PATIENT TEMPERATURE RESPONSE CONTROL SYSTEM AND METHOD
20170348145 ยท 2017-12-07
Inventors
Cpc classification
A61F7/02
HUMAN NECESSITIES
A61B5/11
HUMAN NECESSITIES
A61F7/0097
HUMAN NECESSITIES
A61B5/1455
HUMAN NECESSITIES
A61B2562/0219
HUMAN NECESSITIES
A61B5/01
HUMAN NECESSITIES
A61B5/7435
HUMAN NECESSITIES
International classification
A61F7/00
HUMAN NECESSITIES
A61F7/02
HUMAN NECESSITIES
A61B5/00
HUMAN NECESSITIES
A61B5/01
HUMAN NECESSITIES
Abstract
A system and method are provided that employ a monitoring device to monitor at least one patient physiological response to a change in temperature of the patient (e.g. pursuant to induced hypothermia therapy), wherein a monitoring signal is provided by the monitoring device. In turn, an output (e.g. a visual and/or auditory output) may be provided to a user indicative of at least one measure of patient response to the change in temperature. Alternatively or additionally, a processor may be provided to process the monitoring signal and provide an output employable by medical personnel to control a patient shivering response to the patient temperature change. Such information may comprise information regarding one or more anti-shivering medicament(s), e.g. corresponding dosage and/or frequency information for use by medical personnel in the administration of the anti-shivering medicament. In one approach, a motion sensor may be selectively attached to a patient's chin to provide a wireless monitoring signal to a transceiver. In turn, the transceiver may provide the monitoring signal to the processor on an ongoing basis to output information useful in the administration of an anti-shivering medicament, including updated information that takes into account a patient's response to a prior administration of one or more medicaments in conjunction with the subsequent administration of an anti-shivering medicament.
Claims
1. A medical apparatus, comprising: a monitoring device for monitoring patient shivering and for providing a monitoring signal responsive thereto; at least one of an energy storage device and a wireless energy conversion device, interconnected to said monitoring device for co-movement therewith, for powering said monitoring device; and, an output device for providing an output to a user responsive to said monitoring signal and indicative of at least one measure of said shivering.
2. A medical apparatus as recited in claim 1, wherein said output device provides at least one of a visual output and an auditory output indicative of said at least one measure of said shivering.
3. A medical apparatus as recited in claim 2, wherein said monitoring device is selectively interconnectable to and disconnectable from a patient, and wherein said monitoring device is maintainable in fixed relation to a patient upon interconnection.
4. A medical apparatus as recited in claim 3, wherein said output device is one of interconnected and interconnectable to said monitor device for co-movement therewith.
5. A medical apparatus as recited in claim 1, wherein said monitoring device comprises: a motion sensor selectively interconnectable to a patient.
6. A medical apparatus as recited in claim 5, wherein said motion sensor comprises: an accelerometer.
7. A medical apparatus as recited in claim 5, wherein said motion sensor comprises: a three-dimensional accelerometer, wherein said monitoring signal comprises three-dimensional acceleration data.
8. A medical apparatus as recited in claim 1, further comprising: a processor for processing said monitoring signal to provide an output control signal for use by said output device in providing said output to a user.
9. A medical apparatus as recited in claim 8, further comprising: a plurality of motion sensors for separately monitoring motion of a patient and providing separate monitoring signals responsive thereto; and, at least one of an energy storage device and a wireless energy conversion device, each interconnected to a different corresponding, one of said plurality of motion sensors for co-movement therewith and for powering said corresponding one of said plurality of motion sensors, wherein said processor is adapted to process said separate monitoring signals to provide said output control signal.
10. A method for use in monitoring patient shivering, comprising: monitoring shivering of a patient at monitoring device to provide a monitoring signal responsive thereto; powering said monitoring device by at least one of an energy storage device and a wireless energy conversion device interconnected to said monitoring device for co-movement therewith; and, providing an output to a user responsive to said monitoring signal and indicative of at least one measure of said patient shivering.
