WO2014132016A1 - Tracheostomy tube assemblies and inner cannulae - Google Patents

Tracheostomy tube assemblies and inner cannulae Download PDF

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Publication number
WO2014132016A1
WO2014132016A1 PCT/GB2014/000043 GB2014000043W WO2014132016A1 WO 2014132016 A1 WO2014132016 A1 WO 2014132016A1 GB 2014000043 W GB2014000043 W GB 2014000043W WO 2014132016 A1 WO2014132016 A1 WO 2014132016A1
Authority
WO
WIPO (PCT)
Prior art keywords
inner cannula
cannula
tracheostomy tube
bore
along
Prior art date
Application number
PCT/GB2014/000043
Other languages
French (fr)
Inventor
Timothy Bateman
Stephen James Field
Christopher Stratton Turnbull
Original Assignee
Smiths Medical International Limited
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Smiths Medical International Limited filed Critical Smiths Medical International Limited
Publication of WO2014132016A1 publication Critical patent/WO2014132016A1/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/04—Tracheal tubes
    • A61M16/0402—Special features for tracheal tubes not otherwise provided for
    • A61M16/0427—Special features for tracheal tubes not otherwise provided for with removable and re-insertable liner tubes, e.g. for cleaning
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/04—Tracheal tubes
    • A61M16/0465—Tracheostomy tubes; Devices for performing a tracheostomy; Accessories therefor, e.g. masks, filters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/04—Tracheal tubes
    • A61M16/0434—Cuffs
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/60—General characteristics of the apparatus with identification means
    • A61M2205/6045—General characteristics of the apparatus with identification means having complementary physical shapes for indexing or registration purposes

