MEDICAL DRAINAGE DEVICE AND USES THEREOF
20210322735 · 2021-10-21
Inventors
- Stephanie Goldberg (Richmond, VA, US)
- Jonathan H. DeAntonio (Henrico, VA, US)
- Hilton Bennett (Richmond, VA, US)
Cpc classification
A61M2027/004
HUMAN NECESSITIES
A61M27/00
HUMAN NECESSITIES
A61M1/87
HUMAN NECESSITIES
A61M2025/0056
HUMAN NECESSITIES
A61M27/002
HUMAN NECESSITIES
A61M2025/0233
HUMAN NECESSITIES
International classification
Abstract
A medical drainage device for draining air or fluid from a body cavity is described for its use in treating a subject suffering from pneumothorax and/or pleural effusion. The device comprises a tube or a catheter-over-needle for receiving air or fluid from the body cavity and one or more fixation systems for preventing inadvertent dislodging of the needle and/or catheter during the draining procedure. A woven semi-flexible catheter coated with antithrombic agents is used for reducing kinks and clogs. The device may be used for draining air and/or fluid from a plurality of types of body cavities and is particularly suitable for uses in military and/or emergency settings.
Claims
1. A medical drainage device comprising: i) an elongated wire-lined or woven catheter having a proximal end and a distal end; ii) a puncturing system at the distal end of the catheter for penetrating a body cavity, wherein the puncturing system comprises an outer cannula with a beveled tip and an inner cannula with a blunt tip, wherein the inner cannula is extendable and retractable; and iii) one or more fixation systems attached to an outer surface of the catheter, wherein the one or more fixation systems are an appropriate size for stabilizing and halting movement of the device during a drainage procedure upon insertion of the catheter in the body cavity.
2. The drainage device of claim 1, wherein the catheter has a length of 10-18 cm.
3. The drainage device of claim 1, wherein the puncturing system has a length of 8-22 cm.
4. The drainage device of claim 1, wherein the one or more removable fixation systems are selected from the group consisting of flanges, balloons, foams, stickers, blocks, bumpers, tubes, rubber liners, and any combinations thereof.
5. The drainage device of claim 4, wherein the one or more fixation systems are one or more inflatable balloons.
6. The drainage device of claim 5, wherein the one or more inflatable balloons are inflatable with air, liquid or granular media.
7. The drainage device of claim 5, wherein the one or more inflatable balloons are inflatable to a diameter that is equal to or greater than a maximum diameter of the catheter.
8. The drainage device of claim 5, wherein the one or more inflatable balloons have a diameter of about 0.5-2.5 cm when inflated.
9. The drainage device of claim 5, wherein the one or more fixation systems further comprise one or more movable bumpers encircling a proximal portion of the catheter.
10. The drainage device of claim 5, wherein the one or more inflatable balloons are connected to and configured to be inflated by one or more inflation channels that extend along the longitudinal axis of the catheter.
11. The drainage device of claim 10, wherein the one or more inflation channels are arranged on an outer surface of the catheter.
12. The drainage device of claim 10, wherein the one or more inflation channels are arranged on an inner surface of the catheter.
13. The drainage device of claim 10, further comprising a clip for attaching the one or more inflation channels to the catheter.
14. The drainage device of claim 1, further comprising one or more one-way valves at the proximal end of the catheter.
15. The drainage device of claim 1, further comprising a pump, a syringe, an inflator bulb or an aspirator that is fluidly connected to the catheter to draw or drain the air or fluid from the body cavity.
16. The drainage device of claim 1, wherein the catheter further comprises antifibrinolytic, antithrombotic, anticoagulant, antibiotic or antiviral agents or any combinations thereof coating an inner surface of the catheter.
17. The drainage device of claim 1, wherein the device further comprises one or more luer-lock adapters at the proximal end of the catheter.
18. The drainage device of claim 1, further comprising 3-5 asymmetric holes on the distal end of the catheter for air release.
19. The drainage device of claim 1, further comprising a sensor for measuring and displaying a pressure in the body cavity.
20. A method for removing air or fluid from a body cavity comprising: draining air or fluid from a subject in need thereof using the device as claimed in claim 5 by i) inserting the catheter and at least one of the one or more inflatable balloons into the body cavity of the subject; ii) inflating the one or more balloons to a size sufficient to hold the inserted catheter in place; iii) draining out air or fluid from the body cavity through the catheter; iv) deflating the at least one of the one or more balloons that are inside the body; and v) removing the catheter and the deflated balloons as a single unit.
