SYSTEMS AND METHODS FOR PATIENT CARDIOVASCULAR AND RESPIRATORY MANAGEMENT
20220369938 · 2022-11-24
Inventors
Cpc classification
A61B5/091
HUMAN NECESSITIES
A61M16/1005
HUMAN NECESSITIES
G16H20/40
PHYSICS
G16H50/20
PHYSICS
G16H20/10
PHYSICS
A61B5/0816
HUMAN NECESSITIES
A61B5/4848
HUMAN NECESSITIES
A61M16/024
HUMAN NECESSITIES
A61M1/1613
HUMAN NECESSITIES
A61B5/02028
HUMAN NECESSITIES
A61B5/743
HUMAN NECESSITIES
A61B5/0205
HUMAN NECESSITIES
A61M2230/202
HUMAN NECESSITIES
A61B5/744
HUMAN NECESSITIES
A61B5/029
HUMAN NECESSITIES
A61B5/02007
HUMAN NECESSITIES
A61B5/746
HUMAN NECESSITIES
A61M2205/52
HUMAN NECESSITIES
International classification
A61B5/0205
HUMAN NECESSITIES
Abstract
An information display and control system that enables a fast and easy understanding and management of the status of the patient's dialysis is disclosed. Also disclosed is an information display and control system that enables a fast and easy understanding and management of the status of the patient's cardiovascular and ventilation systems. The system can control management of a patient's dialysis, as well as administration and management of a patient's medication and fluids. The display is organized by goals related to management of patient's dialysis machine, blood flow, dialyzer flow, and patient's body weight. The display is also organized by goals related to management of patient's cardiovascular system, ventilation system, and medications and fluids administration and management. Such goals include urea reduction rate, urea reduction ratio, fractional urea clearance, total urea reduction, dialysis treatment duration, hemodynamics, oxygenation, CO.sub.2 removal, medication status, and fluids status.
Claims
1. A method for displaying integrated graphics for diagnostics and control of patient's physiology, the method comprising: displaying a cardiac graphic object representing cardiac performance, said cardiac graphic object including at least a first, second, and third physiological parameter; displaying at least one dynamic graphical line from the first physiological parameter being displayed to the second physiological parameter being displayed, and wherein the displaying of the dynamic graphical line comprises illustrating at least one functional relationship between the first and second physiological parameters; identifying root causes of failures or suboptimal conditions and their related parameters or functions and the parameters or functions affected by such failures and highlighting root causes of failures or suboptimal conditions and their related parameters or functions and the parameters or functions affected by such failures using alarms, color, text or other format; providing recommendations for corrective actions to correct failures and their root causes and to restore normal functions of patient's cardiovascular system, pulmonary system, medications administration, and fluids management; and controlling system functions or parameters comprising at least one of medication administration flow rate or medication administration duration setting, fluids administration flow rate or fluids administration duration setting, ventilator setting, oxygen delivery flow rate or concentration, or CO2 removal setting to restore normal functions of patient's cardiovascular system, pulmonary system, medications administration, and fluids management.
2. The method of claim 1, further comprising displaying a pulmonary graphic object representing pulmonary performance, wherein displaying the pulmonary graphic object comprises displaying pulmonary vascular blood flow, and wherein the displaying the pulmonary vascular blood flow comprises displaying at least one measurement based on the patient's pulmonary arterial blood pressure and at least one measurement based on the patient's pulmonary venous blood pressure, and at least one measurement based on the patient's pulmonary vascular resistance.
3. The method of claim 1, further comprising displaying a systemic vascular graphic object representing systemic cardiovascular performance, wherein displaying the systemic vascular graphic object comprises displaying systemic vascular blood flow, wherein the displaying the systemic vascular blood flow comprises displaying at least one measurement based on the patient's systemic arterial blood pressure and at least one measurement based on the patient's systemic venous blood pressure, and at least one measurement based on the patient's systemic vascular resistance.
4. The method of claim 1, wherein displaying the cardiac graphic object comprises displaying cardiac output, and wherein the displaying the cardiac graphic output comprises displaying a graph displaying stroke volume and heart rate.
5. The method of claim 4, wherein the graph displaying stroke volume comprises displaying a left ventricle stroke volume and a right ventricle stroke volume.
6. The method of claim 1, further comprising displaying a physiologic performance target.
7. The method of claim 6, further comprising displaying a physiologic performance target-controlled medication delivery correlated with the physiologic performance target.
8. The method of claim 1, comprising displaying a contractility graphic object representing a contractility quotient based on a pre-load and/or contractility of the patient's heart.
9. The method of claim 8, wherein the contractility graphic object represents the pre-load and/or contractility of the patient's heart correlated with a medication delivery.
10. The method of claim 1, further comprising displaying a medication delivery and controlling a delivery of at least one medication to the patient through the display, wherein the controlling of the delivery of the at least one medication comprises automatically controlling the medication delivery by a processor.
11. The method of claim 10, wherein the controlling of the delivery of the at least one medication comprises setting a physiological performance target.
12. The method of claim 1, displaying a net fluid flow graphic representing fluid inflow to the patient and outflow from the patient, wherein displaying a net fluid flow graphic comprises displaying urine output and blood loss, and/or displaying blood flow input and intravenous fluid administration, and/or displaying a net fluid flow balance object display.
13. The method of claim 12, further comprising controlling a delivery of blood or at least one intravenous fluid administration to the patient through the display, wherein the controlling of the delivery comprises automatically controlling the medication delivery by a processor.
14. A method for displaying integrated graphics for diagnostics and control of patient's ventilation, the method comprising: displaying a ventilation graphic object representing ventilation performance based on at least one measurement from the patient's respiratory rate, tidal volume, inspiratory flow rate, inspiratory oxygen concentration, airway pressure, alveolar O.sub.2 pressure or concentration, alveolar CO.sub.2 pressure or concentration, ratio of partial pressure of alveolar oxygen to alveolar carbon dioxide, inspiratory time, or inspiratory-to-expiratory time ratio, said ventilation graphic object including at least a first, second, and third physiologic parameter; displaying at least one dynamic graphical line from the first physiological parameter being displayed to the second physiological parameter being displayed, and wherein the displaying of the at least one dynamic graphical line comprises illustrating at least one functional relationship between the first and second physiological parameters; identifying root causes of failures or suboptimal conditions and their related parameters or functions and the parameters or functions that may be affected by such failures and highlights root causes of failures or suboptimal conditions and their related parameters or functions and the parameters or functions that may be affected by such failures using alarms, color, text or other format; providing recommendations for corrective actions to correct failures and their root causes and to restore normal functions of patient's cardiovascular system, pulmonary system, medications administration, and fluids management; and controlling system functions or parameters comprising at least one of medication administration flow rate or medication administration duration setting, fluids administration flow rate or fluids administration duration setting, ventilator setting, oxygen delivery flow rate or concentration, or CO2 removal setting to restore normal functions of patient's cardiovascular system, pulmonary system, medications administration, and fluids management.
