Catheter assembly with osmolality-increasing fluid
09801979 · 2017-10-31
Assignee
Inventors
Cpc classification
A61M25/002
HUMAN NECESSITIES
A61M25/0017
HUMAN NECESSITIES
A61L29/14
HUMAN NECESSITIES
International classification
A61M27/00
HUMAN NECESSITIES
A61L29/14
HUMAN NECESSITIES
Abstract
A catheter assembly includes a hydrophilic catheter; a wetting fluid for wetting of the catheter; and a receptacle enclosing at least the insertable part of the catheter and the wetting fluid. The wetting fluid is a solution incorporating at least one osmolality-increasing compound, and the total concentration of the osmolality-increasing compound(s) preferably exceeds 600 mOsm/dm.sup.3. The wetting fluid could either be arranged in contact with the hydrophilic surface layer of the catheter in the receptacle, for preservation of the hydrophilic surface layer in a wetted state during accommodation in said receptacle and provision of a ready-to-use catheter assembly, or be arranged to keep the wetting fluid separated from the hydrophilic surface layer of the catheter during storage, but to be brought into contact with said hydrophilic surface layer upon activation before an intended use of the catheter.
Claims
1. A urinary catheter assembly for human use, comprising: wetting fluid; a catheter having on its surface, on at least an insertable part thereof, a hydrophilic surface layer providing low-friction surface character of the catheter by treatment with said wetting fluid; and a receptacle enclosing at least the insertable part of the catheter, wherein the wetting fluid is arranged in wetting contact with the hydrophilic surface layer of the catheter in the receptacle, for preservation of the hydrophilic surface layer in a wetted state during accommodation in said receptacle and provision of a ready-to-use catheter assembly; wherein the wetting fluid comprises at least one dissolved osmolality-increasing compound, wherein the total concentration of the dissolved osmolality-increasing compound(s) exceeds 600 mOsm/dm.sup.3.
2. The urinary catheter assembly as claimed in claim 1, wherein the total concentration of the osmolality-increasing compound(s) in the wetting fluid exceeds 700 mOsm/dm.sup.3.
3. The urinary catheter assembly as claimed in claim 2, wherein the total concentration of the osmolality-increasing compound(s) in the wetting fluid exceeds 800 mOsm/dm.sup.3.
4. The urinary catheter assembly as claimed in claim 1, wherein the total concentration of the osmolality-increasing compound(s) in the wetting fluid is in the range of 850 to 950 mOsm/dm.sup.3.
5. The urinary catheter assembly as claimed in claim 4, wherein the total concentration of the osmolality-increasing compound(s) in the wetting fluid is about 900 mOsm/dm.sup.3.
6. The urinary catheter assembly as claimed in claim 1, wherein the total concentration of the osmolality-increasing compound(s) in the wetting fluid is less than 1500 mOsm/dm.sup.3.
7. The urinary catheter assembly as claimed in claim 1, wherein said osmolality-increasing compound(s) is/are selected from the group consisting of urea, amino acids, mono and disaccharides, sugar alcohols, and non-toxic organic and inorganic salts or acids, polypeptides and mixtures thereof.
8. The urinary catheter assembly as claimed in claim 7, wherein said osmolality-increasing compound(s) is/are selected from the group consisting of glucose, sorbitol, sodium chloride, sodium citrate, sodium benzoate, calcium chloride, potassium chloride, potassium iodide and potassium nitrate.
9. The urinary catheter assembly as claimed in claim 1, wherein said wetting fluid further comprises a polymer.
10. The urinary catheter assembly as claimed in claim 9, wherein the polymer is a hydrophilic polymer.
11. The urinary catheter assembly as claimed in claim 9, wherein the hydrophilic polymer is the same type of hydrophilic polymer as in the hydrophilic coating of the catheter.
12. The urinary catheter assembly as claimed in claim 9, wherein the amount of polymer in the wetting fluid is in the range 0-20% of weight.
13. The urinary catheter assembly as claimed in claim 12, wherein the amount of polymer in the wetting fluid is in the range 5-15% of weight.
14. The urinary catheter assembly as claimed in claim 12, wherein the amount of polymer in the wetting fluid is about 10% of weight.
