MEDICAL MATTRESS AND METHOD FOR REAL-TIME MONITORING

Abstract

A medical mattress for determining a position and/or a change in position of a patient supported on the mattress is provided. The mattress includes a number of fluid channels that are distributed in a matrix, such that a first part of the fluid channels extends parallel to each other and a second part of the fluid channels extends parallel to each other. The first part is orthogonal to the second part. Each of the fluid channels at an output is connected to a respective fluid supply hose. The mattress also includes a fluid supply device that pumps fluid into the fluid channels via the fluid supply hoses, sensors for measuring flow parameters and/or flow change parameters in the fluid channels, and an evaluation unit for evaluation of the flow parameters and/or flow change parameters with respect to a position and/or change in position of the patient supported on the mattress.

Claims

1. A medical mattress for determining a position, a change in position, or the position and the change in position of a patient supported on the medical mattress, the medical mattress being at least partially made of X-ray permeable materials, the medical mattress having a top that is configured as a lying surface for the patient, a bottom opposing the top, and four edge sides opposing each other in pairs, the four edge sides connecting the top and the bottom, the medical mattress comprising: a number of fluid channels that are arranged distributed over at least a portion of the medical mattress between the top and the bottom in a matrix, such that a first part of the number of fluid channels extends parallel to each other from a first of the four edge sides to a second opposing edge side of the four edge sides through the medical mattress and a second part of the number of fluid channels extends parallel to each other from a third of the four edge sides to an opposing fourth edge side of the four edges sides through the medical mattress, wherein the first part is orthogonal to the second part, and wherein each fluid channel of the number of fluid channels at a respective output is connected to a fluid supply hose; a fluid supply device configured to pump fluid into the number of fluid channels via the fluid supply hoses; sensors configured to measure flow, flow change, or flow and flow change parameters, pressure change parameters, or any combination thereof in the number of fluid channels; and an assigned evaluation unit configured to evaluate the flow parameters, the flow change parameters, the pressure change parameters, or the respective combination thereof measured by the sensors with respect to the position, the change in position of the patient supported on the medical mattress, or a combination thereof.

2. The medical mattress of claim 1, wherein the number of fluid channels are formed by air ducts, the fluid supply hoses are formed by air supply hoses, and the fluid supply device is formed by an air supply device.

3. The medical mattress of claim 1, wherein the sensors are formed by flow sensors or pressure sensors.

4. The medical mattress of claim 2, wherein the medical mattress is partially formed from an air permeable material.

5. The medical mattress of claim 4, wherein the air ducts are formed from the air permeable material.

6. The medical mattress of claim 4, wherein the air permeable material is a foam.

7. The medical mattress of claim 1, wherein the assigned evaluation unit is configured to create a position profile of the patient using machine learning methods.

8. The medical mattress of claim 1, wherein the assigned evaluation unit is configured for real-time monitoring of changes in position of the patient.

9. The medical mattress of claim 1, further comprising a memory configured to store data and measured values.

10. The medical mattress of claim 2, wherein the air supply device is formed by a pump or a compressor.

11. The medical mattress of claim 2, wherein the sensors are arranged on or in the air supply hoses.

12. The medical mattress of claim 1, wherein the sensors are arrangeable outside an X-ray beam irradiating the patient.

13. The medical mattress of claim 11, wherein the air supply hoses are arranged outside an X-ray beam screening area, so that the air supply hoses are combinable.

14. The medical mattress of claim 13, wherein the air supply hoses are arranged to the side of the medical mattress.

15. The medical mattress of claim 1, wherein the matrix of the number of fluid channels extends over at least 50% of the medical mattress.

16. The medical mattress of claim 1, further comprising webs between the number of fluid channels, wherein the number of webs are X-ray transparent and compressible.

