EXTENSION SET WITH A PATENCY INSTRUMENT
20210290906 · 2021-09-23
Inventors
- Jonathan Karl Burkholz (Salt Lake City, UT, US)
- Megan Scherich (Salt Lake City, UT, US)
- Yiping Ma (Layton, UT, US)
Cpc classification
A61B5/153
HUMAN NECESSITIES
A61M5/158
HUMAN NECESSITIES
A61B5/150992
HUMAN NECESSITIES
A61M2039/1077
HUMAN NECESSITIES
A61M25/0113
HUMAN NECESSITIES
A61M2025/0063
HUMAN NECESSITIES
International classification
Abstract
An extension set may include a tube, which may include a distal end, a proximal end, and an outer surface. The extension set may include a distal connector coupled to the distal end of the tube and/or a proximal connector coupled to the proximal end of the tube. The extension set may include a patency instrument disposed within the tube. The extension set may include a translation handle coupled to the outer surface of the tube. The translation handle may be configured to move along the outer surface of the tube between a proximal position and a distal position to translate the distal end of the patency instrument between a retracted position and an advanced position. In response to the distal end of the patency instrument being in the advanced position, the distal end of the patency instrument may extend beyond the distal end of the tube.
Claims
1. An extension set, comprising: a tube, comprising a distal end, a proximal end, a lumen extending between the distal end and the proximal end, and an outer surface; a distal connector coupled to the distal end of the tube; a proximal connector coupled to the proximal end of the tube; a patency instrument disposed within the tube; and a translation handle coupled to the outer surface of the tube, wherein the translation handle is configured to move along the outer surface of the tube between a proximal position and a distal position to translate the distal end of the patency instrument between a retracted position and an advanced position, wherein in response to the distal end of the patency instrument being in the advanced position, the distal end of the patency instrument extends beyond the distal end of the tube.
2. The extension set of claim 1, wherein the patency instrument comprises a coupler element disposed within the tube, wherein the patency instrument extends distally from the coupler element, wherein the translation handle compresses a portion of the tube in between the coupler element and the translation handle, wherein the portion of the tube engages the coupler element such that movement of the translation handle along the outer surface of the tube translates the coupler element within the tube and the distal end of the patency instrument is moved between the retracted position and the advanced position.
3. The extension set of claim 2, further comprising another tube, wherein the other tube is disposed within the tube and extends through the coupler element, wherein a space between the other tube and the tube is sealed such that fluid is prevented from entering the space, wherein the patency instrument extends through the space.
4. The extension set of claim 3, further comprising a seal adjacent the distal end of the tube, wherein the other tubing and the patency instrument extend through the seal, wherein a distal end of the space is sealed by the seal such that fluid is prevented from entering the space.
5. The extension set of claim 1, wherein the patency instrument comprises a guidewire.
6. The extension set of claim 1, wherein the translation handle comprises a plurality of ball bearings, a plurality of wheels, or a plurality of sliders to provide localized compression of the tube to engage the coupler element.
7. An extension set, comprising a tube, comprising a distal end, a proximal end, a lumen extending between the distal end and the proximal end, and an outer surface; a distal connector coupled to the distal end of the tube; a proximal connector coupled to the proximal end of the tube; a patency instrument disposed within the tube; a translation handle coupled to the outer surface of the tube, wherein the translation handle is configured to move along the outer surface of the tube between a proximal position and a distal position to translate the distal end of the patency instrument between a retracted position and an advanced position, wherein in response to the distal end of the patency instrument being in the advanced position, the distal end of the patency instrument extends beyond the distal end of the tube; and a fluid path disposed within a wall of the tube.
8. The extension set of claim 7, wherein the patency instrument comprises a coupler element disposed within the tube, wherein the patency instrument extends distally from the coupler element, wherein the translation handle compresses a portion of the tube in between the coupler element and the translation handle, wherein the portion of the tube engages the coupler element such that movement of the translation handle along the outer surface of the tube translates the coupler element within the tube and the distal end of the patency instrument is moved between the retracted position and the advanced position.
9. The extension set of claim 8, wherein the fluid path forms a protrusion into the lumen of the tube, wherein an outer surface of the coupler element comprises a groove aligned with the protrusion, wherein the groove extends through the coupler element.
10. The extension set of claim 8, wherein the lumen is sealed from the fluid path, wherein the patency instrument extends through the space.