15. The urinary catheter assembly as claimed in claim 1, wherein the wetting fluid is a water-based liquid.
16. The urinary catheter assembly as claimed claim 1, wherein the catheter is a urinary catheter intended for intermittent use.
17. The urinary catheter assembly as claimed in claim 1, wherein said receptacle encloses the entire catheter.
18. The urinary catheter assembly as claimed in claim 1, wherein said receptacle entirely encloses said wetting fluid.
19. The urinary catheter assembly of claim 17, wherein the receptacle is filled with the wetting fluid to such an extent that the entire urinary catheter remains in direct contact with the wetting fluid.
20. The urinary catheter assembly of claim 1, wherein the receptacle encloses an insertable part of the catheter, but leaves a part of the urinary catheter outside the receptacle, and wherein wetting fluid is in direct contact with the entire insertable part of the urinary catheter but without contact with the part of the catheter being outside said receptacle.
21. A wetting fluid for activation of a hydrophilic surface layer in order to produce a low-friction surface character of said hydrophilic surface layer by treatment by said the wetting fluid, wherein the wetting fluid comprises at least one dissolved osmolality-increasing compound, wherein the total concentration of the osmolality-increasing compound(s) exceeds 600 mOsm/dm.sup.3.
22. The wetting fluid as claimed in claim 21, wherein the total concentration of said osmolality-increasing compound(s) in the wetting fluid exceeds 700 mOsm/dm.sup.3.
23. The wetting fluid as claimed in claim 22, wherein the total concentration of said osmolality-increasing compound(s) in the wetting fluid exceeds 800 mOsm/dm.sup.3.
24. The wetting fluid as claimed in claim 21, wherein the total concentration of said osmolality-increasing compound(s) in the wetting fluid is in the range of 850 to 950 mOsm/dm.sup.3.
25. The wetting fluid as claimed in claim 24, wherein the total concentration of said osmolality-increasing compound(s) in the wetting fluid is about 900 mOsm/dm.sup.3.
26. The wetting fluid as claimed in claim 21, wherein the total concentration of said osmolality-increasing compound(s) in the wetting fluid is less than 1500 mOsm/dm.sup.3.
27. The wetting fluid as claimed in claim 21, wherein said osmolality-increasing compound(s) is/are selected from the group consisting of urea, amino acids, mono and disaccharides, sugar alcohols, and non-toxic organic and inorganic salts or acids, polypeptides and mixtures thereof.
28. The wetting fluid as claimed in claim 21, wherein the wetting fluid is a water-based liquid.
29. A method for producing a urinary catheter assembly for human use, comprising: providing a receptacle; providing a hydrophilic catheter; providing a wetting fluid; arranging at least an insertable part of the catheter in the receptacle and arranging said wetting fluid as a part of said urinary catheter assembly; said wetting fluid comprising at least one dissolved osmolality-increasing compound, the total concentration of the osmolality-increasing compound(s) exceeding 600 mOsm/dm.sup.3, wherein the wetting fluid is arranged in wetting contact with the hydrophilic surface layer of the catheter in the receptacle, for preservation of the hydrophilic surface layer in a wetted state during accommodation in said receptacle and provision of a ready-to-use catheter assembly.
30. The method as claimed in claim 29, wherein the total concentration of the osmolality-increasing compound(s) in the wetting fluid exceeds 700 mOsm/dm.sup.3.
31. The method as claimed in claim 30, wherein the total concentration of the osmolality-increasing compound(s) in the wetting fluid exceeds 800 mOsm/dm.sup.3.
32. The method as claimed in claim 29, wherein the total concentration of the osmolality-increasing compound(s) in the wetting fluid is in the range of 850 to 950 mOsm/dm.sup.3.
33. The method as claimed in claim 29, wherein the total concentration of the osmolality-increasing compound(s) in the wetting fluid is about 900 mOsm/dm.sup.3.
34. The method as claimed in claim 29, wherein the total concentration of the osmolality-increasing compound(s) in the wetting fluid is less than 1500 mOsm/dm.sup.3.
35. The method of claim 29, wherein the osmolality-increasing compound is selected from the group consisting of urea, amino acids, mono and disaccharides, sugar alcohols, and non-toxic organic and inorganic salts or acids, polypeptides and mixtures thereof.
