US20120118286A1

US20120118286A1 - Nasal airway management device

Info

Publication number: US20120118286A1
Application number: US13/053,785
Authority: US
Inventors: Viachaslau M. Barodka
Original assignee: Johns Hopkins University
Current assignee: Johns Hopkins University
Priority date: 2010-11-12
Filing date: 2011-03-22
Publication date: 2012-05-17
Also published as: US8833373B2; US20120118297A1

Abstract

An airway management device including a hollow flexible tube. The tube defines a lumen extending between a proximal end and a distal end. The proximal end is configured to be coupled to a ventilator and/or anesthesia circuit. An opening is provided at or near the distal end to allow passage of air and/or anesthesia therethrough. The tube is configured to be expanded radially after insertion through a patient's nasopharyngeal passageway when the distal end of the tube is positioned proximate the patient's hypopharynx. The device may include an inflatable outer sleeve surrounding and extending along the length of the tube. When the outer sleeve is in a deflated state, the distal end of the tube may be inserted through a patient's nasopharyngeal passageway. When the distal end of the tube is positioned proximate the patient's hypopharynx, the outer sleeve may be inflated and expanded. The device may include an inflatable cuff attached at or near the distal end of the tube and including an opening fluidly coupled with the opening and lumen of the tube to allow passage of air and/or anesthesia therethrough. When in a deflated state, the inflatable cuff may be inserted through the patient's nasopharyngeal passageway. When in an inflated state, the inflatable cuff may expand to form a seal around the patient's supraglottic laryngeal inlet. An intermediate inflatable cuff having a larger diameter than other portions of the outer sleeve when inflated may be positioned along the length of the tube between the proximal and distal ends. The respective inflatable elements of the device may be concurrently or separately inflatable.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims priority to U.S. Provisional Application No. 61/412,943 filed Nov. 12, 2010, the entire contents of which are hereby incorporated by reference.

BACKGROUND

1. Field of Invention
The invention relates generally to airway management devices and, more particularly, to a nasal airway management device with an inflatable outer sleeve.
2. Discussion of Related Art
Maintaining and securing a patient's airway and providing adequate ventilation when necessary are core principles to ensure oxygen delivery in all human beings. Controlling a patient's airway is the first and most important principle in basic life support and advanced cardiac life support algorithms. Humans cannot survive the interruption of oxygen delivery to the body for more than 5-10 minutes. This puts enormous pressure on ensuring timely and reliable means of airway control in emergency situations. Anesthetized patients, sedated patients, critically ill patients and coding patients, for example, often can not maintain an airway or adequately breath on their own and almost always require assisted ventilation. Accordingly, airway devices are typically placed in a patient's airway by trained professionals in order to assist with ventilation or to maintain and protect the airway. These devices may include, for example, oral and nasal airways, laryngeal mask airways (LMAs), and endotracheal tubes. These devices, however, have several disadvantages. For example, highly trained healthcare personnel and special instrumentation are typically required for the placement of advanced airway devices such as LMAs and endotracheal tubes. Moreover, sedation or general anesthesia are required during placement and use of LMAs and endotracheal tubes. Other devices such as, for example, nasal and oral airways and external face masks, while less invasive, nevertheless provide limited or no ability to provide assisted ventilation.
There is a need for quick, simple and reliable airway management device to provide airway control and assisted ventilation in, for example but not limited to, emergency situations.