21. The method of claim 20, wherein at least one of the one or more balloons are inflated outside the body of the subject.
22. The method of claim 21, wherein the at least one or more balloons outside the body of the subject are inflated after the one or more balloons are inflated inside the body of the subject.
23. The method of claim 20, further comprising a step of sliding a bumper outside of the body cavity towards the distal end of the catheter after insertion to secure the catheter in place.
24. A method for treating a pneumothorax comprising: draining air or fluid from a subject in need thereof by i) inserting a needle and a catheter as a single unit through a chest wall of the subject so that a tip of the needle extends into the pleural cavity of the subject; ii) inflating one or more balloons attached to a surface of the catheter to an appropriate size, wherein the size of the inflated balloon is sufficient to fix the catheter in position; iii) retracting the needle with a retractable needle system and/or removing the needle; iv) draining out the air or fluid from the pleural cavity through the catheter; v) deflating the one or more balloons; and vi) removing the catheter and the deflated balloons as a single unit.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
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DETAILED DESCRIPTION
[0023] Embodiments of the disclosure provide a medical drainage device for use in draining air or fluid from a body cavity of a subject in need thereof. In particular, the disclosure provides a mechanism that allows stabilizing the device during a drainage procedure. In some preferred embodiments, the device comprises one or more inflatable balloons as a fixation mechanism to overcome and to substantially alleviate the deficiencies in the prior art by providing a method to rapidly perform air or fluid removal from a body cavity with a minimally invasive approach. The device is portable, disposable, simple to use and can be packaged as a preassembled and/or constructible kit so that the device may be used not only in hospitals and clinics, but also may be appropriate for outdoor, emergency or military uses.
[0024] A medical drainage device, in some embodiments, comprises a plurality of types of tubes, in which the term “tube” is defined herein as a hollow, cylindrically shaped material or combinations of such materials forming a portion of the device. The tube has a proximal end (distant from the body cavity) and a distal end (toward the body cavity) that opens to accept and transfer air and fluid from the body cavity. The tube may be a catheter, a needle, a hose, a pipe, a conduit, a main, a duct, a line, a channel, a pipeline, a drain, a siphon, a cannula or any hollow cylindrical shaped object.
[0025] With reference to
[0026] In some embodiments, the catheter 11 is made of a material or in combinations of materials that create reasonable flexibility, such as polymeric, polycarbonate, olyvinyl chloride, poly esters, polyethylenes, polyamides, silicone and polyisoprenes, metals and ceramics. Other non-limiting polymer classes that may be suitable for formation of the catheter include Styrene Butadiene Styrene (SBS) polymers such as Kraton®, Dynaflex® and Santoprene®, Vinyl compounds, silicone rubber materials such as poly-dimethylsiloxane, thermoplastic polyester elastomers (TPEs), and polyether block amides such as Pebax®. In some preferred embodiments, a woven catheter is used to lessen the risk of clogging and/or kinking in the device during the drainage procedure. In some embodiments, the catheter is a non-kinking catheter. For example, the catheter may comprise a combination of a woven material and a wire lining material. In some embodiments, the catheter comprises a semi-rigid cavity or body, in line or parallel with the catheter's access hole. In catheters having multiple holes, one or more of the holes (including the central access hole) may be formed from or filled with a semi-rigid material while the remaining portions of the catheter are more flexible. In some embodiments, each of the cathether holes are formed from or filled with a semi-rigid material or wire.
[0027] The proximal portion of the catheter may include a luer lock 16, syringe adaptor or any adaptor that may be suitable for connecting various additional appliances (e.g., pump, aspirator, syringe, bulb, etc.). In some embodiments, one or more one-way valves 17 may be incorporated into the catheter, preferably on a proximal portion of the catheter. The one-way valve comprises an inlet end that opens for receiving air or fluid to be drained and an outlet end that is in a normally closed position and is adaptable to partial opening to permit drainage of the material received from the inlet. Exemplary one-way valve in a medical device is described in U.S. Pat. No. 7,533,696 to Paul, Jr., herein incorporated by reference.
