PHOTOTHERAPY SYSTEM AND METHOD

Abstract

The present invention relates to a phototherapy system comprising an LED carrier (10) for being arranged on or under a subject (100), a set (12; 24, 26; 36) of LEDs (13; 23, 25; 33, 35), wherein at least a first subset (12; 24; 34) of LEDs (13; 23; 33) of said set is arranged in or at the LED carrier (10), a control unit (15) for controlling one or more LEDs (13; 23; 33) of said first subset (12; 24; 34) to switch between an emission mode, in which an LED emits electromagnetic radiation in the direction of the subject, and a detection mode, in which an LED generates a detection signal in dependence on the electromagnetic radiation incident on the LED, and a position determination unit (16) for determining the position of a subject with respect to the LED carrier based on the detection signals of one or more LEDs (13; 23; 33) of said first subset (12; 24; 34) in the detection mode, wherein the control unit (15) is configured to control one or more LEDs (13; 23, 25; 33, 35) to switch into the emission mode based on the determined position of the subject such that their emitted electromagnetic radiation provides phototherapy for the subject. A vital signs determination unit (17) is provided for determining one or more vital signs of the subject from one or more detection signals generated by one or more LEDs of said first subset.

Claims

1. A phototherapy system comprising: an LED carrier for being arranged on or under a subject, a set of LEDs, wherein at least a first subset of LEDs of said set is arranged in or at the LED carrier, a control unit for controlling one or more LEDs of said first subset to switch between an emission mode, in which an LED emits electromagnetic radiation in the direction of the subject, and a detection mode, in which an LED generates a detection signal in dependence on the electromagnetic radiation incident on the LED, a position determination unit for determining the position of a subject with respect to the LED carrier based on the detection signals of one or more LEDs of said first subset in the detection mode, and a vital signs determination unit for determining one or more vital signs of the subject from one or more detection signals generated by one or more LEDs of said first subset, wherein the control unit is configured to control one or more LEDs to switch into the emission mode based on the determined position of the subject such that their emitted electromagnetic radiation provides phototherapy for the subject.

2. The phototherapy system as claimed in claim 1, wherein said control unit is configured to control an LED to switch into the emission mode, if it is configured and arranged such that a substantial amount of electromagnetic radiation emitted by said LED hits the subject.

3. The phototherapy system as claimed in claim 1, wherein said position determination unit is configured to determine if a detection signal is above or below a predetermined threshold.

4. The phototherapy system as claimed in claim 3, wherein said position determination unit is configured to determine that an LED is underneath the subject if the detection signal generated by said LED in detection mode is below said predetermined threshold.

5. The phototherapy system as claimed in claim 4, wherein said control unit is configured to control an LED to switch into the emission mode only if the detection signal generated by said LED in detection mode is below said predetermined threshold.

6. The phototherapy system as claimed in claim 3, wherein said control unit is configured to control an LED to switch off or to switch into the detection mode if the detection signal generated by said LED in detection mode is above said predetermined threshold.

7. The phototherapy system as claimed in claim 3, wherein said set of LEDs is subdivided into groups of LEDs and wherein said control unit is configured to commonly control the LED of a group to switch into the emission mode, if a detection signal generated by one or more LEDs of said group in detection mode is below said predetermined threshold.

8. The phototherapy system as claimed in claim 1, wherein said control unit is configured to control LEDs of said first subset, which are not switched into the emission mode, to switch into the detection mode, wherein said position determination unit is configured to continuously or regularly evaluate detection signals generated by LEDs in the detection mode to determine if the position of the subject with respect to the LED carrier has changed, and wherein said control unit is configured to change the control of the LEDs if it is determined that the position of the subject with respect to the LED carrier has changed.

9. The phototherapy system as claimed in claim 1, wherein all LEDs of said set are arranged in or at the LED carrier.

10. The phototherapy system as claimed in claim 1, wherein one or more LEDs of a second subset of said set are arranged to be placed at two or more different sides of the subject such that electromagnetic radiation emitted by the LEDs of said second subset hits the subject from above, below and/or from one or more sides.