11. The extension set of claim 10, further comprising a seal disposed adjacent the distal end of the tube, wherein the seal comprises a hole aligned with the fluid path, wherein the patency instrument extends through the seal, wherein the lumen is sealed from the fluid path by the seal.
12. The extension set of claim 7, wherein the patency instrument comprises a guidewire.
13. The extension set of claim 7, wherein the translation handle comprises a plurality of ball bearings or a plurality of wheels to provide localized compression of the tube to engage the coupler element.
14. The extension set of claim 7, wherein the extension set comprises a plurality of fluid paths disposed within the wall of the tube.
15. A method to provide access to a patient's vascular system, comprising: coupling an extension set to a catheter assembly, wherein the extension set comprises: a tube, comprising a distal end, a proximal end, a lumen extending between the distal end and the proximal end, and an outer surface; a distal connector coupled to the distal end of the tube; a proximal connector coupled to the proximal end of the tube; a patency instrument disposed within the tube; and a translation handle coupled to the outer surface of the tube, wherein the translation handle is configured to move along the outer surface of the tube between a proximal position and a distal position to translate the distal end of the patency instrument between a retracted position and an advanced position, wherein in response to the distal end of the patency instrument being in the advanced position, the distal end of the patency instrument extends beyond the distal end of the tube. wherein coupling the extension set to the catheter assembly comprises coupling the distal end of the tube to the catheter assembly; moving the translation handle along the tube from a proximal position to a distal position, wherein in response to the translation handle moving to the distal position, the distal end of the patency instrument extends beyond the distal end of the tube into the catheter assembly.
16. The method of claim 15, further comprising coupling a blood collection device to the proximal connector after moving the translation handle along the tube from a proximal position to a distal position.
17. The method of claim 16, further comprising after collecting blood within the blood collection device, moving the translation handle from the distal position to the proximal position, wherein in response to moving the translation handle from the distal position to the proximal position, the distal end of the patency instrument is retracted into the tube.
18. The method of claim 15, wherein the extension set further comprises a fluid path disposed within a wall of the tube.
19. The method of claim 15, wherein the patency instrument comprises a coupler element disposed within the tube, wherein the patency instrument extends distally from the coupler element, wherein the translation handle compresses a portion of the tube in between the coupler element and the translation handle, wherein the portion of the tube engages the coupler element such that movement of the translation handle along the outer surface of the tube translates the coupler element within the tube and the distal end of the patency instrument is moved between the retracted position and the advanced position.
20. The method of claim 19, wherein the patency instrument comprises a guidewire.
Description
BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWINGS
[0015] Example embodiments will be described and explained with additional specificity and detail through the use of the accompanying drawings in which:
[0016]
[0017]
[0018]
[0019]
[0020]
[0021]
[0022]
[0023]
[0024]
DETAILED DESCRIPTION
[0025] As used herein, the terms “proximal” and “distal” may refer to the direction closer to and away from, respectively, a clinician who would place the catheter system into contact with a patient. Thus, for example, the end of the catheter system first touching the body of the patient would be the distal end, while the opposite end of the catheter system would be the proximal end of the catheter system.
[0026] Referring now to
[0027] In some embodiments, the extension set 10 may include a distal connector 22 coupled to the distal end 14 of the tube 12. In some embodiments, the distal connector 22 may include a male luer connector, a female luer connector, a blunt cannula and opposing lever arms (as illustrated, for example in
[0028] In some embodiments, the extension set 10 may include a patency instrument 26 disposed within the tube 12. In some embodiments, the patency instrument 26 may include a guidewire or another suitable patency enhancing structure. In some embodiments, the guidewire may be generally constructed as a wire, a spring, a combination of a wire and a spring, and/or the like. In some embodiments, the extension set 10 may include a translation handle 28 coupled to the outer surface 20 of the tube 12.
[0029] In some embodiments, the translation handle 28 may include any suitable translation handle or grip and the patency instrument 27 may include any suitable patency instrument. The translation handle 28 and/or the patency instrument 27 may be described, for example, in further detail in U.S. patent application Ser. No. 17/127,588, filed Dec. 18, 2020, entitled “FLUSH PATENCY INSTRUMENT WITH BLOOD EXPOSURE PROTECTION AND RELATED METHODS” and U.S. patent application Ser. No. 17/127,623, filed Dec. 18, 2020, entitled “MULTI-LUMEN EXTENSION SYSTEM,” which are incorporated by reference in their entirety.
