CN221637088U - Catheter system - Google Patents

Catheter system Download PDF

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CN221637088U
CN221637088U CN202322463411.1U CN202322463411U CN221637088U CN 221637088 U CN221637088 U CN 221637088U CN 202322463411 U CN202322463411 U CN 202322463411U CN 221637088 U CN221637088 U CN 221637088U
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port
catheter
extension tube
catheter system
blood
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J·K·伯克霍兹
E·E·诺依曼
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Becton Dickinson and Co
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Abstract

一种导管系统,包括导管适配器,导管适配器包括侧端口。导管系统包括导管、具有远端和近端的第一延伸管以及具有远端和远端的第二延伸管。第一延伸管的远端可以与导管适配器的侧端口集成在一起。导管系统包括接入连接器,接入连接器包括远侧端口、近侧端口和侧端口。第一延伸管的近端可与接入连接器的远侧端口集成在一起。第二延伸管的远端可以与接入连接器的侧端口集成在一起。第一延伸管可以比第二延伸管短。该导管系统配置成用于血液采样、用于血压监测和/或血气采样,或者提供近患者接入,以便进行更准确的血液动力学测量,以及提供对器械在血管中的递送的改进。

A catheter system includes a catheter adapter, the catheter adapter including a side port. The catheter system includes a catheter, a first extension tube having a distal end and a proximal end, and a second extension tube having a distal end and a distal end. The distal end of the first extension tube can be integrated with the side port of the catheter adapter. The catheter system includes an access connector, the access connector includes a distal port, a proximal port, and a side port. The proximal end of the first extension tube can be integrated with the distal port of the access connector. The distal end of the second extension tube can be integrated with the side port of the access connector. The first extension tube can be shorter than the second extension tube. The catheter system is configured for blood sampling, for blood pressure monitoring and/or blood gas sampling, or to provide near-patient access for more accurate hemodynamic measurements, and to provide improvements in the delivery of devices in blood vessels.

Description

导管系统Catheter system

技术领域Technical Field

本公开总体上涉及一种导管系统。The present disclosure generally relates to a catheter system.

背景技术Background Art

动脉导管插入术是一项重要的手术,在医院环境中广泛使用于严重受伤患者和围手术期患者二者。据估计,美国每年放置800多万根动脉导管。动脉导管可以连续且准确地测量血压、心率和脉搏曲线,以便立即识别异常的血液动力学事件并开始适当的治疗。动脉导管还提供用于血气分析的样本,不会出现与重复动脉穿刺相关的发病率。然而,在插入患者动脉期间,使用当前的动脉导管可能导致显著的血液泄漏,这可能危及使用者。此外,目前的动脉导管可能难以固定、维护和冲洗。Arterial catheterization is a critical procedure that is used extensively in hospital settings for both critically injured and perioperative patients. It is estimated that more than 8 million arterial catheters are placed in the United States each year. Arterial catheters allow for continuous and accurate measurement of blood pressure, heart rate, and pulse curves so that abnormal hemodynamic events can be immediately identified and appropriate treatment initiated. Arterial catheters also provide samples for blood gas analysis without the morbidity associated with repeated arterial punctures. However, during insertion into a patient's artery, the use of current arterial catheters can result in significant blood leakage, which can endanger the user. In addition, current arterial catheters can be difficult to secure, maintain, and flush.

本文要求保护的主题不限于解决任何缺陷或仅在诸如上述那些的环境中操作的实施例。相反,提供该背景仅仅是为了说明可以实践本文所描述的一些实施方式的一个示例技术领域。The subject matter claimed herein is not limited to embodiments that solve any disadvantages or that operate only in environments such as those described above. Rather, this background is merely provided to illustrate one example technology area in which some embodiments described herein may be practiced.

实用新型内容Utility Model Content

本公开总体上涉及血管接入装置、系统和方法。尤其是,本公开涉及一种导管系统以及相关的装置和方法,所述导管系统配置成用于血液采样,例如动脉血液采样。在一些实施例中,导管系统还可以配置成用于血压监测和/或血气采样。重要的是,在一些实施例中,导管系统可以提供近患者接入,以便进行更准确的血液动力学测量,以及提供对器械(例如,辅助导管和/或传感器)在血管中的递送的改进,所述血管可以包括动脉或静脉。The present disclosure generally relates to vascular access devices, systems and methods. In particular, the present disclosure relates to a catheter system and related devices and methods, wherein the catheter system is configured for blood sampling, such as arterial blood sampling. In some embodiments, the catheter system can also be configured for blood pressure monitoring and/or blood gas sampling. Importantly, in some embodiments, the catheter system can provide near-patient access for more accurate hemodynamic measurements, as well as provide improvements in the delivery of instruments (e.g., auxiliary catheters and/or sensors) in a blood vessel, which can include an artery or a vein.

在一些实施例中,该导管系统可以被称为“集成”式导管系统,这意味着导管系统包括延伸管(例如,延伸套件),该延伸管提供到导管的流体通道。在一些实施例中,导管系统可以在一个或多个部件和/或操作方面类似于NEXIVATM封闭式IV导管系统、NEXIVATMDIFFUSICSTM封闭式IV导管系统、或PEGASUSTM安全封闭式IV导管系统(全部都可以从新泽西州富兰克林湖的Becton,Dickinson&Company获得)或另一种合适的集成式导管系统。在一些实施例中,导管系统可以包括用于提高导管插入成功率的导丝。在一些实施例中,导管系统可以减少在将导管插入患者的动脉中时的血液暴露。In certain embodiments, this catheter system can be referred to as " integrated " type catheter system, which means that the catheter system comprises an extension tube (for example, an extension kit), which provides the fluid passage to the catheter. In certain embodiments, the catheter system can be similar to NEXIVA TM closed IV catheter system, NEXIVA TM DIFFUSICS TM closed IV catheter system or PEGASUS TM safety closed IV catheter system (all can be obtained from Becton, Dickinson & Company in Franklin Lakes, New Jersey) or another suitable integrated catheter system in terms of one or more parts and/or operation. In certain embodiments, the catheter system can include a guide wire for improving the catheterization success rate. In certain embodiments, the catheter system can reduce the blood exposure when the catheter is inserted in the artery of the patient.

在一个方面中,本公开提供一种导管系统,所述导管系统包括:导管适配器,所述导管适配器包括远端、近端、延伸穿过所述导管适配器的远端和所述导管适配器的近端的内腔、位于所述导管适配器的远端与所述导管适配器的近端之间并与所述内腔流体连通的侧端口;导管,所述导管从所述导管适配器的远端延伸;第一延伸管,所述第一延伸管包括远端和近端,其中,所述第一延伸管的远端与所述导管适配器的侧端口集成在一起;接入连接器,所述接入连接器包括远侧端口、近侧端口和位于所述远侧端口与所述近侧端口之间的侧端口,其中,所述远侧端口和所述近侧端口与所述接入连接器的纵向轴线对准,其中,所述接入连接器的所述侧端口相对于所述接入连接器的纵向轴线成角度,其中所述第一延伸管的所述近端与所述接入连接器的所述远侧端口集成在一起;和第二延伸管,所述第二延伸管包括远端和近端,其中所述第二延伸管的远端与所述接入连接器的侧端口集成在一起,其中,所述第一延伸管比所述第二延伸管短。In one aspect, the present disclosure provides a catheter system, the catheter system comprising: a catheter adapter, the catheter adapter comprising a distal end, a proximal end, an inner cavity extending through the distal end of the catheter adapter and the proximal end of the catheter adapter, and a side port located between the distal end of the catheter adapter and the proximal end of the catheter adapter and connected to the inner cavity fluid; a catheter, the catheter extending from the distal end of the catheter adapter; a first extension tube, the first extension tube comprising a distal end and a proximal end, wherein the distal end of the first extension tube is integrated with the side port of the catheter adapter; an access connector, the access connector comprising a distal port, a proximal port, and a side port therebetween, wherein the distal port and the proximal port are aligned with a longitudinal axis of the access connector, wherein the side port of the access connector is angled relative to the longitudinal axis of the access connector, wherein the proximal end of the first extension tube is integrated with the distal port of the access connector; and a second extension tube, the second extension tube comprising a distal end and a proximal end, wherein the distal end of the second extension tube is integrated with the side port of the access connector, wherein the first extension tube is shorter than the second extension tube.

在一些实施例中,导管系统可以包括第一延伸管,该第一延伸管可以包括远端和近端。在一些实施例中,第一延伸管的远端可以与导管适配器的侧端口集成在一起。更详细地,在一些实施例中,第一延伸管的远端可以永久地或不可移除地联接到侧端口,例如,通过粘合剂、结合、非鲁尔联接或另一合适的永久的或不可移除的联接。In some embodiments, the catheter system may include a first extension tube, which may include a distal end and a proximal end. In some embodiments, the distal end of the first extension tube may be integrated with a side port of the catheter adapter. In more detail, in some embodiments, the distal end of the first extension tube may be permanently or non-removably coupled to the side port, for example, by an adhesive, a bond, a non-Luer connection, or another suitable permanent or non-removable connection.