11. The phototherapy system as claimed in claim 10, wherein said control unit is configured to control an LED of said second subset to switch into the emission mode only if the detection signal generated by an LED of the first subset at the same longitudinal position with respect to the subject is below said predetermined threshold, and/or to switch off if the detection signal generated by an LED of the first subset at the same longitudinal position with respect to the subject is above said predetermined threshold.

12. (canceled)

13. The phototherapy system as claimed in claim 1, wherein said control unit is configured to switch only LEDs of said first subset between said emission mode and said detection mode.

14. The phototherapy system as claimed in claim 1, wherein said control unit is configured to switch at least one or more LEDs of said first subset into the emission mode based on the determined position of the subject.

15. The phototherapy system as claimed in claim 1, wherein said position determination unit is configured to measure an open circuit voltage of an LED of said first subset in detection mode as detection signal.

16. A program causing a phototherapy system comprising an LED carrier for being arranged on or under a subject and a set of LEDs, wherein at least a first subset of LEDs of said set is arranged in or at the LED carrier, to carry out, when executed, the following steps: controlling one or more LEDs of said first subset to switch between an emission mode, in which an LED emits electromagnetic radiation in the direction of the subject, and a detection mode, in which an LED generates a detection signal in dependence on the electromagnetic radiation incident on the LED, determining the position of a subject with respect to the LED carrier based on the detection signals of one or more LEDs of said first subset in the detection mode, determining one or more vital signs of the subject from one or more detection signals generated by one or more LEDs of said first subset, and controlling one or more LEDs to switch into the emission mode based on the determined position of the subject such that their emitted electromagnetic radiation provides phototherapy for the subject.

17. (canceled)

18. (canceled)

Description

BRIEF DESCRIPTION OF THE DRAWINGS

[0048] These and other aspects of the invention will be apparent from and elucidated with reference to the embodiment(s) described hereinafter. In the following drawings

[0049] FIG. 1 shows a schematic diagram of a first embodiment of a phototherapy system according to the present invention,

[0050] FIG. 2 shows a diagram of the typical photodiode current-voltage characteristics of an LED,

[0051] FIG. 3 shows a schematic diagram of a second embodiment of a phototherapy system according to the present invention,

[0052] FIG. 4 shows a schematic diagram of the third embodiment of the phototherapy system according to the present invention, and

[0053] FIG. 5 shows a flow chart of an embodiment of the method according to the present invention.

DETAILED DESCRIPTION OF THE INVENTION

[0054] FIG. 1 shows a schematic diagram of a first embodiment of a phototherapy system 1 according to the present invention. The phototherapy system 1 comprises an LED carrier 10, e.g. a bed, mattress, patient table, blanket, etc. In the exemplary embodiment shown in Fig, 1 the LED carrier 10 is configured as a mattress for supporting a subject 100, e.g. an infant (e.g. a neonate), on a top surface 11 thereof. A set 12 of LEDs 13 is arranged in or at the LED carrier 10, wherein in this embodiment all LEDs 13 are arranged inside the LED carrier such that they emit electromagnetic radiation 14 through the top surface 11 (which is transparent for the emitted electromagnetic radiation 14) such that at least part thereof directly impinges on subject 100 and thus provide phototherapy to the subject.

[0055] Phototherapy is particularly used to treat jaundice (or hyperbilirubinemia) by reducing the level of bilirubin. Effective and/or appropriate levels of phototherapy may be based on the subject's age, size, weight, and/or other physiological, environmental, and/or subject-specific parameters. Phototherapy preferably uses electromagnetic radiation having a peak wavelength between, e.g., 460 nm and 500 nm, an emission spectrum ranging from, e.g., 400 nm to 520 nm, and preferably using a narrow bandwidth delivered at an irradiance of, e.g., 30-35 W/cm2/nm to, e.g., up to 80% of a subject's body surface area (BSA). Phototherapy may also be applied to treat other problems, such as acne.