15. The method of claim 14, further comprising displaying a pulmonary graphic object representing pulmonary performance, wherein displaying the pulmonary graphic object comprises displaying pulmonary vascular blood flow, and wherein the displaying the pulmonary vascular blood flow comprises displaying at least one measurement based on the patient's pulmonary arterial blood pressure and at least one measurement based on the patient's pulmonary venous blood pressure, and at least one measurement based on the patient's pulmonary vascular resistance.
16. The method of claim 15, wherein the pulmonary graphic object comprises an animated graphic.
17. The method of claim 15, wherein displaying the pulmonary graphic object comprises displaying a ventilation performance.
18. The method of claim 17, wherein displaying a ventilation performance comprises displaying a measurement of tidal volume, and/or alveolar oxygen concentration, and/or inspired oxygen concentration, alveolar CO2 concentration, and/or expired CO2 concentration, and/or minute ventilation, and/or a ratio of partial pressure of alveolar oxygen to alveolar carbon dioxide, and/or respiratory rate, and/or inspiratory flow rate, and/or inspiratory time, and/or inspiratory-to-expiratory time ratio, and/or positive inspiratory pressure.
19. The method of claim 14, wherein the displaying of the ventilation graphic object comprises displaying an anatomical graphical representation of the ventilation system.
20. The method of claim 14, further comprising displaying an oxygenation graphic object representing oxygenation based on at least one measurement from patient's systemic oxygenation performance, said oxygenation graphic object: displaying a systemic oxygenation graphic object representing systemic oxygenation performance, wherein displaying the systemic oxygenation graphic object comprises displaying systemic arterial oxygen flow rate (SAO.sub.2FR), and wherein the displaying the systemic arterial oxygen flow rate comprises displaying at least one measurement based on the patient's systemic vascular blood flow and at least one measurement based on the patient's systemic arterial oxygen content (SAO.sub.2C), systemic arterial oxygen saturation (SaO.sub.2SAT), or systemic arterial oxygen pressure (PaO.sub.2); displaying a systemic oxygenation graphic object representing systemic oxygenation performance, wherein displaying the systemic oxygenation graphic object comprises displaying systemic venous oxygen flow rate (SVO.sub.2FR), and wherein the displaying the systemic venous oxygen flow rate comprises displaying at least one measurement based on the patient's systemic vascular blood flow and at least one measurement based on the patient's systemic venous oxygen content (SVO.sub.2C), systemic venous oxygen saturation (SaO.sub.2SAT), or systemic venous oxygen pressure (PvO.sub.2); and displaying an Oxygen Consumption graphic object representing systemic oxygenation performance, wherein displaying the Oxygen Consumption graphic object comprises displaying at least one measurement based on systemic arterial oxygen flow rate (SAO.sub.2FR) and at least one measurement based on the patient's systemic venous oxygen flow rate (SVO.sub.2FR).
21. The method of claim 14, further comprising displaying an oxygenation graphic object representing oxygenation based on at least one measurement from patient's pulmonary oxygenation performance, said oxygenation graphic object: displaying a pulmonary oxygenation graphic object representing pulmonary oxygenation performance, wherein displaying the pulmonary oxygenation graphic object comprises displaying pulmonary arterial oxygen flow rate (PAO.sub.2FR), and wherein the displaying the pulmonary arterial oxygen flow rate comprises displaying at least one measurement based on the patient's pulmonary vascular blood flow and at least one measurement based on the patient's pulmonary arterial oxygen content (PAO.sub.2C) or pulmonary arterial oxygen pressures (PaO.sub.2); displaying a pulmonary oxygenation graphic object representing pulmonary oxygenation performance, wherein displaying the pulmonary oxygenation graphic object comprises displaying pulmonary venous oxygen flow rate (PVO.sub.2FR), and wherein the displaying the pulmonary venous oxygen flow rate comprises displaying at least one measurement based on the patient's pulmonary vascular blood flow and at least one measurement based on the patient's pulmonary venous oxygen content (PVO.sub.2C) or pulmonary venous oxygen pressures (PvO.sub.2); and displaying a Blood Oxygenation graphic object representing pulmonary oxygenation performance, wherein displaying the Blood Oxygenation graphic object comprises displaying at least one measurement based on pulmonary arterial oxygen flow rate (PAO.sub.2FR) and at least one measurement based on the patient's pulmonary venous oxygen flow rate (PVO.sub.2FR).
22. The method of claim 14, further comprising displaying a systemic carbon dioxide graphic object representing systemic carbon dioxide performance based on at least one measurement from patient's systemic carbon dioxide, said systemic carbon dioxide graphic object: displaying a systemic carbon dioxide graphic object representing systemic carbon dioxide, wherein displaying the systemic carbon dioxide graphic object comprises displaying systemic arterial carbon dioxide flow rate (SACO.sub.2FR), and wherein the displaying the systemic arterial carbon dioxide flow rate comprises displaying at least one measurement based on the patient's systemic vascular blood flow and at least one measurement based on the patient's systemic arterial carbon dioxide content (SACO.sub.2C) or systemic arterial CO.sub.2 pressure (PaCO.sub.2); displaying a systemic carbon dioxide graphic object representing systemic carbon dioxide, wherein displaying the systemic carbon dioxide graphic object comprises displaying systemic venous carbon dioxide flow rate (SVCO.sub.2FR), and wherein the displaying the systemic venous carbon dioxide flow rate comprises displaying at least one measurement based on the patient's systemic vascular blood flow and at least one measurement based on the patient's systemic venous carbon dioxide content (SVO.sub.2C) or systemic venous CO.sub.2 pressure (PvCO.sub.2); and displaying a carbon dioxide production graphic object representing systemic carbon dioxide, wherein displaying the carbon dioxide production graphic object comprises displaying at least one measurement based on systemic arterial carbon dioxide flow rate (SACO.sub.2FR) and at least one measurement based on the patient's systemic venous carbon dioxide flow rate (SVCO.sub.2FR).
