CORE BODY TEMPERATURE MEASUREMENT
20200060869 ยท 2020-02-27
Inventors
Cpc classification
A61F2007/0075
HUMAN NECESSITIES
A61F7/02
HUMAN NECESSITIES
A61B5/01
HUMAN NECESSITIES
International classification
Abstract
Continuous core body temperature measurements are made during hypothermic operations, where the core body temperature of the patient is lowered to reduce swelling. Caregivers monitor the patient's core body temperature to prevent damage that can occur to the patient if the patient's core body temperature becomes too low. To accurately determine the core body temperature of the patient, a temperature monitoring system measures the temperature at or near the surface of the patient and through at least a portion of a thermal block at multiple locations.
Claims
1. A temperature monitoring system comprising: a first temperature monitoring device configured to be disposed at first location associated with a patient, the first temperature monitoring device comprising a first temperature measuring device, a second temperature measuring device, and a first thermal block having a first thermal conductivity, at least a portion of the first thermal block between the first and second temperature measuring devices, the first temperature measuring device configured to measure a first temperature associated with the patient at the first location, the second temperature measuring device configured to measure a second temperature through the at least a portion of the first thermal block; a second temperature monitoring device configured to be disposed at a second location associated with the patient, the second temperature monitoring device comprising a third temperature measuring device, a fourth temperature measuring device, and a second thermal block having a second thermal conductivity, at least a portion of the second thermal block between the third and fourth temperature measuring devices, the third temperature measuring device configured to measure a third temperature associated with the patient at the second location, the fourth temperature measuring device configured to measure a fourth temperature through the at least a portion of the second thermal block; and one or more processors configured to receive temperature measurements from the first, second, third, and fourth temperature measuring devices, and based on the received temperature measurements, the first and second thermal conductivities, a first distance between the first and second temperature measuring devices, and a second distance between the third and fourth temperature measuring devices, determine a core body temperature of the patient.
2. The system of claim 1 wherein the one or more processors are further configured to determine a skin thermal resistance of the patient.
3. The system of claim 1 wherein the one or more processors further configured to determine an ambient air temperature.
4. The system of claim 1 wherein the first temperature measuring device is further configured to measure the first temperature at or near a surface of the patient at the first location and the third temperature measuring device is further configured to measure the third temperature at or near the surface of the patient at the second location.
5. The system of claim 1 wherein a first side of the first thermal block is over the first location and a first side of the second thermal block is over the second location.
6. The system of claim 5 wherein the second temperature measuring device is configured to measure the second temperature at a second side opposite the first side of the first thermal block and the fourth temperature measuring device is configured to measure the fourth temperature at a second side opposite the first side of the second thermal block.
7. The system of claim 1 wherein at least one of the first, second, third, and fourth temperature measuring devices includes a thermistor.
8. The system of claim 1 further comprising a display configured to display the core body temperature of the patient.
9. The system of claim 1 wherein the first and second distances are approximately the same.
10. The system of claim 1 wherein the first and second thermal conductivities are approximately the same.
11. The system of claim 1 wherein the first and second distances are different.
12. The system of claim 1 wherein the first and second thermal conductivities are different.
13. A temperature monitoring system comprising: at least two passive temperature monitoring devices configured to be disposed at respective locations associated with a patient, each passive temperature monitoring device comprising a thermal block between at least portions of first and second temperature measuring devices, each first temperature measuring device configured to measure a temperature at the respective location, each second temperature measurement device configured to measure a temperature through at least a portion of the corresponding thermal block; and one or more processors configured to determine a core body temperature of the patient responsive to the temperature measurements and physical properties associated with the thermal blocks.
14. The temperature monitoring system of claim 13 wherein the physical properties associated with the thermal blocks include a thermal conductivity and a thickness.
15. The temperature monitoring system of claim 14 wherein, for each passive temperature monitoring device, the thickness of the thermal block represents a distance between the first and second temperature measuring devices.
16. A temperature monitoring system comprising: first and second temperature measuring devices, the first temperature measuring device configured to be disposed at a first location associated with a patient; an insulator having a known thermal conductivity; at least a portion of the insulator disposed between the first and second temperature measuring devices; a Peltier device disposed over the second temperature measuring device; and one or more processors configured to: cool the insulator to a first temperature using the Peltier device; disable the Peltier device once the first temperature is reached; receive temperature measurements from the first and second temperature measuring device after disabling the Peltier device; determine a recovery time for the received temperature measurement from the first temperature measurement device to become approximately equal to the received temperature measurement from the second temperature measurement device; and determine perfusion information based at least in part on the recovery time.
