US 3777742 A
Apparatus for insufflating the airways of a patient with tantalum dust, either by the inhalation method or the catheter method.
Description (OCR text may contain errors)
United States Patent [191 Aumiller et al.
[ Dec. 11, 1973 TANTALUM INSUFFLATOR lnventors: Clyde F. Aumiller, Rockford, 111.;
Lowell 1). Morrison, Fort Atkinson; Dale G. Holinbeck, Madison, both of Wis.
Assignee: Barber-Colman Company, Rockford, Ill.
Filed: Sept. 18, 1972 Appl. No.: 289,836
US. Cl 128/2 A, 128/266, 222/193 Int. Cl. A61b 6/00, 661m 13/00 Field of Search 128/266, 2 A, 185;
 References Cited UNITED STATES PATENTS 277,900 5/1883 Hayes 128/266 881,238 3/1908 Hasbrouck.... 128/266 X 1,599,959 9/1926 Fujimoto 128/266 2,535,844 12/1950 Emerson 128/185 X Primary ExaminerA1drich F. Medbery Att0rneyC. Frederick Leydig et a1.
 ABSTRACT Apparatus for insufflating the airways of a patient with tantalum dust, either by the inhalation method or the catheter method.
14 Claims, 8 Drawing Figures PAIENIEDUEC 1 1 1975 3; 777; 742
' sum 2 OF 2 TANTALUM INSUFFLATOR BACKGROUND OF THE INVENTION This invention relates to apparatus for insufflating the airways of a human with a radiopaque powder, such as powdered tantalum, for the purpose of preparing the airways for radiologic study.
The use of powdered tantalum as a medium for bronchography is explained in Investigative Radiology, Vol.
3, No. 4, July-August 1968 (pp. 229-238) and in Radiology, Vol. 94, No. 3, March 1970 (pp. 547-553),
these publications also disclosing apparatus for insufflating the airways. The latter publication suggests that insufflation of tantalum may be effected either by a catheter method or by an inhalation method, and in each instance, a cloud of tantalum dust is generated by blowing air into a pile of powdered tantalum stored in a chamber defined within a container. With the catheter method, the tantalum dust in the cloud is .blown from the chamber and into the airways of the patient via a catheter tube while, with the inhalation method, the dust is sucked into the airways as the patientinhales on a tube leading from the chamber. The inhalation method is preferred in most casesin order to avoid the need for a catheter but it is sometimes necessary to use a catheter if it is desired to outline a particular area of the bronchus or with infantsor patients who, may not be completely healthy.
SUMMARY OF THE INVENTION The general aim of the present invention is to provide new and improved apparatus which isparticularly suitable for insufflating by the inhalation method and which is characterized by its ability to generatea dust cloud in the chamber without forcing the dust out of thechamber so as to avoid the escape of dust when the patient is not inhaling.
A more detailed object is to use pressurized air to generate the dust cloud in the chamber while keeping the chamber itself unpressurized to prevent the dust from escaping from the chamber except when the patient inhales.
The invention also resides in the provision of new and improved insufflating apparatus with an insufflatingair circuit and a closed loop cloud generating air circuit, the two circuits coacting to accomplish effective tantalum insufflation by the inhalation method.
A further object ofthe invention is to provide unique apparatus which may be used to insufflate the airways either bythe inhalation method or the catheter method.
The invention is further characterized by several advantageous features which insure proper insufflation of the patient and assist in the proper administration of the tantalum.
These and other objects and advantages of the invention will become more apparent from the following detailed description when taken in conjunctionwith the accompanying drawings.
BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a schematic view of new and improved in sufflatin g-appar atus embodying the novel features of the present invention.
FIG. 2 is a top plan view of the tantalum container.
FIG. 3 is afragmentary cross-section taken substantially along the line 3-3 of FIG. 2.
when the catheter method is employed.
DETAILED DESCRIPTION .OF THE PREFERRED EMBODIMENT As shown in the drawings for purposes of illustration, the invention is embodied in apparatus for insufflating the airways of a patient with powdered tantalum or similar radiopaque powder preparatory to taking a bronchogram. The tantalum powder or dust varies in size from zero to five microns or larger, is non-toxic and serves to line and suitably opacify the airways.
