WO2008154800A1

WO2008154800A1 - Multifunctional catheter for detecting respiration and ecg signals

Info

Publication number: WO2008154800A1
Application number: PCT/CN2008/001079
Authority: WO
Inventors: Yuanming Luo; Nanshan Zhong
Original assignee: Yuanming Luo; Nanshan Zhong
Priority date: 2007-06-20
Filing date: 2008-06-02
Publication date: 2008-12-24
Also published as: GB201000533D0; GB2463426B; GB2463426A

Abstract

A multifunctional catheter (18) for detecting respiration and ECG signals can simultaneously detect esophageal pressure, multi-channel diaphragm EMG signals, and esophageal ECG, and has the function of nasal feeding. Three noncommunicating lumens inside the catheter (18) are used for accommodating electrode leads (24), conducting pressure and nasal feeding respectively. The outside of the catheter (18) is equipped with one balloon (22), which is communicated with a small lumen (19) inside the catheter (18) for measuring esophageal pressure. The distal end of the catheter (18) is provided with multiple big pores (14), which are connected witha gastric tube joint (29) at the proximal end of the catheter (18) through a big lumen (21) inside the catheter (18) for nasal feeding. The proximal end of the balloon (22) is provided with one grounding electrode (31) and the distal end of the balloon (22) is successively provided with one ECG electrode (10) and nine electrodes (1-9) for recording diaphragm EMG. There is a distance (15,32) between the grounding electrode (31) and the balloon (22), and between the balloon (22) and the ECG electrode (10) respectively. There is a bigger distance (11) between the ECG electrode (10) and the electrode (9) for recording diaphragm EMG, and there isa minimal distance (12) between the adjacent electrodes (1-9) for recording diaphragm EMG. There is a distance between each one of the big pores (14) at the distal end.

Description

Multifunctional respiratory ECG signal detection catheter

The invention relates to a medical detecting catheter, in particular to a multifunctional respiratory ECG signal detecting catheter capable of simultaneously detecting respiratory power, diaphragmatic myoelectric signal and electrocardiographic signal and having gastric tube function. This catheter can simultaneously measure esophageal pressure, diaphragmatic myoelectricity and esophageal electrocardiogram and has a nasal feeding function.

Background technique

Traditionally, critically ill patients often need to place their stomach tubes through the nose. A tracheal intubation or tracheotomy is often required for a patient with respiratory failure. If you want to detect respiratory muscle function and respiratory center drive, you often need to place two more catheters: one is a catheter with a balloon placed in the esophagus to measure esophageal pressure; the other is an esophageal electrode used to detect diaphragmatic myoelectricity. Since the patient has an endotracheal intubation or a tracheotomy and a gastric tube, it is difficult or even impossible to reinsert two catheters from the nostrils. Due to the difficulty in placing the detection catheter in the critical ward (ICU), it is difficult to implement the monitoring of respiratory function, which may result in the patient's condition change not being detected in time, which seriously affects the patient's success rate. In addition, in order to continuously obtain the patient's heart rate and ECG signals, it is often necessary to place three chest surface electrodes on the patient's chest. These electrodes are easy to fall off, and the chest surface electrodes and their associated three lead wires affect the patient's care. If the ECG monitoring function can also be obtained from the nasal feeding catheter, the nasal feeding catheter can be used instead of the traditional placement of the chest surface electrode and its associated leads, and more ECG information including clear P waves can be obtained, making ECG monitoring more precise. reliable. At present, there is no catheter in the world that can replace the nasogastric tube and simultaneously measure esophageal pressure, multi-conductor myoelectricity and esophageal electrocardiogram.

Summary of the invention

The object of the present invention is to solve the difficulty of placing a plurality of catheters, affecting the detection of respiratory muscle function and the disadvantages of chest electrocardiogram electrodes and related wires affecting nursing, and providing a method for simultaneously measuring respiratory pressure, diaphragmatic myoelectricity, and electrocardiographic signals. Multifunctional respiratory ECG signal detection catheter with nasal feeding function.