17. The temperature monitoring system of claim 16 wherein the one or more processors are further configured to determine patient care instructions based at least in part on the perfusion information.
18. The temperature monitoring system of claim 16 wherein the first temperature is approximately 2 degrees less than a temperature of the patient's skin at the first location.
19. The temperature monitoring system of claim 16 wherein the first temperature is approximately 5 degrees less than a temperature of the patient's skin at the first location.
20. The temperature monitoring system of claim 16 wherein the recovery time is based at least in part on heat flow between the first and second temperature measurement devices through the insulator.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0020] Various embodiments will be described hereinafter with reference to the accompanying drawings. The drawings and the associated descriptions are provided to illustrate embodiments of the present disclosure and do not limit the scope of the claims. In the drawings, similar elements have similar reference numerals.
[0021]
[0022]
[0023]
[0024]
[0025]
[0026]
[0027]
[0028]
[0029]
DETAILED DESCRIPTION
[0030] Although certain embodiments and examples are described below, this disclosure extends beyond the specifically disclosed embodiments and/or uses and obvious modifications and equivalents thereof. Thus, it is intended that the scope of this disclosure should not be limited by any particular embodiments described below.
[0031] Overview of Core Temperature Measurement from Multiple Sites System
[0032] Aspects of the present disclosure describe a temperature monitoring system that measures temperature at or within thermal blocks that are disposed at multiple locations associated with a patient to determine the patient's core body temperature.
[0033]
[0034] Greater accuracy for the core body temperature can be achieved by using a plurality of passive heat flux measurement systems at multiple locations on the skin of the patient. Using at least two passive heat flux measurement systems and solving at least two equations with two unknown variables, as described herein, can provide greater accuracy in the core body temperature measurement. The two unknown variables can be core body temperature and skin resistance. By using the temperature measurements from at least two passive heat flux measurement systems and the physical properties of the passive heat flux measurement systems, the core body temperature can be determined with greater accuracy because the skin resistance does not need to be estimated.
[0035]
[0036] The first temperature monitoring device comprising the first temperature measuring device THERM 1, the first thermal block Thermal Block 1, and the second temperature measuring device THERM 1 can be placed at a first location associated with the surface of the patient.
[0037] For example, the first temperature measuring device THERM 1 can be placed on the patient's skin, on a covering that is on the patient's skin, or near the patient's skin at the first location associated with the patient. The first thermal block Thermal Block 1 can be placed over the first temperature measuring device THERM 1. The first temperature measuring device THERM 1 can be located within the first thermal block Thermal Block 1 at the first location. The first temperature measuring device THERM 1 can be placed on an outer surface of the first thermal block Thermal Block 1.
[0038] The second temperature measuring device THERM 2 can be placed over the first thermal block Thermal Block 1. The second temperature measuring device THERM 2 can be located within the first thermal block Thermal Block 1 at the first location and separated from the first temperature measuring device THERM 1 by a known distance. The second temperature measuring device THERM 2 can be located on an outer surface of the first thermal block Thermal Block 1. The outer surface of the first thermal block Thermal Block 1 associated with the second temperature measuring device THERM 2 may be opposed to an outer surface of the first thermal block Thermal Block 1 associated with the first temperature measuring device THERM 1.
[0039] The second temperature monitoring device comprising the third temperature measuring device THERM 3, the second thermal block Thermal Block 2, and the fourth temperature measuring device THERM 4 can be placed at a second location associated with the surface of the patient.
[0040] For example, the third temperature measuring device THERM 3 can be placed on the patient's skin, on a covering that is on the patient's skin, or near the patient's skin at a second location, different from the first location, and associated with the patient. The second thermal block Thermal Block 2 can be placed over the third temperature measuring device THERM 3. The third temperature measuring device THERM 3 can be located within the second thermal block Thermal Block 2 at the second location. The third temperature measuring device THERM 3 can be placed on an outer surface of the second thermal block Thermal Block 2.