Definitions

  • This invention relates to inner cannulae of the kind for replaceable insertion in a tracheostomy tube, the inner cannula having a bore extending along its length.
  • tracheostomy tube assemblies commonly include an outer tube and an inner tube or cannula that is a removable fit within the outer tube.
  • the inner cannula can be removed and replaced periodically to ensure that the passage through the assembly does not become blocked by secretions. This avoids the need to remove the outer tube frequently.
  • the inner cannula presents various problems because it must be thin walled and a close fit within the outer tube so as to provide a large bore and thereby limit the resistance to flow of gas along the assembly. It must, however, also be sufficiently stiff to be inserted in the outer tube without buckling or kinking.
  • WO94/01 156 and WO2004/101048 describe inner cannulae made of PTFE.
  • EP1938857 describes an arrangement of tracheostomy tubes and inner cannulae where the hubs of the inner cannulae of different sizes are shaped differently so that they will only fit in the appropriate tracheostomy tube.
  • EP2224985 describes an arrangement for attaching a hub to the shaft of an inner cannula.
  • GB2056285 describes an inner cannula having a wall corrugated both externally and internally and a longitudinal groove or other reinforcement member traversing at least some of the corrugations.
  • US4817598 describes a smooth-walled inner cannula having a ring-pull formation at its rear, machine end.
  • US51 19811 describes an inner cannula with a flared patient end and formed of two layers of different materials.
  • US5386826 describes an inner cannula with an outer helical filament or layer of low friction material.
  • US5983895 describes an inner cannula with straight sections at opposite ends joined by an intermediate curved section.
  • US6019753 describes an inner cannula with two elongate regions of different flexibility so that the cannula has a plane of preferential bending.
  • US6019753 describes an inner cannula having a shaft formed with slots to make it more flexible, the slots being covered by an outer thin sheath.
  • US61351 10 describes a curved inner cannula that is retained with the outer tube by means of a rotatable spring fitting. It is an object of the present invention to provide an alternative tracheostomy tube assembly or inner cannula for such an assembly.
  • an inner cannula of the above-specified kind characterised in that the bore is offset from the centre of the inner cannula along a major part of the length of the cannula and is located when bent during use towards the inside of the curve of the cannula.
  • the inner cannula preferably has a smooth internal and external surface.
  • the inner cannula may be preformed with a bent shape.
  • the inner cannula is preferably moulded with an integral hub at its machine end.
  • the bore and external surface of the inner cannula are both preferably circular in section.
  • a tracheostomy assembly including an outer tracheostomy tube and an inner cannula according to the above one aspect of the present invention inserted within the outer tube and being removable therefrom.
  • a tracheostomy tube assembly including an outer tracheostomy tube that is bent along its length and an inner cannula extending along the inside of the outer tube, characterised in that the inner cannula has a bore along its length that is offset from the centre towards the inside of the bend.
  • Figure 1 is a side elevation view of a tracheostomy tube assembly including an inner cannula;
  • Figure 2 is a perspective view of the inner cannula; and Figure 3 is a cross-sectional view through the inner cannula along the line III-III of
  • the tracheostomy assembly comprises an outer tracheostomy tube 1 and a removable inner cannula 20 inserted within the outer tube.
  • the outer tube 1 has a shaft 10 with a straight forward section 1 1, a straight rear section 12 and a curved intermediate section 13 linking the forward and rear sections.
  • An inflatable sealing cuff 14 embraces the forward section 11 close to the patient end 15 of the tube, the cuff being inflated via an inflation lumen 16 and a combined connector and inflation indicator 17.
  • the outer tube 1 has a hub 18 and flange 19 to which a retaining tape can be fastened for securing the tube with the patient's neck.
  • the inside of the hub 18 is formed with keying flats (not shown), of the kind described in EP1938857, adapted to prevent full insertion of an inner cannula of the wrong size.
  • the outer tube 1 could have an internal diameter between about 6mm and 10mm, and its length could be between 60mm and 200mm.
  • the inner cannula 20 is moulded from a plastics material such as by blow moulding or injection moulding.
  • the main part of the cannula 20 is provided by a shaft 21 that is moulded, preformed with a curved or angled shape corresponding to the shape of the outer tube 1 within which it is to be used. In this case it comprises a straight forward section 22, a straight rear section 23 and a curved intermediate section 24.
  • the shaft 21 has a smooth outer surface 25 of circular section and a smooth bore 26 also of circular section, which extends along the length of the cannula.
  • the bore 26 does not extend concentrically within the inner cannula 20 but, along most of its length, is displaced to one side of the centre of the shaft 21 , towards the inside of its curve so that the thickness of the wall 27A along the inside of the curve is less than that of the wall 27B along the outside of the curve.
  • the wall thickness of the shaft 21 is preferably about 0.25mm in the side regions 27C, which is thinner than conventional inner cannula shafts which are typically between about 0.5mm and 1mm.
  • the thickness of the wall in the thickened region 27B is greater than this whereas the thickness in the thinner region 27A is less than this.
  • the inner cannula 20 is moulded with an integral hub portion 30 as one piece with the shaft 21.
  • the hub portion 30 has a smooth external surface, the portion 31 at its forward end being shaped to fit into a 15mm connector.
  • the hub 30 has a keying portion 32 provided with flats 33 of the kind described in EP1938857 adapted to fit with corresponding formations in the hub 18 of the outer tube 1.
  • the bore 26 aligns concentrically, centrally within the hub portion 30.
  • the rear end of the hub 30 has a ring-pull formation 34 of the kind described in US4817598, which facilitates removal of the inner cannula 20 from the outer tube 1 after use.
  • the flexibility of the inner cannula 20 is such that it can readily bend to follow the shape of the different sections 12, 13 and 1 1 during insertion into the outer tube 1 without buckling or kinking.
  • the thickened wall 27B along the outside curve helps the cannula 20 maintain its curved shape, preventing it from kinking or buckling and ensuring that the bore 26 maintains its maximum cross sectional area.
  • the thinner wall 27A on the inside of the curve allows the cannula 20 to flex sufficiently during insertion so that it can be inserted within the outer tube 1 without the need for excessive insertion pressure.
  • the smooth inner surface of the shaft 21 allows for smooth, non-turbulent flow of gas along the assembly. It also allows devices, such as endoscopes, probes, suction catheters or the like to be inserted freely along the cannula without the risk of catching, as might be the case with a cannula having a corrugated inner surface.
  • the inner cannula 20 is described as being an integral, one-piece moulding with the hub portion 30, it could, instead, be formed of separate components.
  • the shaft could be extruded and the hub portion subsequently attached with the shaft by overmoulding.
  • the inner cannula need not be preformed to a bent shape but could be moulded straight, the off-centre bore giving the cannula a preferential plane of bending in which the thinner part of the wall lies on the inside of the curvature.

Abstract

A tracheostomy tube assembly includes an outer tracheal tube (1) bent along its length and a removable inner cannula (20). The inner cannula (20) has a smooth bore (26) and outer surface (25) both circular in section. The bore (26) is offset from the centre of the inner cannula (20) towards the inside of the bend of the outer tube (1).