SUMMARY

In an embodiment of the invention, an airway management device is provided. The airway management device according to an embodiment of the invention includes a hollow flexible tube. The tube defines a lumen extending between a proximal end and a distal end. The proximal end may be coupled to at least one of a ventilator and an anesthesia circuit. An opening is provided proximate the distal end of the tube to allow passage of air and/or anesthesia therethrough. The tube may be expanded radially after insertion through a patient's nasopharyngeal passageway when the distal end of the tube is positioned proximate the patient's hypopharynx.
According to an embodiment of the invention, the airway management device may also include an inflatable outer sleeve surrounding and extending along the length of the tube. When the outer sleeve is in a deflated state, the distal end of the tube may be inserted through a patient's nasopharyngeal passageway. When the distal end of the tube is positioned proximate the patient's hypopharynx, the outer sleeve may be inflated and expanded.
According to another embodiment, an inflatable cuff may be attached at or near the distal end of the tube. The inflatable cuff may define an opening fluidly coupled with the opening and lumen of the tube to allow passage of air and/or anesthesia therethrough. When in a deflated state, the inflatable cuff may be inserted through the patient's nasopharyngeal passageway. When in an inflated state, the inflatable cuff may expand to form a seal around the patient's supraglottic laryngeal inlet.
According to another embodiment, the device may include an intermediate inflatable cuff positioned along the length of the tube between the proximal and distal ends and having a larger diameter than other portions of the outer sleeve when inflated.
According to another embodiment, the respective inflatable elements of the device may be concurrently or separately inflatable.
Further features and advantages, as well as the structure and operation of various embodiments of the invention, are described in detail below with reference to the accompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

The foregoing and other features and advantages of the invention will be apparent from the following, more particular description of some example embodiments of the invention, as illustrated in the accompanying drawings. Unless otherwise indicated, the accompanying drawing figures are not to scale. Several embodiments of the invention will be described with respect to the following drawings, in which like reference numerals represent like features throughout the figures, and in which:

FIG. 1 depicts a perspective view of a nasal airway management device having an inflatable outer sleeve and an inflatable supraglottic laryngeal cuff, both in a deflated state, according to an embodiment of the invention;

FIG. 2 depicts a perspective view of the nasal airway management device of FIG. 1 with both the outer sleeve and supraglottic laryngeal cuff in an inflated state according to an embodiment of the invention;

FIG. 3 depicts the nasal airway management device of FIG. 1 in a deflated state in a patient's laryngopharynx after insertion through the nasopharyngeal passageway;

FIG. 4 depicts the nasal airway management device of FIG. 3 in the patient's laryngopharynx after insertion through the nasopharyngeal passageway and inflation of the outer sleeve and supraglottic laryngeal cuff;

FIG. 5 depicts a perspective view of a nasal airway management device having an inflatable outer sleeve, an inflatable intermediate cuff, and an inflatable supraglottic laryngeal cuff, all in a deflated state, according to an embodiment of the invention;

FIG. 6 depicts a perspective view of the nasal airway management device of FIG. 5 with the outer sleeve, intermediate cuff, and supraglottic laryngeal cuff all in an inflated state according to an embodiment of the invention;

FIG. 7 depicts the nasal airway management device of FIG. 5 in a deflated state in a patient's laryngopharynx after insertion through the nasopharyngeal passageway;

FIG. 8 depicts the nasal airway management device of FIG. 6 in the patient's laryngopharynx after insertion through the nasopharyngeal passageway and inflation of the outer sleeve, the intermediate cuff, and the supraglottic laryngeal cuff;

FIG. 9 depicts a perspective view of a nasal airway management device having an inflatable outer sleeve in an inflated state according to an embodiment of the invention;

FIG. 10 depicts a perspective view of a nasal airway management device having an inflatable outer sleeve and an inflatable intermediate cuff, both in an inflated state, according to an embodiment of the invention; and

FIGS. 11A-H and 12 depict a cross-sectional view of the nasal airway management device of any of FIGS. 1-10 according to another embodiment of the invention, including at least one pilot tube to provide for separate inflation of one or more of the respective inflatable elements.

FIGS. 13-14 depict a schematic cross-sectional view of the tube according to an embodiment of the invention having multiple pilot tubes extending along the length thereof to expand the lumen of the tube when inflated.