36. The method of claim 29, wherein the wetting fluid is a water-based liquid.
37. Method of using a wetting fluid solution for activation of a urinary catheter for human use having on its surface, on at least an insertable part thereof, a hydrophilic surface layer providing low-friction surface character of the urinary catheter by treatment with said wetting fluid, comprising the steps: providing a wetting fluid comprising at least one dissolved osmolality-increasing compound, wherein the total concentration of the dissolved osmolality-increasing compound(s) is in the range of 850 to 950 mOsm/dm.sup.3, and using said wetting fluid for activation of the urinary catheter.
38. The method as claimed in claim 37, wherein the total concentration of the osmolality-increasing compound(s) in the wetting fluid is about 900 mOsm/dm.sup.3.
39. A urinary catheter assembly for human use, comprising: a hydrophilic catheter; and a receptacle enclosing at least part of said catheter; and a wetting fluid, arranged within said receptacle, comprising at least one dissolved osmolality-increasing compound, the total concentration of the dissolved osmolality-increasing compound(s) is in the range of 850 to 950 mOsm/dm.sup.3.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
(1) By way of example embodiments of the invention will now be described with reference to the accompanying drawings in which:
(2)
(3)
(4)
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(6)
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(8)
DESCRIPTION OF PREFERRED EMBODIMENTS
(9) In the following detailed description preferred embodiments of the invention will be described. However, it is to be understood that features of the different embodiments are exchangeable between the embodiments and may be combined in different ways, unless anything else is specifically indicated. It may also be noted that, for the sake of clarity, the dimensions of certain components illustrated in the drawings may differ from the corresponding dimensions in real-life implementations of the invention, e.g. the length of the catheter, the dimensions of the fluid compartments, etc.
(10) The Catheter
(11) Hydrophilic catheters may be used for many different purposes, and for insertion into various types of body-cavities. However, the following discussion is in particular concerned with the preferred field of use, urinary catheters, even though the invention is not limited to this particular type of catheters.
(12) A catheter 130 as illustrated in the drawings, e.g. in
(13) At least a part of the elongate tube 132 forms an insertable length to be inserted through a body opening of the user, such as the urethra in case of a urinary catheter. By insertable length is normally, in the context of a hydrophilic catheter, meant that length of the elongate tube 132 which is coated with a hydrophilic material, for example PVP, and which is insertable into the urethra of the patient. Typically, this will be 80-140 mm for a female patient and 200-350 mm for a male patient.
(14) According to the invention, and applicable for the embodiments disclosed herein, the wetting fluid may be used for the wetting of many different types of well-known hydrophilic surfaces. For example, the catheter may be provided with a hydrophilic coating wherein the hydrophilic polymer coating comprises material selected from polyvinyl compounds, polysaccharides, polyurethanes, polyacrylates or copolymers of vinyl compounds and acrylates or anhydrides, especially polyethyleneoxide, polyvinyl-pyrrolidone, heparin, dextran, xanthan gum, polyvinyl alcohol, hydroxy propyl cellulose, methyl cellulose, copolymer of vinylpyrrolidone and hydroxy ethylmethyl acrylate or copolymer of polymethylvinyl ether and maleinic acid anhydride. The preferred hydrophilic polymer is polyvinylpyrrolidone.
(15) The coating may also comprise an osmolality-increasing compound, as is e.g. taught in EP 0 217 771, even though this may, at least for some embodiments, be superfluous when using the wetting fluid as discussed in the following. However, in some embodiments, it may be useful to incorporate the osmolality-increasing compound(s) into both the wetting fluid and into the hydrophilic coating of the catheter, wherein the concentrations in the wetting fluid and in the hydrophilic coating, respectively, are high enough to provide a total dissolved concentration of the osmolality-increasing compound(s) in the hydrophilic coating when wetted in preparation for an intended use. Still further, it is also possible to incorporate the osmolality increasing compound(s) solely in the hydrophilic coating before the wetting, and in a concentration high enough to provide the intended dissolved concentration of the osmolality-increasing compound(s) when wetted in preparation for an intended use. For incorporation of the osmolality-increasing compound(s) into the coating, any one of the per se known methods discussed in the background section may be used, such as e.g. the method disclosed in EP 217 771.
(16) The substrates may be made from any polymer material, which are well-known in the technical field and to which the said hydrophilic polymers adhere, such as polyurethanes, latex rubbers, other rubbers, polyvinylchloride, other vinyl polymers, polyesters and polyacrylates.