在一些实施例中,导管系统可以包括接入连接器,该接入连接器可以配置成提供近患者接入。在一些实施例中,接入连接器可以包括远侧端口、近侧端口以及在远侧端口与近侧端口之间的侧端口。在一些实施例中,远侧端口和近侧端口可以与接入连接器的纵向轴线对准。在一些实施例中,侧端口可以相对于接入连接器的纵向轴线成角度。在一些实施例中,第一延伸管的近端可以与接入连接器的远侧端口集成在一起。In some embodiments, the catheter system may include an access connector that may be configured to provide near-patient access. In some embodiments, the access connector may include a distal port, a proximal port, and a side port between the distal port and the proximal port. In some embodiments, the distal port and the proximal port may be aligned with the longitudinal axis of the access connector. In some embodiments, the side port may be angled relative to the longitudinal axis of the access connector. In some embodiments, the proximal end of the first extension tube may be integrated with the distal port of the access connector.

在一些实施例中,导管系统可以包括第二延伸管,该第二延伸管可以包括远端和近端。在一些实施例中,第二延伸管的远端可以与接入连接器的侧端口集成在一起。在一些实施例中,第一延伸管可以比第二延伸管短,使得第一延伸管促进将辅助导管和/或传感器推进通过第一延伸管。在一些实施例中,接入连接器的纵向轴线、第一延伸管和侧端口可以配置成对准以形成笔直路径,这可以促进将辅助导管和/或传感器在导管系统内推进。在一些实施例中,第一延伸管可以是刚性的或半刚性的,这可以促进将辅助导管和/或传感器推进通过所述第一延伸管。In some embodiments, the catheter system may include a second extension tube, which may include a distal end and a proximal end. In some embodiments, the distal end of the second extension tube may be integrated with a side port of the access connector. In some embodiments, the first extension tube may be shorter than the second extension tube so that the first extension tube facilitates the advancement of an auxiliary catheter and/or a sensor through the first extension tube. In some embodiments, the longitudinal axis of the access connector, the first extension tube, and the side port may be configured to align to form a straight path, which may facilitate the advancement of an auxiliary catheter and/or a sensor within the catheter system. In some embodiments, the first extension tube may be rigid or semi-rigid, which may facilitate the advancement of an auxiliary catheter and/or a sensor through the first extension tube.

在一些实施例中,近侧端口可以包括阴鲁尔接头,这可以促进将血液采样装置联接到接入连接器。在一些实施例中,近侧端口可以包括另一合适的连接器。在一些实施例中,血液采样装置可以联接到近侧端口。在一些实施例中,血液采样装置可以包括导管推进装置,例如PIVOTM无针血液采集装置,其可以从新泽西州富兰克林湖的Becton,Dickinson&Company获得。在一些实施例中,血液采样装置可以包括另一合适的血液采样装置。In some embodiments, the proximal port may include a female Luer connector, which may facilitate coupling the blood sampling device to the access connector. In some embodiments, the proximal port may include another suitable connector. In some embodiments, the blood sampling device may be coupled to the proximal port. In some embodiments, the blood sampling device may include a catheter advancement device, such as a PIVO needleless blood collection device, which may be obtained from Becton, Dickinson & Company of Franklin Lakes, New Jersey. In some embodiments, the blood sampling device may include another suitable blood sampling device.

在一些实施例中,导管系统可以包括三通旋塞阀,该三通旋塞阀可以包括第一端口、与第一端口相对的第二端口、和第三端口。在一些实施例中,第三端口可以与第一端口和第二端口垂直。在一些实施例中,第二延伸管的近端可以联接到三通旋塞阀的第一端口。在一些实施例中,第二延伸管的近端可以与第一端口集成在一起,这可以降低流体暴露于使用者的风险。In some embodiments, the catheter system may include a three-way stopcock, which may include a first port, a second port relative to the first port, and a third port. In some embodiments, the third port may be perpendicular to the first port and the second port. In some embodiments, the proximal end of the second extension tube may be coupled to the first port of the three-way stopcock. In some embodiments, the proximal end of the second extension tube may be integrated with the first port, which may reduce the risk of fluid exposure to the user.

在一些实施例中,导管系统可以包括至少在导管、导管适配器、第一延伸管、接入连接器和第二延伸管内的流体通道。在一些实施例中,第二端口、第三端口和接入连接器的近侧端口可以配置成提供到导管系统的流体通道的接入。在一些实施例中,导管系统可以包括从周围环境到该流体通道的一个或多个其他接入点。在一些实施例中,导管系统可以不包括从周围环境到该流体通道的其他接入点,这可以限制潜在的细菌污染。在一些实施例中,近侧端口可以用于近患者血液样本采集,第二端口可以用于促进通过单次冲洗对管线的清理,第三端口可以用于临时从患者抽取血液以确保高质量的样本。In some embodiments, the catheter system may include at least a fluid channel in a catheter, a catheter adapter, a first extension tube, an access connector, and a second extension tube. In some embodiments, the second port, the third port, and the proximal port of the access connector may be configured to provide access to the fluid channel of the catheter system. In some embodiments, the catheter system may include one or more other access points from the surrounding environment to the fluid channel. In some embodiments, the catheter system may not include other access points from the surrounding environment to the fluid channel, which can limit potential bacterial contamination. In some embodiments, the proximal port can be used for near-patient blood sample collection, the second port can be used to facilitate the cleaning of the pipeline by a single flush, and the third port can be used to temporarily draw blood from the patient to ensure high-quality samples.

在一些实施例中,导管系统可以包括联接到第二端口的预填充冲洗注射器,使得第二端口的关闭(例如,通过旋转三通旋塞阀的中心毂)防止预填充冲洗注射器与流体通道之间的流体连通。在一些实施例中,临时丢弃式样本注射器可以联接到第三端口,使得第三端口的关闭(例如,通过旋转三通旋塞阀的中心毂)防止该临时丢弃式样本注射器与流体通道之间的流体连通。在一些实施例中,临时丢弃式样本注射器可以配置成用于临时抽血。In some embodiments, the catheter system can include a pre-filled flush syringe coupled to the second port, such that closing of the second port (e.g., by rotating the center hub of a three-way stopcock) prevents fluid communication between the pre-filled flush syringe and the fluid channel. In some embodiments, a temporary disposable sample syringe can be coupled to the third port, such that closing of the third port (e.g., by rotating the center hub of a three-way stopcock) prevents fluid communication between the temporary disposable sample syringe and the fluid channel. In some embodiments, the temporary disposable sample syringe can be configured for temporary blood draws.

在一些实施例中,导管系统可以包括压力监测装置。在一些实施例中,压力监测装置可以设置在第二端口与预填充冲洗注射器之间,这可以促进通过单次冲洗对导管系统的冲洗。In some embodiments, the catheter system may include a pressure monitoring device. In some embodiments, the pressure monitoring device may be disposed between the second port and the pre-filled flush syringe, which may facilitate flushing of the catheter system with a single flush.

在一些实施例中,第二延伸管的近端可以与一适配器集成在一起,该适配器可以配置成联接到预填充冲洗注射器、临时丢弃式样本注射器和三通旋塞阀中的一个或多个。在一些实施例中,适配器可以联接到无针连接器,这可以降低细菌污染的风险。在一些实施例中,适配器的近端可以包括单端口或双端口。In some embodiments, the proximal end of the second extension tube can be integrated with an adapter that can be configured to be coupled to one or more of a prefilled flush syringe, a temporary disposable sample syringe, and a three-way stopcock. In some embodiments, the adapter can be coupled to a needleless connector, which can reduce the risk of bacterial contamination. In some embodiments, the proximal end of the adapter can include a single port or a dual port.

在一些实施例中,导管系统可以是紧凑的,易于使用,并且可以改进采集动脉或静脉血液样本时的工作流程。在一些实施例中,一种血液采集方法可以包括将预填充冲洗注射器和临时丢弃式样本注射器联接到导管系统并关闭第二端口。在一些实施例中,在关闭第二端口之后,该方法可以包括把血液抽入到临时丢弃式样本注射器中。在一些实施例中,在将血液抽入到临时丢弃式样本注射器之后,该方法可以包括关闭第一端口。在一些实施例中,在关闭第一端口之后,该方法可以包括在血液采样装置中采集血液,该血液采样装置可以联接到接入连接器的近侧端口。在一些实施例中,血液采样装置可以包括肝素化注射器,然后血液可以被分配到动脉血气(ABG)测试盒,以便进行护理点(POC)血液测试。In some embodiments, the catheter system can be compact, easy to use, and can improve the workflow when collecting arterial or venous blood samples. In some embodiments, a blood collection method can include connecting a prefilled flush syringe and a temporary disposable sample syringe to the catheter system and closing a second port. In some embodiments, after closing the second port, the method can include drawing blood into the temporary disposable sample syringe. In some embodiments, after drawing blood into the temporary disposable sample syringe, the method can include closing the first port. In some embodiments, after closing the first port, the method can include collecting blood in a blood sampling device that can be connected to a proximal port of an access connector. In some embodiments, the blood sampling device can include a heparinized syringe, and the blood can then be distributed to an arterial blood gas (ABG) test box for point-of-care (POC) blood testing.