[0030] In some embodiments, the translation handle 28 may be configured to move along the outer surface 20 of the tube 12 between a proximal position and a distal position to translate a distal end 30 of the patency instrument 26 between a retracted position and an advanced position. In some embodiments, in response to the distal end 30 of the patency instrument 26 being in the advanced position, the distal end 30 of the patency instrument 26 may extend beyond the distal end 14 of the tube 12 and the distal connector 22.
[0031] In some embodiments, the patency instrument 26 extend from a coupler element 32 disposed within the tube 12. In some embodiments, a proximal end of the patency instrument 26 may be secured within the coupler element 32. In some embodiments, the patency instrument 26 may extend distally from the coupler element 32. In some embodiments, the patency instrument 26 may extend distally from the coupler element 32 to facilitate translating the patency instrument 26 within the tube 12 without requiring direct contact.
[0032] In some embodiments, the translation handle 28 may compress a portion of the tube 12 in between the coupler element 32 and the translation handle 28. In some embodiments, the portion of the tube 12 may engage the coupler element 32 such that movement of the translation handle 28 along the outer surface 20 of the tube 12 translates the coupler element 32 within the tube 12 and the distal end 30 of the patency instrument 26 is moved between the retracted position and the advanced position. In some embodiments, the translation handle 28 may include multiple features 34, which may include ball bearings, wheels, low-friction sliders, or other suitable features to provide localized compression of the tube to engage the coupler element. In some embodiments, the features 34 may be coupled to the translation handle 28. In some embodiments, the features 34 may be directly coupled to the translation handle 28. In some embodiments, the features 34 and the translation handle 28 may be molded together or monolithically formed as a single unit. In some embodiments, the features 34 and the translation handle 28 may be integrated or fitted together.
[0033] In some embodiments, the features 34 may include a pinch mechanism and may be positioned to pinch or press against the outer surface of the tube 12. In some embodiments, one or more of the features 34 may oppose or be on opposite sides of the tube 12 as one or more other of the features 34. In some embodiments, an interior surface of the tube 12 within the translation handle 28 may be too small to permit passage of the coupler element 32 therethrough. In some embodiments, the features 34 may include wheels, which may be rotatably coupled to the translation handle 28. In some embodiments, the features 34 may include the ball bearings, which may be rotatable within sockets formed in the translation handle 28. In some embodiments, the features 34 may include sliders, which may be slick and/or constructed of plastic, and which may slide along the tube 12. In some embodiments, the sliders may be stationary or static with respect to the translation handle.
[0034] In some embodiments, the translation handle 28 may extend partially (e.g. a c-channel) or entirely around the tube 12. In some embodiments, the translation handle 28 may include a collar. In some embodiments, the coupler element 32 may be magnetically attracted to the translation handle 28 through the tube 12 to facilitate movement of the patency instrument 26 without direct contact.
[0035] In some embodiments, the extension set 10 may include another tube 36. In some embodiments, the other tube 36 may include or correspond to any suitable housing that includes a lumen extending therethrough. In some embodiments, the other tube 36 may be disposed within the tube 12 and may extend through the coupler element 32. In some embodiments, a space 38 between the other tube 36 and the tube 12 may be sealed such that fluid is prevented from entering the space 38. In some embodiments, the other tube 36 may form a fluidic channel, while the space 38 may correspond to a non-fluidic channel. In some embodiments, the patency instrument 26 may extend through the space 38. In some embodiments, the space 38 may be part of the lumen 18 and/or annular.
[0036] In some embodiments, the extension set 10 may include a seal 40 adjacent the distal end 14 of the tube 12. In some embodiments, the seal 40 may be elastomeric. In some embodiments, the seal 40 may be disposed within the distal connector 22 and/or within the distal end 14 of the tube 12. In some embodiments, a distal end of the space 38 may be sealed by the seal 40 such that fluid is prevented from entering the space 38.
[0037] In some embodiments, the lumen 18, such as the space 38, may include venting to allow airflow into and out of the lumen 18, which may facilitate movement of the translation handle 28 and coupler element 32. In some embodiments, one or more vents to provide the venting may be reduced in size to allow air movement while still maintaining good aseptic protection of the patency instrument 26 and/or other portions of the extension set 10.