23. The method of claim 14, further comprising displaying a pulmonary carbon dioxide graphic object representing pulmonary carbon dioxide performance based on at least one measurement from patient's pulmonary carbon dioxide, said pulmonary carbon dioxide graphic object: displaying a pulmonary carbon dioxide graphic object representing pulmonary carbon dioxide, wherein displaying the pulmonary carbon dioxide graphic object comprises displaying pulmonary arterial carbon dioxide flow rate (PACO.sub.2FR), and wherein the displaying the pulmonary arterial carbon dioxide flow rate comprises displaying at least one measurement based on the patient's pulmonary vascular blood flow and at least one measurement based on the patient's pulmonary arterial carbon dioxide content (PACO.sub.2C) or pulmonary arterial CO.sub.2 pressure (PaCO.sub.2); displaying a pulmonary carbon dioxide graphic object representing pulmonary carbon dioxide, wherein displaying the pulmonary carbon dioxide graphic object comprises displaying pulmonary venous carbon dioxide flow rate (PVCO.sub.2FR), and wherein the displaying the pulmonary venous carbon dioxide flow rate comprises displaying at least one measurement based on the patient's pulmonary vascular blood flow and at least one measurement based on the patient's pulmonary venous carbon dioxide content (PVCO.sub.2C) or pulmonary venous CO.sub.2 pressures (PaCO.sub.2); and displaying a carbon dioxide elimination graphic object representing pulmonary carbon dioxide, wherein displaying the carbon dioxide elimination graphic object comprises displaying at least one measurement based on pulmonary arterial carbon dioxide flow rate (PACO.sub.2FR) and at least one measurement based on the patient's pulmonary venous carbon dioxide flow rate (PVCO.sub.2FR).
24. The method of claim 14, further comprising displaying oxygenation balance graphic object, wherein displaying oxygenation balance graphic comprises displaying oxygen consumption, and/or displaying blood oxygenation, and/or displaying a balance between oxygen consumption and blood oxygenation in an object display.
25. The method of claim 14, further comprising displaying CO.sub.2 balance graphic object, wherein displaying CO.sub.2 balance graphic comprises displaying CO.sub.2 production, and/or displaying CO.sub.2 elimination, and/or displaying a balance between CO.sub.2 production and CO.sub.2 elimination in an object display.
26. The method of claim 14, further comprising displaying a physiologic performance target.
27. The method of claim 26, further comprising displaying a physiologic performance target-controlled medication delivery correlated with the physiologic performance target.
28. The method of claim 14, further comprising displaying a medication delivery and controlling a delivery of at least one medication to the patient through the display, wherein the controlling of the delivery of the at least one medication comprises automatically controlling the medication delivery by a processor and setting a physiological performance target.
29. The method of claim 28, wherein the controlling of the delivery of the at least one medication comprises setting a physiological performance target.
30. The method of claim 14, displaying a net fluid flow graphic representing fluid inflow to the patient and outflow from the patient, wherein displaying a net fluid flow graphic comprises displaying urine output and blood loss, and/or displaying blood flow input and intravenous fluid administration, and/or displaying a net fluid flow balance object display.
31. The method of claim 30, further comprising controlling a delivery of blood or at least one intravenous fluid administration to the patient through the display, wherein the controlling of the delivery comprises automatically controlling the medication delivery by a processor.
32. A method for displaying integrated graphics for control and diagnostics of patient's physiology, the method comprising: displaying a ventilation graphic object representing ventilation performance based on at least one measurement from the patient's ventilation performance, said ventilation graphic object including at least a first, second, and third physiologic parameter; displaying a cardiac graphic object representing cardiac performance based on at least one measurement from the patient's cardiac performance, said cardiac graphic object including at least a first, second, and third physiologic parameter; displaying at least one dynamic graphical line from the first physiological parameter being displayed to the second physiological parameter being displayed, and wherein the displaying of the at least one dynamic graphical line comprises illustrating at least one functional relationship between the first and second physiological parameters; wherein the displaying of the cardiac graphic object comprises displaying an anatomical graphical representation of the heart, and wherein the anatomical graphical representation of the heart is animated to represent the anatomical graphical representation of the heart contracting and expanding at a measured heart contractility value; displaying an anatomical graphical representation of the cardiovascular vessels, and wherein the anatomical graphical representation of the cardiovascular vessels is animated to represent the anatomical graphical representation of the cardiovascular vessels expanding or increasing in diameter during a decrease of vascular resistance and contracting or decreasing in diameter during an increase in vascular resistance; wherein the displaying of the ventilation graphic object comprises displaying an anatomical graphical representation of the ventilation system, and wherein the anatomical graphical representation of the ventilation system is animated and expands and contracts at a measured respiratory rate value; identifying root causes of failures or suboptimal conditions and their related parameters or functions and the parameters or functions that are affected by such failures and highlights root causes of failures or suboptimal conditions and their related parameters or functions and the parameters or functions that are affected by such failures using alarms, color, text or other format; providing recommendations for corrective actions to correct failures and their root causes and to restore normal functions of patient's cardiovascular system, pulmonary system, medications administration, and fluids management; and controlling system functions or parameters comprising at least one of medication administration flow rate or medication administration duration setting, fluids administration flow rate or fluids administration duration setting, ventilator setting, oxygen delivery flow rate or concentration, or CO2 removal setting to restore normal functions of patient's cardiovascular system, pulmonary system, medications administration, and fluids management.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
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DETAILED DESCRIPTION
[0059] A patient management system 150 is described. The patient management system 150 can monitor, control and communicate (e.g., visually display or audibly sound) patient physiological diagnosis, status and treatment. The system can have a human-machine interface for process monitoring and control of patient's cardiovascular and ventilation systems, and for the administration and management of patient's medications and fluids capable of the creation of displays and controls, wherein such displays are collections of one or more displays that may be graphs showing mathematical relationships or graphical in nature, and wherein such controls are collections of one or more controls that may be used to control patient's cardiovascular and ventilation systems, and for the administration and management of patient's medications and fluids using a touch screen, a mouse, keyboard, or any other human-machine interface control.