The multifunctional respiratory ECG signal detecting catheter of the present invention comprises three lumens, namely a small lumen for measuring esophageal pressure, a small lumen for accommodating electrode leads, and a large lumen for nasal feeding. The outer surface of the multifunctional respiratory ECG signal detection catheter is attached to a closed balloon. The balloon communicates with the small lumen measuring the esophageal pressure through a plurality of small holes. The distal end of the multifunctional respiratory ECG signal detecting catheter is provided with a plurality of large holes. The large holes communicate with the large lumen for nasal feeding. An electrode lead is placed in the small lumen of the electrode lead. The multifunctional respiratory ECG signal detects the appearance of the catheter. The distal end of the balloon is equipped with a plurality of electrodes for recording esophageal electrocardiogram and diaphragmatic myoelectricity. There is a gap between the balloon and the electrocardiographic electrode. Electrocardiogram electrode and recording There is also a gap between the electrodes of the muscle myoelectricity. An equal small insulation gap is provided between adjacent electrodes recording the myoelectrical muscles. The distal recording electrode is located at a distance from the distal large hole of the catheter. The electrocardiographic electrodes and the individual electrodes recording the myoelectrical muscles are of equal length and are respectively connected to the electrode leads in the small lumen. A small lumen for measuring esophageal pressure, a small lumen for accommodating the electrode lead, and a large lumen for nasal feeding are bifurcated at the proximal end of the multifunctional respiratory ECG signal detection catheter and connected to the corresponding connector. In use, the three connectors are respectively connected to the esophageal pressure sensor, the diaphragmatic myoelectric sensor, the electrocardiographic signal sensor, and the gastric tube.

Multi-function respiratory ECG signal detection catheter The proximal end of the balloon is equipped with an electrode for grounding. The distal end is equipped with an electrode for recording esophageal electrocardiogram and 9 electrodes for recording diaphragmatic myoelectricity.

The multifunctional respiratory ECG signal detection catheter has a balloon length of 5-10 cm and a circumference of about 3 cmo. The proximal end of the balloon has an electrode for grounding. There is a gap between the distal end of the balloon and the ECG electrode. The gap of l cm. The length of each electrode is 1 cm, the gap between the electrocardiographic electrode and the diaphragmatic myoelectric electrode is 2 cm, and the gap between the adjacent diaphragmatic myoelectric electrodes is below 1 mm.

Ten recording electrodes constitute six leads: lead I consists of electrode 1 and electrode 5, lead II consists of electrode 2 and electrode 6, lead ΠΙ consists of electrode 3 and electrode 7, lead IV consists of electrode 4 and The electrode 8 is composed of a lead V composed of an electrode 5 and an electrode 9. The recording of the esophageal electrocardiogram consists of a lead VI composed of an electrode 10 and an electrode 9. Therefore, the electrode 9 functions both as a diaphragmatic myoelectric electrode and as an electrocardiographic electrode.

In use, when the electrode 5 is at the diaphragm level of the esophagus, the two leads that participate in the composition will record the myoelectrical signals of the diaphragm that are similar in amplitude and larger than the other leads. By observing the amplitude of the myoelectrical signal recorded by each lead, the electrode 5 can be accurately and quickly placed at the level of the diaphragm of the esophagus. Since the gap between the two electrodes is extremely small, the interference of the diaphragmatic movement on the diaphragmatic electrical recording during respiration is overcome. When an electrode that is adjacent to the diaphragm becomes far from the diaphragm, the other electrode is adjacent to the diaphragm, as if a lead is tracking the diaphragm muscle movement to overcome the interference caused by diaphragmatic movement. When the electrode 5 is in the diaphragm plane, according to the anatomical relationship, the balloon is located in the esophagus and the distal end of the catheter is in the stomach.