在一些实施例中,血液采样装置可以包括导管推进装置。在一些实施例中,该方法可以包括推进辅助导管和/或导管推进装置的传感器穿过导管系统的导管。在一些实施例中,在联接到接入连接器的近侧端口的血液采样装置中采集血液之后,该方法可以包括再一次关闭第二端口。在一些实施例中,在再一次关闭第二端口之后,该方法可以包括将被抽入到临时丢弃式注射器中的血液返回到患者体内。In some embodiments, the blood sampling device may include a catheter propulsion device. In some embodiments, the method may include propelling the auxiliary catheter and/or the sensor of the catheter propulsion device through the catheter of the catheter system. In some embodiments, after collecting blood in the blood sampling device connected to the proximal port of the access connector, the method may include closing the second port again. In some embodiments, after closing the second port again, the method may include returning the blood drawn into the temporary disposable syringe to the patient.

在一些实施例中,在将抽入到临时丢弃式注射器的血液返回到患者体内之后,该方法可以包括将三通旋塞阀转动到打开位置,并推动预填充冲洗注射器以通过单次冲洗对导管系统进行清理。在一些实施例中,导管系统可以包括压力监测装置,该压力监测装置可以设置在第二端口与预填充冲洗注射器之间或设置在另一合适的位置。In some embodiments, after returning the blood drawn into the disposable syringe to the patient, the method may include turning the three-way stopcock to an open position and pushing the prefilled flush syringe to clear the catheter system with a single flush. In some embodiments, the catheter system may include a pressure monitoring device that may be disposed between the second port and the prefilled flush syringe or at another suitable location.

在一些实施例中,一种血液采集方法可以包括将导管系统插入到患者的血管中。在一些实施例中,该方法可以包括将导管推进装置的辅助导管推进通过导管。在一些实施例中,导管推进装置可以联接到接入连接器的近侧端口。在一些实施例中,接入连接器的纵向轴线、第一延伸管和侧端口配置成对准以形成笔直路径,并且将导管推进装置的辅助导管推进通过导管可以包括推进辅助导管通过该笔直路径。在一些实施例中,血管可以是动脉。In some embodiments, a blood collection method may include inserting a catheter system into a patient's blood vessel. In some embodiments, the method may include advancing an auxiliary catheter of a catheter advancement device through the catheter. In some embodiments, the catheter advancement device may be coupled to a proximal port of an access connector. In some embodiments, the longitudinal axis of the access connector, the first extension tube, and the side port are configured to align to form a straight path, and advancing the auxiliary catheter of the catheter advancement device through the catheter may include advancing the auxiliary catheter through the straight path. In some embodiments, the blood vessel may be an artery.

应当理解,上述概括性描述和以下详细描述都是示例和解释性的,不是对所要求保护的本实用新型的限制。应当理解,各种实施例不限于附图中所示的布置和手段。还应当理解,在不脱离本实用新型的各种实施例的范围的情况下,可以对这些实施例进行组合,或者可以利用其他实施例,并且可以进行结构改变,除非如此要求。因此,以下详细描述不具有限制意义。It should be understood that the above general description and the following detailed description are exemplary and explanatory, and are not limitations of the claimed invention. It should be understood that the various embodiments are not limited to the arrangements and means shown in the accompanying drawings. It should also be understood that these embodiments may be combined, or other embodiments may be utilized, and structural changes may be made without departing from the scope of the various embodiments of the invention, unless so required. Therefore, the following detailed description is not intended to be limiting.

附图说明BRIEF DESCRIPTION OF THE DRAWINGS

通过使用附图,将以额外的具体性和细节来描述和解释示例性实施例,其中:Through the use of the accompanying drawings, exemplary embodiments will be described and explained with additional specificity and detail, in which:

图1是根据一些实施例的示例性导管系统的上部透视图;FIG1 is an upper perspective view of an exemplary catheter system according to some embodiments;

图2A是根据一些实施例的导管系统的上部透视图,示出了示例性三通旋塞阀、示例性预填充冲洗注射器和示例性临时丢弃式样本注射器;2A is an upper perspective view of a catheter system according to some embodiments, showing an exemplary three-way stopcock, an exemplary pre-filled flush syringe, and an exemplary temporary disposable sample syringe;

图2B是根据一些实施例的导管系统的上部透视图,示出了三通旋塞阀;2B is an upper perspective view of a catheter system showing a three-way stopcock according to some embodiments;

图2C是根据一些实施例的导管系统的一部分的放大上部透视图;2C is an enlarged upper perspective view of a portion of a catheter system according to some embodiments;

图3A是根据一些实施例的导管系统的上部透视图,示出了在采集临时丢弃式样本之后的临时丢弃式样本注射器;3A is an upper perspective view of a catheter system showing a temporarily disposable sample syringe after collecting a temporarily disposable sample, according to some embodiments;

图3B是根据一些实施例的导管系统的上部透视图,示出了示例性血液采样装置中的血液采集;3B is an upper perspective view of a catheter system illustrating blood collection in an exemplary blood sampling device according to some embodiments;

图3C是根据一些实施例的导管系统的上部透视图,示出了将血液从血液采样装置分配到动脉血气(ABG)测试盒上以便进行护理点(POC)血液测试;3C is an upper perspective view of a catheter system showing the dispensing of blood from a blood sampling device onto an arterial blood gas (ABG) test cartridge for point-of-care (POC) blood testing, according to some embodiments;

图3D是根据一些实施例的导管系统的上部透视图,示出了被抽入到临时丢弃式注射器中的血液返回到患者体内;3D is an upper perspective view of a catheter system showing blood drawn into a disposable syringe returning to the patient, according to some embodiments;

图3E是根据一些实施例的导管系统的上部透视图,示出了导管系统的冲洗;3E is an upper perspective view of a catheter system showing flushing of the catheter system according to some embodiments;

图4A是根据一些实施例的导管系统的上部透视图,示出了示例性适配器,该适配器包括具有双端口的近端;4A is an upper perspective view of a catheter system showing an exemplary adapter including a proximal end having dual ports according to some embodiments;

图4B是根据一些实施例的导管系统的上部透视图,示出了适配器双鲁尔端口;4B is an upper perspective view of a catheter system showing an adapter dual Luer port according to some embodiments;

图4C是根据一些实施例的导管系统的上部透视图,示出了三通旋塞阀;4C is an upper perspective view of a catheter system showing a three-way stopcock according to some embodiments;

图4D是根据一些实施例的导管系统的上部透视图,示出了三通旋塞阀;4D is an upper perspective view of a catheter system showing a three-way stopcock according to some embodiments;

图5A是根据一些实施例的适配器的上部透视图,示出了具有双鲁尔端口的近端;5A is an upper perspective view of an adapter showing a proximal end with dual Luer ports according to some embodiments;

图5B是根据一些实施例的适配器的横截面图,示出了具有双鲁尔端口的近端;5B is a cross-sectional view of an adapter showing a proximal end with dual Luer ports according to some embodiments;

图6A是根据一些实施例的导管系统的上部透视图,示出了联接到示例性压力监测装置的示例性无针连接器;6A is an upper perspective view of a catheter system showing an exemplary needleless connector coupled to an exemplary pressure monitoring device according to some embodiments;

图6B是根据一些实施例的导管系统的上部透视图,示出了在预填充冲洗注射器与压力监测装置之间的示例性无针连接器;6B is an upper perspective view of a catheter system showing an exemplary needleless connector between a prefilled flush syringe and a pressure monitoring device, according to some embodiments;

图7是根据一些实施例的导管系统的上部透视图,该导管系统联接到血液动力学监测系统;7 is an upper perspective view of a catheter system coupled to a hemodynamic monitoring system according to some embodiments;

图8是根据一些实施例的导管系统的上部透视图,该导管系统联接到封闭式近患者动脉血液采样系统。8 is an upper perspective view of a catheter system coupled to a closed proximal-patient arterial blood sampling system, according to some embodiments.

具体实施方式DETAILED DESCRIPTION

现在参考图1,在一些实施例中,导管系统10可以配置成用于血液采样,例如动脉血液采样。在一些实施例中,导管系统10还可以配置成用于血压监测和/或血气采样。重要的是,在一些实施例中,导管系统10可以提供近患者接入,以便进行更准确的血液动力学测量,以及提供对器械(例如,辅助导管和/或传感器)在血管中的递送的改进,所述血管可以包括动脉或静脉。Referring now to Fig. 1, in some embodiments, the catheter system 10 can be configured for blood sampling, such as arterial blood sampling. In some embodiments, the catheter system 10 can also be configured for blood pressure monitoring and/or blood gas sampling. Importantly, in some embodiments, the catheter system 10 can provide near-patient access for more accurate hemodynamic measurements, as well as provide improvements in the delivery of instruments (e.g., auxiliary catheters and/or sensors) in blood vessels, which can include arteries or veins.

在一些实施例中,导管系统10可以被称为“集成”式导管系统,这意味着导管系统包括延伸管(例如,延伸套件),该延伸管提供到导管的流体通道。在一些实施例中,导管系统10可以在一个或多个部件和/或操作方面类似于NEXIVATM封闭式IV导管系统、NEXIVATMDIFFUSICSTM封闭式IV导管系统、或PEGASUSTM安全封闭式IV导管系统(全部都可以从新泽西州富兰克林湖的Becton,Dickinson&Company获得)或另一合适的集成式导管系统。In some embodiments, the catheter system 10 can be referred to as an "integrated" catheter system, meaning that the catheter system includes an extension tube (e.g., an extension kit) that provides fluid access to the catheter. In some embodiments, the catheter system 10 can be similar to the NEXIVA closed IV catheter system, the NEXIVA DIFFUSICS closed IV catheter system, or the PEGASUS safety closed IV catheter system (all available from Becton, Dickinson & Company of Franklin Lakes, NJ) or another suitable integrated catheter system in one or more components and/or operation.