(17) The Wetting Fluid
(18) According to the invention, and in the embodiments disclosed herein, the wetting fluid serves the dual purposes of (i) wetting the hydrophilic surface coating, whereby a low-friction character of the surface is produced, and (ii) providing a dissolved osmolality-increasing compound to the wetted hydrophilic surface, thereby making the hydrophilic coating more stable and less likely to loose water and dry out during use. To this end, the wetting fluid comprises at least one dissolved osmolality-increasing compound.
(19) Several different osmolality-increasing compounds are feasible for incorporation into the wetting fluid. Preferably, the osmolality-increasing compound(s) is selected from the group consisting of urea, amino acids, mono and disaccharides, sugar alcohols, and non-toxic organic and inorganic salts or acids, polypeptides and mixtures thereof. Most preferably, the osmolality-increasing compound(s) is selected from the group consisting of glucose, sorbitol, sodium chloride, sodium citrate, sodium benzoate, calcium chloride, potassium chloride, potassium iodide and potassium nitrate.
(20) The wetting fluid is preferably a water-based liquid, i.e. using water as a solvent.
(21) The concentration of osmolality-increasing compound(s) is relatively high in the solution, and e.g. exceeding the concentration in physiological saline, i.e. about 300 mOsm/dm.sup.3. The total concentration of the osmolality-increasing compound(s) in the wetting fluid solution and/or in the hydrophilic coating when wetted in preparation for an intended use exceeds 600 mOsm/dm.sup.3. Further, the total concentration of the osmolality-increasing compound(s) preferably exceeds 700 mOsm/dm.sup.3 and most preferably exceeds 800 mOsm/dm.sup.3. It is also preferred that the total concentration of the osmolality-increasing compound(s) is in the range 600-1500 mOsm/dm.sup.3, and preferably in the range 850 to 950 mOsm/dm.sup.3, and as a guiding value about 900 mOsm/dm.sup.3.
(22) Still further, the wetting fluid preferably also comprises a dissolved hydrophilic polymer, and preferably the same hydrophilic polymer as in the hydrophilic coating of the catheter for which the wetting fluid is intended. The amount of hydrophilic polymer in the wetting fluid is preferably in the range 0-20% of weight, and most preferably in the range 5-15%, and typically about 10%.
(23) The Catheter Assembly
(24) With reference to
(25) The catheter assembly 110 comprises a wetting receptacle or bag 120, preferably of a transparent flexible plastics material. The receptacle 120 has an elongate pocket 121 at its forward end. At its rearward end 122 the receptacle presents an opening. The wetting receptacle 120 is adapted for accommodation of at least the insertable length of the catheter tube 132 in the elongate pocket 121.
(26) The catheter assembly 110 further comprises a hydrophilic urinary catheter 130, as is discussed in more detail in the foregoing.
(27) The catheter assembly 110 comprises a wetting fluid 150 forming part of the assembly 110, i.e. the wetting fluid is not provided completely separate from the assembly. More specifically, in the embodiment in
(28) The wetting fluid container 140 is openable, in order to enable activation of the catheter assembly. Thus, the activation is performed by opening the container and releasing the wetting fluid into the wetting receptacle 120 so that it comes into contact with the hydrophilic coating of the catheter 130. The wetting fluid container 140 may be openable by means of pressing, tearing, piercing, twisting, etc, which is per se well-known in the art. The wetting fluid 150 is discussed in more detail in the foregoing.
(29) The wetting receptacle 120 preferably forms a sealed compartment around the catheter 3 and at least part of the wetting fluid container 140.
(30) The wetting receptacle 120 preferably comprises opening means for facilitating opening of the receptacle in order to expose the catheter 130 for use. The opening means may comprise a tear line 123 connected to a gripping handle 124, such as a pulling tab. Hereby, the user may pull the gripping handle 124 and, thereby, tearing open the side wall of the wetting receptacle 120. Additionally, or alternatively, a gripping handle may be arranged in the opposite end of the tear line 123. However, alternative opening means are also feasible, such as tear-lines arranged in different fashions and locations, peel-off joints, etc.