DETAILED DESCRIPTION

Some embodiments of the invention are discussed in detail below. In describing embodiments, specific terminology is employed for the sake of clarity. However, the invention is not intended to be limited to the specific terminology so selected. A person skilled in the relevant art will recognize that other equivalent components can be employed and other methods developed without departing from the broad concepts of the invention. All references cited herein are incorporated by reference as if each had been individually incorporated.
FIGS. 1 and 2 depict perspective views of a nasal airway management device 10 according to an embodiment of the invention. The device 10 includes a hollow flexible tube 12 defining a lumen extending between a proximal end 18 and a distal end 20. An inflatable outer sleeve 14 may surround and extend along the length of the tube 12. An inflatable supraglottic laryngeal cuff 16 may be attached at or near the distal end 20 of the tube 12. Both outer sleeve 14 and cuff 16 are shown in a deflated state in FIG. 1. In FIG. 2, both the outer sleeve 14 and cuff 16 are shown in an inflated state. The proximal end 18 of the tube 12 may include a connector portion 22 and an inflation port 23. The connector portion 22 may be configured to be coupled to a ventilator, a ventilation bag, or an anesthetic circuit (not shown). The inflation port 23 may be configured to be coupled to an automatic or manual inflation mechanism such as, for example, a syringe filled with air or another suitable gas or liquid substance for inflation and deflation of one or both of the outer sleeve 14 and cuff 16. Additional inflation ports are possible to provide for separate inflation/deflation of respective inflatable elements. An adjustable annular flange 24 may be moveably disposed on an outer periphery of the tube 12 near the proximal end 18 to help stabilize and hold the tube 12 in place at the patient's nostril N.
The tube 12, particularly the distal end 20, is configured for insertion through a patient's nostril N and nasopharyngeal passageway NP to a position in the laryngopharynx (or hypopharynx) LP (see FIG. 3). The tube 12 may be formed from a variety of suitable materials such as, for example but not limited to, polyvinylchloride (PVC), although other materials are possible so long as they are body tolerated and constructed to provide enough rigidity to prevent collapse, twisting, kinking and/or buckling of the tube in the nasal cavity and in the pharynx. The tube 12 should also be flexible enough to avoid causing nasal trauma during insertion and use. As discussed in further details below, the tube 12 is configured to be expanded radially after insertion through the patient's nasopharyngeal passageway NP when the distal end 20 of the tube 12 is positioned proximate the patient's hypopharynx LP so as to allow easier passage of air, anesthesia, or a combination thereof.
In some embodiments, the inflatable cuff 16 is attached at or near the distal end 20 of the tube 12 and may be arranged to be inflated and deflated via an inflation passage defined by a space between the inner surface of the outer sleeve 14 and the outer surface of the tube 12. The inflation passage may extend along the tube 12 and may be fluidly coupled to the inflatable cuff 16 to allow concurrent inflation and deflation of the outer sleeve 14 and the cuff 16. In some embodiments, discussed further below, a pilot tube 140 (see FIGS. 11A-11H and 12) may extend along the tube 12 to provide for concurrent or separate radial expansion of the tube 12, inflation of the cuff 16, and/or inflation of the outer sleeve 14.
The outer sleeve 14 and inflatable cuff 16 may include thin, flexible and compliant material such as, for example, PVC or polyurethane, although other materials are possible. When in a deflated state such as, for example, as shown in the embodiment depicted in FIG. 1, the outer sleeve 14 and inflatable cuff 16 are sized and configured to be inserted through the patient's nasopharyngeal passageway NP (see FIG. 3). For example, the outer sleeve 14 and inflatable cuff 16 may be densely packed about the tube 12 so as to facilitate insertion via the patient's nostril N and nasopharyngeal passageway NP. In an embodiment, the densely packed inflatable cuff 16 may form a substantially conical shape extending from the distal end 20 of the tube 12. The deflated cuff 16 may define, for example, a round, smooth elongated tip with a gradually increasing diameter to facilitate atraumatic insertion of the device 10. The inflatable cuff 16 defines an opening 26 fluidly coupled with the lumen of the tube 12 to allow passage of air or other gaseous substance. In an embodiment not shown in greater detail herein, the inflatable cuff 16 may comprise an outer portion and an inner portion. The outer portion may be formed from a relatively thick and semi-rigid material such as, for example, of the same thickness and rigidity as the tube 12. The inner portion may be of a relatively thinner and more flexible material densely packed inside the outer portion about the distal end 20 of the tube 12 when the inflatable cuff 16 is in the deflated state to facilitate insertion of the distal end 20 of the tube 12 through the patient's nasopharyngeal passageway NP. Once inflated, the outer portion unfolds and forms a semi-rigid base wider than the diameter of the tube 12 against posterior wall of the laryngopharynx forming a base and structural support for the inner portion of the cuff 16. The inflated inner portion the cuff 16 expands on the edges of the semi-rigid outer portion and forms a final shape to provide a seal of the supraglottic laryngeal inlet.