System Components
[0060]
[0061] The management algorithm 6 can monitor and identify parameters transitioning from normal conditions or settings to abnormal conditions or settings and the possible consequences on system functions or goals including failures as a result of such parameters' transitions. The algorithm 6 can highlight the abnormal parameters settings and system functions or goals that can be affected as a result of such parameters' transitions using color or visual or auditory alarms in order to make such parameters and system conditions more prominent and visible.
[0062] When system failures or abnormal system functions or conditions occur or when parameters transition from normal conditions or settings to abnormal conditions or settings, the management algorithm 6 can identify root causes and parameters related to the failures or abnormal system functions or conditions or parameters transition from normal conditions or settings to abnormal conditions or settings. The management algorithm 6 can highlight the abnormal parameters settings, parameters or functions related to failures root causes, and affected system functions or goals that were or could be impacted using color or visual or auditory alarms in order to make such parameters and system conditions more prominent and visible. When system parameters transition from normal conditions or settings to abnormal conditions or settings or when system failures or abnormal functions or conditions occur, the management algorithm 6 can provide suggested actions to the user to prevent or correct abnormal system functions or failures and restore normal system functions.
[0063] When system parameters transition from normal conditions or settings to abnormal conditions or settings or when system failures or abnormal functions or conditions occur, the management algorithm 6 can automatically adjust parameters to prevent or correct abnormal system functions or failures and restore normal system functions.
[0064] The management algorithm 6 can display information through a one-way or two-way (e.g., touch screen) visual display monitor 7 and/or speakers (e.g., output speakers and/or one or more microphones). The management algorithm 6 can receive instructions from a control 8 which can be a separate input device (e.g., a keyboard, mouse or joystick), an integrated input device (e.g., the touch screen on the display monitor 7), or combinations thereof. The user 20 can provide instructions to the management algorithm 6 through the control 8, which can be part of the display 7.
[0065] The direct subsystems 100 can be physically integrated with the management algorithm 6, the control 8, the display 7 or combinations thereof. For example, the direct subsystems, and the management algorithm 6, the control 8, the display 7 or combinations thereof can be in a unitary form factor, such as in a single case or container.
[0066]
Displays
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[0068] The management display 200 can have text labels on the display, for example, the type, quantity and timing of the medications can be shown on the medication administration display 600, and the systemic blood gas measurements can be shown in the graphic object representations of the vascular system.
[0069] The management display 200 can be animated to show different states in real-time. For example, the animation can include graphic object changes showing increased lung size in the pulmonary display 500 to indicate inspiration, beating of the heart in the cardiac display 300 to indicate cardiac function, expansion and contraction of the capillaries or vessels in the systemic vascular display 400 to represent vascular dilation, or combinations thereof. The graphic objects indicating medication and fluid levels, the vascular system flow and all other data can also animate during use.
[0070]
Left Heart Displays
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[0072] The cardiac display 300 can include a left heart display showing a graphical representation of the higher-level goals, the middle-level functional parameters, and the lower-level functional parameters and controls used in monitoring and managing the left heart including its cardiac output, stroke volume, heart rate, contractility, and pre-load. The graphical representation also shows interrelationships and interactions between the higher-level goals, the functional parameters, and the lower-level functional parameters and controls used in monitoring and managing the left heart including its cardiac output, stroke volume, heart rate, contractility, and pre-load.
Left Heart Cardiac Output, Stroke Volume, and Heart Rate Display
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[0074] The functional variables can include Heart Rate (HR), graphed along axis 303, and Left Heart Stroke Volume (LHSV), graphed along axis 302. The variables in the Left Heart Display can be shown and integrated in a graph where the HR value is shown on one axis 303, and the LHSV value is shown on another axis 302 perpendicular to the HR axis. The area of the rectangle along the HR and LHSV values is a measure of the Left Heart Cardiac Output (LHCO) value (HR×LHSV). The LHSV can be projected onto the contractility and pre-load display 398 as LHSV 310. The LHSV represented in the cardiac output display 399 can be visually linked by lines on the display to the LHSV 310 on the contractility and pre-load display 398.
[0075] An administered medication label 311 and the medication concentration or dose 312 can be shown adjacent to a target or control graph of the medication with a setting level 313. The setting level 313 can be adjusted by the user and/or the management algorithm. Relationships between administered medications and fluids and the functional variables HR and LHSV can be shown by a line 314 connecting between the flow rate or dose of the administered medication or fluid and the HR or LHSV functional parameter or a combination thereof which the medication or fluid has an effect on. The display 399 presents such information onto a graphical representation showing the anatomy of the left heart (e.g., behind the opaque graphs, as shown, or layered with translucent or transparent graphs). The anatomical graphical representation can show the left atrium and ventricle, the aorta, and pulmonary vein.
Right Heart Displays
[0076] The cardiac display 300 can include a right heart display showing a graphical representation of the higher-level goals, the middle-level functional parameters, and the lower-level functional parameters and controls used in monitoring and managing the right heart including its cardiac output, stroke volume, heart rate, contractility, and pre-load. The display also shows interrelationships and interactions between the higher-level goals, the middle-level functional parameters, and the lower-level functional parameters and controls used in monitoring and managing the right heart including its cardiac output, stroke volume, heart rate, contractility, and pre-load.
Right Heart Cardiac Output, Stroke Volume, and Heart Rate Display
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[0078] The functional parameters include Heart Rate (HR), graphed along axis 303, and Right Heart Stroke Volume (RHSV), graphed along axis 301. The higher-level goal and functional parameters in the Right Heart Display are shown and integrated in a graph where the HR value is shown on one axis 303, and the RHSV value is shown on another axis 301 perpendicular to the HR axis. The RHSV can be projected onto the contractility and pre-load display 398 as RHSV 309. The RHSV represented in the cardiac output display 399 can be visually linked by lines on the display to the RHSV 309 on the contractility and pre-load display 398.