(31) In a method of wetting the catheter 130 according to the embodiment in
(32) In the embodiment in
(33) With reference to
(34) In this embodiment, the wetting receptacle 220 is adapted for accommodation of only the catheter tube 232 in the elongate pocket 221, whereas the opening end 222 of the wetting receptacle 220 is sealingly connected to and closed by the connector or rearward end 231 of the catheter 230. Hereby, the receptacle 220 encloses the insertable length of the catheter 230, but leaves a part of the catheter 230 outside the receptacle 220.
(35) In the embodiment in
(36) In a method of activating the catheter 230, the user applies a compressing force to the wetting fluid container 240 in such a way that the rupturable separation wall 241 is opened and the wetting fluid 250 is introduced into the catheter-holding compartment 221 of the wetting receptacle 220. It may be noted that the sealingly connection at the opening end 222 with the connector 231 maintains the wetting fluid 250 in the catheter-holding compartment 221. After release of the wetting fluid into the catheter compartment 221 and when the catheter has been activated, the receptacle 220 may be opened in order to expose the catheter 230 for use. The wetting receptacle 220 may either be ripped off from the wetted catheter 230 before use of the catheter and then disposed of, or be maintained connected to the catheter 230 during use.
(37) With reference to
(38) For activation of the catheter, the user applies e.g. a compressing force to the separate wetting container 340 in such a way that the rupturable separation wall 341 is opened and wetting fluid is introduced into the catheter compartment via the connector and through the catheter lumen. Preferably, the wetting container contains a sufficient amount of wetting fluid for the insertable length of the catheter to be sufficiently wetted.
(39) With reference to
(40) The wetting fluid 450 may be discharged into the other compartment of the receptacle by compressing the wetting fluid container 440, and/or by applying a pulling force between the end parts of the assembly.
(41) In order to achieve a stronger and preferably gas impermeable wetting fluid compartment, it is preferred to arrange an additional cover 460 around said compartment 440. This additional cover 460 may be arranged on the inside of the Wetting fluid compartment 440 formed in the receptacle 420, but is preferably arranged as an outer cover 460 arranged over the part of the receptacle 420 forming the wetting fluid compartment 440, as illustrated in
(42) For activation of the catheter 430 in
(43) With reference to
(44) More specifically, in the embodiment illustrated in
(45) Further, the separation between the wetting fluid compartment and the cavity accommodating the catheter provides a rupturable sealed closure 451, in which it is provided at least one point of weakness, in order for an induced rupture to occur in a predetermined position, thereby enabling fluid communication between the wetting fluid compartment and the compartment housing the catheter. In this embodiment this is achieved by means of a non-linear geometrical arrangement of the joint together with a weld width variation. The joint is here arranged with a knee directed towards the wetting fluid compartment. The knee has an angled peak portion directed towards the wetting fluid compartment. Further, this effect is supported and increased by an advantageously arranged width variation of the weld. Accordingly, the two parameters, weld width and geometrical arrangement, cooperates to form a very predictable and easily ruptured separation wall.
(46) The method of activation of the catheter according to this embodiment resembles the wetting process discussed with reference to
(47) With reference to
(48) In use, the receptacle is simply opened, and the catheter could immediately be introduced into the patient.
(49) With reference to
(50) Like in the embodiment in
(51) Measuring Method Using Artificial Urethra
(52) Previously known friction measurement methods for catheters do not take into consideration the special circumstances and conditions prevailing in the urethra. Accordingly, said methods fail to provide reliable information on the extraction force actually needed for removal of catheters in the use situation and, consequently, also fail to provide information on the possible pain and suffer the patient may endure.
(53) Accordingly, there is a need for an improved method for measuring the extraction force from the urethra for urinary catheters, taking into account at least some parameters specific for the environment of the intended use, such as the constituents of the surrounding fluids (in the epithelial cells), the circumferential enclosing of the catheter shaft and the pressure thereby applied to the catheter, the frictional properties of the inner urethra wall (epithelium), the dehydration of the hydrophilic surface occurring within the urethra, etc.
(54) To this end, an improved measuring method involving an artificial urethra, as discussed in more detail in the following, is hereby proposed by the present inventors.
(55) The newly developed measuring method has been developed for measuring extraction friction during removal of a catheter from the urethra, where several parameters are taken into account, such as: the pressure in the urethra, which is normally between 2.4−13.7 kPa. the concentration relations. the catheterization time period.
