AORTIC CATHETER

Abstract

The invention relates to an aortic catheter (1) for insertion into the aorta (A), having a flexible tube (2), two occlusion balloons (3, 4), which are spaced part from one another and each of which is connected to a supply line (5, 6) for supplying a pumping medium (7) for inflating the occlusion balloons (3, 4), having at least one opening (8) arranged between the occlusion balloons (3, 4) in the tube (2) for supplying a cooling medium (9), which at least one opening (8) is connected to a first cooling medium supply line (10) running in the tube (2), and also relates to a resuscitation set (22) with such an aortic catheter (1), and a distal port (13) for supplying a cooling medium (9) in the direction of cerebral vessels is disposed in the tube (2), which distal port (13) is connected to a second cooling medium supply line (14) running in the tube (2).

Claims

1. An aortic catheter for insertion into the aorta (A), comprising: a flexible tube, two occlusion balloons spaced a distance apart from one another, each connected to a supply line for supplying a pumping medium for inflating the occlusion balloons and the flexible tube having at least one opening arranged between the occlusion balloons for supplying a cooling medium, the at least one opening being connected to a first cooling medium supply line running in the tube, wherein an intra-aortic balloon pump, which is arranged between the occlusion balloons, is connected to another supply line, and a distal port for supplying a cooling medium in direction of an cerebral vessels, is arranged in the tube, said distal port being connected to a second cooling medium supply line running in the tube.

2. The aortic catheter according to claim 1, wherein a ratio of a cross-section of the first cooling medium supply line to a cross-section of the second cooling medium supply line is between 1:1.75 and 1:2.25.

3. The aortic catheter according to claim 1, wherein multiple openings are arranged in the tube between the occlusion balloons, said openings having a diameter between 1 mm and 2 mm.

4. The aortic catheter according to claim 1, wherein the two occlusion balloons are arranged at a distance of 20 cm to 30 cm from one another.

5. The aortic catheter according to claim 1, wherein the tube has an outside diameter of 5 mm to 10 mm between the occlusion balloons.

6. The aortic catheter according to claim 1, wherein a lumen connected to a distal opening for inserting instruments is arranged in the tube.

7. The aortic catheter according to claim 1, wherein a cooling device which is provided in the intra-aortic balloon pump is connected to a coolant supply and a coolant drain line.

8. The aortic catheter according to claim 1, wherein at least one temperature sensor is provided.

9. The aortic catheter according to claim 8, wherein said at least one temperature sensor is arranged on a distal end of the tube.

10. The aortic catheter according to claim 1, wherein markers made of a radiopaque material are arranged on the tube.

11. The aortic catheter according to claim 1, wherein the cooling medium is formed by a crystalloid solution.

12. The aortic catheter according to claim 1, wherein the pumping medium is formed by helium.

13. A resuscitation set comprising: an aortic catheter according to claim 1, a tank for the cooling medium, a pump for pumping the cooling medium into the cooling medium supply lines and, optionally, a cooling medium supply of the aortic catheter, a pump for operating the intra-aortic balloon pump, and a heart monitor, wherein a control unit is provided which is connected to the heart monitor and the pump for pumping the cooling medium and to the pump for operating the intra-aortic balloon pump.

14. The resuscitation set according to claim 13, wherein the components are arranged in a carrying case.

15. The resuscitation set according to claim 14, wherein the carrying case has wheels and a handlebar.

16. The resuscitation set according to claim 14, wherein the carrying case has carrying straps.

17. The resuscitation set according to claims 13, wherein a defibrillator is provided.

18. The resuscitation set according to claims 13, wherein a cardiac catheter is provided.

19. The resuscitation set according to claims 13, wherein the control unit has an input for connecting a temperature sensor.

20. The resuscitation set according to claims 13, wherein the control unit has an input/output unit.

21. The aortic catheter according to claim 2, wherein the ratio of the cross-section of the first cooling medium supply line to the cross-section of the second cooling medium supply line is between 1:2.

Description

[0029] The invention will now be described in greater detail on the basis of the accompanying drawings, in which:

[0030] FIG. 1 shows a basic diagram of the aortic catheter according to the invention;

[0031] FIG. 2 shows a partial sectional diagram of a resuscitation set according to the present invention;

[0032] FIG. 3 shows a side view of a resuscitation set; and

[0033] FIG. 4 shows another basic diagram of a resuscitation set being used on a patient.