The beneficial effects of the present invention are that the multifunctional respiratory ECG signal detecting catheter has the functions of a conventional four catheters, namely, a gastric tube, an esophageal cystic duct, an esophageal electrode for recording the diaphragmatic myoelectricity, and an electrode catheter for recording an esophageal electrocardiogram. The electrode portion of the catheter can be accurately and quickly placed at the level of the diaphragm of the esophagus, the esophageal sac is placed in the esophagus, the electrocardiographic electrode is placed close to the heart, and the distal end of the catheter is placed in the stomach.

The multifunctional respiratory ECG signal detection catheter has four functions. The multifunctional respiratory ECG signal detection catheter is placed in the stomach-esophagus, which can replace the common stomach tube for nasal feeding, measure the esophageal pressure for reflecting the intrathoracic pressure, and record the esophageal electrocardiogram, and at the same time be accurate. The diaphragmatic myoelectricity is recorded to eliminate the interference of the diaphragmatic movement on the diaphragmatic electrical signal. Multi-function respiratory ECG signal detection catheter has changed the traditional Due to the measurement of esophageal pressure, diaphragmatic muscles and nasal feeding, three catheters have to be placed, and three chest surface ECG electrodes and their associated lead wires can be replaced to facilitate care and obtain more ECG information. In addition, the esophageal pressure recorded by the catheter is detected by the multi-function respiratory ECG signal, and the diaphragmatic muscle can trigger the regulation of the ventilator air supply for offline timing selection.

DRAWINGS

BRIEF DESCRIPTION OF THE DRAWINGS Fig. 1 is a configuration diagram of a multifunctional respiratory ECG signal detecting catheter of the present invention.

Fig. 2 is an enlarged cross-sectional view taken along line A-A of Fig. 1;

3 is a cross-sectional view of the multifunctional respiratory ECG signal detecting catheter.

Figure 4 is a schematic diagram showing the relationship between the electrode and the lead of the multifunctional respiratory ECG signal detection catheter.

In the figure, 1-10 recording electrode 11 two gaps between the electrocardiographic electrodes record the insulating gap between the adjacent electrodes of the diaphragmatic myoelectric 13 distal electrode and distal large hole distance 14 proximal end of the catheter large hole 15 Distance between the electrode and the balloon 16 distal connection of the balloon 17 proximal connection of the balloon 18 multi-function respiratory ECG signal detection catheter 19 multi-function respiratory ECG signal detection catheter measuring more than 20 small lumens of esophageal pressure Functional Respiratory ECG Signal Detection Catheter Contains Small Electrode Wires in the Catheter 21 Multi-Purpose Respiratory ECG Signal Detection Intracavitary Large Catheter 22 Balloons 23 Balloons and Small Catheters in the Catheter Catheter Wire 25 The proximal end of the catheter is connected to the small lumen of the catheter. The proximal end of the catheter is connected to the bifurcation that measures the esophageal pressure lumen. The proximal end of the catheter is connected to the nasal cavity of the nasal feeding. 28 Electrode wire connector 29 Gastric tube connector 30 tee connector 31 grounding electrode 32 The gap between the balloon and the ground electrode.

detailed description

The multi-function respiratory ECG signal detecting catheter of the present invention has three mutually independent lumens for measuring esophageal pressure, accommodating electrode leads and nasal servos. The multifunctional respiratory ECG signal detection catheter also includes a proximal connector, a balloon, ten electrodes of equal length and connected to the electrode lead, and a distal end of the catheter with a hole. There are three proximal connectors of the catheter, which are tee fittings, electrode lead fittings and gastric tube fittings. The balloon is located at the distal end of the ground electrode and communicates with a small lumen in the catheter through a plurality of small holes to measure esophageal pressure. The most proximal electrode is the reference electrode for grounding. The remaining recording electrodes were used to simultaneously record multi-channel diaphragmatic myoelectricity and ECG. An equal small insulation gap is provided between the electrodes recording the myoelectrical muscles.