(56) The measurement results reflect how firmly the catheter is held in the urethra, i.e. how sticky the catheter surface is to the inner urethra wall (epithelium).
(57) In the measuring method, the mucous membrane of the urethra is simulated with an artificial urethra, accomplished by means of a dialysis membrane formed as a tube. For the measurement, the catheter is placed in the membrane, and the entire assembly is placed in a saline solution with the same concentration of osmolality increasing compound as in ordinary urine, and maintained in said solution during a time period corresponding to the catheterization time period. Subsequently, a pressure is applied to the catheter by means of the artificial urethra to form a constant pressure, said pressure being established with applied air pressure. The force required for the withdrawal of the catheter is measured by means of a dynamometer or the like. The measured force is a measure on the extraction force required to withdraw the catheter from a urethra in the actual use situation, and is therefore also a measure on the friction between the urethra and the catheter surface.
(58) It has been found that the results of said measuring method provide a very good conformity with other measurements performed on urethras in vitro, as well as with in vivo measurements.
(59) The measuring device simulating the urethra comprises a dialysis membrane formed as a tube, into which the catheter may be introduced. The pore size of the dialysis membrane is preferably chosen to be approximately MWCO (Molecular Weight Cut Off) 500 Dalton. For example, the dialysis membrane Spectra/Por® CE (Cellulose Ester) membrane MWCO 500 may be used. The membrane provides a gel-like surface when wetted, which provides a good resemblance with the mucous membrane of the urethra.
(60) Pressure applying means are arranged around the inner tube made of dialysis membrane. These pressure applying means may comprise an outer tube of a relatively rigid material arranged coaxially outside the inner tube, and an inflatable bag arranged between the inner and outer tubes. The inflatable bag could be made of a plastic film, e.g. EBA foil (polyethylene butyl acrylate). Pressure regulating means, such as a pump, and pressure sensing means are connectable to the inflatable bag for controlling the pressure applied to the catheter through the dialysis membrane.
(61) For the measurement, the catheter is wetted as in ordinary use, and thereafter placed in the membrane.
(62) The entire assembly is then placed in a saline solution with a salt concentration resembling the one in ordinary urine. The solution preferably comprises NaCl, and the concentration is preferably about 3.0% of weight. However, even other values could be used, such as 4% of weight NaCl, or 0% of weight NaCl, i.e. distilled water, in order to simulate extreme situations.
(63) The assembly is maintained in said solution during a time period corresponding to the catheterization time period to be measured, which is normally in the range 0.5-10 minutes, and preferably about 5 minutes. For measurements of short time periods, the dialysis membrane may even be pre-wetted with the saline solution before the introduction of the catheter.
(64) Subsequently, a pressure is applied to the catheter by means of the artificial urethra to form a constant pressure, said pressure e.g. being established with applied air pressure, as discussed above.
(65) With the measuring device as discussed above, the pressure is controllable within a wide range. However, the pressure is preferably set to a value of about 10 kPa in the measurements, since this is pressure corresponding to the pressure experienced in an ordinary urethra in a living person. The pressure may also be set slightly above this range, preferably at about 14 kPa, in order to obtain a maximum friction and force measurement value that is not exceeded during ordinary use.
(66) The withdrawal of the catheter is made with a dynamometer, e.g. Mecmesin Force Gauge, for measuring the extraction force required. Preferably, the retraction is made with a constant speed, which could be achieved by using a so called pull testing device, e.g. Mecmesin VersaTest.
(67) The relation between the extraction force and the pressure is generally:
F=μ*P*A (1) where, F is the required extraction force [N], μ is the coefficient of friction, P is the applied pressure [Pa] and A is the area [m.sup.2].
Experiments
(68) In an experimental tests, the method using an artificial urethra was used. Two different types of catheters were used: LoFric®, which is commercially available from AstraTech AB, and Speedicath®, which is commercially available from Coloplast AS.