[0028] In some embodiments, a fixation system is attached to an outer wall of the catheter. A preferred fixation system, in some embodiments, is one or more balloons. As shown in
[0029] In other embodiments, inflation and deflation of balloon are controlled through an inflator channel 18 that is connected to each balloon and embedded along a partial or full longitudinal length of the inner wall of the catheter 11. When multiple balloons are present in the device, the volume of each balloon may be controlled separately. A controlled volume inflation-deflation device may also be attached with increments of controlled, selected, and/or equal volumes of air to control the outer diameter of the one or more balloons to predetermined or adjusted outer diameters. The outer diameter of the balloon may be controlled by inflating and deflating with selected or controlled volumes of relatively incompressible liquids and solutions, which may vary depending on the intended usage. The balloon inflation channel 18 and the channel port 19 are partially or completely housed within the inner lumen or embedded in the wall of the catheter. However, there is no communication between the drainage lumen and balloon inflation channel. In some embodiments, one or more inflation channels may be used. In these embodiments, each inflating channel has a port at a proximal portion of the catheter. The inflation port 19 may be positioned just below the luer lock 16 to allow majority of the catheter to insert into the chest of a subject. An exemplary balloon inflation system may include a syringe or a bulb, a volume of balloon inflation fluid such as sterile saline or air and a valve or a stopcock. When in deflated state, the balloon 12 is sized and configured to fit snugly and lie flat around the catheter 11. One or more sliding bumpers 20, for the purpose of preventing the inflated balloon 12 to distally slide on the catheter, may also be included in the device. The bumper 20, in these embodiments, is placed around the outer surface of the catheter 11. In some embodiments, the inner portion of the bumper 20 is lined with materials that are slide-resistant (e.g., rubber) that fits snugly around the outer wall of the catheter 11. After inserting the catheter into a body cavity, the later inflated balloon may be held against the surface of the subject's internal body wall while the exterior wall surface may be flush with an additional fixation system, in this case, bumper 20. By clamping the device onto the subject's body with two or more fixation systems, the device will remain stable throughout the draining procedure. In some embodiments, the position of bumper 20 is easily adjustable by frictionally engaging or sliding the bumper on catheter. In some embodiments, a balloon is to be inflated outside the subject's body as a means to stabilize the inserted catheter. In these embodiments, bumper 20 is moved to a position so that the bumper is flush with the inflated balloon 12 and thus supporting and fixating the device in place. Unlimited numbers of balloons and bumpers may be used to secure the inserted tube (i.e., catheter) against the skin so that the device is stabilized and immobile during the procedure. In most preferred embodiments, the balloon is larger than the incision or insertion hole. The inflated balloon has a diameter of about 0.5-4 cm, preferably 0.8-3 cm, more preferably 1-2.5 cm. In some embodiments, the balloon may have a size smaller than the incision site especially when one or more balloons are used in combination. In this instance, the one or more balloons together have a size larger than the incision or insertion hole when inflated.
[0030] As shown in
[0031] With reference to
[0032] With reference to
[0033] With reference to
[0034] In some embodiments, as shown in
[0035] With reference to
[0036] Preferably, the needle or tube of the device is connected as a single unit and the majority of the catheter, for example at least ½ of the length, more preferably ⅔ of the length, is inserted into the body of a subject. In some embodiments, the inflating channel may be attached to the outer wall of the catheter and thus a portion of the channel also enters the body. The time period for use of the drainage device can vary from minutes to hours to days, e.g., from 12 hours up to or even exceeding 30 days. The desired time period for use of the drainage device will vary based on the nature of the disease, the medical professional's recommendations, the heating rate of the patient, etc. There is no time limit beyond which use of the medical drainage device is no longer beneficial.