[0056] The phototherapy system 1 further comprises a control unit 15 for controlling one or more LEDs 13 of said set 12 to switch between an emission mode, in which an LED emits electromagnetic radiation in the direction of the subject 100, and a detection mode, in which an LED generates a detection signal in dependence on the electromagnetic radiation incident on the LED. Hence, single LEDs, groups of LEDs or all LEDs can be operated in those two different modes, in which they either function as a conventional radiation emitting element or as a radiation detection element (similar to a photo detector or photodiode) as will be explained below in more detail.

[0057] The phototherapy system 1 further comprises a position determination unit 16 for determining the position of a subject 100 on the top surface 11 of the LED carrier 10 based on the detection signals of one or more LEDs 13 (e.g. of all LEDs) in the detection mode. Hereby, the effect is evaluated that an LED in the detection mode provides an output signal, whose intensity is dependent on the intensity of the incident electromagnetic radiation, particularly in the spectral range, in which the LED emits electromagnetic radiation in the emission mode. Hence, if an LED outputs a detection signal with a small (or zero) amplitude indicating a small intensity of incident radiation, it is interpreted such that this LED is covered by the subject's body and no ambient radiation (or radiation from a dedicated illumination source (not shown in FIG. 1)) is incident on the LED. On the other hand, if an LED outputs a detection signal with comparably large amplitude indicating a larger intensity of incident radiation, it is interpreted such that this LED is not covered by the subject's body and ambient radiation (or radiation from a dedicated illumination source) is incident on the LED. The detection signals thus allow determining the position of the subject 100.

[0058] The control unit 15 and the position determination unit 16 are preferably implemented by a common element or separate elements, e.g. a common or separate processor or programmable elements, which are programmed accordingly.

[0059] The control unit 15 is hence configured to control one or more LEDs 13 to switch into the emission mode based on the determined position of the subject 100 such that their emitted electromagnetic radiation provides phototherapy for the subject 100.

[0060] Hereby, in one embodiment, all LEDs 13 are used in both modes, so that in this case all LEDs which have shown a detection signal with comparably small (or zero) amplitude (indicating that they are covered by the subject 100; in FIG. 1 e.g. the fourth to seventh LEDs, counted from the left side) will be switched into the emission mode to provide phototherapy. All other LEDs 13 (in FIG. 1 e.g. the three LEDs on the left side and the two LEDs on the right side) will either be switched off or kept in the detection mode (which may be the same in case the detection mode is effected by disconnecting the LED from its power supply to switch it into detection mode) to continuously monitor if any position changes of the subject's position happen.

[0061] Preferably, the control unit 15 is configured to control an LED 13 to switch into the emission mode, if it is configured and arranged such that a substantial amount, e.g. more than 10, 25, or 50% (or any other percentage determined in the particular application, of electromagnetic radiation emitted by said LED 13 hits the subject 100. This could be directly measured with the position determination unit 16, which may be configured to determine if a detection signal is above or below a predetermined threshold. The threshold is generally predetermined, e.g. through calibration measurements, trials or simulation.

[0062] For instance, the position determination unit 16 may be configured to determine that an LED 13 is underneath the subject 100 if the detection signal generated by said LED 13 in detection mode is below said predetermined threshold. The control unit 15 is then preferably configured to control an LED 13 to switch into the emission mode only if the detection signal generated by said LED 13 in detection mode is below said predetermined threshold and/or to control an LED 13 to switch off or to switch into the detection mode if the detection signal generated by said LED 13 in detection mode is above said predetermined threshold.

[0063] In another embodiment the control unit 15 is configured to control one or more LEDs 13, which are not switched into the emission mode, to switch into the detection mode and the position determination unit 16 is configured to continuously or regularly evaluate detection signals generated by LEDs 13 in the detection mode to determine if the position of the subject 100 with respect to the LED carrier 10 (in this embodiment on the top surface 11 of the mattress) has changed. If the position of the subject 100 with respect to the LED carrier 10 has indeed changed and if this has been detected by the evaluation of the detection signals, the control unit 15 changes the control of the LEDs 13, i.e. changes the modes for one or more LEDs to make sure that only LEDs, whose radiation substantially impinges on the subject 100 are in the emission mode.