FIG. 3 depicts a side cross-sectional view of a patient's head with after insertion of the device 10 through the nostril N and nasopharyngeal passageway NP. The outer sleeve 14 and inflatable cuff 16 are shown positioned in the patient's oronasopharynx OP and laryngopharynx LP, respectively, in a deflated state. FIG. 4 depicts the distal end 20 of the tube 12 of the nasal airway management device 10 in the patient's laryngopharynx LP after inflation of the outer sleeve 14 and cuff 16. When inflated, for example, the outer sleeve 14 may be expanded. Similarly, when in the inflated state, the inflatable cuff 16 is expanded to a shape and size configured to form a seal around the patient's supraglottic laryngeal inlet L. For example, the inflated cuff 16 may form a substantially elliptical or oval structure circumscribing the opening 26 and disposed at an angle to a longitudinal axis of the tube 12. In this regard, the cuff 16 can function as a nasally-inserted supraglottic laryngeal mask, allowing ventilation of the patient while the patient's oral cavity O remains free of any airway devices. The inflatable cuff 16 seals the larynx and trachea T from the esophagus E and pharynx and allows a healthcare provider to deliver PPV (positive pressure ventilation), CPAP (continuous positive airway pressure) or PEEP (positive end expiratory pressure) to the patient via the device 10. Thus, once inflated, the cuff 16 may be in the form of, for example, a triangular pyramid occupying the laryngopharynx LP, the space between the glottic opening and choana (i.e., the anatomical opening of the nasal airway passage in the nasopharynx). Inflation of the cuff 16 lifts the epiglottis away from the glottic opening to prevent it from obstructing the airway (see FIG. 4). Alternatively, when the inflatable cuff 16 is positioned in the patient's laryngopharynx LP in the deflated state (FIG. 3), the device 10 may serve to simply maintain patency of the patient's airway and allow spontaneous ventilation via the opening 26.
As shown in the embodiment depicted in FIGS. 1-4, the tube 12 may include a curved shaped such as, for example, a U-shape to mimic nasal airway anatomy and add a second dimension to allow only one position for insertion. Other positioning structures and/or indicator markings are, however, possible to ensure correct positioning of the cuff 16 adjacent to the supraglottic laryngeal inlet L. The device 10 may be offered in different sizes to fit different patients. Before placement, the outer sleeve 14 and cuff 16 should be in the deflated state. Lubrication jelly, possibly including local anesthetic, may be applied to the outer sleeve 14 and cuff 16 and along the outer wall of the tube 12 from the distal end 20 to assist with gentle insertion through the patient's nostril N and nasopharyngeal passageway NP. Local anesthetic spray may also be applied to the patient's nostril N. Once inserted, the outer sleeve 14 and cuff 16 may be inflated concurrently via the inflation port 23 (or separately via respective inflation ports) by, for example, a 10-20 cc syringe filled with air or another suitable gas or liquid substance. The inflated cuff 16 will make the form of a laryngeal mask providing the seal between larynx and the rest of pharynx and esophagus E. Inflation of the cuff 16 may protect the vocal cords and airway and allow the delivery of PPV, CPAP or PEEP assisted ventilation.
When PPV, CPAP, or PEEP is no longer needed, or if the patient should undergo unassisted spontaneous breathing trials such that simple maintenance the patency of the airway remains, the device 10 can be left in place with cuff 16 deflated and outer sleeve 14 either deflated or still inflated (if separately inflatable). In this case, the device 10 can serve as a conventional nasal airway. Nasal airways provide minimal stimulation to the patient and are extremely well tolerated compared to endotracheal tubes or LMAs. In addition the patient would be able to talk. At any time, the cuff 16 could be inflated again if there is a need to resume assisted ventilation.
FIGS. 5 and 6 depict perspective views of a nasal airway management device 100 according to another embodiment of the invention and having a tube 112, an outer inflatable sleeve 114, an inflatable cuff 116 and an inflatable intermediate positioning cuff 130. The outer sleeve 114, cuff 116, and intermediate cuff 130 are all shown in a deflated state in FIG. 5. In FIG. 6, the outer sleeve 114, cuff 116, and intermediate cuff 130 are all shown in an inflated state. Airway management device 100 is substantially the same as device 10, described above, except that device 100 includes the second intermediate inflatable cuff 130 at a position along the tube 112 between the proximal and distal ends 118, 120, respectively. The intermediate inflatable cuff 130 may be configured to be inflated in order to fix and hold the airway tube 112 in position patient's nasopharyngeal passageway NP. When the device 100 is inserted with the outer sleeve 114 and cuffs 116, 130 all in the deflated state, the intermediate cuff 130 should be positioned along the tube 112 on outer sleeve 114 so that it corresponds to the oronasoparynx (see FIGS. 7 and 8). Once inflated, as shown in FIG. 8, the device 100 may be gently pulled back such that the intermediate cuff 130 will be positioned in the oronasopharynx OP and will prevent dislodgement of the tube 112 back out of the nostril N. The intermediate inflatable cuff 130 may be part of the outer sleeve 114 or coupled thereto and may have a larger diameter than other portions of the outer sleeve 114 when inflated. The intermediate cuff 130 may be fluidly coupled to one or both of the outer sleeve 114 and cuff 116 to allow concurrent inflation therewith. Alternatively, the intermediate cuff 130 may be separately inflated via a pilot tube as further discussed below.