[0079] The area of the rectangle along the HR and RHSV values is a measure of the Right Heart Cardiac Output value. A measurement of the RHCO 304 is shown on the display. Relationships between administered medications and fluids and the functional parameters HR and RHSV are shown by a line connecting between the flow rate or dose of the administered medication or fluid and the HR or RHSV functional parameter or a combination thereof which the medication or fluid has an effect on. The display presents such information onto a graphical representation of the anatomy of the right heart. The anatomical graphical representation shows the right atrium and ventricle, the pulmonary artery, the superior vena cava, and inferior vena cava.
Left Heart Pre-Load & Contractility Display
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Right Heart Pre-Load & Contractility Display
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Cardiovascular System Displays
Systemic Vascular Display
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[0083] The systemic vascular display 400 shows a representation of the higher-level goals, the middle-level functional parameters, and the lower-level functional parameters and controls used in monitoring and managing the systemic vascular system including the systemic arterial and venous vascular blood flow, systemic arterial and venous vascular blood pressures, and systemic vascular resistance. The Systemic Vascular Display's graphical representation also shows interactions between the higher-level goals, the middle-level functional parameters, and the lower-level functional parameters and controls used in monitoring and managing the systemic vascular circulatory system including the systemic arterial and venous vascular blood flow, systemic arterial and venous vascular blood pressures, and systemic vascular resistance. The display presents such information onto a graphical representation of the anatomy of the systemic vascular system. The anatomical graphical representation shows the systemic arterial and venous vascular systems.
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[0085] Administered medications can be shown in the systemic vascular blood flow display 498, for example listing the medication name 415 and/or the medication concentration and/or dose 416. Relationships between administered medications and fluids and the functional parameters SAP, CVP, and SVR can be shown by a line 401 connecting between the flow rate or dose of the administered medication or fluid and the functional parameter SAP, CVP, or SVR or a combination thereof which the medication or fluid has an effect on. The graphical object representing the medication can be shown along a dosage axis 418 and can have a target or current dosage rate 417 shown.
[0086] The SBF 404 can be projected onto the balance object display 800 as SBF 803. SBF 404 can be linked by a line to SBF 803.
Systemic Oxygen Display
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[0088] The oxygen consumption 421 can be projected onto the balance object display 898 as oxygen consumption 805. The oxygen consumption 421 can be linked by a line to the oxygen consumption 805.
Systemic Carbon Dioxide Display
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Pulmonary Vascular Display
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[0092] The Pulmonary Vascular Display 598 displays the higher level goal of Pulmonary Blood Flow (PBF) 504, the middle-level functional parameters include Pulmonary Arterial Pressure (PAP), shown on axis 502, and Pulmonary Venous Pressure (PcW), shown on axis 503. The lower-level functional parameters include the Pulmonary Vascular Resistance (PVR), shown on axis 532. The higher-level goal and functional parameters in the Pulmonary Vascular Display 598 can be shown and integrated in a graph where PAP and PcW values are shown on one axis, 502 and/or 503, and the PVR value is on another axis 532 perpendicular to the PAP and PcW axis. A line connecting between the PAP and PcW values along the PVR axis 532 indicates the Pulmonary Blood Flow (BPF) 504 by the slope of that line.
[0093] The PBF 504 can be projected onto the balance object display 800 as PBF 804. A line can link PBF 504 to PBF 804.
[0094] Administered medications can have labels 528 and/or medication concentration and/or dose levels 529 shown. Relationships between administered medications and fluids and the functional parameters PAP, PcW, and PVR are shown by a line 501 connecting between the flow rate or dose of the administered medication or fluid and the functional parameter PAP, PcW, or PVR or a combination thereof which the medication or fluid has an affect on.
[0095] The graphical object representing the medication can be shown along a dosage axis 531 and can have a target or current dosage rate 530 shown.
Lungs and Ventilation Display
[0096] The Pulmonary Vascular display 598 can have an anatomical graphical representation of the lungs. The lungs graphical representation can include a Respiratory Rate (RR) 507 on a RR graph 508, Tidal Volume (TV), Alveolar Oxygen Concentration (F.sub.alvO.sub.2), Inspired Oxygen Concentration (F.sub.iO.sub.2), Alveolar CO.sub.2 Concentration (F.sub.alvCO.sub.2), Expired CO.sub.2 Concentration (F.sub.expCO.sub.2) 516, Minute Ventilation (MV) 515, a ratio of partial pressure of alveolar oxygen to alveolar carbon dioxide (P.sub.alvO.sub.2/P.sub.alvCO.sub.2) 517, or combinations thereof.
[0097] Information pertaining to mechanical ventilation can be presented on or around the anatomical lungs graphical representation, for example if the patient is being ventilated mechanically. The display can include ventilation information displays including Respiratory Rate (RR), Tidal Volume (TV), Inspired Oxygen Concentration (F.sub.iO.sub.2), Inspiratory Flow Rate, Inspiratory Time, Inspiratory/Expiratory Time Ratio (I:E ratio) 509 on an I:E graph 510, Positive Inspiratory Pressure (PIP) 506 or combinations thereof.
[0098] Mapped onto each of the mechanical ventilation variables Respiratory Rate (RR), Tidal Volume (TV) 511 on a TV graph 512, Inspired Oxygen Concentration (F.sub.iO.sub.2) 513 on an F.sub.iO.sub.2 graph 514, Inspiratory Flow Rate, Inspiratory Time, and Inspiratory/Expiratory Time Ratio (I:E ratio) can be a control for controlling each of the variables. The user can control patient's mechanical ventilation by manipulating controls of the mechanical ventilation variables on the Lungs and Ventilation display including Respiratory Rate (RR), Tidal Volume (TV), Inspired Oxygen Concentration (F.sub.iO.sub.2), Inspiratory Flow Rate, Inspiratory Time, Inspiratory/Expiratory Time Ratio (I:E ratio).
Pulmonary Oxygenation Display
[0099]
[0100] The blood oxygenation 533 can be projected onto the balance object 898. A line can link the blood oxygenation 533 to the blood oxygenation 807.