17. The medical mattress of claim 1, further comprising a device configured for heating the fluid.

18. A method for real-time monitoring of positioning of a patient during a medical diagnosis, therapy, or diagnosis and therapy with a medical imaging device using a mattress, on which the patient is supported, for determining a position, a change in position, or the position and the change in position of the patient supported on the mattress, the mattress being at least partially made of X-ray permeable materials, the mattress having a top that is configured as a lying surface for the patient, a bottom opposing the top, and four edge sides opposing each other in pairs, the four edge sides connecting the top and the bottom, the mattress comprising a number of fluid channels that are arranged distributed over at least a portion of the mattress between the top and the bottom in a matrix, such that a first part of the number of fluid channels extends parallel to each other from a first of the four edge sides to a second opposing edge side of the four edge sides through the mattress and a second part of the number of fluid channels extends parallel to each other from a third of the four edge sides to an opposing fourth edge side of the four edges sides through the mattress, wherein the first part is orthogonal to the second part, and wherein each fluid channel of the number of fluid channels at a respective output is connected to a fluid supply hose, the mattress further comprising a fluid supply device configured to pump fluid into the number of fluid channels via the fluid supply hoses, sensors configured to measure flow, flow change, or flow and flow change parameters, pressure change parameters, or any combination thereof in the number of fluid channels, and an assigned evaluation unit configured to evaluate the flow parameters, the flow change parameters, the pressure change parameters, or the respective combination thereof measured by the sensors with respect to the position, the change in position of the patient supported on the medical mattress, or a combination thereof, the method comprising: pumping fluid into the number of fluid channels through the fluid supply device via the fluid supply hoses; measuring the flow, flow change, or flow and flow change parameters, the pressure change parameters, or the respective combination thereof in the number of fluid channels; and evaluating the flow, flow change, or flow and flow change parameters, the pressure change parameters, or the respective combination thereof measured by the sensors with respect to the position, the change in position of the patient, of the combination thereof, wherein the pumping, the measuring, and the evaluating are carried out continuously, at predetermined time intervals, or continuously and at the predetermined time intervals, respectively, up to a cancellation criterion.

19. The method of claim 18, wherein measuring the flow, flow change, or flow and flow change parameters, the pressure change parameters, or the respective combination thereof comprises measuring the flow, flow change, or flow and flow change parameters, wherein the method further comprises: creating a position profile from the measured flow, flow change, or flow and flow change parameters; and using the created position profile for a registration of the medical imaging device with the patient position.

20. The method of claim 18, further comprising passing on a notice or warning when the evaluation results in a change in position of the patient.

21. The method of claim 18, further comprising triggering a re-registration of the medical imaging device with the patient position when the evaluation results in a change in position of the patient.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

[0025] FIG. 1 shows a view of one embodiment of a medical mattress;

[0026] FIG. 2 shows a view of an exemplary arrangement matrix for air ducts of a medical mattress;

[0027] FIG. 3 shows an enlarged cross-section through one embodiment of a medical mattress;

[0028] FIG. 4 shows one embodiment of a medical imaging device with a medical mattress;

[0029] FIG. 5 shows a view of an exemplary position profile; and

[0030] FIG. 6 shows a sequence of an embodiment of a method.

DETAILED DESCRIPTION

[0031] FIGS. 1 and 2 show one embodiment of a medical mattress 6 with a top 12 for supporting a patient. The medical mattress 6 has a large number of air ducts 10 that extend matrix-like through the mattress. Air ducts of a first part (y.sub.1, y.sub.2, . . . , y.sub.n1, y.sub.n) of the air ducts are parallel to each other and extend from a first edge side 30 to a second edge side 31, air ducts of a second part (x.sub.1, x.sub.2, . . . , x.sub.n1,x.sub.n) of the air ducts are also parallel to each other and extend from a third edge side 32 to a fourth edge side 33. The second part (x.sub.1, x.sub.2, . . . , x.sub.n1i, x.sub.n) of the air ducts and the first part (y.sub.1, y.sub.2, . . . , y.sub.n1, y.sub.n) of the air ducts are orthogonal to each other, so that a matrix results from this. The matrix may only partially cover the mattress 6, as shown in FIG. 1, or cover the entire mattress 6, as shown in FIG. 2. The portion over which the matrix extends occupies, for example, at least 50% of a surface of a top of the mattress. The top 12 of the mattress 6 may have a covering or a cover.

