path is N%, the narrowing rate of the breathing gas flow path P achieved by the flow path narrowing mechanism 33 is also within the range of N%. In this example, although the flow path narrowing mechanism 33 is provided at the first connection end portion 31, the location where the flow path narrowing mechanism 33 is formed is not particularly limited. For example, the flow path narrowing mechanism 33 may be integrally formed with the intake side pipe portion 27. Similarly in this case, the flow path narrowing mechanism 33 is formed on the breathing gas flow path P between the intake port 22 and the tracheal port 20.

[0020] According to the present embodiment, since the flow path narrowing mechanism 33 configured to narrow the breathing gas flow path P is provided on the breathing gas flow path P between the intake port 22 and the tracheal port 20 (specifically, at the first connection end portion 31 of the connector tube 3), the intake flow F2 is constricted by the flow path narrowing mechanism 33. Further, the intake flow F2 that has passed through the flow path narrowing mechanism 33 collides with the flow of the exhaled breath of the patient U (hereinafter, exhaled flow F1) that has passed through the tracheal port 20, thereby forming a turbulent flow region around the tracheal port 20. For this reason, it becomes difficult for the exhaled flow F1 to flow smoothly toward the exhaust port 21 side, so the pressure around the tracheal port 20 increases.

[0021] As a result, the value of dynamic PEEP (positive end-expiratory airway pressure) increases dramatically. Furthermore, because the flow path narrowing mechanism 33 is not provided on the exhaust port 21 side, a situation in which the flow path narrowing mechanism 33 prevents the patient U's exhaled breath from being sufficiently discharged into the atmosphere is effectively prevented. For example, if the flow path narrowing mechanism 33 were provided on the exhaust port 21 side, it is conceivable that the patient U's phlegm or the like contained in the exhaled breath would block the through orifice 35 of the flow path narrowing mechanism 33. However, this embodiment effectively prevents such a situation. Therefore, it is possible to provide a tracheal connector 1 that can effectively prevent a situation in which the patient U's exhaled breath is not sufficiently discharged into the atmosphere while dramatically improving the value of dynamic PEEP for the patient U. Furthermore, the dramatic improvement in the patient U's dynamic PEEP can shorten the period of time the patient U needs to be fitted with a ventilator.

[0022] In this embodiment, the narrowing rate of the respiratory gas flow path P achieved by the flow path narrowing mechanism 33 is set within a range of 75% to 90%. This allows the respiratory gas supplied from the respiratory gas supply device 5 to be reliably delivered into the airway of the patient U, and also makes it possible to dramatically increase the dynamic PEEP value. In this regard, if the narrowing rate of the respiratory gas flow path P exceeds 90%, the dynamic PEEP value increases, while the pressure around the flow path narrowing mechanism 33 rises excessively. On the other hand, if the narrowing rate of the respiratory gas flow path P is less than 75%, it becomes difficult to dramatically increase the dynamic PEEP value.

[0023] Also, in the present embodiment, the angle θ between the axial direction A1 of the exhaust-side pipe portion 26 and the axial direction A2 of the intake-side pipe portion 27 is, for example, within the range of 35° to 55°. Therefore, it is possible to significantly increase the value of the dynamic PEEP while eliminating the variation in the value of the dynamic PEEP for patients U having various respiratory disorders. In this regard, the smaller the angle θ between the axial direction A1 and the axial direction A2, the more difficult it is for the exhaled air flow F1 to smoothly flow toward the exhaust port 21 side, and thus the value of the dynamic PEEP tends to increase. On the other hand, the smaller the angle θ, the greater the variation in the value of the dynamic PEEP for each patient. Thus, considering the variation in the dynamic PEEP value for each patient, the angle θ is preferably within the range of 35° to 55°.

[0024] As described above, the embodiments of the present invention have been explained, but the technical scope of the present invention should not be construed in a limited manner by the description of the present embodiment. The present embodiment is an example, and it is understood by those skilled in the art that various modifications of the embodiments are possible within the scope of the invention described in the claims. The technical scope of the present invention should be determined based on the scope of the invention described in the claims and its equivalent scope.

[0025] For example, in the flow path narrowing mechanism 33 according to the present embodiment, a concentric single through orifice 35 is formed in the closing plate 34, but the formation position, number, and shape of the through orifice 35 are not particularly limited. For example, two or more through orifices may be formed at arbitrary positions on the closing plate 34. Also, the shape of the through orifice 35 may be a polygon (for example, a triangle or a quadrilateral). Thus, the configuration of the flow path narrowing mechanism 33 shown in the present embodiment is not particularly limited.

Explanation of Reference Numerals

[0026] 1: Tracheal connector 2: Tracheal connector main body portion 3: Connector tube 5: Respiratory gas supply device 6: Gas tube 7: Tracheal tube 8: Gas supply unit main body 20: Trachea port 21: Exhaust port 22: Intake port 26: Exhaust side pipe portion 27: Intake side pipe portion 31: First connection end 32: Second connection end 33: Flow path narrowing mechanism 34: Blocking plate 35: Through orifice 36: Tube main body portion

Claims

1. A tracheal connector connected to a breathing gas supply configured to supply breathing gas to a subject and a tracheal tube inserted into the trachea of the subject, respectively, wherein the tracheal connector includes a tracheal connector main body connected to the tracheal tube, a connector tube connected between the tracheal connector main body and the breathing gas supply, and a flow path narrowing mechanism configured to narrow a breathing gas flow path through which the breathing gas flows, and the tracheal connector main body has a tracheal port connected to the tracheal tube, an exhaust port facing the tracheal port and through which at least exhaled breath of the subject is discharged, and an intake port connected to the connector tube, and the connector tube has a first connection end connected to the intake port, and a second connection end located on the side opposite to the first connection end and connected to the breathing gas supply, and the flow path narrowing mechanism is provided at the first connection end on the breathing gas flow path between the intake port and the tracheal port, a tracheal connector.

2. The flow path narrowing mechanism includes a closing plate configured to block a part of the opening of the first connection end, and at least one through orifice formed in the closing plate, and is the tracheal connector according to Claim 1.

3. The narrowing rate of the breathing gas flow path achieved by the flow path narrowing mechanism is in the range of 75% to 90%, is the tracheal connector according to Claim 1 or 2.

4. The ratio of the surface area of the closing plate to the cross-sectional area of the flow path of the connector tube at the first connection end is in the range of 75% to 90%, is the tracheal connector according to Claim 2.

5. The tracheal connector main body has an exhaust side tube portion extending between the tracheal port and the exhaust port, and an intake side tube portion connected to the exhaust side tube portion and including the intake port, and the axial direction of the intake side tube portion extends obliquely with respect to the axial direction of the exhaust side tube portion, and the angle between the axial direction of the intake side tube portion and the axial direction of the exhaust side tube portion is in the range of 35° to 55°, is the tracheal connector according to any one of Claims 1 to 4.

Images