Endotracheal Tubes

Background of the endotracheal tube

It is a common practice to provide human medical patients with artificial ventilation during surgery or in emergency situations. For example, accident victims will frequently require CPR or intubation by a paramedic in an emergency vehicle or by an anesthesiologist in an operating room. There are other surgical procedures which require use of an endotracheal tube to collapse one lung.

Intubation is accomplished by insertion of an endotracheal tube through the patient’s mouth or nasal passages into the airway passage. Such devices have generally comprised a relatively pliable tube with means for connecting it to a respirator or other air supply mechanism for introduction of air into the lungs. An improvement to feeding tubes includes an inflatable/deflatable bag-like structure or balloon “cuff” around the exterior of the tube.

Both single lumen and double lumen endotracheal tubes are known. Typically, a single lumen endotracheal tube is an tracheostomy tube that extends into the trachea of a patient upon intubation and includes one inflatable balloon cuff near its distal end. Commonly, the double lumen endotracheal tube is referred to as an endobronchial tube and, in addition to one lumen which extends to the trachea, has a second longer lumen which extends into the bronchus of a patient upon intubation.

The so-called double lumen endobronchial tubes also offer anesthesiologists the ability to insufflate selectively either the right or left lung or both lungs as required. The so-called double lumen endobronchial tubes also offer the physician the ability to collapse either lung as needed for certain procedures. The size of laryngeal mask airway and endobronchial tubes is limited.

When an endotracheal tube is needed for pediatric use, the size limitations are even more restrictive. In pediatric patients, the size of the trachea is approximately the same size as the patient’s pinky finger. In pediatric patients, a single lumen endotracheal tube is advanced into the bronchus until breath sounds on the operative lung disappear. A fiberoptic bronchoscope may be passed along the endotracheal tube to confirm or guide placement of the endotracheal tube.

The larger lumen provided in a single lumen endotracheal tube affords the anesthesiologist access for other instrumentation through the lumen as required. The removal of mucus, the injection of medication, or the insertion of fiberoptic instrumentation for viewing within the endotracheal tube are examples of the additional instrumentation capability which is afforded by a single lumen tube.

For these and other reasons both prior art single and double lumen tubes are not fully satisfactory. There is a need for an endotracheal tube that can be inserted and quickly located in the correct position. There is also a need for an endotracheal tube that can be used to collapse one lung while ventilating the other lung. There is also a need for a single lumen endotracheal tube that can be used in pediatric patients. There is also a need for catheters that can be sealed at their distal ends.

Originally published here.