[0032] Each of the air ducts 10 is connected at an output 16 to an air supply hose 11, as shown in FIG. 1 and enlarged also in the cross-section of FIG. 3. The top 12, the bottom 13, as well as the edge sides, to which no air supply hoses are connected, may be sealed in an airtight manner, so that air that is pumped through the air supply hose 11 into the air duct cannot escape. Using an air supply device 7 (e.g., a compressor or a pump), air is pressed through the air supply hoses into the air ducts 10. In addition, sensors 8 are provided for the measurement of flow and/or flow change parameters and/or pressure change parameters of the air ducts 10. Sensors 8 measure the respective parameters either continuously or at specified intervals.

[0033] The air ducts 10 are also X-ray transparent, as are the air supply hoses 11. The material from which the mattress is formed in the air ducts 10 is air permeable and elastically formed to make compression of the mattress possible. The material may be, for example, a foam 14 (e.g., an elastomeric foam (polyurethane soft foam, acrylonitrile butadiene rubber) or a thermoplastic foam (PS-E, PP-E, PVC-E)) that is also X-ray transparent. The mattress is configured to be X-ray transparent (e.g., in the possible X-ray screening area). Between the air ducts, webs 15 that are also compressible and X-ray transparent may be arranged. The orthogonal structure of the matrix is implemented via the webs 15.

[0034] Sensors 8, unless not also X-ray transparent, are arranged in such a way that the sensors 8 are or may be arranged outside the X-ray beam screening area. If the sensors 8 are mounted, for example, at the end of the air supply hoses, the air supply hoses may be bundled. Then, the sensors 8 may be arranged on the side of the mattress (right or left of the mattress or on both sides) or in the foot area of a patient couch on which the medical mattress rests, so that during an X-ray examination, the sensors 8 are located below the X-ray detector. The sensors 8 may also be arranged in the region of the output 16 of the air ducts.

[0035] Due to different mattress loading on the part of a patient arranged on the mattress at different points of the mattress, the air-permeable structure is compressed to a greater or lesser extent, resulting in a pressure drop corresponding to the loading above the respective air duct. The pressure drop is then measured by the respective sensor 8. From the parameters, a position profile of the patient or changes in position or movements of the patient may then be determined by an evaluation unit 9 and, for example, by software or an algorithm. Machine learning or deep learning algorithms that have already been trained with a large number of data sets of subjects may also be used for this purpose in order to identify the actual position or movement of the patient from the patient's characteristic patterns. Movements may then be interpreted, for example, as breathing or heart movements or other movements. The result of the evaluation of the flow and/or flow change parameters supplied by the sensors may be, for example, a position profile 19, as shown in FIG. 5. Accuracy depends on the dimension of the matrix of air ducts.

[0036] Due to the medical mattress 6, effective real-time monitoring of the patient's position may be carried out without additional camera technology. The initial position of the patient as well as real-time changes or movements or displacements may be detected. For example, regular pressure fluctuations in the patient's thoracic and abdominal areas may be interpreted as a breathing movement. When using the mattress during X-rays, therapies, and interventional procedures, optimum patient care is thus possible.

[0037] The mattress 6 may also have a device for heating air. In this way, temperature-controlled ventilation may also be provided for warming the patient. The patient's weight and/or patient's size may also be obtained from the flow and/or flow change parameters using a calibration.

[0038] FIG. 4 shows one embodiment of a medical imaging device 1 that X-rays the patient 5 arranged on the mattress. The medical imaging device 1 has, for example, a movable C-arm 2 with an X-ray source 3 and an X-ray detector 4, and is controlled by a system control 18. The sensors 8 of the mattress and the air supply device 7 are located on the side of the mattress outside the X-ray beam screening area of the X-ray source 3. Not shown is a patient couch on which the mattress and the patient are supported. The sensors of the mattress and the air supply device 7 may also be arranged in a foot area of the patient couch. The evaluation unit 9 of the mattress may also have only a communications link with the mattress and have the measurement data or parameters transmitted by the sensors. The evaluation unit may, for example, also be part of the medical imaging device 1.

[0039] FIG. 6 shows a procedure of an embodiment of a method for real-time monitoring of a patient's positioning during a medical diagnosis and/or therapy with a medical imaging device using the described mattress, on which the patient is supported. In a first act 20, air is pumped into the air ducts via the air supply hoses by the air supply device. The mattress is compressed by a patient supported on a top of the mattress according to the weight of the patient, and the air ducts are compressed accordingly. As a result, the flow conditions in the respective air ducts change compared to non-compressed air ducts. In a second act 21, flow parameters and/or flow change parameters are measured in the air ducts. These are then evaluated by the evaluation unit 9 in a third act 22, and, more precisely, with regard to a position and/or change in position of the patient.