[0064] In another embodiment only some of the LEDs 13 (i.e. a subset thereof, e.g. each second LED) is used in both modes, i.e. the other LEDs are either switched on (to emit radiation) or off (not to emit radiation). The latter LEDs are then controlled according to the detection signal(s) of one or more of the neighboring LEDs, which are used in both modes. Hence, in general, the LEDs may be grouped into groups, where only one or more LEDs of the group is used in both modes and the detection signal of said LED(s) controls the state of the other or all LEDs of the group. In other words, the control unit 15 commonly controls the LEDs of a group to switch into the emission mode, if a detection signal generated by one or more LEDs of said group in detection mode is below said predetermined threshold.

[0065] The open circuit voltage can be measured across an LED in detection mode as a function of illumination of the LED. The LED then behaves like a photodiode when illuminated and is sensitive to incident radiation (in particular light) with a wavelength equal or smaller than the output wavelength of the LED. When the LED is illuminated with a radiation intensity above 0, a voltage will develop over a resistor (e.g. included in the control unit 15 or provided as separate element), for instance a voltmeter. This is illustrated in FIG. 2 showing a diagram of the typical current-voltage characteristics of an LED. As can be seen there, an LED in detection mode can be operated both in photovoltaic mode as well as in photoconductive mode, when the LED is negatively biased. As shown, when no voltage is applied to the LED the output voltage (which is one embodiment of the detection signal) increases with increasing intensity (in this case lux) of the incident radiation. In both the emission mode and in the detection mode the LEDs can be pulsed. In FIG. 2 the lines R1 and R2 indicate the voltage-current relation for a given resistance and the double arrows A1 and A2 indicate how the slope of these lines changes when the resistance changes.

[0066] There are generally two ways to measure: photovoltaic mode, where the LED generates a voltage as function of the incident light, and photoconductive mode where the change in current flowing through the LED is measured as a function of incident light. The photoconductive mode is reverse biased and the photovoltaic mode is typically unbiased, but can be maintained up to a small positive bias (i.e. under the threshold voltage for the LED as also shown in FIG. 2). The photoconductive and photovoltaic modes both fall under the detection mode definition, while the region above the threshold for light emission of the LED (i.e. when the current becomes positive, for instance at about 0.6V to 0.7V in the graph in FIG. 2). Any voltage that is applied above 0.7 V will cause the LED to emit light (i.e. the LED is set to emission mode).

[0067] FIG. 3 shows a schematic diagram of a second embodiment of a phototherapy system 2 according to the present invention, wherein the subject 100 is at a first position in FIG. 3A and at a second position in FIG. 3B. In this embodiment the total set 22 of LEDs comprises a first subset 23 of LEDs 24 arranged in or at the LED carrier 10 and a second subset 25 of LEDs 26 arranged in or at one or more other LED carriers 27 (such as a side wall, frame, ceiling, etc. of e.g. an incubator or other assembly (e.g. a baby crib) or integrated in a flexible blanket arranged around the subject 100; alternatively the LED carrier 10 and the one or more other carriers 27 may also be a common LED carrier). The position determination unit 15 and the control unit 16 are not shown in this embodiment.

[0068] The LEDs 24 of the first subset 23 are generally configured in the same way as the LEDs 13 of the first embodiment of the phototherapy system 1. If the LEDs 25 of the second subset 26 are not in contact with the subject 100, they are preferably configured to emit radiation only or to be switched off, but they are generally not used to be switched between the emission mode and the detection mode like the LEDs 23 since other stray light may reach these LEDs even if an LED is directly above the subject making position detection inaccurate if not impossible.