Description

TRACHEOSTOMY TUBE ASSEMBLIES AND INNER CAN ULAE
This invention relates to inner cannulae of the kind for replaceable insertion in a tracheostomy tube, the inner cannula having a bore extending along its length.
Tubes are used in many medical and non-medical applications. For example, tracheostomy tube assemblies commonly include an outer tube and an inner tube or cannula that is a removable fit within the outer tube. The inner cannula can be removed and replaced periodically to ensure that the passage through the assembly does not become blocked by secretions. This avoids the need to remove the outer tube frequently.
The inner cannula presents various problems because it must be thin walled and a close fit within the outer tube so as to provide a large bore and thereby limit the resistance to flow of gas along the assembly. It must, however, also be sufficiently stiff to be inserted in the outer tube without buckling or kinking. WO94/01 156 and WO2004/101048 describe inner cannulae made of PTFE. EP1938857 describes an arrangement of tracheostomy tubes and inner cannulae where the hubs of the inner cannulae of different sizes are shaped differently so that they will only fit in the appropriate tracheostomy tube. EP2224985 describes an arrangement for attaching a hub to the shaft of an inner cannula. GB2056285 describes an inner cannula having a wall corrugated both externally and internally and a longitudinal groove or other reinforcement member traversing at least some of the corrugations. US4817598 describes a smooth-walled inner cannula having a ring-pull formation at its rear, machine end. US51 19811 describes an inner cannula with a flared patient end and formed of two layers of different materials. US5386826 describes an inner cannula with an outer helical filament or layer of low friction material. US5983895 describes an inner cannula with straight sections at opposite ends joined by an intermediate curved section. US6019753 describes an inner cannula with two elongate regions of different flexibility so that the cannula has a plane of preferential bending.
US6019753 describes an inner cannula having a shaft formed with slots to make it more flexible, the slots being covered by an outer thin sheath. US61351 10 describes a curved inner cannula that is retained with the outer tube by means of a rotatable spring fitting. It is an object of the present invention to provide an alternative tracheostomy tube assembly or inner cannula for such an assembly.
According to one aspect of the present invention there is provided an inner cannula of the above-specified kind, characterised in that the bore is offset from the centre of the inner cannula along a major part of the length of the cannula and is located when bent during use towards the inside of the curve of the cannula.
The inner cannula preferably has a smooth internal and external surface. The inner cannula may be preformed with a bent shape. The inner cannula is preferably moulded with an integral hub at its machine end. The bore and external surface of the inner cannula are both preferably circular in section.
According to another aspect of the present invention there is provided a tracheostomy assembly including an outer tracheostomy tube and an inner cannula according to the above one aspect of the present invention inserted within the outer tube and being removable therefrom.
According to a further aspect of the present invention there is provided a tracheostomy tube assembly including an outer tracheostomy tube that is bent along its length and an inner cannula extending along the inside of the outer tube, characterised in that the inner cannula has a bore along its length that is offset from the centre towards the inside of the bend.
A tracheostomy tube assembly including an inner cannula in accordance with the present invention, will now be described, by way of example, with reference to the accompanying drawings, in which:
Figure 1 is a side elevation view of a tracheostomy tube assembly including an inner cannula;
Figure 2 is a perspective view of the inner cannula; and Figure 3 is a cross-sectional view through the inner cannula along the line III-III of
Figure 2.
With reference first to Figure 1, the tracheostomy assembly comprises an outer tracheostomy tube 1 and a removable inner cannula 20 inserted within the outer tube. The outer tube 1 has a shaft 10 with a straight forward section 1 1, a straight rear section 12 and a curved intermediate section 13 linking the forward and rear sections. An inflatable sealing cuff 14 embraces the forward section 11 close to the patient end 15 of the tube, the cuff being inflated via an inflation lumen 16 and a combined connector and inflation indicator 17. At its rear end the outer tube 1 has a hub 18 and flange 19 to which a retaining tape can be fastened for securing the tube with the patient's neck. The inside of the hub 18 is formed with keying flats (not shown), of the kind described in EP1938857, adapted to prevent full insertion of an inner cannula of the wrong size. The outer tube 1 could have an internal diameter between about 6mm and 10mm, and its length could be between 60mm and 200mm.
With reference now also to Figures 2 and 3, the inner cannula 20 is moulded from a plastics material such as by blow moulding or injection moulding. The main part of the cannula 20 is provided by a shaft 21 that is moulded, preformed with a curved or angled shape corresponding to the shape of the outer tube 1 within which it is to be used. In this case it comprises a straight forward section 22, a straight rear section 23 and a curved intermediate section 24. The shaft 21 has a smooth outer surface 25 of circular section and a smooth bore 26 also of circular section, which extends along the length of the cannula. The bore 26 does not extend concentrically within the inner cannula 20 but, along most of its length, is displaced to one side of the centre of the shaft 21 , towards the inside of its curve so that the thickness of the wall 27A along the inside of the curve is less than that of the wall 27B along the outside of the curve.
The wall thickness of the shaft 21 is preferably about 0.25mm in the side regions 27C, which is thinner than conventional inner cannula shafts which are typically between about 0.5mm and 1mm. The thickness of the wall in the thickened region 27B is greater than this whereas the thickness in the thinner region 27A is less than this. At its rear end, the inner cannula 20 is moulded with an integral hub portion 30 as one piece with the shaft 21. The hub portion 30 has a smooth external surface, the portion 31 at its forward end being shaped to fit into a 15mm connector. To the rear of the forward portion 31 the hub 30 has a keying portion 32 provided with flats 33 of the kind described in EP1938857 adapted to fit with corresponding formations in the hub 18 of the outer tube 1. At the rear end of the cannula the bore 26 aligns concentrically, centrally within the hub portion 30. The rear end of the hub 30 has a ring-pull formation 34 of the kind described in US4817598, which facilitates removal of the inner cannula 20 from the outer tube 1 after use.
The flexibility of the inner cannula 20 is such that it can readily bend to follow the shape of the different sections 12, 13 and 1 1 during insertion into the outer tube 1 without buckling or kinking. The thickened wall 27B along the outside curve helps the cannula 20 maintain its curved shape, preventing it from kinking or buckling and ensuring that the bore 26 maintains its maximum cross sectional area. The thinner wall 27A on the inside of the curve allows the cannula 20 to flex sufficiently during insertion so that it can be inserted within the outer tube 1 without the need for excessive insertion pressure.
The smooth inner surface of the shaft 21 allows for smooth, non-turbulent flow of gas along the assembly. It also allows devices, such as endoscopes, probes, suction catheters or the like to be inserted freely along the cannula without the risk of catching, as might be the case with a cannula having a corrugated inner surface.
Although the inner cannula 20 is described as being an integral, one-piece moulding with the hub portion 30, it could, instead, be formed of separate components. For example, the shaft could be extruded and the hub portion subsequently attached with the shaft by overmoulding. The inner cannula need not be preformed to a bent shape but could be moulded straight, the off-centre bore giving the cannula a preferential plane of bending in which the thinner part of the wall lies on the inside of the curvature.

