Pharyngeal-Enteric Tube Combination Device

Tech ID: ros000903

 

Introduction

Patients with a wide variety of illnesses are intolerant of managing (that is, reflex swallowing) their oral secretions leading to fluid buildup in the pharynx with fluid aspiration into the lungs and often visible drooling out of the mouth.  As such, patients do not tolerate oral nutrition they also receive, liquid nutrition delivered via a long flexible tube (‘enteric tube’) inserted through the nasal passages and into the stomach.  A common complication of enteral nutrition is, however, unnoticed regurgitation of stomach fluid (i.e., at night time) with aspiration of gastric acid, saliva, food and secretions into the airway. Therefore, patients with impaired swallowing are at great risk of developing aspiration-induced compromised breathing function and lung infection leading to increased length of stay and health care costs. Further, patients in this situation are often also in need of supplemental oxygen.

Intermittent (trans-)oral suctioning to clean out the mouth and pharynx from secretions is currently used to reduce aspiration risks.  Other preventative measures include elevating head/body positioning and applying careful feeding protocols. However, these measures are imperfect and require significant care taker commitment.  In addition, intermittent oropharyngeal suctioning evokes gag reflexes and is very unpleasant for the majority of patients.

 

Technology Description

Dr. Axel Rosengart of Cedars-Sinai Medical Center (CSMC) has designed a device that combines an enteric feeding and an pharyngeal suctioning tube that both pumps food into a patient’s stomach while independently allowing suctioning of a patient’s throat to remove pharyngeal secretions. The device has a ‘tube-in-tube’ design where the tubes are coaxially arranged with the pharyngeal suctioning lumen positioned external to the feeding tube. The pharyngeal tube provides a path for secretions that have been vacuumed into perforations to flow outwards toward an external reservoir for disposal.  Optional embodiments include a third tube which provides access to the throat for supplemental oxygen delivery directly to the patient’s tracheal entrance.

 

Stage of Development

Concept only

 

Advantages/Novelty

The current method of intermittent suctioning of patients with impaired swallowing has many drawbacks including (a) the need for constant monitoring of the caregiver; (b) uncomfortable arousal each time a catheter is inserted into the throat which elicits strong gag reflexes; and (c) risks for bleeding and laceration of mucous membranes. Additionally, (d) the current solutions for supplemental oxygen administration (e.g., nasal prongs or face masks) are frequently irritating and cumbersome for the patient and unreliable for the care giver.

In contrast, Dr. Rosengart’s device:

a)       Replaces transoral suctioning and reduces the discomfort and risks associated with it. This also drastically decreases the need for effort and monitoring by the caregiver.

b)       Reduces the amount, rate, and frequency of aspirations with reduction of aspiration-induced lung injury and infections.

c)       In optional embodiments, provides a convenient, safe and reliable method to provide supplemental oxygen directly to the patient’s tracheal entrance which is a safer, more reliable and more effective method of oxygen delivery.

 

Applications

Enteral nutrition

 

Intellectual Property

• PCT application PCT/US2016/060630 filed.

Patent Information:
Category(s):
Device(s)
For Information, Contact:
Julien Brohan
julien.brohan@cshs.org
Inventors:
Axel Rosengart
Keywords:
Surgery