在一些实施例中,导管系统10可以包括配置成插入到动脉中的动脉导管系统。在这些实施例中,导管系统10可以包括对现有动脉导管系统的显著改进,通过显著降低血液暴露和感染风险,为使用者提供改进的动脉接入确认,以及改善患者的整体体验。一些现有的动脉导管系统,例如Teleflex 集成式动脉导管,可能无法提供有效的动脉接入确认或血液控制,这可能导致放置程序出现显著的血液暴露风险、感染风险、清理成本和较差的患者体验。Teleflex 集成式动脉导管包括非刚性开槽管,大量血液可能会从该非刚性开槽管泄漏出来,从而增加血液暴露于使用者的风险。In some embodiments, the catheter system 10 may include an arterial catheter system configured to be inserted into an artery. In these embodiments, the catheter system 10 may include a significant improvement over existing arterial catheter systems by significantly reducing blood exposure and infection risks, providing the user with improved arterial access confirmation, and improving the overall patient experience. Some existing arterial catheter systems, such as the Teleflex Integrated arterial catheters may not provide effective arterial access confirmation or blood control, which can result in significant blood exposure risk during the placement procedure, infection risk, cleanup costs, and a poor patient experience. Teleflex The integrated arterial catheter includes a non-rigid slotted tube from which a large amount of blood may leak, thereby increasing the risk of blood exposure to the user.

如本公开中进一步详细解释的,导管系统10可以包括以下中的一个或多个,其可以提供优于现有技术的优点:降低血液暴露的动脉血液采样;血压监测;血气采样;用于使用辅助导管和/或传感器的近患者接入;配置成在动脉压力下操作的血液控制;导丝;以及磁性导引针引导技术。As explained in further detail in the present disclosure, the catheter system 10 may include one or more of the following, which may provide advantages over the prior art: arterial blood sampling with reduced blood exposure; blood pressure monitoring; blood gas sampling; near-patient access for use with auxiliary catheters and/or sensors; blood control configured to operate at arterial pressure; a guidewire; and magnetic introducer needle guidance technology.

如图1所示,在一些实施例中,导管系统10可以包括导管适配器12,该导管适配器可以包括远端14、近端16、延伸穿过导管适配器12的远端14和导管适配器12的近端16的内腔。在一些实施例中,导管适配器12还可以包括侧端口18,该侧端口位于导管适配器12的远端14与导管适配器12的近端16之间并且与内腔流体连通。在一些实施例中,导管系统10可以包括从导管适配器12的远端14延伸的导管19。在一些实施例中,导管19可以包括动脉导管、外周插入中心导管、中线导管、外周静脉内导管或另一合适的导管。As shown in FIG. 1 , in some embodiments, the catheter system 10 may include a catheter adapter 12, which may include a distal end 14, a proximal end 16, and an inner cavity extending through the distal end 14 of the catheter adapter 12 and the proximal end 16 of the catheter adapter 12. In some embodiments, the catheter adapter 12 may also include a side port 18, which is located between the distal end 14 of the catheter adapter 12 and the proximal end 16 of the catheter adapter 12 and is in fluid communication with the inner cavity. In some embodiments, the catheter system 10 may include a catheter 19 extending from the distal end 14 of the catheter adapter 12. In some embodiments, the catheter 19 may include an arterial catheter, a peripherally inserted central catheter, a midline catheter, a peripheral intravenous catheter, or another suitable catheter.

在一些实施例中,导管系统10可以包括联接到针座23的导引针21。在一些实施例中,导管19可以包括“套针”型导管,导引针21可以延伸穿过导管19以帮助将导管19插入到患者的血管中。在一些实施例中,在将导管19插入到血管之后(这可以由使用者通过在闪回室或INSTAFLASHTM中观察血液来确认),针座23可以从导管适配器12脱离联接,并且导引针21可以被移除。In some embodiments, the catheter system 10 may include an introducer needle 21 coupled to a needle hub 23. In some embodiments, the catheter 19 may include a "over-the-needle" type catheter, and the introducer needle 21 may extend through the catheter 19 to assist in inserting the catheter 19 into a patient's blood vessel. In some embodiments, after the catheter 19 is inserted into the blood vessel (which may be confirmed by the user by observing blood in a flashback chamber or INSTAFLASH ), the needle hub 23 may be decoupled from the catheter adapter 12 and the introducer needle 21 may be removed.

在一些实施例中,导管系统10可以包括第一延伸管20,该第一延伸管可以包括远端22和近端24。在一些实施例中,第一延伸管20的远端22可以与导管适配器12的侧端口18集成在一起,这可以降低流体暴露于使用者的风险。更详细地,在一些实施例中,第一延伸管20的远端22可以永久地或不可移除地联接到侧端口18,例如,通过粘合剂、结合、非鲁尔联接或另一合适的永久的或不可移除的联接。在一些实施例中,血液可以响应于导引针21的插入和导管19进入血管而流入第一延伸管20。因此,在一些实施例中,第一延伸管20可以提供对血管进入确认的改进。In some embodiments, the catheter system 10 may include a first extension tube 20, which may include a distal end 22 and a proximal end 24. In some embodiments, the distal end 22 of the first extension tube 20 may be integrated with the side port 18 of the catheter adapter 12, which may reduce the risk of fluid exposure to the user. In more detail, in some embodiments, the distal end 22 of the first extension tube 20 may be permanently or non-removably connected to the side port 18, for example, by an adhesive, a bond, a non-Luer connection, or another suitable permanent or non-removable connection. In some embodiments, blood may flow into the first extension tube 20 in response to the insertion of the introducer needle 21 and the entry of the catheter 19 into the blood vessel. Therefore, in some embodiments, the first extension tube 20 may provide an improvement in confirmation of blood vessel entry.

在一些实施例中,导管系统10可以包括接入连接器26,该接入连接器可以配置成提供近患者接入。在一些实施例中,接入连接器26可以包括远侧端口28、近侧端口30以及在接入连接器26的远侧端口28与接入连接器26的近侧端口30之间的侧端口32。在一些实施例中,远侧端口28和近侧端口30可以与接入连接器26的纵向轴线34对准。在一些实施例中,侧端口32可以相对于接入连接器的纵向轴线34成角度。例如,侧端口32可以相对于纵向轴线34成15度至165度的角度,并且可以形成T形或Y形。在一些实施例中,侧端口32可以在接入连接器26的左侧或右侧,和/或可以配置成引导第二延伸管36远离导管在血管中的插入部位。在一些实施例中,第一延伸管20的近端24可以与接入连接器26的远侧端口28集成在一起,这可以降低流体暴露于使用者的风险。更详细地,在一些实施例中,第一延伸管20的近端24可以永久地或不可移除地联接到远侧端口28,例如,通过粘合剂、结合、非鲁尔联接或另一合适的永久的或不可移除的联接。In some embodiments, the catheter system 10 may include an access connector 26 that may be configured to provide near-patient access. In some embodiments, the access connector 26 may include a distal port 28, a proximal port 30, and a side port 32 between the distal port 28 of the access connector 26 and the proximal port 30 of the access connector 26. In some embodiments, the distal port 28 and the proximal port 30 may be aligned with the longitudinal axis 34 of the access connector 26. In some embodiments, the side port 32 may be angled relative to the longitudinal axis 34 of the access connector. For example, the side port 32 may be at an angle of 15 to 165 degrees relative to the longitudinal axis 34 and may form a T-shape or a Y-shape. In some embodiments, the side port 32 may be on the left or right side of the access connector 26, and/or may be configured to guide the second extension tube 36 away from the insertion site of the catheter in the blood vessel. In some embodiments, the proximal end 24 of the first extension tube 20 may be integrated with the distal port 28 of the access connector 26, which may reduce the risk of fluid exposure to the user. In more detail, in some embodiments, the proximal end 24 of the first extension tube 20 can be permanently or non-removably coupled to the distal port 28, such as by an adhesive, bonding, a non-Luer coupling, or another suitable permanent or non-removable coupling.

在一些实施例中,导管系统10可以包括第二延伸管36,其可以包括远端38和近端40。在一些实施例中,第二延伸管36的远端38可以与接入连接器26的侧端口32集成在一起,这可以降低流体暴露于使用者的风险。更详细地,在一些实施例中,第二延伸管36的远端38可以永久地或不可移除地联接到侧端口32,例如,通过粘合剂、结合、非鲁尔联接或另一合适的永久的或不可移除的联接。In some embodiments, the catheter system 10 may include a second extension tube 36, which may include a distal end 38 and a proximal end 40. In some embodiments, the distal end 38 of the second extension tube 36 may be integrated with the side port 32 of the access connector 26, which may reduce the risk of fluid exposure to the user. In more detail, in some embodiments, the distal end 38 of the second extension tube 36 may be permanently or non-removably coupled to the side port 32, for example, by an adhesive, a bond, a non-Luer coupling, or another suitable permanent or non-removable coupling.