[0069] The control unit 15 controls one or more LED 25 of said second subset 26 to switch into the emission mode only if the detection signal generated by an LED 23 of the first subset 24 at the same longitudinal position with respect to the subject 100 is below the above mentioned predetermined threshold, i.e. if it indicates that no or not much radiation is received because it is covered by the subject. For instance, in the position of the subject 100 shown in FIG. 3A the LED b is covered by the subject 100 and will output no or only a small detection signal. The control unit 15 will switch the LED b and the LED h (which is at the same longitudinal position as the LED b) into the emission mode. In contrast LED f is not covered by the subject 100 and will thus output a larger detection signal so that the control unit 15 will not switch the LED 1 (which is at the same longitudinal position as the LED f, which is also not switched on for the rest of the treatment) into the emission mode (but will e.g. be switched off). In the position of the subject 100 shown in FIG. 3B, in contrast, LEDs g and a will be switched off and LEDs k and e will be used in emission mode.

[0070] The LEDs 23 of the first subset 24 are generally used and controlled in the same manner as the LEDs 13 of the set 12 of the first embodiment.

[0071] Hence, according to the present invention movement sensing can be achieved using the LEDs. Generally, when the subject 100 changes position, the output of the LEDs in detection mode changes. This can trigger a change of the control or even an alert. To determine the position of the infant more accurately the response of individually addressed LEDs can be determined. The individual responses (detection signals) can be mapped to determine where the subject is positioned and even how it is oriented.

[0072] The position sensing could also be done in the same plane by measuring the response of the adjacent LED. This shall be explained by referring to the subset 26 of LEDs 25 shown in FIG. 3A. When the LED g is in emission mode and the other LEDs are in detection mode the adjacent LED h measures light. When the LED h is in emission mode and the other LEDs are in detection mode the adjacent LED g measures light but the LED i does not because it is blocked by the subject's body. When the LED i is in emission mode and the other LEDs are in detection mode the adjacent LEDs h and j do not measure light because the source LED i is blocked by the subject's body. When the LED j is in emission mode and the other LEDs are in detection mode the adjacent LED k measures light but the LED i does not. When the LED k is in emission mode and the other LEDs are in detection mode the adjacent LEDs j and 1 measure light. Hence the measurement confirms that LED i is blocked.

[0073] FIG. 4 shows third embodiment of the phototherapy system 3 according to the present invention, which may additionally be applied for SpO2 measurements. Like in FIG. 3, the subject 100 is at a first position in FIG. 4A and at a second position in FIG. 4B. This embodiment is partly similar in that a first set 34 of LEDs 33 is arranged in the LED carrier 10 and a second set 36 of LEDs 35 is arranged in or at another LED carrier 27.

[0074] When the subject is not (or not much) moving (for instance when it is asleep), vital signs (such as heart rate, respiration rate, SpO2, etc.) can be measured using a part of the set of LEDs, which are switchable between detection mode and emission mode as conventional LED and photo detector, as e.g. used in a conventional pulse oximeter, for acquiring photoplethysmography (PPG) signals. For the pulse oximeter to work optimally for SpO2, the LEDs emit red and infrared (IR) light. This can e.g. be achieved by positioning pairs of a red and infrared LEDs (one for emission and one for detection) between the other (e.g. blue) LEDs used for performing phototherapy. In an alternative embodiment, LEDs or LED units that can be switched between different colors, may be used. For instance, a configurable RGB-IR LED chip, which contains multiple LEDs on one die, can be used for this purpose.

[0075] In FIG. 4 the LEDs 33 of the first subset 34 are grouped into LED units (e.g. LEDs unit 37 indicated as example) of two LEDs (e.g. LEDs c and e in LED unit 37) each, as shown in FIG. 4 (or one configurable RGB-IF LED chip). Each LED unit 37 can be switched between emission mode (to emit radiation, e.g. blue light, for phototherapy), detection mode and vital signs mode for acquiring a vital sign signal or information from which a vital sign of the subject can be derived. If close enough to the subject 100, the LEDs 35 of the second subset 36 may also be used for acquisition of vital sign signals or information from which a vital sign of the subject can be derived.