[0041] The fourth temperature measuring device THERM 4 can be placed over the second thermal block Thermal Block 2. The fourth temperature measuring device THERM 4 can be located within the second thermal block Thermal Block 2 at the second location and separated from the third temperature measuring device THERM 3 by a known distance. The fourth temperature measuring device THERM 4 can be located on an outer surface of the second thermal block Thermal Block 2. The outer surface of the second thermal block Thermal Block 2 associated with the fourth temperature measuring device THERM 4 may be opposed to an outer surface of the second thermal block Thermal Block 2 associated with the third temperature measuring device THERM 3.
[0042] The temperature measuring devices THERM 1, THERM 2, THERM 3, THERM 4 are shown as blocks having height and width for illustrative purposes. The one or more of the temperature measuring devices THERM 1, THERM 2, THERM 3, THERM 4 may be a small device in relation to the thermal blocks Thermal Block 1, Thermal Block 2, and occupy a point or small area on or over the patient's skin or within the thermal blocks Thermal Block 1, Thermal Block 2.
[0043] The thermal blocks Thermal Block 1, Thermal Block 2 are shown as rectangles having height and width for illustrative purposes. One or more of the thermal blocks Thermal Block 1, Thermal Block 2 may be cubic, cylindrical, spherical, irregularly-shaped, and the like.
[0044] The first and second temperature measuring devices THERM 1, THERM 2 are separated by a distance m.sub.1 of the first thermal block Thermal Block 1 and the third and fourth temperature measuring devices THERM 3, THERM 4 are separated by a distance m.sub.2 of the second thermal block Thermal Block 2. In some embodiments, m.sub.1 and m.sub.2 can be substantially the same. In alternative embodiments, m.sub.1 and m.sub.2 can be different.
[0045] The first thermal block Thermal Block 1 can have a thermal conductivity k.sub.1 and the second thermal block Thermal Block 2 can have a thermal conductivity k.sub.2. Thermal conductivity can include the degree to which a specific material conducts heat. Thermal conductivity can be expressed in units of W/m K. The first and second thermal blocks THERM 1 and THERM 2 can be the same material, such that k.sub.1 and k.sub.2 are substantially the same. In alternative embodiments, the first and second thermal blocks THERM 1 and THERM 2 can be different materials, such that k.sub.1 and k.sub.2 are different. One or more of the thermal blocks THERM 1, THERM 2 can comprise multiple materials such that k.sub.1 and k.sub.2 are not constant but are functions of the thicknesses of the multiple materials.
[0046] The first temperature measuring device THERM 1 can measure the temperature associated with the surface of the patient, such as at or near the patient's skin, at the first location, and the second temperature measuring device THERM 2 can measure the temperature through the first thermal block Thermal Block 1 at a distance m.sub.1 from the first temperature measuring device THERM 1 at the first location.
[0047] The third temperature measuring device THERM 3 can measure the temperature associated with the surface of the patient, such as at or near the patient's skin, at the second location, and the fourth temperature measuring device THERM 4 can measure the temperature through the second thermal block Thermal Block 2 at a distance m.sub.2 from the third temperature measuring device THERM 3 at the second location.
[0048] Examples of temperature measuring devices are, but not limited to, temperature sensors, resistance temperature detector, a thermocouple, semiconductor-based sensors, infrared sensors, bimetallic devices, thermometers, thermistors, change-of-state sensors, silicon diodes, and/or the like.
[0049] The temperature monitoring system of
Instrumentation-Sensors and Signal Processing Device
[0050]
[0051] The temperature measurements from the temperature monitoring devices 202 can be received by the signal processing module 210 and stored in memory 214. The temperature monitoring devices 202 can transmit raw sensor data to the signal processing module 210, and the signal processing module 210 can convert the raw sensor data into data representing physiological parameters for transmission to the display 220. For example, temperature measurements can be analyzed by the processor 212 to estimate a patient's core body temperature. The processor 212 can transmit the estimated core body temperature to the display 220 to be displayed.