The distal end of the catheter has a plurality of large holes and communicates with the large lumen of the multifunctional respiratory ECG signal detection catheter for nasal feeding. One proximal electrode is used for grounding and 10 recording electrodes are used to record ECG and diaphragm myoelectricity.

The present invention will be further described below in conjunction with the accompanying drawings:

As shown in Fig. 1, the multifunctional respiratory ECG signal detecting catheter 18 of the present invention is composed of 11 electrodes 1010 and 31 of exactly the same length, a balloon 22, a distal large hole 14 and a proximal end of the catheter. The distal end of the balloon 22 and the multi-function respiratory ECG signal detecting catheter 18 have a distal end of the balloon 16, the proximal end of the balloon 22 and the multi-function respiratory ECG signal detecting catheter 18 have a proximal end of the balloon 17 . There is a distance 15 between the balloon 22 and the electrode 10. The electrode 31 and the balloon 22 have a gap 32.

As shown in Fig. 2, the multifunctional respiratory ECG signal detecting catheter 18 is composed of three mutually non-intersecting lumens. One is a small lumen 19 for measuring esophageal pressure within the catheter. The esophageal small lumen 19 communicates with the balloon 22, the other is a small lumen 20 through which the electrode lead 24 passes, and the other is a nasal feeding large lumen 21. The nasal cavity 21 is connected to the distal large hole 14 and is used for the nasal word.

As shown in FIG. 3, the balloon 22 communicates with the small tube 19 by measuring the small hole 23 in the esophageal pressure small lumen 19, and the small lumen 19 for measuring the esophageal pressure is connected to the tee connector 30 through the bifurcation 26, Thereby the balloon pressure is measured. The proximal electrode 31 is used for grounding as a reference electrode, and the remaining 10 are recording electrodes 1-10. There is a distance 15 between the electrocardiographic electrode 10 and the balloon. There is a gap 11 between the electrocardiographic electrode 10 and the electrode 9. There is a slight insulation gap 12 between the recording electrodes. The recording electrode 1 has a distance 13 from the distal opening 14 of the catheter. Each of the electrodes is coupled to a lead 24 in the small lumen 20 and extends through a bifurcation 25 to a lead connector 28 at the proximal end of the catheter to derive a diaphragmatic myoelectric signal. The distal end of the multifunctional respiratory ECG signal detecting catheter has a plurality of large holes 14 communicating with the large lumen 21 of the catheter, and is connected to the gastric tube connector 29 through the catheter bifurcation 27 for nasal communication.