[0101] Ventilation properties can be shown in the graphic objects of the organs themselves, such as on the graphic objects of the vascular system between the organs. On the graphic objects for the vessels within the cardiovascular representation, the systemic arterial oxygen saturation (SaO2SAT), systemic venous oxygen saturation (SvO2SAT), systemic arterial and venous oxygen pressures PaO.sub.2, PvO.sub.2, pulmonary arterial and venous oxygen pressures PaO.sub.2, PvO.sub.2, and combinations thereof can be shown.
Pulmonary CO.SUB.2 .Display
[0102] In the Pulmonary CO.sub.2 display 599, the Pulmonary Arterial CO.sub.2 Content (PACO.sub.2C), shown on axis 523, and the Pulmonary Blood Flow Rate (PBF) 525 can be used to calculate the Pulmonary Arterial CO.sub.2 Flow Rate (PACO.sub.2FR) 526, while the Pulmonary Venous CO.sub.2 Content (PVCO.sub.2C), shown along axis 524, and the Pulmonary Blood Flow Rate (PBF) 525 can be used to calculate the Pulmonary Venous CO.sub.2 Flow Rate (PVCO.sub.2FR) 527. An object display shows the difference between PACO.sub.2FR 526 and PVCO.sub.2FR 527, indicating a CO.sub.2 mass transfer rate 534 from the blood to the lungs (CO.sub.2 Elimination from the blood).
[0103] The CO.sub.2 mass transfer rate 534 can be projected onto the balance object 897. A line can link the CO.sub.2 mass transfer rate 534 to the CO.sub.2 mass transfer rate 808.
[0104] In the vessels within cardiovascular representation, displayed are the systemic arterial CO.sub.2 pressure PaCO.sub.2, systemic venous CO.sub.2 pressure PvCO.sub.2, and pulmonary arterial and venous CO.sub.2 pressures PaCO.sub.2, PvCO.sub.2, respectively.
[0105] Ventilation properties can be shown in the graphic objects of the organs themselves, such as on the graphic objects of the vascular system between the organs.
Medication Administration and Management Display
[0106]
[0107] A line can connect between each medication's flow rate or dose control (regulator) 603 and the cardiovascular functional parameter which the medication has an effect on. For example, vasoconstrictive medications can have a line connecting between the medication's flow rate or dose control (regulator) 603 and the systemic vascular resistance (SVR) 401 or pulmonary vascular resistance (PVR) 501 on the cardiovascular display or a combination thereof. Medications which affect the heart rate 303 can have a line connecting between the medication's flow rate or dose control (regulator) 603 and the heart rate 303 value on the cardiovascular display.
Expanded Medication Administration and Management Display
[0108] For each administered medication, the user can select to expand or collapse the medication's administration and management display 600. In the expanded Medication Administration and Management Display 600, the medication's flow rate and/or dose values 604a,b can be displayed on one axis, while time 610 is shown on another perpendicular axis. The user can choose to display the medication's flow rate or dose or both. The area under the flow rate or dose 604a,b vs. time 610 graph represents the medication's volume or amount (mass) 605a,b, respectively. Mapped onto the medication flow rate or dose information 604a,b is the medication's flow rate or dose control or regulator 603a,b, respectively. The user can manipulate the medication's flow rate or dose control (regulator) to adjust the medication's flow rate or dose, respectively (i.e., increase or decrease the flow rate or dose setting, respectively). A line connects between each medication's flow rate or dose control (regulator) 603a,b and the cardiovascular functional parameter which the medication has an affect on.
[0109] In combination with the medication flow rate and/or dose and time information, the flow rate/dose vs time display shows the medication's name 601a,b, concentration 602a,b, volume and/or amount to be infused to the patient 607a,b, volume and/or amount administered to the patient 611a,b, period of medication administration 606a,b, remaining volume and/or amount to be infused or administered to the patient 608a,b, remaining time to complete medication administration at the currently set flow rate or dose 609a,b, and the total volume and/or amount of medication remaining in the reservoir 608a,b.
Target-Controlled (Model-Driven) Infusion Pump Display
[0110] A medication management display 600 can be used for medications infused by target-controlled or model-driven “smart” infusion pumps. The medication management display 600 can have a display showing the medication's flow rate or dose information 604a,b, as well as the medication's name 601a,b, concentration 602a,b, total volume and/or amount, volume and/or amount administered to the patient 611a,b, period of medication administration, remaining volume (i.e., volume to be infused “VTBI”) 607a,b, (volume infused “VI”) 605a,b, (total volume infused) TVI 611a,b. and/or amount to be infused or administered to the patient, remaining time to complete medication administration at the currently set flow rate or dose (“TR”) 609a,b, and the total volume and/or amount of medication remaining in the reservoir (“VR”) 608a,b. Mapped onto the medication flow rate or dose information is the medication's flow rate or dose control or regulator 603, respectively. The user can manipulate the medication's flow rate or dose control (regulator) to adjust the medication's flow rate or dose (as shown by target dose controls 604a,b), respectively (i.e., increase or decrease the flow rate or dose setting, respectively).
[0111] For each cardiovascular functional parameter 303 which is affected and controlled by a medication being administered using a target-controlled or model-driven infusion pump, a control or regulator 314 of the cardiovascular functional parameter is mapped onto its measurement value on the cardiovascular display. The cardiovascular display then shows both the measured 303 and target (set/desired) 314 values of the cardiovascular functional parameter.
[0112] The user can adjust the cardiovascular functional parameter's target, set or desired value 314 by manipulating the medication delivery control 313 on the target control pump anywhere in the management display (e.g., within the cardiovascular display, pulmonary display, systemic vascular display) which in turn will automatically control and adjust the flow rate or dose of the medication or medications which affect this (e.g., cardiovascular, pulmonary, systemic vascular) functional parameter.
[0113] The functional parameter can be adjusted to control the infusion pump. For example, a target functional parameter can be entered through the control 8. The target functional parameter can be processed by the management algorithm 6, which in turn can automatically control and adjust the flow rate or dose of the medication or medications which affect this (e.g., cardiovascular, pulmonary, systemic vascular) functional parameter. For example, a smart infusion pump can be used to control delivery of the medication to the patient.