[0038] In some embodiments, the patency instrument 26 may be centered within the tube 12, which may facilitate smooth advancement of the patency instrument 26. In these and other embodiments, the other tube 36 may be off-center within the tube 12. In some embodiments, as the patency instrument 26 may be off-center within the tube 12 and/or the other tube 36 may be centered within the tube 12.
[0039] In some embodiments, an outer surface of the coupler element 32 and/or an inner surface of the tube 12 may include a lubricant to facilitate translation of the patency instrument 26 within the tube 12. In some embodiments, an outer surface of the tube 12 and/or the features 34 may include the lubricant. In some embodiments, one or more of the following: the coupler element 32, the tube 12, and the features 34, may be constructed from a lubricious material, such as, for example, PEG polyurethane, siliconized polyurethane, fluorinated polyurethane, silicone, or another suitable material to reduce friction.
[0040] In some embodiments, the tube 12 may be flexible. In some embodiments, the outer surface 20 of the tube 12 may include one or more visual markings or tactile elements (detents, grooves, ribs, or the like) to provide user feedback regarding a position of the patency instrument 26 with respect to the IV device. In some embodiments, an inner surface of the coupler element 32 and/or an outer surface of the other tube 36 may include the lubricant, which may facilitate movement of the coupler element 32 with respect to the other tube 36, which may be stationary. In some embodiments, a distal end and/or a proximal end of the other tube 36 may be secured within the extension set 10. In some embodiments, the proximal end of the other tube 36 may be wedged or secured within the proximal connector 24 such that blood cannot flow between the proximal connector 24 and the other tube 36 into the space 8.
[0041] Referring now to
[0042] Referring now to
[0043] Referring now to
[0044] In some embodiments, the tube 12 may be extruded via a co-extrusion process that includes a first material and a second material harder than the first material. In some embodiments, the first material may form a portion of the tube 12 that is pinched by features 34, and the second material may form another portion of the tube 12 proximate and/or forming the fluid paths 44. In some embodiments, the first material and the portion of the tube 12 may be soft or flexible. In some embodiments, the fluid paths 44 may be created by a multi-lumen extrusion process or may be created as a separate extruded tube that is encompassed within an inner diameter of the tube 12 of the larger non-fluid path extension tubing. In some embodiments, the separate extruded tube may be concentrically aligned or offset from the axis of the tube 12. Alternatively, in some embodiments, the fluid paths 44 could extend from another component of the extension set 42, such as a particular connector or cannula. In some embodiments, a volume of the lumen 18 may be greater than a volume of each of the fluid paths 44, which may accommodate the coupler element 32.
[0045] Referring now to
[0046] In some embodiments, a method to provide access to a patient's vascular system may include coupling an extension set (such as, for example, the extension set 10 discussed with respect to
[0047] In some embodiments, coupling the extension set to the catheter assembly may include coupling the distal end 14 of the tube 12 to the catheter assembly. In some embodiments, the method may include moving the translation handle 28 along the tube 12 from the proximal position to the distal position. In some embodiments, in response to the translation handle 28 moving to the distal position, the distal end 30 of the patency instrument 26 may extend beyond the distal end 14 of the tube 12 into the catheter assembly and/or vasculature of the patient. In these embodiments, the patency instrument 26 may extend beyond a distal end of a catheter of the catheter assembly. In some embodiments, the catheter may include a peripheral IV catheter, a peripherally-inserted central catheter, or a midline catheter.
[0048] In some embodiments, the method may include coupling a blood collection device to the proximal connector 24 after moving the translation handle 28 along the tube 12 from the proximal position to the distal position. In some embodiments, the blood collection device may include any suitable blood collection device, such as, for example, a VACUTAINER® or a VACUTAINER® LUER-LOK™, available from Becton Dickinson and Company of Franklin Lakes, N.J., a syringe, or a point of care acquisition device. In some embodiments, the blood collection device may be integrated with or monolithically formed as a single unit with the proximal connector 24.
[0049] In some embodiments, the method may include after collecting blood within the blood collection device, moving the translation handle 28 from the distal position to the proximal position. In some embodiments, in response to moving the translation handle 28 from the distal position to the proximal position, the distal end 30 of the patency instrument 26 may be retracted into the tube.