As shown in Fig. 4, as a preferred embodiment, the balloon 22 of the multifunctional respiratory ECG signal detecting catheter has a length of 5-10 cm and a circumference of about 3 cm. The gap 15 between the balloon 22 and the electrode 10 is 1 cm. The gap 32 between the balloon 22 and the electrode 31 is 1 cm. The length of each electrode is 1 cm, the gap 11 between the electrocardiographic electrode 10 and the diaphragmatic myoelectric electrode 9 is 2 cm, and the adjacent gap 12 between the electrodes 1-9 is about 1 leg. Ten recording electrodes constitute six leads: lead I consists of electrode 1 and electrode 5, lead II consists of electrode 2 and electrode 6, lead ΠΙ consists of electrode 3 and electrode 7, lead IV consists of electrode 4 and The electrode 8 is composed of a lead V composed of an electrode 5 and an electrode 9, and a lead VI is composed of an electrode 9 and an electrode 10. 4厘米。 The lead I - V is used to record the diaphragm muscle EMG, the distance between the two electrodes of each lead is about 3. 4 cm. Lead VI is used to record the esophageal ECG with a distance of 2 cm between the two electrodes. When the electrode is placed, the amplitude of the diaphragm myoelectricity recorded by the lead I-V is observed in real time. When the lead I and the lead V record a signal having a similar amplitude and a larger signal amplitude than that recorded by other leads, the prompt electrode 5 is In The level of the diaphragm of the esophagus. At this time, the lead m is equal to the distance between the upper and lower electrodes and the diaphragm, and the potential is canceled, and only a small diaphragmatic myoelectric signal is recorded. Due to the maximal respiratory motion, the esophageal part of the diaphragm is moved less than 1.5 cm, and there is only a gap of 1 mm between adjacent recording electrodes, so if the recording electrode 5 is placed at the diaphragm level of the esophagus, no matter how large the breathing is. There is always one electrode at the diaphragm level. For example, when the lung volume is increased or the diaphragm contraction causes the diaphragm to move downward by 1 cm when inhaling, the electrode 5 originally at the diaphragm level leaves the diaphragm, and the recording electrode 6 becomes at the diaphragm level of the esophagus. By dynamically selecting the maximal diaphragmatic myoelectricity in 5 leads, it is as if one electrode is always following the diaphragmatic movement. This eliminates the disturbance caused by respiratory movement or diaphragmatic movement during diaphragmatic electromyography. Since the diaphragm of the esophagus is 2 - 3 cm away from the cardia, when the electrode 5 is in the plane of the diaphragm of the esophagus, the distal hole 14 of the catheter is in the stomach, and nasal feeding can be smoothly performed through the proximal gastric tube joint. At this time, the balloon 22 can measure the esophageal pressure in the lower part of the esophagus and can be used to trigger the ventilator to deliver air.

Claims

Claim

A multifunctional respiratory ECG signal detecting catheter comprising three lumens, namely a small lumen for measuring esophageal pressure, a small lumen for accommodating electrode wires, and a large lumen for nasal words; The outer surface of the ECG signal detection catheter is attached to a closed balloon, and the balloon communicates with the small lumen for measuring esophageal pressure through a plurality of small holes; the distal end of the multifunctional respiratory ECG signal detection catheter is provided with a plurality of large holes, The hole communicates with the large lumen for nasal feeding; the small lumen containing the electrode lead is provided with an electrode lead; and the characteristic is: the appearance of the multifunctional respiratory ECG signal detecting catheter, and the distal part of the balloon is provided with a plurality of records Electrode of esophageal electrocardiogram and diaphragmatic muscle; a gap is provided between the balloon and the electrocardiographic electrode, and a gap is also provided between the electrocardiographic electrode and the electrode for recording the diaphragmatic myoelectricity, and the adjacent electrode of the diaphragmatic muscle is recorded. An equal small insulating gap is provided; the distal recording electrode is provided with a distance from the distal large hole of the catheter; the electrocardiographic electrode and the respective electrodes recording the diaphragmatic myoelectricity are respectively connected to the electrode lead in the small lumen; measuring the esophagus The small lumen of the pressure, the small lumen for accommodating the electrode lead, and the large lumen for the nasal word are bifurcated at the proximal end of the multifunctional respiratory ECG signal detection catheter and connected to the corresponding connector; multifunctional respiratory ECG signal detection The proximal end of the catheter balloon is fitted with an electrode for grounding.

2. The multifunctional respiratory ECG signal detecting catheter according to claim 1, wherein: the distal end portion of the multifunctional balloon electrocardiographic signal detecting catheter is equipped with an electrode for recording esophageal electrocardiogram and 9 records. Electrode of the diaphragmatic muscle.

3. The multifunctional respiratory ECG signal detecting catheter according to claim 1, wherein: the multifunctional respiratory ECG signal detecting catheter has a balloon length of 5-10 cm and a circumference of about 3 cm; The proximal end of the capsule has an electrode for grounding, and there is a 1 cm gap between the distal end of the balloon and the electrocardiographic electrode; the length of each electrode is 1 cm, and the gap between the electrocardiographic electrode and the myoelectric electrode of the diaphragm is 2 Cm, the gap between the adjacent diaphragmatic myoelectric electrodes is below 1 dish.