[0076] When not in vital signs mode the LEDs 33 (including the LED units 37) and 35, can emit radiation for phototherapy in emission mode and some (or all) of the LEDs 33 are in detection mode for detecting the subject's position (illustrated in FIG. 4A). For SpO2 measurements the LED unit 37 can both emit and receive red and IR wavelengths, wherein the difference in response can be used to sense SpO2, as conventionally known from pulse oximeters. The LED unit 37 comprising the LEDs c and d, where the subject 100 is positioned, is then switched into the vital signs mode to record the signals for reflective SpO2 measurement. For this purpose, e.g., the LED c emits red and IR light and the LED d receives red and IR light reflected from the subject's skin. The received signals are then processed by a vital signs determination unit 17 (which may be implemented by the separate processor or the same processor as used for the control unit 15 and/or the position determination unit 16) for determining one or more vital signs of the subject from one or more detection signals generated by the LED d.

[0077] In an embodiment, the red and infrared LEDs are not sensitive to blue light, for instance by providing a filter that blocks blue light, so that the SpO2 measurement is not influenced by the phototherapy treatment of the other (blue) LEDs, and the SpO2 measurement can thus be performed without interrupting the phototherapy.

[0078] The present invention can also be used for vital signs measurement of other vital signs. For instance, respiratory measurements may be conducted by measuring the photo induced voltage as a function of the breathing induced movements. In this case the voltage induced by the LEDs in detection mode is dependent on the (dynamic) shape of the subject's body. When the body moves, the total registered output voltage of all LEDs in detection mode (e.g. all LEDs arranged in or at the LED carrier) changes also. The periodicity of these changes can then be interpreted as the respiration rate.

[0079] Alternatively, a single LED can be used for measurements. This requires individual addressing of the LEDs, but increases the accuracy of the measurement. Multiple LEDs can be addressed sequentially in a sweep to determine the position of the most sensitive LED(s). This LED is subsequently used for monitoring the respiratory movement. If the subject moves, this is registered as a large change in the (DC) signal of the LED, which triggers a new sweep to determine the most sensitive LED for the new position.

[0080] LEDs are generally temperature dependent. If the temperature dependence of measurement LEDs is known (e.g. calibrated), these LEDs can be used as temperature sensors, enabling monitoring of the temperature of the subject during operation. In this case the LED junction temperature is calculated from the current-voltage characteristics (and changes therein). If the position of the subject is known (using the method disclosed herein), it is known whether the LED is in contact with the baby or not. This influences the temperature of the LED for a given driving current, because it influences the ambient temperature in the local vicinity of the LED. A comparison can be made between an LED which is in contact with the subject (subject temperature) and an LED which is not in contact with the subject (room temperature).

[0081] FIG. 5 shows a flow chart of an embodiment of the method of operating a phototherapy system according to the present invention. In a first step S10 one or more LEDs of said first subset of the phototherapy device are set to switch between an emission mode, in which an LED emits electromagnetic radiation in the direction of the subject, and a detection mode, in which an LED generates a detection signal in dependence on the electromagnetic radiation incident on the LED. In a second step S12 the position of a subject with respect to the LED carrier is determined based on the detection signals of one or more LEDs of said first subset in the detection mode. In a third step S14 one or more LEDs are controlled to switch into the emission mode based on the determined position of the subject such that their emitted electromagnetic radiation provides phototherapy for the subject.

[0082] In summary, according to the present invention a phototherapy system and a corresponding control method are presented using only LEDs as sensing system for position detection and phototherapy treatment (and, optionally, vital signs measurements). Such a combination of multiple measurements in one type of sensor is useful and interesting because of its simplicity.

[0083] While the invention has been illustrated and described in detail in the drawings and foregoing description, such illustration and description are to be considered illustrative or exemplary and not restrictive; the invention is not limited to the disclosed embodiments. Other variations to the disclosed embodiments can be understood and effected by those skilled in the art in practicing the claimed invention, from a study of the drawings, the disclosure, and the appended claims.

[0084] In the claims, the word comprising does not exclude other elements or steps, and the indefinite article a or an does not exclude a plurality. A single element or other unit may fulfill the functions of several items recited in the claims. The mere fact that certain measures are recited in mutually different dependent claims does not indicate that a combination of these measures cannot be used to advantage.

[0085] Any reference signs in the claims should not be construed as limiting the scope.