Circuit Block Diagram Representation of Multi-Site Core Temperature Monitoring System
[0052]
[0053] The thermal conductivities k.sub.1 and k.sub.2 can be substantially the same. In alternative embodiments, the thermal conductivities k.sub.1 and k.sub.2 can be different. The two thermal blocks of
[0054] The distance m.sub.1 is the distance between the first and second temperature measuring devices through the first thermal block and the distance m.sub.2 is the distance between the third and fourth temperature measuring devices through the second thermal block. The distances m.sub.1 and m.sub.2 can be substantially the same. In alternative embodiments, the distances m.sub.1 and m.sub.2 can be different.
[0055]
[0056] The temperature monitoring system of
[0057] The first temperature monitoring device and the second temperature monitoring device can be placed at different locations associated with the surface of the patient. For example, the first temperature monitoring device and the second temperature monitoring device can be placed at different locations on or near the patient's skin. The embodiment of the circuit block diagram in
Circuit Representation of Multi-Site Core Temperature Monitoring System
[0058]
[0059] Equations based on the circuit representation can be used to determine the core body temperature T.sub.CORE of the patient. The equations and calculations below illustrate one possible example that can be used to determine the core body temperature T.sub.CORE of the patient using the measured temperatures T1, T.sub.2, T.sub.3, and T.sub.4, the known thermal conductivities k.sub.1, k.sub.2 of the first and second thermal blocks, respectively, and the distances m.sub.1 and m.sub.2 between the first and second temperature measuring devices and the third and fourth temperature measuring devices, respectively. In other embodiments, other calculations and equations can be used to determine the core body temperature T.sub.CORE of the patient based on the temperature monitoring systems of
[0060] The thermal resistance R.sub.BLOCK1 and R.sub.BLOCK2 can be determined by:
[0061] where:
[0062] k.sub.1 is the thermal conductivity of the first thermal block Thermal Block 1;
[0063] k.sub.2 is the thermal conductivity of the second thermal block Thermal Block 2;
[0064] m.sub.1 is the distance through the first thermal block Thermal Block 1 between the first temperature measuring device THERM 1 and the second temperature measuring device THERM 2; and
[0065] m.sub.2 is the distance through the second thermal block Thermal Block 2 between the third temperature measuring device THERM 3 and the fourth temperature measuring device THERM 4.
[0066] The heat transfer rates, {dot over (Q)}.sub.1 and {dot over (Q)}.sub.2, for each of the two thermal blocks can be determined by:
[0067] where:
[0068] T.sub.1 is the temperature measured by the first temperature measuring device THERM 1;
[0069] T.sub.2 is the temperature measured by the second temperature measuring device THERM 2;
[0070] T.sub.3 is the temperature measured by the third temperature measuring device THERM 3; and
[0071] T.sub.4 is the temperature measured by the fourth temperature measuring device THERM 4.
[0072] The core body temperature of the patient T.sub.core can be determined by:
T.sub.CORET.sub.1={dot over (Q)}.sub.1R.sub.SKIN
T.sub.CORET.sub.3={dot over (Q)}.sub.2R.sub.SKIN
[0073] where R.sub.SKIN represents the thermal resistance of the patient's skin.
[0074] With two equations for the core temperature and two unknowns (T.sub.CORE and R.sub.SKIN), each value can be determined. An example calculation is:
[0075] where, as shown above:
[0076] Further, equations based on the circuit representation can be used to determine the temperature of the air T.sub.AIR. In some embodiments, T.sub.AIR represents the ambient air temperature. The equations and calculations below illustrate one possible example that can be used to solve for the temperature of the air T.sub.AIR using the measured temperatures T.sub.1, T.sub.2, T.sub.3, and T.sub.4, the known thermal conductivities k.sub.1, k.sub.2 of the first and second thermal blocks, respectively, and the distances m.sub.1 and m.sub.2 between the first and second temperature measuring devices and the third and fourth temperature measuring devices, respectively. In other embodiments, other calculations and equations can be used to determine the air temperature T.sub.AIR based on the temperature monitoring systems of
[0077] The temperature of the air T.sub.AIR can be determined by:
T.sub.AIRT.sub.2={dot over (Q)}.sub.1R.sub.A/R
T.sub.AIRT.sub.4={dot over (Q)}.sub.2R.sub.AIR
[0078] where:
[0079] R.sub.AIR represents the thermal resistance of air;
[0080] T.sub.2 is the temperature measured by the second temperature measuring device THERM 2;
[0081] T.sub.4 is the temperature measured by the fourth temperature measuring device THERM 4;
[0082] With two equations for the air temperature and two unknowns (T.sub.AIR and R.sub.AIR), each value can be determined. For example, the values of T.sub.AIR and R.sub.AIR can be determined in a similar manner as described above with respect to T.sub.CORE and R.sub.SKIN. In an aspect, the ambient temperature calculation can improve or refine the core body temperature calculation. The ambient temperature calculation can provide patient thermoregulation information. For example, the ambient temperature calculation may be useful in determining whether the patient is under thick insulation (i.e., a thick blanker), has little insulation (i.e., a shirt and no blanket), or has no insulation (patient's skin exposed to air).