(69) Each of the catheters were wetted with a wetting solution comprising an osmolality-increasing compound (predominantly NaCl) of about 500, 700 and 900 mOsm/dm.sup.3, respectively, and the wetting period was about 1 minute before testing. The experimental set-up for the testing was the same for all the catheters, and a the saline solution surrounding the artificial urethra had a salt concentration resembling the one in ordinary urine, viz, about 3.0% of weight. The measured extraction force required for the different catheters are illustrated in table 1 below:
(70) TABLE-US-00001 TABLE 1 Measurement of extraction force from an artificial urethra for catheters wetted in different wetting fluid solutions Catheter type, and concentration of the osmolaltiy Extraction Standard increasing compound in the wetting fluid force (N) deviation LoFric ®, about 500 mOsm/dm.sup.3 1.8 0.41 LoFric ®, about 700 mOsm/dm.sup.3 0.9 0.21 LoFric ®, about 900 mOsm/dm.sup.3 0.9 0.19 Speedicath ®, about 500 mOsm/dm.sup.3 3.3 1.20 Speedicath ®, about 700 mOsm/dm.sup.3 2.1 0.80 Speedicath ®, about 900 mOsm/dm.sup.3 2.0 0.84
(71) As is clearly evident from the measurements illustrated in table 1, there is a dramatic improvement and decrease in the required extraction force when wetting fluids having an osmolality level of 700 mOsm/dm.sup.3 or above is used, compared to when a level of 500 mOsm/dm.sup.3 is used. This effect is clearly visible in both the catheter types discussed above, and on which the experimental testing were conducted.
(72) In another line of experiments, the difference in stability during wetting was studied between catheters in which the osmolality increasing compound was integrated in the hydrophilic coating as compared to where the osmolality increasing compound was dissolved in the wetting fluid.
(73) In this experimental tests, the LoFric® catheter, as discussed above, was used. Two different preparations of these catheters were used: 1. Catheters with hydrophilic coatings comprising PVP K90, and in which an osmolality increasing compound (here NaCl) is incorporated into the hydrophilic coating in the way disclosed in e.g. EP 0 217 771. These catheters were wetted in destilled water, i.e. in a wetting fluid without any dissolved osmolality increasing compound. 2. The same type of catheters as in 1), with hydrophilic coatings comprising PVP K90, but without any osmolality increasing compound. These catheters were wetted with a wetting fluid comprising a dissolved osmolality increasing compound. The wetting fluid comprised 3.0% weight of NaCl.
(74) The catheters were wetted in the wetting fluid as specified above during 5 seconds, 30 seconds or 5 minutes. It is to be noted that a recommended wetting duration for this type of catheters is normally about 30 seconds, but intentional and unintentional variations may occur in actual use. The osmolality of the wetted surface was determined by means of a conductivity test (the conductivity, e.g. measured as μS/cm, is proportional to the salt concentration, e.g. measured as mg(NaCl)/area unit). The results are presented in table 2.
(75) TABLE-US-00002 TABLE 2 Measurement of osmolality on the wetted catheter surface in dependence on different wetting times Wetting time Catheter 1 Catheter 2 5 s 1508 mOsm/dm.sup.3 802 mOsm/dm.sup.3 30 s 558 mOsm/dm.sup.3 828 mOsm/dm.sup.3 5 min 192 mOsm/dm.sup.3 891 mOsm/dm.sup.3
(76) As is clearly evident from the measurements illustrated in table 2, there is a dramatic improvement in stability in the catheter 2) in which the osmolality increasing compound is dissolved in the wetting fluid, compared to catheter 1) in which the osmolality increasing compound is incorporated in the hydrophilic coating.
(77) In still another line of experiments, the difference in water retention in ambient air was studied between catheters in which the osmolality increasing compound was integrated in the hydrophilic coating as compared to where the osmolality increasing compound was dissolved in the wetting fluid. The same two types of catheters as in the experiment discussed in relation to table 2 were used.
(78) Again, the catheters were wetted in the wetting fluid as specified above during 5 seconds, 30 seconds or 5 minutes. The were allowed to dry in ambient air for a period of 1 minute or 6 minutes, and where then weighed. The weight was compared to the weight of the un-wetted catheter, and the difference was calculated, and serves as a measure of the amount of wetting fluid held by the hydrophilic coating,
(79) It is to be noted that the water retention in ambient air is an important parameter since in practical use, a time period may elapse between the wetting of the catheter and the subsequent insertion into the urethra. However, the water retention in ambient air and the water retention in the urethra are not necessarily the same, or even necessarily correlated. The results of the measurements are presented in table 3.