[0114] As an example, a line connects between the cardiovascular functional parameter's control or regulator on the cardiovascular display and the flow rate or dose information on the medication display of the medication or medications which affect the cardiovascular functional parameter. The target-controlled or model-driven infusion pump system monitors the cardiovascular functional parameter's measured value and adjusts the medication's flow rate or dose automatically to achieve the set or desired cardiovascular functional parameter value. For example, when the user adjusts the target or desired heart rate value 314 on the cardiovascular display, the pump adjusts the flow rate or dose of the medication or medications which control the heart rate accordingly to achieve the desired heart rate value. The pump system monitors the heart rate value and adjusts the medication's flow rate automatically to achieve the desired heart rate value. Similarly, when the user adjusts the left heart stroke volume (LHSV) or contractility values on the cardiovascular display, the pump adjusts the flow rate or dose of the medication or medications which affect LHSV or contractility, respectively.
Medication Administration and Management Graphical Display & Animation
[0115] Each medication being administered to the patient is represented graphically by displaying an image of the medication's reservoir such as an image of a medication bag, bottle, or syringe. On the image representing the medication displayed is the medication's name, concentration, total volume and/or amount, administration flow rate and/or dose, period of medication administration, remaining volume and/or amount to be infused or administered to the patient, remaining time to complete medication administration at the currently set flow rate or dose, and the total volume and/or amount remaining in the reservoir.
[0116] A line representing the administered medication's flow in a clear plastic tubing routes from the medication's reservoir to its administered location on the patient's vascular system's anatomical graphical representation within the cardiovascular display. This line has a similar color to the medication's color (e.g., gray for a clear color medication) and connects between each administered medication reservoir and its administration location on the patient's vascular system's anatomical graphical representation within the cardiovascular display. The medication line can be animated to show the medication flowing in a plastic tubing from its reservoir bag to its administered location on the patient's vascular system's anatomical graphical representation within the cardiovascular display. Higher medication flow rate is represented by a medication line moving at a faster rate.
[0117] A display of the medication's flow rate and/or dose is shown on the medication's reservoir and/or anywhere on the medication line connecting between the medication's reservoir and its administration location on the patient's vascular system's anatomical graphical representation within the cardiovascular display.
Patient's Fluids Administration and Management Display
[0118]
[0119] In the Fluids Administration and Management Display 700 all fluids collected from the patient are displayed and managed such as urine collected from the patient and blood loss, etc. For each fluid being collected from the patient, displayed are the fluid's name, collection flow rate 706, 707, and volume collected 709, 710. When several fluids are being collected from the patient, a Total Outflow Rate (TOFR) 708 can be calculated and displayed by the system.
Inflow and Outflow Fluids Balance Display
[0120] The Inflow and Outflow Fluids Balance display 712 shows balance information between fluids being administered to the patient (inflow fluids) and fluids being collected from the patient (outflow fluids) using one or multiple object displays. Each fluid balance object display shows balance information both graphically and numerically by displaying information such as difference or % difference between inflow and outflow rate values for inflow and outflow fluids, and difference or % difference between inflow and outflow volumes (e.g., volume administered to patient and volume collected from patient) for inflow and outflow fluids.
[0121] The user can select which inflow and outflow fluids to be incorporated in any fluids balance object display 700. For example, the user could select blood collected from the patient (i.e., blood loss) and blood and IV solutions administered to the patient to be incorporated in a blood fluid balance object display 711. If multiple inflow and/or outflow fluids are incorporated in one fluids balance object display, a second balance object display is displayed showing balance information between TIFR and TOFR values and/or between total administered volume and total collected volume for the inflow and outflow fluids.
Balance Object Display
[0122]
[0123] The balance object display 800 can have integral or configurate displays. For example, the balance object display can show interactions and balance information among the higher-level goals of managing the cardiovascular, pulmonary and fluid systems.
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Animations
Cardiovascular Display Animation
[0127] The cardiovascular graphical representation is also animated showing the heart beating (contracting) at the measured HR value. The LHSV and RHSV measurements can be shown in the animation by the size of expansion of the left and right ventricles, respectively. The blood can also be shown circulating throughout the cardiovascular system including the left and right hearts and systemic and pulmonary vascular systems. The blood in the left heart, the systemic arterial vascular system, and the pulmonary venous vascular system is shown in red color to indicate blood oxygenation. The blood flowing in the right heart, the pulmonary arterial vascular system, and the systemic venous vascular system is shown in blue color to indicate blood de-oxygenation. The intensity of the blood's red and blue colors can indicate the systemic and pulmonary arterial and venous O.sub.2 and CO.sub.2 contents, systemic P.sub.aO.sub.2, P.sub.vO.sub.2, P.sub.aCO.sub.2, and P.sub.vCO.sub.2 and pulmonary P.sub.aO.sub.2, P.sub.vO.sub.2, P.sub.aCO.sub.2, and P.sub.vCO.sub.2.
Lungs Display Animation
[0128] The lungs graphical representation can be animated to show the lungs expand or inflate to mimic inspiration and deflate to mimic expiration. The patient's RR is animated by the rate at which the lungs expand and deflate, while the TV measurement is animated by the size of lungs' expansion. The lungs' color during inspiration (i.e., lungs' expansion) can turn to green to indicate alveolar oxygenation, while lungs' color during expiration (lungs' deflation) can turn to gray to indicate CO.sub.2 transfer to the lungs. The intensity or saturation of the lungs' green color can graphically represent the F.sub.alvO.sub.2 or F.sub.iO.sub.2 values. The intensity or saturation of the lungs' gray color can graphically represent the F.sub.alvCO.sub.2 or F.sub.expCO.sub.2 values. Higher F.sub.alvO.sub.2 or F.sub.iO.sub.2 values are represented by a more intense or saturated green color, and lower F.sub.alvO.sub.2 or F.sub.iO.sub.2 values are represented by a less intense or saturated green color. Similarly, higher F.sub.alvCO.sub.2 or F.sub.expCO.sub.2 values are represented by a more intense or saturated gray color, and lower F.sub.alvCO.sub.2 or F.sub.expCO.sub.2 values are represented by a less intense or saturated gray color.