In the illustrated apparatus, a pile 10 of tantalum powder is placed in the lower end of a chamber 11 de? fined within an upright vessel or container 13 formed with a downwardly tapered frusto-co'nical body 14, a
small cylindrical bottom 15 and a'large cylindrical top g 16 covered by a topplate l7. Pressurized air then is directed at the pile to generate a dense cloud of tantalum dust in the chamber..After the cloud has been created, insufflation of the airways is effected by the patient sucking through an outlet line 20 leading from the chamber and, in this way, the dust from the cloud is drawn from the chamber and into the patients lungs when the patient inhales. f I
According to the primary aspect of the present inven- I tion, the dust cloud is effectively generated in the chamber 11 by blowing pressurized air against the pile of tantalum powder but, at the same time, is created without producing positive pressure in the chamber so as to avoid blowing the powder out of the outlet line 20 when the patient is not inhaling. As a result, a dense dust cloud may be continuously generated in the chamber while the patient is being prepared forinsufflation and yet the dust will not flow out of or escape from the chamber until the patient actually sucks through the outlet line. I
In keeping with the invention, provision is made in the preferred apparatus of two air circuits, namely, a cloud generating circuit 21 and an insufflating or inhalation circuit 23 (FIG. 1) to enable creation of the tantalum dust cloud in the chamber 11 without positive pressure and to enable the patient to suck from the chamber a stream of tantalum-laden air. The inhalation circuit 23 includes the outlet line 20, which extends downwardly into the chamber 11 through the top plate 17 as shown in FIG. 3,and further includes an inlet line 24 whose downstream end also communicates with the chamber through the top plate. The upstream end of the inlet line 24 is adapted to communicate with the atmosphere and thus, when the patient sucks on the outlet line 20, a stream of air is drawn into the chamber from the inlet line and flows through the chamber and into the outlet line for delivery into the lungs of the patient.
The cloud generating circuit 21 includes a power driven pressure pump 30, such as a diaphragm pump, whose discharge side is connected to an outlet conduit 31 (FIGS. 1 and 3) extending downwardly into the chamber 11 and terminating in a generally cylindrical nozzle 33 disposed immediately above the pile of powder. Advantageously, the nozzle is formed with one centrally located and vertically extending hole 34 (FIG. 4) and with a series of angularly spaced holes 35 which are inclined downwardly and outwardly. Thus, when the pump 30 is operated, the air discharged from the nozzle is dispersed as a series of spaced jets which impinge on the pile of powder and create turbulence to produce the dust cloud. Because of the arrangement of the holes 34 and 35, the powder is blown uniformly from the top of the pile to avoid the formation of craters in the pile and thus enable the use of a comparatively shallow pile. A pressure regulator 37 (FIG. 1) preferably is placed in the outlet conduit 31 to enable selective controlof the turbulence created above the dust pile. To enable easy replenishing of the dust pile and cleaning of the container 13, the latter is connected detachably to the cover plate 17 by a bayonet connection indicated generally at 39 in FIGS. 3 and 5 and thus the container may be turned and pulled downwardly away from the cover plate. Alternatively, the container may be loaded through the outlet line 20 with the aid of a funnel or the like.
Further to the invention, the cloud generating circuit 21 (FIG. 1) includes an inlet conduit 40 whose one end is connected to the suction side of the pump and whose other end communicates with the chamber 11 by way of a T-fitting 41 in the inlet line 24. Accordingly, the cloud generating circuit.2l consists of the pump 30, the outlet conduit 31, the chamber 11 and the inlet conduit 40 and thus forms a closed loop which extends through the chamber. As a result, the chamber is not pressurized to any substantial extent when -the pump is operated to form the dust cloud but, instead, that quantity of air which is discharged into the chamber through the outlet conduit 31 is removed from the chamber and returned to the pump through the inlet conduit 40. The chamber thus remains at substantially atmospheric pressure in spite of the air jets being discharged from the nozzle 33 and hence the tantalum dust is conserved and is not blown through the outlet line 20 when thepatient is not inhaling. When the patient does inhale, some ofthe dustparticles in the cloud become entrained in the air stream being drawn into the chamber 11 through the inlet line 24 and are sucked through the outlet line and into the airways of the patient.