FIG. 9 depicts a perspective view of a nasal airway management device 200 according to another embodiment of the invention and having a tube 212 and an outer inflatable sleeve 214. The outer sleeve 214 is shown in an inflated state in FIG. 9. Airway management device 200 is substantially the same as devices 10 and 100, described above, without an inflatable cuff at the distal end 220 of the tube 212 or an intermediate inflatable cuff at a position along the tube 212 between the proximal and distal ends 218, 220. When inflated after insertion through a patient's nostril N, for example, the outer sleeve 214 may be expanded with the distal end 220 of the tube 212 positioned proximate the laryngopharynx LP. FIG. 10 depicts a perspective view of a nasal airway management device 300 according to another embodiment of the invention and having a tube 312, an outer inflatable sleeve 314, and an intermediate inflatable cuff 330 at a position along the tube 312 between the proximal and distal ends 318, 320. The outer sleeve 314 and intermediate inflatable cuff 330 are shown in an inflated state in FIG. 10. Airway management device 300 is substantially the same as devices 10, 100, and 200, described above, without an inflatable cuff at the distal end 320 of the tube 312. When inflated after insertion through a patient's nostril N, for example, the outer sleeve 314 may be expanded with the distal end 320 of the tube 312 positioned proximate the laryngopharynx LP. The intermediate cuff 330 may be fluidly coupled to the outer sleeve 314 to allow concurrent inflation and deflation therewith. Alternatively, the intermediate cuff 330 may be separately inflated and deflated via a pilot tube as further discussed below.
FIGS. 11A-11H and 12 depict cross-sectional views of the nasal airway management device as shown in any of FIGS. 1-10 according to several embodiments of the invention and which optionally allows for separate inflation and deflation of the respective inflatable members of the device. For simplicity, reference is made hereafter to the embodiment of the device 100 depicted in FIGS. 5-8. As shown in FIG. 11A, for example, a pilot tube 140 may be provided extending along the length of the tube 112 to allow for separate inflation of one or more of the respective inflatable elements such as, for example, outer sleeve 114, inflatable cuff 116, and intermediate inflatable cuff 130 (not shown in FIGS. 11A-11H). As shown in FIGS. 11A, 11C, and 11D, the pilot tube 140 may be coupled to or formed integral with the tube 112. As shown in FIG. 11B, the pilot tube 140 may be disposed within the lumen of the tube 112 and extend freely along the length of the tube 112. As shown in FIGS. 11F, 11G, and 11H, the pilot tube 140 may be coupled to or formed integral with the outer sleeve 114. As shown in FIG. 11E, the pilot tube 140 may extend freely along the length of the tube 112 in a space between an outer surface of the tube 112 and an inner surface of the outer sleeve 114. As shown in FIG. 12, multiple pilot tubes 140′, 140″ may be provided along the length of the tube 112.
As shown in the embodiment depicted in FIGS. 13-14, the tube 112 may be provided without an outer sleeve, and may be expanded radially (e.g., increasing internal diameter) when the pilot tubes 140, 140′, 140″ extending along the length thereof are inflated. The pilot tubes 140, 140′, 140″ may also spiral (not shown in detail) along the length of the tube 112 such that when the pilot tubes 140, 140′, 140″ are inflated, the length of the tube 112 increases.
The embodiments of the nasal airway management device may be useful and beneficial in various medical situations. For example, the device may be utilized for rescue ventilation in emergency situations to provide effective and reliable ventilation by nurses or other non-anesthesia trained personnel involved in the management of a coding patient before arrival of anesthesia or emergency rooms doctors and placement of an endotracheal tube. Additionally, the device may be utilized in the early postoperative period to prevent a patient's tongue and soft tissue from collapsing onto the pharynx and obstructing the patient's upper airway while also providing the ability to rapidly transition to PPV by inflating the cuff when a patient stops breathing due to over-sedation, muscle weakness or residual anesthetic effects.
The device may also be utilized in outpatient procedures requiring sedation. These procedures (e.g. colonoscopies, endoscopies, transesophageal echocardiograms) are done under anesthesia sedation with intravenous general anesthetics (e.g. propofol) or combination of narcotic with anxiolitic. One of the anesthetic goals of such a technique is to keep patients breathing on their own (spontaneous ventilation) while supplemental oxygen is provided via nasal cannula. Emergency situations arise when a patient is over-sedated and stops breathing. Effective use of the device in place of conventional nasal cannulas will dramatically improve safety, by allowing timely, effective and smooth transition to PPV in a case of anesthetic overdose and cessation of spontaneous ventilation. Similar use under general anesthesia may be provided.
While various embodiments of the present invention have been described above, it should be understood that they have been presented by way of example only, and not limitation. Thus, the breadth and scope of the present invention should not be limited by any of the above-described embodiments, but should instead be defined only in accordance with the following claims and their equivalents.