在一些实施例中,第一延伸管20可以比第二延伸管36短,这可以促进将辅助导管和/或传感器推进通过第一延伸管20。在一些实施例中,例如,第一延伸管20可以小于或等于1英寸、小于或等于2英寸、或小于或等于3英寸。在一些实施例中,接入连接器26的纵向轴线34、第一延伸管20和侧端口18可以配置成对准以形成笔直路径,这可以促进将辅助导管和/或传感器在导管系统10内推进。在一些实施例中,第一延伸管20可以是刚性的或半刚性的,和/或可以包括特定厚度或目标厚度,这可以促进将辅助导管和/或传感器推进通过该第一延伸管,以及提供足够的刚度或不顺应性以传输更精确的压力脉冲,从而引起更精确的压力测量。In some embodiments, the first extension tube 20 can be shorter than the second extension tube 36, which can facilitate advancing the auxiliary catheter and/or sensor through the first extension tube 20. In some embodiments, for example, the first extension tube 20 can be less than or equal to 1 inch, less than or equal to 2 inches, or less than or equal to 3 inches. In some embodiments, the longitudinal axis 34 of the access connector 26, the first extension tube 20, and the side port 18 can be configured to align to form a straight path, which can facilitate advancing the auxiliary catheter and/or sensor within the catheter system 10. In some embodiments, the first extension tube 20 can be rigid or semi-rigid, and/or can include a specific thickness or target thickness, which can facilitate advancing the auxiliary catheter and/or sensor through the first extension tube, as well as provide sufficient stiffness or non-compliance to transmit more accurate pressure pulses, thereby causing more accurate pressure measurements.

如图1所示,在一些实施例中,近侧端口30可以包括阴鲁尔接头,这可以促进将血液采样装置联接到接入连接器26。在一些实施例中,近侧端口30可以包括另一种类型的连接器。现在参考图2A,在一些实施例中,血液采样装置42可以联接到近侧端口30。在一些实施例中,近侧端口30可以是红色的,以指示近侧端口30提供到动脉的接入。在一些实施例中,血液采样装置42可以包括真空管或注射器。在一些实施例中,血液采样装置42可以包括探针和/或传感器。在一些实施例中,血液采样装置42可以包括导管推进装置,例如PIVOTM无针血液采集装置,其可以从新泽西州富兰克林湖的Becton,Dickinson&Company获得。在一些实施例中,血液采样装置42可以包括另一合适的血液采样装置。在一些实施例中,血液采样装置42可以配置成将辅助导管和/或传感器推进通过笔直路径和/或通过导管19进入患者的血管内,例如动脉内。As shown in FIG. 1 , in some embodiments, the proximal port 30 may include a female Luer connector, which may facilitate coupling the blood sampling device to the access connector 26. In some embodiments, the proximal port 30 may include another type of connector. Referring now to FIG. 2A , in some embodiments, a blood sampling device 42 may be coupled to the proximal port 30. In some embodiments, the proximal port 30 may be red to indicate that the proximal port 30 provides access to the artery. In some embodiments, the blood sampling device 42 may include a vacuum tube or a syringe. In some embodiments, the blood sampling device 42 may include a probe and/or a sensor. In some embodiments, the blood sampling device 42 may include a catheter advancement device, such as a PIVO TM needleless blood collection device, which may be obtained from Becton, Dickinson & Company of Franklin Lakes, New Jersey. In some embodiments, the blood sampling device 42 may include another suitable blood sampling device. In some embodiments, the blood sampling device 42 may be configured to advance an auxiliary catheter and/or a sensor through a straight path and/or through a catheter 19 into a patient's blood vessel, such as an artery.

在一些实施例中,导管系统10可以包括三通旋塞阀44,该三通旋塞阀可以包括第一端口46、与第一端口46相对的第二端口48、和第三端口50。在一些实施例中,三通旋塞阀44的中心毂52可以被旋转以选择性地打开或关闭通过第一端口46、第二端口48和第三端口50的流体流动,如本领域中已知的那样。在一些实施例中,第二延伸管36的近端40可以联接到三通旋塞阀44的第一端口46。在一些实施例中,第二延伸管36的近端40可以与第一端口46集成在一起,这可以降低流体暴露于使用者的风险。更详细地,在一些实施例中,第二延伸管36的近端40可以永久地或不可移除地联接到第一端口46,例如,通过粘合剂、结合、非鲁尔联接或另一合适的永久的或不可移除的联接。在一些实施例中,第二端口48和/或第三端口50可以包括鲁尔接头,例如阴鲁尔接头,这可以促进到一装置的联接。In some embodiments, the catheter system 10 may include a three-way stopcock 44, which may include a first port 46, a second port 48 opposite the first port 46, and a third port 50. In some embodiments, the central hub 52 of the three-way stopcock 44 may be rotated to selectively open or close the flow of fluid through the first port 46, the second port 48, and the third port 50, as known in the art. In some embodiments, the proximal end 40 of the second extension tube 36 may be coupled to the first port 46 of the three-way stopcock 44. In some embodiments, the proximal end 40 of the second extension tube 36 may be integrated with the first port 46, which may reduce the risk of fluid exposure to the user. In more detail, in some embodiments, the proximal end 40 of the second extension tube 36 may be permanently or non-removably coupled to the first port 46, for example, by an adhesive, a bond, a non-Luer connection, or another suitable permanent or non-removable connection. In some embodiments, the second port 48 and/or the third port 50 may include a Luer connector, such as a female Luer connector, which may facilitate the connection to a device.

在一些实施例中,导管系统10可以包括至少在导管19、导管适配器12、第一延伸管20、接入连接器26和第二延伸管36内的流体通道。在一些实施例中,第二端口48、第三端口50和接入连接器26的近侧端口30可以配置成提供对导管系统10的流体通道的接入。在一些实施例中,导管系统10可以包括从周围环境到流体通道的一个或多个其他接入点。在一些实施例中,导管系统10可以不包括从周围环境到流体通道的其他接入点,这可以限制潜在的细菌污染。In some embodiments, the catheter system 10 may include fluid pathways within at least the catheter 19, the catheter adapter 12, the first extension tube 20, the access connector 26, and the second extension tube 36. In some embodiments, the second port 48, the third port 50, and the proximal port 30 of the access connector 26 may be configured to provide access to the fluid pathways of the catheter system 10. In some embodiments, the catheter system 10 may include one or more other access points to the fluid pathways from the surrounding environment. In some embodiments, the catheter system 10 may not include other access points to the fluid pathways from the surrounding environment, which may limit potential bacterial contamination.

在一些实施例中,第一端口46、第二端口48、第三端口50中的一个或多个可以是不可移除的和/或与三通旋塞阀44的主体一体形成为单个单元,中心毂52在所述主体中旋转。在一些实施例中,第二端口48、第三端口50和近侧端口30中的一个或多个可以包括联接到相应端口的不可移除部分的可移除无针连接器。在一些实施例中,无针连接器可以降低细菌污染的风险。在一些实施例中,近侧端口30可以用于近患者血液样本采集,第二端口48可以用于促进通过单次冲洗对导管系统10(包括流体通道)的清理,第三端口50可以用于从患者临时抽取血液以确保高质量的样本。在一些实施例中,适配器58、第一端口46、第二端口48和第三端口50中的一个或多个可以包括通气塞或端盖。In some embodiments, one or more of the first port 46, the second port 48, and the third port 50 may be non-removable and/or integrally formed with the body of the three-way stopcock 44 as a single unit, in which the central hub 52 rotates. In some embodiments, one or more of the second port 48, the third port 50, and the proximal port 30 may include a removable needleless connector coupled to the non-removable portion of the corresponding port. In some embodiments, the needleless connector may reduce the risk of bacterial contamination. In some embodiments, the proximal port 30 may be used for near-patient blood sample collection, the second port 48 may be used to facilitate cleaning of the catheter system 10 (including the fluid channel) by a single flush, and the third port 50 may be used to temporarily draw blood from the patient to ensure high-quality samples. In some embodiments, one or more of the adapter 58, the first port 46, the second port 48, and the third port 50 may include a vent plug or end cap.

在一些实施例中,导管系统10可以包括联接到第二端口48的预填充冲洗注射器54,使得第二端口48的关闭(例如,通过旋转三通旋塞阀44的中心毂52)防止预填充冲洗注射器54与流体通道之间的流体连通。在一些实施例中,临时丢弃式样本注射器56可以联接到第三端口50,使得第三端口50中的关闭(例如,通过旋转三通旋塞阀44的中心毂52)防止临时丢弃式样本注射器56与流体通道之间的流体连通。在一些实施例中,临时丢弃式样本注射器56可以配置成用于从患者临时抽取血液。In some embodiments, the catheter system 10 can include a pre-filled flush syringe 54 coupled to the second port 48, such that closing of the second port 48 (e.g., by rotating the central hub 52 of the three-way stopcock 44) prevents fluid communication between the pre-filled flush syringe 54 and the fluid channel. In some embodiments, a temporary disposable sample syringe 56 can be coupled to the third port 50, such that closing in the third port 50 (e.g., by rotating the central hub 52 of the three-way stopcock 44) prevents fluid communication between the temporary disposable sample syringe 56 and the fluid channel. In some embodiments, the temporary disposable sample syringe 56 can be configured to temporarily draw blood from a patient.