[0037] In preferred embodiments, a device of the disclosure is used in a method for treating pneumothorax by draining air or fluid from a subject using the device by following the steps comprising: i) cleaning or sanitizing a chest skin of the subject prior to a needle insertion ii) inserting a needle through a chest wall so that the needle tip extends into a pleural cavity of the subject; iii) inflating one or more balloons of the device to an appropriate size, wherein the size of the inflated balloon is sufficient to place the inserted needle and the attached catheter in a fixed position; iv) retracting the needle by activating a retractive needle system; v) opening one or more one-way valves to operation position vi) draining out the air from the pleural cavity through the catheter for an appropriate amount of time; vii) deflating the balloons; and viii) removing the catheter. In some embodiments, the incision may be made with appropriately preparing and anesthetizing a subject. The size of the incision will be determined depending on the volume of the drained materials as well as the diameter of the catheter used. In addition, some embodiments, one or more balloons may be fixated on the distal end of the catheter. In other embodiments, the balloons may be replaced with adhesives or any other forms of securing measures of the device (e.g., foam, block, bumpers, etc.). Any other forms of securing methods including flange, balloon, balloon and bumper and/or a series of small balloons to help maintain the catheter in the chest wall are used. In some embodiments, the device will be placed in same anatomical position as for a needle decompression thoracostomy (i.e., between 2.sup.nd and 3.sup.rd intercoastal spaces, above the rib). The catheter and stylet-type needle are held perpendicular to the skin and with steady and deliberate pressure, the combined catheter and stylet as a single unit may be inserted into the skin, through the chest way and into pleural space. In some embodiments, the needle “click pen” retractile component may be included and the protective center of the needle will re-extend once in the pleural space with an audible click. The practitioner will note the measured depth of the catheter at this time and the stylet is removed. The catheter is generally inserted approximately 0.5-5 cm, preferably 1-4.5 cm, more preferably 2-4 cm more.
[0038] All or some of the components of the device is made portable, small enough for a medical use outside of the hospital or clinical settings. Although the device itself does not require a pump assembly, however, it may be assembled with a pump or any other devices known in the art that are portable and suitable for assisting drainage of air or fluid material from body cavity. In some embodiments, portions or entirety of the device may be disposable in order to limit either possible infections or contaminations. Alternatively, some portions of the device may be kept for limited multiple uses if some single-use parts are appropriately attached and disposed after each use. Depending on the use of the device, different sensors or diagnostic accessories (e.g., air flow sensor, diagnostic probe, etc.) known in the art may be attached to the device, for example, via tubing. Additionally, the device may include a pressure sensor, a microcontroller, a screen or the like that displays the changes of pressure in the cavity (e.g., before and after restabilization of pressure in the cavity). For example, the attached sensor or screen may be placed in line with the catheter via a plurality of types of arrangements, such as “T” or “Y” configurations. In some embodiments, the device includes an audio, haptic or visual response in relation to stabilization or destabilization of the pleural cavity and/or an in between condition such as a “yellow light” visual response. The response may be displayed on a screen and/or processed through an attached circuit board. In preferred embodiments, a device of this disclosure may be used for traumatic and spontaneous pneumothorax, in particular, during field decompression of pneumothorax by EMS or military medics and/or decompression by providers not comfortable or appropriate trained to place tube thoracostomies (i.e., chest tube). In some embodiments, the method further comprises a step of making clinical diagnosis by appropriate medical professionals observing mechanism of injury, respiratory distress, hypoxia, absent breath sounds, and hypotension. The device may also be used in non-emergency settings for the treatment of spontaneous pneumothorax as a less invasive measure than a chest tube placement.
[0039] It is to be understood that this invention is not limited to particular embodiments described, as such may, of course, vary. It is also to be understood that the terminology used herein is for the purpose of describing particular embodiments only, and is not intended to be limiting, since the scope of the present invention will be limited only by the appended claims.
[0040] Where a range of values is provided it is understood that each intervening value, to the tenth of the unit of the lower limit unless the context clearly dictates otherwise, between the upper and lower limit of that range and any other stated or intervening value in that state range, is encompassed within the invention. The upper and lower limits of these smaller ranges may independently be included in the smaller ranges and are also encompassed within the invention, subject to any specifically excluded limit in the stated range. Where the stated range includes one or both of the limits, ranges excluding either or both of those included limits are also included in the invention.
[0041] It is noted that, as used herein and in the appended claims, the singular forms “a”, “an”, and “the” include plural referents unless the context clearly dictates otherwise. It is further noted that the claims may be drafted to exclude any optional element. As such, this statement is intended to serve as antecedent basis for use of such exclusive terminology as “solely”, “only” and the like in connection with the recitation of claim elements, or use of a “negative” limitation.
[0042] As will be apparent to those of skill in the art upon reading this disclosure, each of the individual embodiments described and illustrated herein has discrete components and features which may be readily separated from or combined with the features of any of the other several embodiments without departing from the scope or spirit of the present invention. Any recited method can be carried out in the order of events recited or in any other order which is logically possible.
[0043] While the invention has been described in terms of its preferred embodiments, those skilled in the art will recognize that the invention can be practiced with modification within the spirit and scope of the appended claims. Accordingly, the present invention should not be limited to the embodiments as described above, but should further include all modifications and equivalents thereof within the spirit and scope of the description provided herein.