Claims

1. An airway management device, comprising:

a hollow flexible tube defining a lumen extending between a proximal end and a distal end, wherein the proximal end is configured to be coupled to at least one of a ventilator and an anesthesia circuit, wherein an opening is provided proximate the distal end to allow passage of air and/or anesthesia therethrough, and wherein the tube is configured to be expanded radially after insertion through a patient's nasopharyngeal passageway when the distal end of the tube is positioned proximate the patient's hypopharynx.

2. The airway management device according to claim 1, further comprising:

an inflatable outer sleeve surrounding and extending along a length of the tube, wherein, when the outer sleeve is in a deflated state, the distal end of the tube is configured to be inserted through a patient's nasopharyngeal passageway, and wherein, when the distal end of the tube is positioned proximate the patient's hypopharynx, the outer sleeve is configured to be inflated and expanded.

3. The airway management device according to claim 2, further comprising:

an inflatable cuff attached at or near the distal end of the tube, wherein the inflatable cuff defines an opening fluidly coupled with the opening and lumen of the tube to allow passage of air and/or anesthesia therethrough, wherein, when in a deflated state, the inflatable cuff is configured to be inserted through the patient's nasopharyngeal passageway, and wherein, when in an inflated state, the inflatable cuff is configured to expand to form a seal around the patient's supraglottic laryngeal inlet.

4. The airway management device according to claim 3, wherein a space between an outer surface of the tube and an inner surface of the outer sleeve defines an inflation passage extending along the tube and fluidly coupled to the inflatable cuff to allow concurrent inflation and deflation of the outer sleeve and the inflatable cuff.