现在参考图2B-2C,在一些实施例中,第二延伸管36的近端40可以与适配器58集成在一起,适配器58可以配置成联接到预填充冲洗注射器54、临时丢弃式样本注射器56和三通旋塞阀44中的一个或多个。如图2B所示,在一些实施例中,适配器58可以联接到无针连接器60,这可以降低细菌污染的风险。如本公开中所述,术语“无针连接器”可以指MAXZEROTM无针连接器(可以从Becton,Dickinson&Company获得)或本领域已知的另一合适的可移除无针连接器,其可以被设计成降低细菌污染的风险。Referring now to FIGS. 2B-2C , in some embodiments, the proximal end 40 of the second extension tube 36 can be integrated with an adapter 58 that can be configured to be coupled to one or more of a prefilled flushing syringe 54, a temporary disposable sample syringe 56, and a three-way stopcock 44. As shown in FIG. 2B , in some embodiments, the adapter 58 can be coupled to a needleless connector 60, which can reduce the risk of bacterial contamination. As described in the present disclosure, the term “needleless connector” can refer to a MAXZERO TM needleless connector (available from Becton, Dickinson & Company) or another suitable removable needleless connector known in the art that can be designed to reduce the risk of bacterial contamination.

现在参考图3A-3E,在一些实施例中,导管系统10可以包括压力监测装置62,该压力监测装置可以包括压力变送器。在一些实施例中,压力变送器可以包括IV一次性压力变送器(可以从ICU Medical获得)或任何其他合适的压力变送器。在一些实施例中,压力监测装置62可以设置在第二端口48与预填充冲洗注射器54之间,这可以促进通过单次冲洗对导管系统10的冲洗。更详细地,在一些实施例中,当第二端口48打开,临时丢弃式样本注射器56和血液采样装置42被移除,并且预填充冲洗注射器54通过压下预填充冲洗注射器54的柱塞而被致动时,注射器内的流体可以行进通过压力监测装置62,并对第二端口48、第三端口50、第一端口46、第二延伸管36、接入连接器26(包括侧端口32、近侧端口30和远侧端口28)、导管适配器12和导管19进行清理。在一些实施例中,预填充冲洗注射器54内的流体可以包括盐水或另一合适的冲洗溶液。在一些实施例中,导管系统10的通过单次冲洗进行清理的配置可以减少冲洗所需的流体量。Referring now to FIGS. 3A-3E , in some embodiments, the catheter system 10 may include a pressure monitoring device 62, which may include a pressure transmitter. In some embodiments, the pressure transmitter may include IV disposable pressure transmitter (available from ICU Medical) or any other suitable pressure transmitter. In some embodiments, the pressure monitoring device 62 can be disposed between the second port 48 and the pre-filled flush syringe 54, which can facilitate flushing of the catheter system 10 by a single flush. In more detail, in some embodiments, when the second port 48 is opened, the temporary disposable sample syringe 56 and the blood sampling device 42 are removed, and the pre-filled flush syringe 54 is actuated by depressing the plunger of the pre-filled flush syringe 54, the fluid in the syringe can travel through the pressure monitoring device 62 and clean the second port 48, the third port 50, the first port 46, the second extension tube 36, the access connector 26 (including the side port 32, the proximal port 30 and the distal port 28), the catheter adapter 12 and the catheter 19. In some embodiments, the fluid in the pre-filled flush syringe 54 can include saline or another suitable flushing solution. In some embodiments, the configuration of the catheter system 10 for cleaning by a single flush can reduce the amount of fluid required for flushing.

在一些实施例中,导管系统10可以是紧凑的,易于使用,并且可以改进采集动脉或静脉血液样本时的工作流程。在一些实施例中,一种血液采集方法可以包括将导管系统10的导管19插入到患者的血管中,例如静脉或动脉中。在一些实施例中,可以在经由压力监测装置62监测动脉血压的同时执行该方法的一个或多个步骤。在一些实施例中,血液采集方法可以包括将预填充冲洗注射器54和/或临时丢弃式样本注射器56联接到导管系统10。在一些实施例中,该方法可以包括关闭第二端口48(这可以使第三端口50和第一端口46保持打开),例如,如图3A所示。在一些实施例中,在关闭第二端口48之后,该方法可以包括将血液从血管抽入临时丢弃式样本注射器56中。这可以通过拉动临时丢弃式样本注射器56的柱塞来实现。例如,如图3B所示,在一些实施例中,在将血液抽入临时丢弃式样本注射器56之后,该方法可以包括关闭第一端口46。在一些实施例中,在关闭第一端口46之后,该方法可以包括在血液采样装置42中采集血液,该血液采样装置可以联接到接入连接器26的近侧端口30。In some embodiments, the catheter system 10 can be compact, easy to use, and can improve the workflow when collecting arterial or venous blood samples. In some embodiments, a blood collection method can include inserting a catheter 19 of the catheter system 10 into a patient's blood vessel, such as a vein or artery. In some embodiments, one or more steps of the method can be performed while monitoring arterial blood pressure via a pressure monitoring device 62. In some embodiments, the blood collection method can include connecting a prefilled flushing syringe 54 and/or a temporary disposable sample syringe 56 to the catheter system 10. In some embodiments, the method can include closing the second port 48 (which can keep the third port 50 and the first port 46 open), for example, as shown in FIG. 3A. In some embodiments, after closing the second port 48, the method can include drawing blood from the blood vessel into the temporary disposable sample syringe 56. This can be achieved by pulling the plunger of the temporary disposable sample syringe 56. For example, as shown in FIG. 3B, in some embodiments, after drawing blood into the temporary disposable sample syringe 56, the method can include closing the first port 46. In some embodiments, after closing the first port 46 , the method may include collecting blood in a blood sampling device 42 , which may be coupled to the proximal port 30 of the access connector 26 .

在一些实施例中,血液采样装置42可以包括导管推进装置,该导管推进装置配置成推进辅助导管以延长导管19的寿命和/或提供血液采样。在一些实施例中,导管推进装置可以包括PIVOTM无针血液采集装置(其可以从新泽西州富兰克林湖的Becton,Dickinson&Company获得)或另一合适的导管推进装置。在一些实施例中,该方法可以包括将辅助导管和/或导管推进装置的传感器推进通过导管系统10的导管19。In some embodiments, the blood sampling device 42 may include a catheter advancement device configured to advance an auxiliary catheter to extend the life of the catheter 19 and/or provide blood sampling. In some embodiments, the catheter advancement device may include a PIVO needleless blood collection device (which may be obtained from Becton, Dickinson & Company of Franklin Lakes, New Jersey) or another suitable catheter advancement device. In some embodiments, the method may include advancing an auxiliary catheter and/or a sensor of the catheter advancement device through the catheter 19 of the catheter system 10.

例如,如图3C所示,在一些实施例中,血液采样装置42可以包括肝素化注射器,并且通过抽回肝素化注射器的柱塞而被抽取到肝素化注射器中的血液然后可以被分配到动脉血气(ABG)测试盒,以便进行护理点(POC)血液测试。For example, as shown in FIG. 3C , in some embodiments, the blood sampling device 42 may include a heparinized syringe, and the blood drawn into the heparinized syringe by withdrawing the plunger of the heparinized syringe may then be dispensed into an arterial blood gas (ABG) test cartridge for point-of-care (POC) blood testing.

例如,如图3D所示,在一些实施例中,在联接到接入连接器26的近侧端口30的血液采样装置42中采集血液之后,该方法可以包括再一次关闭第二端口48(这可以使第三端口50和第一端口46保持打开)。在一些实施例中,在再一次关闭第二端口48之后,该方法可以包括将被抽入临时丢弃式样本注射器56的血液返回到患者体内,例如通过压下临时丢弃式样本注射器56的柱塞。3D , in some embodiments, after collecting blood in the blood sampling device 42 coupled to the proximal port 30 of the access connector 26, the method may include once again closing the second port 48 (which may leave the third port 50 and the first port 46 open). In some embodiments, after once again closing the second port 48, the method may include returning the blood drawn into the temporary disposable sample syringe 56 to the patient, for example by depressing the plunger of the temporary disposable sample syringe 56.

例如,如图3E所示,在一些实施例中,该方法可以包括在将被抽入临时丢弃式样本注射器56中的血液返回到患者体内之后,将三通旋塞阀44转动到打开位置(使得第三端口50、第二端口48和第一端口46中的每个打开)并且推动预填充冲洗注射器54以通过单次冲洗对导管系统10进行清理。在一些实施例中,导管系统10可以包括压力监测装置62,该压力监测装置可以设置在第二端口48与预填充冲洗注射器54之间或设置在另一合适的位置。3E, in some embodiments, the method may include, after returning the blood drawn into the temporary disposable sample syringe 56 to the patient, turning the three-way stopcock 44 to an open position (so that each of the third port 50, the second port 48, and the first port 46 is open) and pushing the pre-filled flush syringe 54 to clean the catheter system 10 by a single flush. In some embodiments, the catheter system 10 may include a pressure monitoring device 62, which may be disposed between the second port 48 and the pre-filled flush syringe 54 or at another suitable location.