The outlet line 20, the inlet line 24 and the outlet conduit 31 are positioned in such a manner as to create a long flow path for the inhaled stream of air through the tantalum cloud. In the preferred arrangement, the outlet conduit 31 extends downwardly through the center of the top plate 17 (see FIGS. 2 and 3) while the outlet line 20 and the inlet line 24 are located on opposite sides of the outlet conduit. The inlet line 24 terminates at the top plate 17 but the outlet line 20 extends well downwardly into the container 13 as shown in FIG. 3. Air being discharged from the centrally located outlet conduit 31 tends to create a turbulent swirl of dust in the chamber 11 and, because of the angular and vertical spacing between the outlet line 20 and the inlet line 24, the inhaled stream of air tends to flow along a comparatively long path as the stream moves through the chamber (see the arrows in FIG. 3). As a result of the long flow path, more of the tantalum dust becomes entrained in the inhaled stream.
The preferred apparatus includes several advantageous features which insure proper insufflation of the patient and assist in the proper admistration of the tantalum. For example, a throttle valve 45 (FIG. 1) is located in the upstream end portion of the inlet line 24 and may be adjusted to regulate the volume of air which the patient may inhale. Located in the inlet line downstream of the throttle valve is a desiccator 46 containing a suitable drying agent such as calcium sulfate for removing moisture from the inhaled air so as to prevent a moisture build up in the chamber 11 and reduce caking of the tantalum and bacterial contamination of the chamber. One suitable desiccator is that sold by Sargent Welch under N0. S-28730. Downstream of the desiccator is a flow meter 47 with a peak flow indicator 49, and associated with the flow meter is a resettable total volume indicator 50 which enables the radiologist to determine the total amount of tantalum-laden air which has been inhaled by the patient at any given time.
Advantageously, a biological filter 53 (FIGS. 1 and 2) is located in the inlet line 24 just downstream of the T-fitting 41 and just above the cover plate 17 of the chamber 11. As the patient inhales the filter catches any foreign particles larger than one micron so as to clean the air inhaled through the line 24 before such air reaches the patients airways. In addition, the filter collects tantalum dust which otherwise would be sucked upwardly from the chamber into the inlet conduit 40 and the cloud generating pump 30. When the patient inhales, the ,air being sucked downwardly through the filter tends to clear the latter by returning the collected tantalum back to the chamber. A filter which is suitable for these purposes is sold by Ohio Medical Products under part designation 225-2605-700.
Because of the height of the chamber 1 1 and because of the positioning of the discharge nozzle 33 near the bottom of the chamber, the dust cloud is formed primarily in the lower two-thirds of the chamber at a location remote from the filter 53 and the downstream or open end of the inlet line 24. Accordingly, less tantalum is sucked into the filter than otherwise would be the case if the cloud formation were concentrated near the top of the chamber.
Means 55 are provided for vibrating off of the interior surfaces of the container 13 that tantalum which collects on the surfaces during generation of the dust cloud. Herein, these means comprise a power-driven hammer '56 (FIG. 5) which repeatedly raps against the cover plate 17 of the container 13 to shake the latter and shear away the tantalum which collects on the container surfaces.
More specifically, the hammer 56 (FIG. 5) comprises a headed bolt which is threaded into the free end of an arm 57 whose other end is pivoted at 59 for up and down swinging on a bracket 60 upstanding from a mounting plate 61fastened to and supporting the cover plate 17. An electric motor 63 (FIGS. 2 and 5) also is supported on the mounting plate and its drive shaft 64 rotates a wheel 65 at a rate of about rpm. Carried on the wheel in radially offset relation with the shaft 64 is a pin 66 which is adapted to underlie a pad 67 secured to and projecting from one side of the arm 57 and adjustable lengthwise along the arm. As the wheel is rotated clockwise from the position shown in FIG. 5,
the pin 66 swings the arm 57 upwardly to raise the hammer 56 away from the cover plate l7.Then, when the pin clears the pad 67, the arm swings downwardly under the influence of a series of weights 69 supported on a stud 70 upstanding from the arm. As the arm swings downwardly, the hammer strikes an anvil 71 on the cover plate 17 and thus vibrates the container 13 to shaflce the tantalum loose from the container walls. Becausethe hammer strikes the cover plate of the container, the bond between the tantalum and the container side walls is broken in shear and thus the tantalum is removed more effectively than otherwise would be'the case if the hammer stuck against the side of the container. Because the filter 53 is located just above the container, the vibration effected by the hammer also shakes the filter to cause the tantalum collected thereon ,to fall back into the container. As the tantalum falls, the' conical walls of the body 14 of the container serve to funnel the dust back into the tantalum pile stored in the cylindrical bottom portion 15 of the container.