Claims

An inner cannula (20) for replaceable insertion in a tracheostomy tube (1), the inner cannula (20) having a bore (26) extending along its length, characterised in that the bore (26) is offset from the centre of the inner cannula (20) along a major part of the length of the cannula and is located when bent during use towards the inside of the curve of the cannula.
An inner cannula according to Claim 1 , characterised in that the inner cannula (20) has a smooth internal and external surface (26 and 25).
An inner cannula according to Claim 1 or 2, characterised in that inner cannula (20) is preformed with a bent shape.
An inner cannula according to any one of the preceding claims, characterised in that the inner cannula (20) is moulded with an integral hub (30) at its machine end.
An inner cannula according to any one of the preceding claims, characterised in that the bore (26) and external surface (25) of the inner cannula (20) are both circular in section.
A tracheostomy tube assembly including an outer tracheostomy tube (1) and an inner cannula (20) according to any one of the preceding claims inserted within the outer tube (1) and being removable therefrom.
A tracheostomy tube assembly including an outer tracheostomy tube (1) that is bent along its length and an inner cannula (20) extending along the inside of the outer tube (1),
characterised in that the inner cannula (20) has a bore (26) along its length that is offset from the centre towards the inside of the bend.
PCT/GB2014/000043 2013-02-28 2014-02-05 Tracheostomy tube assemblies and inner cannulae WO2014132016A1 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
GBGB1303553.0A GB201303553D0 (en) 2013-02-28 2013-02-28 Tracheostomy tube assemblies and inner cannulae
GB1303553.0 2013-02-28

Publications (1)

Publication Number Publication Date
WO2014132016A1 true WO2014132016A1 (en) 2014-09-04

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WO (1) WO2014132016A1 (en)

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2016149518A1 (en) * 2015-03-19 2016-09-22 Hansa Medical Products, Inc. Endotracheal tube having outer and inner cannulae and method of use
WO2016174378A1 (en) * 2015-04-29 2016-11-03 Smiths Medical International Limited Medico-surgical tube assemblies
WO2016198818A1 (en) 2015-06-11 2016-12-15 Smiths Medical International Limited Tracheostomy tube assemblies and inner cannulae
WO2016198817A1 (en) 2015-06-11 2016-12-15 Smiths Medical International Limited Tracheostomy tube assemblies and inner cannulae
WO2017037404A1 (en) 2015-08-29 2017-03-09 Smiths Medical International Limited Tracheostomy tube assemblies and inner cannulae