Flow Diagram for Multi-Site Core Temperature Monitoring System
[0083]
[0084] At block 505, the multi-site temperature monitoring system can measure temperature at multiple locations associated with the surface of the patient. For example, the first temperature measuring device THERM 1 of
[0085] At block 510, the multi-site temperature monitoring system can measure temperature through thermal blocks at multiple sites. For example, the second temperature measuring device THERM 2 of
[0086] At block 515, the multi-site temperature monitoring system can determine the heat transfer rate through the thermal blocks at the multiple sites. For example, the processor 212 of
[0087] At block 520, the multi-site temperature monitoring system can determine thermal resistance of the patient's skin and/or the core body temperature of the patient based on the heat transfer rates and measured temperatures. For example, the processor 212 of
[0088] At block 530, the multi-site temperature monitoring system can display the core body temperature of the patient. For example, the multi-site temperature monitoring system can transmit the core body temperature to the display 220 of
Heat Flux Measurement System
[0089]
[0090]
[0091] For example, the active heat flux measurement system of
[0092]
Terminology
[0093] The embodiments disclosed herein are presented by way of examples only and not to limit the scope of the claims that follow. One of ordinary skill in the art will appreciate from the disclosure herein that many variations and modifications can be realized without departing from the scope of the present disclosure.
[0094] The term and/or herein has its broadest least limiting meaning which is the disclosure includes A alone, B alone, both A and B together, or A or B alternatively, but does not require both A and B or require one of A or one of B. As used herein, the phrase at least one of A, B, and C should be construed to mean a logical A or B or C, using a non-exclusive logical or.
[0095] The description herein is merely illustrative in nature and is in no way intended to limit the disclosure, its application, or uses. For purposes of clarity, the same reference numbers will be used in the drawings to identify similar elements. It should be understood that steps within a method may be executed in different order without altering the principles of the present disclosure.
[0096] As used herein, the term module may refer to, be part of, or include an Application Specific Integrated Circuit (ASIC); an electronic circuit; a combinational logic circuit; a field programmable gate array (FPGA); a processor (shared, dedicated, or group) that executes code; other suitable components that provide the described functionality; or a combination of some or all of the above, such as in a system-on-chip. The term module may include memory (shared, dedicated, or group) that stores code executed by the processor.
[0097] The term code, as used above, may include software, firmware, and/or microcode, and may refer to programs, routines, functions, classes, and/or objects. The term shared, as used above, means that some or all code from multiple modules may be executed using a single (shared) processor. In addition, some or all code from multiple modules may be stored by a single (shared) memory. The term group, as used above, means that some or all code from a single module may be executed using a group of processors. In addition, some or all code from a single module may be stored using a group of memories.
[0098] The apparatuses and methods described herein may be implemented by one or more computer programs executed by one or more processors. The computer programs include processor-executable instructions that are stored on a non-transitory tangible computer readable medium. The computer programs may also include stored data. Non-limiting examples of the non-transitory tangible computer readable medium are nonvolatile memory, magnetic storage, and optical storage. Although the foregoing invention has been described in terms of certain preferred embodiments, other embodiments will be apparent to those of ordinary skill in the art from the disclosure herein. Additionally, other combinations, omissions, substitutions and modifications will be apparent to the skilled artisan in view of the disclosure herein. Accordingly, the present invention is not intended to be limited by the reaction of the preferred embodiments, but is to be defined by reference to claims.
[0099] Additionally, all publications, patents, and patent applications mentioned in this specification are herein incorporated by reference to the same extent as if each individual publication, patent, or patent application was specifically and individually indicated to be incorporated by reference.