[0034] FIG. 1 shows a basic diagram of an aortic catheter according to the invention 1, which is situated in a patient's aorta A. The aortic catheter 1 comprises a flexible tube 2 and a distal occlusion balloon 3 as well as a proximal occlusion balloon 4, which are arranged at a distance d of preferably 20 cm to 30 cm from one another. The total length 1 of the aortic catheter 1 is between 50 cm and 60 cm to permit use in adult patients. The diameter D of the tube 2 is preferably 5 mm to 10 mm between the occlusion balloons 3, 4. The occlusion balloon 3 is supplied with a corresponding pumping medium 7, for example, helium, through a supply line 5, and the proximal occlusion balloon 4 is supplied with the pumping medium 7 through a supply line 6, and closure of the aorta A is induced after the aortic catheter 1 has been positioned. Openings 8 for supplying a cooling medium 9 are arranged between the occlusion balloons 3, 4 in the tube 2 of the aortic catheter 1. The openings 8 in the tube are connected to a first cooling medium supply line 10. In addition, an intra-aortic balloon pump 11 with a supply line 12 is arranged between the occlusion balloons 3, 4. The patient's circulation can be maintained with the assistance of a heart-lung machine (not shown) by way of the intra-aortic balloon pump 11. In addition, a distal port 13 is arranged on the distal end of the aortic catheter 1 and is connected to a second cooling medium supply line 14, through which the cooling medium 9 can be introduced. This cooling medium is injected through the aortic catheter 1 into the patient's brain, where it induces hypothermia. To be able to introduce most of the cooling medium through the distal port 13, whereas only approximately 30% of the cooling medium 9 is introduced through the openings 8, the ratio of the cross-section of the first cooling medium supply line 10 to the cross-section of the second cooling medium supply line 14 is between 1:1.75 and 1:2.25, in particular 1:2. The cerebral regions of the patient are thus supplied with more cooling medium 9 than are the internal organs or the spinal cord. The first cooling medium supply line 10 and the second cooling medium supply line 14 can also be realized by a shared cooling medium supply (not shown), wherein the quantitative division of the cooling medium 9 can be adjusted through the size of the distal port 13 and the openings 8. Instruments such as a cardiac catheter can be inserted through an additional lumen 16, which extends from the proximal end to the distal end of the aortic catheter 1 if a suitably tight introducer sheath is arranged in the lumen 16. The second cooling medium supply line 14, which is connected to the distal port 13, may of course also be used with a corresponding introducer sheath for introducing instruments. A maintenance cooling can be achieved with a heart-lung machine during the treatment of the patient by means of a cooling device 17 in the intra-aortic balloon pump 11, which is connected to a coolant supply line 18 and a coolant drain line 19. The cooling device 17 acts as a heat exchanger and delivers the cold of the cooling medium to the circulating blood and thus increases the patient's chances of survival by inducing hypothermia. A temperature sensor 20 may preferably be provided at the distal end of the aortic catheter 1 to detect the patient's core temperature. Corresponding markers 21 of radiopaque material can indicate the correct position of the aortic catheter 1 under an X-ray device.

[0035] The aortic catheter 1 according to the invention serves as a so-called flush catheter for invasive induction of hypothermia, while also serving as a bypass catheter for maintaining pulmonary function and as an intra-aortic balloon pump 11 for use in combination with a heart-lung machine, permitting a cardiac catheter examination or the like and endovascular cooling by means of the cooling device 17 in the intra-aortic balloon pump 11. Such a multifunction catheter can serve to substantially increase the chance of survival of a cardiac arrest patient.

[0036] FIG. 2 shows one possible embodiment of a resuscitation set 22 which has an aortic catheter 1, which was described above with reference to FIG. 1, a tank 23 for the cooling medium 9, a pump 24 for pumping the cooling medium 9 into the cooling medium supply lines 10, 14 and the cooling medium supply 19 of the aortic catheter 1 as well as a pump 25 for operating the intra-aortic balloon pump 11 and a container 37 for the pumping medium 7 for pumping up the occlusion balloons 3, 4. In addition, a heart monitor 26 is provided and may also be combined with a defibrillator 32. A control unit 27 controls the corresponding components, such as the pump 24, for pumping the cooling medium 8, the pump 25 for operating the intra-aortic balloon pump 11, etc. The components of the resuscitation set 22 are preferably arranged in a carrying case 28 or the like, which has wheels 29 and a handlebar 30 for facilitating easy transport. In addition, the carrying case 28 may also have carrying straps 31 or the like. An external temperature sensor 35 may be provided, for example, in a respiration tube (not shown) by means of an input 34 on the control unit 27. An input/output unit 36 is preferably provided for operating the control unit 27.

[0037] FIG. 4 shows a basic diagram of use of the resuscitation set on a patient, wherein the aortic catheter 1 was positioned by means of the femoral artery and connected by means of corresponding lines, which are in the carrying case 28 of the resuscitation set 22. Hypothermia can be induced rapidly through the aortic catheter 1 and a significant increase in the patient's chance of survival can be achieved in this way. Cardiac activity is determined by means of suitable electrodes 38, which are connected to the heart monitor 26, with the signals being forwarded to the control unit 27.