5. The airway management device according to claim 5, wherein the outer sleeve further comprises an intermediate inflatable cuff portion disposed between the proximal and distal ends, wherein the intermediate inflatable cuff portion is configured to have a larger diameter than other portions of the outer sleeve when inflated, and wherein, when positioned in the patient's oropharynx and inflated, the intermediate inflatable cuff portion of the outer sleeve is configured to secure the tube therein and prevent the tube from sliding back into the nasopharyngeal passageway.

6. The airway management device according to claim 3, further comprising a pilot tube extending along the length of the tube.

8. The airway management device according to claim 6, wherein the pilot tube is fluidly coupled to the inflatable cuff and to a space between an outer surface of the tube and an inner surface of the outer sleeve to allow concurrent inflation and deflation of the inflatable cuff and the outer sleeve.

9. The airway management device according to claim 8, further comprising an intermediate inflatable cuff provided on the outer sleeve between the proximal and distal ends, wherein the intermediate inflatable cuff is configured to have a larger diameter than the outer sleeve when inflated, and wherein, when positioned in the patient's oropharynx and inflated, the intermediate inflatable cuff is configured to secure the tube therein and prevent the tube from sliding back into the nasopharyngeal passageway.

10. The airway management device according to claim 9, wherein the intermediate inflatable cuff is fluidly coupled to at least one of the pilot tube and a space between the outer surface of the tube and the inner surface of the outer sleeve to allow concurrent inflation and deflation of the outer sleeve, the inflatable cuff, and the intermediate inflatable cuff.

11. The airway management device according to claim 9, wherein the intermediate inflatable cuff is fluidly coupled to a second pilot tube to allow inflation and deflation of the intermediate inflatable cuff separate from the outer sleeve and the inflatable cuff.

12. The airway management device according to claim 6, wherein the pilot tube is fluidly coupled to the inflatable cuff to allow inflation and deflation of the inflatable cuff separate from the outer sleeve.

13. The airway management device according to claim 12, further comprising an intermediate inflatable cuff provided on the outer sleeve between the proximal and distal ends, wherein the intermediate inflatable cuff is configured to have a larger diameter than the outer sleeve when inflated, and wherein, when positioned in the patient's oropharynx and inflated, the intermediate inflatable cuff is configured to secure the tube therein and prevent the tube from sliding back into the nasopharyngeal passageway.

14. The airway management device according to claim 13, wherein the intermediate inflatable cuff is fluidly coupled to a space between the outer surface of the tube and the inner surface of the outer sleeve to allow concurrent inflation and deflation of the outer sleeve and the intermediate inflatable cuff.

15. The airway management device according to claim 13, wherein the intermediate inflatable cuff is fluidly coupled to at least one of the pilot tube and the inflatable cuff to allow concurrent inflation and deflation of the inflatable cuff and the intermediate inflatable cuff.

16. The airway management device according to claim 13, wherein the intermediate inflatable cuff is fluidly coupled to a second pilot tube to allow inflation and deflation of the intermediate inflatable cuff separate from the outer sleeve and the inflatable cuff.

17. The airway management device according to claim 2, further comprising an intermediate inflatable cuff provided on the outer sleeve between the proximal and distal ends, wherein the intermediate inflatable cuff is configured to have a larger diameter than the outer sleeve when inflated, and wherein, when positioned in the patient's oropharynx and inflated, the intermediate inflatable cuff is configured to secure the tube therein and prevent the tube from sliding back into the nasopharyngeal passageway.

18. The airway management device according to claim 17, wherein a space between an outer surface of the tube and an inner surface of the outer sleeve defines an inflation passage extending along the tube and fluidly coupled to the intermediate inflatable cuff to allow concurrent inflation and deflation of the outer sleeve and the intermediate inflatable cuff.

19. The airway management device according to claim 17, further comprising a pilot tube extending along the length of the tube.

20. The airway management device according to claim 19, wherein the intermediate inflatable cuff is fluidly coupled to the pilot tube to allow inflation and deflation of the intermediate inflatable cuff separate from the outer sleeve.

21. The airway management device according to claim 1, further comprising a plurality of pilot tubes extending along a length of the tube and configured to radially expand the tube when inflated.

22. The airway management device according to claim 21, wherein the pilot tubes spiral along the length of the tube, wherein, when the pilot tubes are inflated, the length of the tube increases.