现在参考图4A-4D,在一些实施例中,适配器58的近端64可以包括单端口或双端口。在一些实施例中,近端64可以包括双端口,该双端口可以包括鲁尔端口66a和鲁尔端口66b(例如,如图4A所示)。在一些实施例中,双端口可以包括T形或Y形。在一些实施例中,鲁尔端口66a和/或鲁尔端口66b可以包括阴鲁尔接头,以促进可移除地联接到另一装置。在一些实施例中,通气塞70可以设置在鲁尔端口66a内,这可以允许空气的通气,但降低细菌污染的风险。在一些实施例中,鲁尔端口66b可以包括其中的隔膜,这可以降低细菌污染的风险。在一些实施例中,鲁尔端口66b可以联接到一连接器,该连接器可以包括套环。在一些实施例中,套环可以包括套环上的一个或多个螺纹,因此,套环可以促进牢固连接。Now referring to Fig. 4A-4D, in some embodiments, the proximal end 64 of adapter 58 can include a single port or a dual port. In some embodiments, the proximal end 64 can include a dual port, which can include a Luer port 66a and a Luer port 66b (e.g., as shown in Fig. 4A). In some embodiments, the dual port can include a T-shape or a Y-shape. In some embodiments, Luer port 66a and/or Luer port 66b can include a female Luer connector to facilitate removably connecting to another device. In some embodiments, a vent plug 70 can be arranged in Luer port 66a, which can allow ventilation of air, but reduces the risk of bacterial contamination. In some embodiments, Luer port 66b can include a diaphragm therein, which can reduce the risk of bacterial contamination. In some embodiments, Luer port 66b can be connected to a connector, which can include a collar. In some embodiments, the collar can include one or more threads on the collar, so that the collar can promote a firm connection.

在一些实施例中,近端64的双端口中的一个端口可以联接到临时丢弃式样本注射器,以在从接入连接器26的近侧端口30进行血液采样之前临时抽取血液样本,特定的血液采样装置(例如PIVOTM无针血液采集装置,可以从新泽西州富兰克林湖的Becton,Dickinson&Company获得)可以联接到接入连接器的该近侧端口。在一些实施例中,在从接入连接器26的近侧端口30进行血液采样之后,可以通过致动预填充冲洗注射器,来利用单次冲洗对导管系统10进行清理。在一些实施例中,近端64的双端口中的另一个端口可以联接到预填充冲洗注射器。在一些实施例中,双端口可以允许临时丢弃式样本注射器和预填充冲洗注射器同时联接到近端64。In some embodiments, one of the dual ports of the proximal end 64 can be connected to a temporary disposable sample syringe to temporarily draw a blood sample before blood sampling from the proximal port 30 of the access connector 26, and a specific blood sampling device (e.g., a PIVO TM needleless blood collection device, available from Becton, Dickinson & Company of Franklin Lakes, New Jersey) can be connected to the proximal port of the access connector. In some embodiments, after blood sampling from the proximal port 30 of the access connector 26, the catheter system 10 can be cleaned with a single flush by actuating a pre-filled flush syringe. In some embodiments, the other of the dual ports of the proximal end 64 can be connected to a pre-filled flush syringe. In some embodiments, the dual ports can allow a temporary disposable sample syringe and a pre-filled flush syringe to be connected to the proximal end 64 at the same time.

在一些实施例中,一个或多个双端口可以包括可移除无针连接器,该无针连接器联接到双端口中的相应的一个端口的不可移除部分。在一些实施例中,无针连接器可以降低细菌污染的风险。在一些实施例中,预填充冲洗注射器和/或临时丢弃式样本注射器可以经由无针连接器联接到近端64。In some embodiments, one or more of the dual ports can include a removable needleless connector that is coupled to a non-removable portion of a corresponding one of the dual ports. In some embodiments, the needleless connector can reduce the risk of bacterial contamination. In some embodiments, a prefilled flush syringe and/or a temporary disposable sample syringe can be coupled to the proximal end 64 via a needleless connector.

如图4B所示,在一些实施例中,近端64可以包括双端口,双端口可以包括两个鲁尔端口66a、66b。如图所示,在一些实施例中,鲁尔端口66a和/或鲁尔端口66b可以联接到一连接器,该连接器可以包括套环。在一些实施例中,套环可以包括套环上的一个或多个螺纹,因此,套环可以促进牢固连接。在一些实施例中,适配器58的近端64和/或与其连接的无针连接器不需要包括与PIVOTM无针采血装置兼容的端口,因为PIVOTM无针血液采集装置或其他导管推进装置可以联接到接入连接器26的近侧端口30,并且可以延伸通过近侧端口30、第一延伸管20、侧端口18和导管19以接入血管进行血液采样。因此,在一些实施例中,第二延伸管36可以比第一延伸管20更具柔性,这可以允许第二延伸管弯曲并降低当使用者将一装置联接到近端64时干扰插入部位的风险。在一些实施例中,第二延伸管36可以比第一延伸管20长,以降低当使用者将一装置联接到近端64时干扰插入部位的风险。As shown in FIG. 4B , in some embodiments, the proximal end 64 may include a dual port, which may include two Luer ports 66a, 66b. As shown, in some embodiments, the Luer port 66a and/or the Luer port 66b may be connected to a connector, which may include a collar. In some embodiments, the collar may include one or more threads on the collar, so that the collar may promote a secure connection. In some embodiments, the proximal end 64 of the adapter 58 and/or the needleless connector connected thereto does not need to include a port compatible with the PIVO TM needleless blood collection device, because the PIVO TM needleless blood collection device or other catheter propulsion device can be connected to the proximal port 30 of the access connector 26, and can extend through the proximal port 30, the first extension tube 20, the side port 18 and the catheter 19 to access the blood vessel for blood sampling. Therefore, in some embodiments, the second extension tube 36 may be more flexible than the first extension tube 20, which may allow the second extension tube to bend and reduce the risk of interfering with the insertion site when the user connects a device to the proximal end 64. In some embodiments, the second extension tube 36 may be longer than the first extension tube 20 to reduce the risk of interference with the insertion site when a user couples a device to the proximal end 64 .

如图4C-4D所示,在一些实施例中,第一端口46可以包括鲁尔接头,例如阴鲁尔接头。在一些实施例中,这可以允许无针连接器60(例如,如图4D所示)联接到第一端口46和适配器58并设置在该第一端口与该适配器之间,这可以降低细菌污染的风险。As shown in Fig. 4C-4D, in some embodiments, the first port 46 can include a Luer connector, such as a female Luer connector. In some embodiments, this can allow a needleless connector 60 (e.g., as shown in Fig. 4D) to be coupled to the first port 46 and the adapter 58 and disposed between the first port and the adapter, which can reduce the risk of bacterial contamination.

现在参考图5A-5B,在一些实施例中,双端口可以包括从适配器58的纵向轴线76轴向对准的轴向端口74偏置的偏置侧端口72。更详细地,在一些实施例中,偏置侧端口72可以与轴向端口74是非平面的(non-planar),并且可以通过产生湍流来促进冲洗。在一些实施例中,偏置侧端口72可以在一个或多个特征和/或操作方面对应于图4A-4B的鲁尔端口66a和/或图4A-4B的鲁尔端口66b。在一些实施例中,轴向端口74可以在一个或多个特征和/或操作方面对应于图4A-4B的鲁尔端口66a和/或图4A-4B的鲁尔端口66b。在一些实施例中,适配器58的内腔可以包括一个或多个流体偏转斜面78,其可以产生湍流并增强冲洗。附加地或可替代地,在一些实施例中,流体偏转斜面78可以设置在接入连接器26的近侧端口30内,以在近患者端口处产生湍流并增强冲洗。Now referring to Figures 5A-5B, in some embodiments, the dual port can include an offset side port 72 offset from an axial port 74 axially aligned with the longitudinal axis 76 of the adapter 58. In more detail, in some embodiments, the offset side port 72 can be non-planar with the axial port 74, and can promote flushing by generating turbulence. In some embodiments, the offset side port 72 can correspond to the Luer port 66a of Figures 4A-4B and/or the Luer port 66b of Figures 4A-4B in one or more features and/or operations. In some embodiments, the axial port 74 can correspond to the Luer port 66a of Figures 4A-4B and/or the Luer port 66b of Figures 4A-4B in one or more features and/or operations. In some embodiments, the inner cavity of the adapter 58 can include one or more fluid deflection ramps 78, which can generate turbulence and enhance flushing. Additionally or alternatively, in some embodiments, the fluid deflection ramp 78 can be disposed in the proximal port 30 of the access connector 26 to generate turbulence and enhance flushing near the patient port.

现在参考图6A-6B,压力监测装置62可以可操作地联接到压力变送器电连接器80,该电连接器可以从压力监测装置62延伸(也参见图3A-3E)。在一些实施例中,压力监测装置62的近端可以联接到无针连接器60,这可以降低细菌污染的风险。在一些实施例中,预填充冲洗注射器54可以联接到压力监测装置62或无针连接器60,这可以促进通过单次冲洗对导管系统10的冲洗。在一些实施例中,压力监测装置62可以联接到第三端口50或另一合适的位置。在一些实施例中,压力监测装置62可以联接到第三端口50或接入连接器26的近侧端口30,以由于接近血管而提供精确的测量。在一些实施例中,无针连接器60和/或流体输送管线可以联接到压力监测装置62。根据一些实施例,图6B示出了联接到无针连接器60的近端的预填充冲洗注射器54,图6A示出了无针连接器60的空着的近端。Referring now to FIGS. 6A-6B , the pressure monitoring device 62 can be operably coupled to a pressure transmitter electrical connector 80 that can extend from the pressure monitoring device 62 (see also FIGS. 3A-3E ). In some embodiments, the proximal end of the pressure monitoring device 62 can be coupled to the needleless connector 60, which can reduce the risk of bacterial contamination. In some embodiments, a prefilled flushing syringe 54 can be coupled to the pressure monitoring device 62 or the needleless connector 60, which can facilitate flushing of the catheter system 10 by a single flush. In some embodiments, the pressure monitoring device 62 can be coupled to the third port 50 or another suitable location. In some embodiments, the pressure monitoring device 62 can be coupled to the proximal port 30 of the third port 50 or the access connector 26 to provide accurate measurements due to proximity to a blood vessel. In some embodiments, the needleless connector 60 and/or a fluid delivery line can be coupled to the pressure monitoring device 62. According to some embodiments, FIG. 6B shows a prefilled flushing syringe 54 coupled to the proximal end of the needleless connector 60, and FIG. 6A shows an empty proximal end of the needleless connector 60.