Fluids Administration and Management Graphical Display and Animation
[0129] Each fluid being administered to the patient is represented graphically by displaying an image of the fluid's reservoir such as an image of a blood or IV solution bag. On the image representing the fluid being administered, displayed is the fluid's name, concentration or dose information, total volume, administration flow rate, time remaining to complete fluid administration at the set flow rate, remaining volume to be infused or administered to the patient, and the total volume remaining in the reservoir. Displayed also is a line representing the administered fluid's flow in a clear plastic tubing from the fluid's reservoir to its administered location on the patient's vascular system within the cardiovascular display. This line has a similar color to the fluid's color (e.g., gray for IV saline solution, red for blood) and connects between each administered fluid reservoir and its administered location on the patient's vascular system within the cardiovascular display. The fluid line can be animated to show the fluid flowing in the plastic tubing from its reservoir bag to its administered location on the patient's vascular system within the cardiovascular display. Higher fluid flow rate is represented by a fluid line moving at a faster rate. A measurement of the fluid's administration flow rate is displayed on the fluid's reservoir and/or anywhere on the fluid line connecting between the fluid's reservoir and its administered location on the patient's vascular system within the cardiovascular display. Mapped onto the fluid administration flow rate value is the fluid's flow rate control or regulator. The user can control and adjust the fluid's flow rate by manipulating its flow control or regulator to increase or decrease the fluid flow rate value. In this flow rate control, the user can move the flow rate value indicator from the current flow rate value to the desired flow rate value.
[0130] When several fluids are being administered to the patient, a Total Inflow Rate (TIFR) value is calculated and displayed by the system. For each of the administered fluids, a first fluid line connects between the fluid's reservoir and the TIFR value, while a second fluid line connects between the TIFR value and the fluids' administered location on the patient's vascular system within the cardiovascular display. The first and second fluids lines for each of the administered fluids can be animated as described above to graphically show the fluid's flow rate. For each of the administered fluids, a measurement of the fluid's flow rate value is displayed on the fluid's reservoir and/or anywhere on the first fluid line connecting between its reservoir and the TIFR value. Mapped onto each of the fluid's flow rate value is the fluid's flow rate control or regulator. The user can control and adjust the fluid's flow rate by manipulating its flow control or regulator to increase or decrease the flow rate value. In this flow rate control, the user can move the flow rate value indicator from the current flow rate value to the desired flow rate value.
[0131] Each fluid being collected from the patient is represented graphically by displaying an image of the fluid's collection reservoir such as an image of a blood collection canister or a urine collection bag. On or adjacent to the image representing the fluid displayed is the fluid's name, collected volume, and collection flow rate. Displayed also is a line representing the collected fluid flowing in a plastic tubing from the fluid's source on the patient's vascular system within the cardiovascular display to its collection reservoir. This line has a similar color to the fluid's color (e.g., yellow for urine, red for blood) and connects between each collected fluid's source location on the patient's vascular system within the cardiovascular display and its collection reservoir. The fluid line can also be animated as described above to show the fluid flowing from its source location on the patient's vascular system within the cardiovascular display to its collection reservoir. Higher fluid flow rate is represented by a fluid line moving at a faster rate. For each of the fluids being collected from the patient, a measurement of the fluid's collection flow rate is displayed on the fluid's collection container and/or anywhere on the fluid line connecting between its source location on the vascular system within the cardiovascular display and its collection reservoir.
[0132] When several fluids are being collected from the patient, a Total Outflow Rate (TOFR) value is calculated and displayed by the system. For each of the collected fluids, a first fluid line connects between the fluids' collection source on the patient's vascular system within the cardiovascular display and the TOFR value, while a second fluid line connects between the TOFR value and the fluid's collection reservoir. The first and second fluid lines for collected fluids can be animated as described above to mimic and graphically represent the flow rate value for each of the collected fluids. For each of the collected fluids, a measurement of the fluid's collection flow rate value is displayed on the fluid's collection reservoir and/or anywhere on the first fluid line connecting between its collection source location on the patient's vascular system within the cardiovascular display and the TOFR value.
[0133] A patient dialysis management system 900 is also described and disclosed. The patient dialysis management system 900 can monitor, control and communicate (e.g., visually display or audibly sound) patient's dialysis treatment and status. The system can have a human-machine interface for monitoring and control of patient's dialysis, and capable of the creation of displays and controls, wherein such displays are collections of one or more displays that may be graphs showing mathematical relationships or graphical in nature, and wherein such controls are collections of one or more controls that may be used to control patient's dialysis using a touch screen, a mouse, keyboard, or any other human-machine interface control.
System Components
[0134]
[0135] The direct subsystems 901 can be physically integrated with the management algorithm 907, the control 906, the display 905 or combinations thereof. For example, the direct subsystems 901, and the management algorithm 907, the control 906, the display 905 or combinations thereof can be in a unitary form factor, such as in a single case or container.
[0136] The management algorithm 907 can monitor and identify parameters transitioning from normal conditions or settings to abnormal conditions or settings and the possible consequences on system functions or goals including failures as a result of such parameters' transitions. The management algorithm 907 can highlight the abnormal parameters settings and system functions or goals that can be affected as a result of such parameters' transitions using color or visual or auditory alarms in order to make such parameters and system conditions more prominent and visible.
[0137] When system failures or abnormal system functions or conditions occur, the management algorithm 907 can identify root causes and parameters related to the failures or abnormal system functions or conditions. The management algorithm 907 can highlight the abnormal parameters settings and affected system functions or goals that were impacted using color or visual or auditory alarms in order to make such parameters and system conditions more prominent and visible.
[0138] When system parameters transition from normal conditions or settings to abnormal conditions or settings or when system failures or abnormal functions or conditions occur, the management algorithm 907 can automatically adjust parameters to prevent or correct abnormal system functions or failures and restore normal system functions.
Displays
[0139]
[0140] The management display 1000 can have text labels on the display, for example, the rate and ratio of urea reduction, concentration of urea, the arterial and venous blood flow rate, and the dialysate flow rate in the dialyzer which can be shown in the graphic object representations within the management display 1000. The management display 1000 can be animated to show different states in real-time. For example, the animation can include graphic object changes showing arterial and venous blood flow, dialysate flow, and dialysis pump motion.
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[0148] Any labels shown or other text data shown on the display can be shown on, in, or adjacent to the representative graphic to which that label or text data is associated. Exemplary labels and text data are shown throughout the figures for illustrative purposes.
[0149] Any combinations or pluralities of elements herein are disclosed. The descriptions herein are exemplary and not intended to be limiting in any way.