[0050] In some embodiments, the extension set may reduce hemolysis of a blood sample collected via the fluid path, which may include the other tube 36 (discussed for example, with respect to
in which ΔP is the pressure drop along a path with a length of L and an interior radius of r. k is shrinkage index.
[0051] To fill a certain volume of collection tube, V, with a flow rate of Q, the time needed can be simply assessed by:
in which μ is the dynamic viscosity of the fluid. Hemolysis is typically associated with both the wall shear stress and the time a blood cell is exposed to wall shear stress. From literature, it has been widely considered that hemolysis index can be approached as a function of:
HI (%)=A*t.sup.α*T.sup.β
in which A, α, and β are coefficients.
[0052] In principle, the hemolysis index is related to pressure gradient and cross-sectional characteristic dimension:
[0053] In some embodiments, a length of the other tube 36 and/or the fluid paths 44 may be selected based on one or more of the following: a gauge of a particular catheter, a particular catheter assembly configuration, or a clinical setup. In some embodiments, the patency instrument 110 may include a length L. In some embodiments, the other tube 36 and/or the fluid paths 44 may include an inner diameter D.
[0054] Fluid flow in a fluid pathway (such as the that of the other tube 36 and/or the fluid paths 44) can be analyzed using Poiseuille's equation when the fluid pathway is tubular:
where ΔP is a change in pressure gradient across the length of the fluid pathway, D and L are the inner diameter and length, respectively, of the fluid pathway, μ is the viscosity of a fluid, and
is the fluid resistance. Since μ is the viscosity of the fluid and not part of the extension tube geometry, a geometric factor G.sub.f is defined such that R.sub.f (the fluid resistance) is
where
[0055] In some embodiments, the fluid pathway may have multiple sections with lengths (L1, L2, L3) and inner diameters of (D1, D2, D3), the geometric factor is then:
In some embodiments, the fluid pathway may have an inner diameter that changes over the length of the fluid pathway, the geometric factor is then:
In some embodiments, the fluid pathway may have a cross section that is not circular or may have a complicated inner diameter profile. The geometric factor can then be determined by measuring the flow rate (Q) at given pressure (ΔP) with known viscosity (μ) fluid:
[0056] The G.sub.f value of the fluid pathway may be selected to reduce the maximum shear stress for each catheter gauge to be the same or less than the max shear stress of a BD 21G VACUTAINER® UltraTouch™ push button blood collection set (available from Becton, Dickinson & Company of Franklin Lakes, N.J.), which was previously considered the gold standard for blood draws. In some embodiments, G.sub.f value of the fluid pathway may be selected to reduce the maximum shear stress for each catheter gauge to be the same or less than the max shear stress of a BD 25G VACUTAINER® UltraTouch™ push button blood collection set (available from Becton, Dickinson & Company of Franklin Lakes, N.J.).
[0057] In some embodiments, an extended fluid pathway of a blood collection system, which may include one or more of the blood collection device, the other tube 36 and/or the fluid paths 44, and the catheter assembly (which may include an extension tube), may include an entirety of a blood collection pathway through which blood flows after leaving the vasculature and into or through the blood collection device during blood collection. The system geometric factor G.sub.fs for the extended fluid pathway of the blood collection system can be determined in similar fashion as for the fluid pathway (such as the that of the other tube 36 and/or the fluid paths 44) described earlier. In some embodiments, the system geometric factor G.sub.fs may be equal to or more than 7.34E+06 (1/in.sup.3) when the translation handle 28 is in the distal position. In some embodiments, G.sub.fs may include another value. In some embodiments, the system geometric factor G.sub.fs may be 7.34E+06 (1/in.sup.3) plus or minus 10 percent, plus or minus 25 percent, plus or minus 50 percent, or plus or minus 75 percent. In some embodiments, G.sub.fs may include another value, which may be selected based on a gauge and/or length of the catheter.
[0058] All examples and conditional language recited herein are intended for pedagogical objects to aid the reader in understanding the invention and the concepts contributed by the inventor to furthering the art, and are to be construed as being without limitation to such specifically recited examples and conditions. Although embodiments of the present disclosure have been described in detail, it should be understood that the various changes, substitutions, and alterations could be made hereto without departing from the spirit and scope of the disclosed embodiments.