在一些实施例中,第一延伸管20和/或第二延伸管36可以是刚性的或半刚性的。在一些实施例中,第二延伸管36可以是刚性的或半刚性的,这可以促进在压力监测装置62处进行更精确的压力测量。在一些实施例中,联接到三通旋塞阀44的压力监测装置62可以提供在比现有系统更靠近患者的位置处监测动脉压力的益处,这可以促进在压力监测装置62处进行更精确的压力测量。In some embodiments, the first extension tube 20 and/or the second extension tube 36 can be rigid or semi-rigid. In some embodiments, the second extension tube 36 can be rigid or semi-rigid, which can facilitate more accurate pressure measurements at the pressure monitoring device 62. In some embodiments, the pressure monitoring device 62 coupled to the three-way stopcock 44 can provide the benefit of monitoring arterial pressure at a location closer to the patient than existing systems, which can facilitate more accurate pressure measurements at the pressure monitoring device 62.

现在参考图7,导管系统10联接到血液动力学监测系统82,该血液动力学监测系统可以可操作地联接到一个或多个血液动力学监测系统传感器84。在一些实施例中,第二采样端口86可以提供相对于接入连接器26而言的替代或附加位置用于血液采样。在一些实施例中,第二采样端口86可以用于围手术期环境和外科手术环境中。由于接入连接器26的存在,第二采样端口86可以被消除,从而在一些实施例中不需要第二采样端口86。Referring now to FIG. 7 , the catheter system 10 is coupled to a hemodynamic monitoring system 82, which can be operably coupled to one or more hemodynamic monitoring system sensors 84. In some embodiments, a second sampling port 86 can provide an alternative or additional location relative to the access connector 26 for blood sampling. In some embodiments, the second sampling port 86 can be used in perioperative environments and surgical environments. Due to the presence of the access connector 26, the second sampling port 86 can be eliminated, so that in some embodiments, the second sampling port 86 is not required.

在一些实施例中,如果需要,临时丢弃式样本注射器88可以与血液动力学监测系统传感器84一起固定到血液动力学监测系统82。在一些实施例中,管线90(可以包括压力管)可以经由连接器92流体连接到导管系统10。In some embodiments, if desired, a disposable sample syringe 88 may be secured to the hemodynamic monitoring system 82 along with the hemodynamic monitoring system sensor 84. In some embodiments, a line 90 (which may include a pressure tube) may be fluidly connected to the catheter system 10 via a connector 92.

现在参考图8,在一些实施例中,管线90可以联接到血液清理系统94,该血液清理系统可以是近患者的和/或封闭的。在一些实施例中,血液清理系统94可以是直列的(in-line),并且可以促进采集临时抽血体积,该临时抽血体积可以稍后再次输注或推回患者体内。在一些实施例中,在通过提升血液清理系统94的柱塞95以将临时抽血体积采集在血液清理系统94的储器内之后,可以关闭截止阀97,从而防止与管线90的流体连通以及防止从储器抽吸血液。在一些实施例中,在截止阀97关闭的情况下,可以从接入连接器26的近侧端口30采集血液样本。在一些实施例中,可以使用血液采样装置42来采集血液样本,该血液采样装置可以包括导管推进装置,例如PIVOTM无针血液采集装置,其可以从新泽西州富兰克林湖的Becton,Dickinson&Company获得。在一些实施例中,在抽取血液样本之后,可以打开截止阀97,并且可以压下或向下推动血液清理系统94的柱塞95,以将储器内的临时抽血体积重新输注到患者体内。在一些实施例中,除接入连接器26的近侧端口30外,导管系统10内的血液清理系统94可以不包括血液采样端口,该近侧端口可以提供近患者血液采集,并且还可以促进导管系统10与导管推进装置的使用。Referring now to FIG. 8 , in some embodiments, the line 90 can be coupled to a blood cleaning system 94, which can be near-patient and/or closed. In some embodiments, the blood cleaning system 94 can be in-line and can facilitate the collection of a temporary blood draw volume that can be later re-infused or pushed back into the patient. In some embodiments, after the temporary blood draw volume is collected in the reservoir of the blood cleaning system 94 by lifting the plunger 95 of the blood cleaning system 94, the shutoff valve 97 can be closed to prevent fluid communication with the line 90 and prevent blood from being drawn from the reservoir. In some embodiments, with the shutoff valve 97 closed, a blood sample can be collected from the proximal port 30 of the access connector 26. In some embodiments, a blood sampling device 42 can be used to collect a blood sample, which can include a catheter advancement device, such as a PIVO needleless blood collection device, which can be obtained from Becton, Dickinson & Company of Franklin Lakes, New Jersey. In some embodiments, after the blood sample is drawn, the shutoff valve 97 may be opened and the plunger 95 of the blood cleaning system 94 may be depressed or pushed downward to reinfuse the temporarily drawn blood volume in the reservoir into the patient. In some embodiments, the blood cleaning system 94 in the catheter system 10 may not include a blood sampling port other than the proximal port 30 of the access connector 26, which may provide for near-patient blood collection and may also facilitate the use of the catheter system 10 with a catheter advancement device.

本文所列举的所有示例和条件性语言旨在用于教学目的,以帮助读者理解本实用新型为进一步推进本领域所贡献的构思,并且应被解释为不限于这些具体记载的示例和条件。尽管已经详细描述了本实用新型的实施例,但是应当理解,在不脱离本实用新型的精神和范围的情况下,可以对本实用新型进行各种改变、替换和变更。All examples and conditional language listed herein are intended for teaching purposes to help readers understand the concepts contributed by the present invention to further advance the art, and should be interpreted as not being limited to these specifically recorded examples and conditions. Although the embodiments of the present invention have been described in detail, it should be understood that various changes, substitutions and modifications may be made to the present invention without departing from the spirit and scope of the present invention.

Claims (11)

1. A catheter system, the catheter system comprising:
A catheter adapter comprising a distal end, a proximal end, a lumen extending through the distal end of the catheter adapter and the proximal end of the catheter adapter, a side port located between the distal end of the catheter adapter and the proximal end of the catheter adapter and in fluid communication with the lumen;
a catheter extending from a distal end of the catheter adapter;
A first extension tube comprising a distal end and a proximal end, wherein the distal end of the first extension tube is integrated with a side port of the catheter adapter;
An access connector comprising a distal port, a proximal port, and a side port located between the distal port and the proximal port, wherein the distal port and the proximal port are aligned with a longitudinal axis of the access connector, wherein the side port of the access connector is angled with respect to the longitudinal axis of the access connector, wherein the proximal end of the first extension tube is integrated with the distal port of the access connector; and
A second extension tube comprising a distal end and a proximal end, wherein the distal end of the second extension tube is integrated with a side port of the access connector, wherein the first extension tube is shorter than the second extension tube.
2. The catheter system of claim 1, wherein the longitudinal axis of the access connector, the first extension tube, and the side port of the catheter adapter are configured to align to form a straight path.
3. The catheter system of claim 2, wherein the first extension tube is rigid or semi-rigid.
4. The catheter system of claim 1, wherein the proximal port comprises a female luer fitting.
5. The catheter system of claim 1, further comprising a blood sampling device coupled to the proximal port of the access connector.
6. The catheter system of claim 1, further comprising a three-way stopcock, wherein the three-way stopcock comprises a first port, a second port opposite the first port, and a third port, wherein a proximal end of the second extension tube is coupled to the first port of the three-way stopcock.
7. The catheter system of claim 6, wherein a proximal end of the second extension tube is integrated with the first port.
8. The catheter system of claim 6, comprising a fluid channel within the catheter, the catheter adapter, the first extension tube, the access connector, and the second extension tube, wherein the second port, the third port, and the proximal port of the access connector are configured to provide access to the fluid channel of the catheter system.
9. The catheter system according to claim 8, characterized in that the catheter system further comprises: a syringe coupled to the third port such that closure of the third port prevents fluid communication between the syringe and the fluid channel, wherein the syringe is configured for temporary blood drawing; and a pre-filled flush syringe coupled to the second port such that closure of the second port prevents fluid communication between the pre-filled flush syringe and the fluid channel.
10. The catheter system of claim 9, further comprising a pressure monitoring device disposed between the second port and the pre-filled flush syringe.
11. The catheter system of claim 1, wherein the proximal end of the second extension tube is integrated with another adapter coupled to a needleless connector, the proximal end of the other adapter comprising a single port or a dual port.
CN202322463411.1U 2022-09-12 2023-09-12 Catheter system Active CN221637088U (en)

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US63/405,700 2022-09-12
US18/238,967 US20240082546A1 (en) 2022-09-12 2023-08-28 Integrated catheter system configured for blood sampling
US18/238,967 2023-08-28

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