The frequency with which the hammer 56 vibrates the container 13 may be changed by adding one or more pins to the wheel in angularly spaced relation with the pin 66. The position to which the hammer swings on its upstroke may be adjusted by changing the position of the pad 67 along the arm 57 while the distance through which the hammer falls for any given upstroke may be changed by threading the hammer into or out of the arm and then anchoring the hammer in its adjusted position with a lock nut 72 (FIG. 5). By adding or removing weights 69, the force with which the hammer strikes the anvil 71 may be adjusted.
As shown in FIG. 1, a shut off valve 75 is located in the outlet line 20 so that the latter can be closed off to prevent moisture from entering the cloud chamber 11 when the apparatus is not'in use. Fastened to the end of the outlet line 20 is an adaptor fitting 76 to which is' connected the tube 77 of a mouthpiece 79 which may' be used by the patient to facilitate inhalation of the tantalum-laden air stream.
The mouthpiece 79 (FIG. 6) is of unique construction and comprises a hollow. central body 80 withthree angularly spaced branches 81, 82 and 83. Telescoped detachably over the branch 81 is an inhalation tube 84 which is shaped to curve over and around the tongue without depressing the tongue so as to discharge the powder directly into the throat area and minimize the deposition of tantalum on the tongue.-The inhalation tube may be made of easily washable and sterilizable material or may be a disposable item.
As shown in FIG. 6, a fitting 85 is telescoped into the branch 82 and is connected at one end of the tube 77 leading from the adapter 76. An inlet valve 86 is located at the opposite end of the fitting and comprises an apertured rubber disc 87 which is sandwiched between the fitting and a shoulder formed within the branch 82. An integral flapper 89 (FIG. 7) is hinged as indicated at 90 to one edge of the opening 91 through the disc and the flapper normally closes off the internal passage through the fitting 85. As the patient inhales on the tube 84, the flapper 89 is sucked open at an angle to provide the most direct line of flow possible between the tube 77 and the tube 84 to reduce turbulence. When the patient exhales, the flapper is forced against the fitting 85vand prevents the exhaled air from passing into the chamber 11.
A valve 93 (FIG. 6) similar to the valve 86 is located between the branch 83 and a telescoped fitting 94 and is positioned to close when the patient inhales and to open when the patient exhales. The fitting 94 communicates with the atmosphere and is provided with a disposable filter 95 which is held on the fitting by a removable cap 96, the filter serving to clean any tantalum from the exhaled air. I
As an alternative to using the mouthpiece 79 and inhaling the tantalum, insufflation may be effected by a catheter method. In such a case, a catheter tube (FIG. 8) is connected to the adaptor 76 in place of the mouthpiece tube 77 and is adapted to be inserted into the pulmonary system of the patient. In addition, the tantalum-laden stream is positively forced through the outlet line 20 rather than being sucked through the line by the patient. For this purpose, a diaphragm pump 101 (FIG. 1) is connected to the inlet line 24 by way of a line 103 and a T-fitting 104, the latter being located in the inlet line 24 between the throttle valve 45 and the desiccator 46. When the pump 101 is operated, air is forced into the chamber 11 through the inlet line 24 and then flows out of the outlet line 20 and through the catheter MP0 to insufflate the patient with tantalum. An adjustable flow regulator valve 105 (FIG. 1) is connected into the line 103 to control the rate of flow into the chamber while a check valve 106 is located in the extreme upstream end of the inlet line 24 to prevent the pumped air from being forced out of the inlet line.
When the catheter method is used, the air pumped to the patient is heated so that the air will be warm upon entering the patients airways. To this end, an electrically energizable heater 107 (FIG. 1) is placed in the inlet line 24 upstream of the T-fitting 41 and may be set to warm the air to a preselected temperature. Alternatively, the heater may be placed around the top portion 17 of the container 13. A temperature sensor 110 (FIG. 1) is placed in the outlet line 20 and, if the temperature of the air flowing therethrough exceeds a predetermined safe level, the sensor acts through appropriate circuitry (not shown) to shut down the pumps 30 and 101 and the heater 107 and to trigger audio and visual alarms (not shwon). If desired, the heater also may be used with the inhalation method.