(80) TABLE-US-00003 TABLE 2 Measurement of water retention in the wetted catheter surface in dependence on different wetting times and after allowing to dry in ambient air for a period of 1 minute or 6 minutes, respectively. Wetting Catheter 1 Catheter 2 time 1 minute 6 minutes 1 minute 6 minutes 5 s 7.90 mg/cm.sup.2 5.03 mg/cm.sup.2 8.43 mg/cm.sup.2 5.93 mg/cm.sup.2 30 s 9.31 mg/cm.sup.2 5.85 mg/cm.sup.2 11.69 mg/cm.sup.2 8.58 mg/cm.sup.2 5 min 10.24 mg/cm.sup.2 6.46 mg/cm.sup.2 14.22 mg/cm.sup.2 9.68 mg/cm.sup.2
(81) As is clearly evident from the measurements illustrated in table 2, the wetting fluid content in the catheters 2 are significantly higher than in the catheters 1, and the water retention in the catheters wetted by a wetting fluid in which the osmolality increasing compound is dissolved is apparently improved over the water retention in the catheters having a corresponding concentration of osmolality increasing compound in the coating.
CONCLUSION AND SUMMARY
(82) In the foregoing, a catheter assembly has been disclosed comprising: a hydrophilic catheter; a wetting fluid for wetting of the catheter; and a receptacle enclosing at least the insertable part of the catheter. Further, the wetting fluid comprises at least one dissolved osmolality-increasing compound, wherein the total concentration of the dissolved osmolality-increasing compound(s) is very high, exceeding 600 mOsm/dm.sup.3. The wetting fluid could either be arranged in contact with the hydrophilic surface layer of the catheter in the receptacle, for preservation of the hydrophilic surface layer in a wetted state during accommodation in said receptacle and provision of a ready-to-use catheter assembly, or be arranged to keep the wetting fluid separated from the hydrophilic surface layer of the catheter during storage, but to be brought into contact with said hydrophilic surface layer upon activation before an intended use of the catheter. A similar method, use, catheter and wetting fluid are disclosed as well.
(83) The provision of at least one osmolality-increasing compound in the wetting fluid provides several advantages per se, such as a improved properties of the hydrophilic coating, a more predictable and controllable wetting process, a more expedient and cost efficient production, etc. Further, the use of the inventive very high concentration of osmolality-increasing compound(s) in the wetting fluid has proven remarkably efficient.
(84) The invention has now been discussed in relation to different embodiments. However, it should be appreciated by those versed in the art that several further alternatives are possible. For example, the features of the different embodiments discussed above may naturally be combined in many other ways.
(85) It is further possible to use the invention for other types of catheters than urinary catheters, such as vascular catheters or the like. It is also possible to use many different types of osmolality-increasing compounds in the wetting fluid, either alone or in different combinations. Many different levels of concentration of the osmolality-increasing compounds above 600 mOsm/dm.sup.3 are also feasible, even though the higher levels proposed in the foregoing are normally more advantageous.
(86) Still further, it is possible to arrange the wetting fluid container in many different ways. For example, the container may be a separate container, but forming part of the assembly. Such a wetting fluid container may be arranged completely inside the receptacle, partly inside the receptacle, or completely outside the receptacle. Alternatively, the wetting fluid container may be an integrated compartment of the receptacle. This compartment may be separated from the compartment housing the insertable part of the catheter, or be integrated with such a compartment. In the latter case, the catheter may be maintained in a wetted, activated state.
(87) Further, the wetting fluid container may be arranged close to the distal part of the catheter, close to the proximal part of the catheter, or in any other suitable location in the assembly. In case the wetting fluid is arranged separately from the insertable part of the catheter, the separation wall or joint could e.g. be a breakable or peelable membrane wall, but alternative embodiments are naturally feasible, such as various types of detachable or openable caps or closings. The wetting fluid container may be arranged to be discharged upon application of a twist, a compression, a pull or the like on the fluid container. Preferably the wetting fluid may be discharged without breaking or rupturing the receptacle, even though this may not be necessary, depending on the intended use, etc.
(88) Many different materials could also be used for the different parts of the catheter assembly.
(89) It will be appreciated by those versed in the art that several such alternatives similar to those described above could be used without departing from the spirit of the invention, and all such modifications should be regarded as a part of the present invention, as defined in the appended claims.