Citations (15)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB2056285A (en) 1979-08-16 1981-03-18 Smiths Industries Ltd Tracheal tube assembly
US4817598A (en) 1987-06-08 1989-04-04 Portex, Inc. Tracheostomy tube with ring pull removable inner cannula
US5119811A (en) 1990-02-21 1992-06-09 Smiths Industries Public Limited Company Tracheal assembly having inner and outer tubes and surface materials
WO1994001156A1 (en) 1992-07-01 1994-01-20 Mallinckrodt Medical, Inc. Inner cannula for tracheostomy tube
US5386826A (en) 1990-02-21 1995-02-07 Smiths Industries Public Limited Company Tracheal tube assemblies
EP0861673A2 (en) * 1996-11-08 1998-09-02 Smiths Industries Public Limited Company Catheter assemblies and inner cannulae
US5983895A (en) 1995-10-12 1999-11-16 Smiths Industries Plc Tracheostomy tubes and assemblies
US6019753A (en) 1997-12-02 2000-02-01 Smiths Industries Public Limited Company Catheter assemblies and inner cannulae
US6135110A (en) 1998-04-22 2000-10-24 Sims Portex Inc. Tracheostomy tube
US6248099B1 (en) * 1998-05-14 2001-06-19 Medcare Medical Group, Inc. Disposable tracheostomy inner cannula connector
US20030136413A1 (en) * 2002-01-23 2003-07-24 Brain Archibald I. J. Endotracheal tube which permits accurate determination of mucosal pressure
WO2004101048A2 (en) 2003-05-06 2004-11-25 Mallinckrodt Inc Tracheal tube with inner and outer cannulas
WO2005016428A1 (en) * 2003-08-18 2005-02-24 Metran Co., Ltd. Tube for tracheotomy
EP1938857A2 (en) 2006-12-21 2008-07-02 Smiths Group plc Medical tube assemblies
EP2224985A1 (en) 2008-01-04 2010-09-08 Smiths Group PLC Tubes and their manufacture

Patent Citations (15)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB2056285A (en) 1979-08-16 1981-03-18 Smiths Industries Ltd Tracheal tube assembly
US4817598A (en) 1987-06-08 1989-04-04 Portex, Inc. Tracheostomy tube with ring pull removable inner cannula
US5119811A (en) 1990-02-21 1992-06-09 Smiths Industries Public Limited Company Tracheal assembly having inner and outer tubes and surface materials
US5386826A (en) 1990-02-21 1995-02-07 Smiths Industries Public Limited Company Tracheal tube assemblies
WO1994001156A1 (en) 1992-07-01 1994-01-20 Mallinckrodt Medical, Inc. Inner cannula for tracheostomy tube
US5983895A (en) 1995-10-12 1999-11-16 Smiths Industries Plc Tracheostomy tubes and assemblies
EP0861673A2 (en) * 1996-11-08 1998-09-02 Smiths Industries Public Limited Company Catheter assemblies and inner cannulae
US6019753A (en) 1997-12-02 2000-02-01 Smiths Industries Public Limited Company Catheter assemblies and inner cannulae
US6135110A (en) 1998-04-22 2000-10-24 Sims Portex Inc. Tracheostomy tube
US6248099B1 (en) * 1998-05-14 2001-06-19 Medcare Medical Group, Inc. Disposable tracheostomy inner cannula connector
US20030136413A1 (en) * 2002-01-23 2003-07-24 Brain Archibald I. J. Endotracheal tube which permits accurate determination of mucosal pressure
WO2004101048A2 (en) 2003-05-06 2004-11-25 Mallinckrodt Inc Tracheal tube with inner and outer cannulas
WO2005016428A1 (en) * 2003-08-18 2005-02-24 Metran Co., Ltd. Tube for tracheotomy
EP1938857A2 (en) 2006-12-21 2008-07-02 Smiths Group plc Medical tube assemblies
EP2224985A1 (en) 2008-01-04 2010-09-08 Smiths Group PLC Tubes and their manufacture

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2016149518A1 (en) * 2015-03-19 2016-09-22 Hansa Medical Products, Inc. Endotracheal tube having outer and inner cannulae and method of use
WO2016174378A1 (en) * 2015-04-29 2016-11-03 Smiths Medical International Limited Medico-surgical tube assemblies
WO2016198818A1 (en) 2015-06-11 2016-12-15 Smiths Medical International Limited Tracheostomy tube assemblies and inner cannulae
WO2016198817A1 (en) 2015-06-11 2016-12-15 Smiths Medical International Limited Tracheostomy tube assemblies and inner cannulae
WO2017037404A1 (en) 2015-08-29 2017-03-09 Smiths Medical International Limited Tracheostomy tube assemblies and inner cannulae

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