We claim as our invention:
'1. Apparatus for insufflating the airways of a patient with radiopaque powder, said apparatus comprising a container defining a chamber adapted to hold a pile of said powder, in insufflating circuit comprising an inlet line communicating with said chamber and also communicating with the atmosphere, said insufflating circuit also comprising an outlet line communicating with and leading from said chamber said outlet line being adapted to be sucked upon by the patient and constituting a means by which the patient may provide intermittant negative pressure in said chamber whereby, when the patient inhales, a stream of air is drawn into said chamber from said inlet line and flows through said chamber and into said outlet line for delivery into the airways of the patient, a cloud generating circuit comprising a pressure pump having inlet and outlet conduits, said outlet conduit being connected to the discharge side of said pump and being positioned with its discharge end located adjacent and directed toward said pile of powder whereby operation of said pump causes air to impinge against said pile and creates a cloud of powder within said chamber for entrainment in said air stream, and said inlet conduit being connected to the suction side of said pump and communicating with said chamber to keep the chamber substantially at atmospheric pressure and thereby prevent air and powder from being forced into said outlet line as a result of operation of said pump.
2. Apparatus as defined in claim 1 further including a second pressure pump, means for connecting the discharge side of said second pump to said inlet line whereby operation of said second pump causes a stream of air to flow in said insufflating circuit without the patient sucking on said outlet line, means in said inlet line for preventing air in the inlet line from escaping to atmosphere during operation of said second pump, a catheter tube, and means for connecting said catheter tube to said outlet line.
3. Apparatus as defined in claim 1 further including means in said inlet line for removing moisture from said air stream before the latter enters said chamber.
4. Apparatus as defined in claim 1 further including heating means in said insufflating circuit for warming said air stream before the latter passes into said outlet line.
5. Apparatus as defined in claim 1 in which said con tainer includes a generally frusto-conical body disposed in an upright position, said pile of powder being located at the lower end of said chamber, a biological filter located in said inlet line near the upper end of said container, said inlet line terminating adjacent the upper end of said chamber, and said outlet conduit having its discharge end located adjacent the lower end of said chamber and just above said pile of powder.
6. Apparatus as defined in claim 5 in which said inlet conduit of said pump communicates with said chamber by way of said inlet line and communicates with said inlet line at a point located upstream of said filter whereby the air passing into said inlet conduit from said chamber is cleaned by said filter.
7. Apparatus as defined in claim 6 in which air flowing into said chamber through said inlet line helps clean said filter by returning powder particles thereon back into said chamber.
8. Apparatus as defined in claim 7 further including means for vibrating said filter and said container to shake powder loose from the filter and the interior surfaces of the container.
9. Apparatus as defined in claim 1 in which the discharge end of said outlet conduit is located below the downstream end of said inlet line and the inlet end of said outlet line, the downstream end of said inlet line and the inlet end of said outlet line being spaced vertically and angularly from one another.
10. Appparatus as defined in claim 1 in which the downstream end of said inlet line is located adjacent the upper end of said chamber, said outlet conduit having its discharge end located adjacent the lower end of said chamber and just above said pile of powder, and said outlet line having its inlet end located between the downstream end of said inlet line and the discharge end of said outlet conduit and spaced angularly from the downstream end of said inlet line.
11. Apparatus as defined in claim 10 in which said inlet line, said outlet line and said outlet conduit all extend into said chamber through the top of said container, said inlet and outlet lines being angularly spaced from each other and being located on opposite sides of said outlet conduit.
12. Apparatus as defined in claim 10 further including a nozzle on the discharge end of said outlet conduit, said nozzle including a centrally located discharge hole extending in substantially a vertical direction and including a series of discharge holes spaced angularly around said centrally located hole and inclined downwardly and outwardly from said centrally located hole.
13. Apparatus as defined in claim 1 further including means for vibrating said container to shake powder loose from the interior surfaces of the container.
14. Apparatus as defined in claim 13 in which said means comprises a movable hammer, and mechanism for repeatedly striking said hammer against the top of said container.
@ 3 3 j UNITED STATES PATENT OFFICE CERTIFICATE OF CORRECTION Pat nt N 4 7 2 Dated December 11', 1973 Inventor) Clyde F. AuMiller; Lowell D. Morrison & Dale G. Holinbeck It is certified that error appears in the above-identified patent and that said Letters Patent are hereby corrected as shown below:
Column 5, line 8, "shafke' should read ---shake---.
Column 6, line 43, "shwon should read ---shown---; line 49, "in" should read ---an---; line 53, a comma should be inserted after.,"chamber"; "linev 56, "tant" should read ---tent---.
Column 8, line12, "Appparatus" should read 'f--Apparatus"-.
, Signed and sealed this 9th day of April 197A.
EDWARD l LFLEIC HERJH. C. MARSHALL DANN Attesting Officer Commissioner of Patents