[0040] For example, a position profile of the patient may be created from the parameters (e.g., using software and/or a pre-trained machine learning algorithm). The position profile thus created may be used, for example, for a registration of the patient position with the imaging device or with previously recorded volume images of the patient. As soon as a cancellation criterion 23 applies (e.g., a previously set time or a user input or similar), the method comes to an end 26. If no cancellation criterion 23 applies, the method is continued. While the air supply takes place, for example, continuously, the measurement of the second act 21 and the evaluation of the third act 22 may be carried out continuously or at predetermined time intervals, depending on the need or preset.

[0041] Position changes may also be evaluated from the parameters if the patient slips or changes his position due to cyclic or spontaneous movements. Changes in position may be evaluated individually, or a new position profile may be created and compared with the previous position profile to derive changes in position. All this may be done live and in real time if necessary (e.g., during a fluoroscopic examination, as part of an operation, or an interventional procedure). As soon as a cancellation criterion 23 applies (e.g., a previously set time or a user input or similar), the method comes to an end 26.

[0042] In addition, as soon as a change in position is queried and detected in an optional fourth act 24, a notice or warning may be passed on. Alternatively, in an optional fifth act 25, a re-registration of the medical imaging device with the patient position may also be triggered.

[0043] The mattress of one or more of the present embodiments has a large number of advantages over the prior art: an initial registration of the patient's position may be carried out automatically based on information from the mattress (and the system position of the imaging device) with existing 3D volume images. Live monitoring of patient movements may be performed and used as a warning for medical personnel or the imaging device. As a result, an existing registration may be automatically corrected. Regular pressure fluctuations in the patient's thoracic and abdominal areas may be evaluated as respiratory triggering. Further monitoring devices in the intervention space are not necessary or may be omitted (e.g., cameras). The mattress does not have image-disturbing electronics in the X-ray screening area, so that the imaging is of unaffected high quality. Optionally, temperature-controlled ventilation may be implemented through the mattress to heat the patient during the examination. In addition, the patient's weight and size may be derived from data (e.g., calibrated data).

[0044] In addition to the use of air as a fluid, other gases or liquids may also be used (e.g., water).

[0045] One or more of the present embodiments may be briefly summarized as follows: A medical mattress for determining the position and/or change in position of a patient supported on the mattress. The mattress is at least partially made of X-ray permeable materials. The mattress has a top that is configured as a lying surface for the patient, a bottom opposing the top, and four edge sides opposing each other in pairs. The four edge sides connect the top and the bottom. The mattress includes a large number of fluid channels that are arranged distributed over at least a portion of the mattress between the top and the bottom in a matrix, such that a first part of the fluid channels extends parallel to each other from a first edge side to a second opposing edge side through the mattress and a second part of the fluid channels extends parallel to each other from a third edge side to an opposing fourth edge side through the mattress. The first part is orthogonal to the second part. Each of the number of fluid channel at a respective output is connected to a fluid supply hose. The mattress also includes a fluid supply device that pumps fluid into the fluid channels via the fluid supply hoses. The mattress includes sensors for measuring flow parameters and/or flow change parameters in the fluid channels, and an assigned evaluation unit for the evaluation of the flow parameters and/or flow change parameters measured by the sensors with respect to a position and/or change in position of the patient supported on the mattress.

[0046] The elements and features recited in the appended claims may be combined in different ways to produce new claims that likewise fall within the scope of the present invention. Thus, whereas the dependent claims appended below depend from only a single independent or dependent claim, it is to be understood that these dependent claims may, alternatively, be made to depend in the alternative from any preceding or following claim, whether independent or dependent. Such new combinations are to be understood as forming a part of the present specification.

[0047] While the present invention has been described above by reference to various embodiments, it should be understood that many changes and modifications can be made to the described embodiments. It is therefore intended that the foregoing description be regarded as illustrative rather than limiting, and that it be understood that all equivalents and/or combinations of embodiments are intended to be included in this description.