11. A method as recited in claim 10, wherein said providing step comprises: outputting at least one of a visual output and an auditory output indicative of said at least one measure of said patient shivering.
12. A method as recited in claim 10, further comprising: interconnecting said monitoring device to a patient prior to a therapy procedure, wherein said monitoring device is maintainable in fixed relation to the patient upon said interconnection; and, disconnecting said monitoring device from said patient after said therapy procedure.
13. A method as recited in claim 12, wherein said interconnecting step comprises: adhesively attaching said monitoring device to a selected location on a patient.
14. A method as recited in claim 10, further comprising: transmitting said monitoring signal as a wireless signal; and, receiving said wireless monitoring signal for use in said providing step.
15. A method as recited in claim 14, wherein said powering step comprises: converting a wireless power signal to an electrical signal utilizing a wireless energy conversion device, wherein said electrical signal provides power to said monitoring device and to a transmitter for use in said transmitting step.
16. A method as recited in claim 15, wherein said wireless energy conversion device and said transmitter are interconnected to said monitoring device for co-movement therewith.
17. A method as recited in claim 10, wherein said monitoring step comprises: utilizing a motion sensor interconnected to said patient to provide said monitoring signal indicative of motion of said patient.
18. A method as recited in claim 17, further comprising: processing motion data comprising said monitoring signal utilizing frequency domain processing.
19. A method as recited in claim 18, wherein said motion data includes three-dimensional accelerometer output data.
20. A method as recited in claim 19, wherein said processing step includes: windowing said three-dimensional motion data; transforming the windowed three-dimensional motion data to frequency domain data; and, performing a statistical analysis of the frequency domain data in relation to a plurality of predetermined frequency bands to monitor one of a relative magnitude, degree and stage of patient shivering.
21. A medical apparatus, comprising: a monitoring device for monitoring at least one physiological response of a patient to an change in temperature of the patient to provide a monitoring signal responsive thereto; a processor for processing said monitoring signal to provide an output employable for use in controlling a patient shivering response to said patient temperature change.
22. A medical apparatus as recited in claim 21, wherein said monitoring device is non-invasive.
23. A medical apparatus as recited in claim 22, wherein said monitoring device is selectively interconnectable and disconnectable from a patient, and wherein said monitoring device is maintainable in fixed relation to a patient upon interconnection.
24. A medical apparatus as recited in claim 23, wherein said monitoring device is selected from a group consisting of: a monitoring device for monitoring blood oxygen saturation of a patient; a monitoring device for monitoring vasoconstriction of a patient; a monitoring device for surface monitoring of muscular electrical activity of a patient; a monitoring device for monitoring at least one carbon dioxide parameter of a respiratory gas of a patient; and a monitoring device for monitoring motion of a patient.
25. A medical apparatus as recited in claim 21, wherein said monitoring device comprises: a motion sensor selectively interconnectable to a patient.
26. A medical apparatus as recited in claim 25, wherein said motion sensor comprises: an accelerometer.
27. A medical apparatus as recited in claim 21, wherein said output comprises: information employable for use in administering at least one anti-shivering medicament to a patient.
28. A medical as recited in claim 27, wherein said information comprises at least one of anti-shivering medicament dosage information and anti-shivering medicament frequency of dosage information.
29. A medical apparatus as recited in claim 27, wherein said information is at least in part, utilizing a magnitude of said monitored responses as reflected by said monitoring signal.
30. A medical apparatus as recited in claim 27, wherein said information is generated, at least in part, utilizing patient-specific data inputted by a user.
31. A medical apparatus as recited in claim 27, wherein said information is generated, at least in part, in accordance with a user-established protocol.
32. A medical apparatus as recited in claim 27, wherein said processor is operable to process said monitoring signal to assess patient shivering response to at least one administration of said at least one anti-shivering medicament to provide updated information employable in a subsequent administration of said at one anti-shivering medicament.
33. A medical apparatus as recited in claim 27, further comprising: a user interface for providing said output information in at least one of said audible form and visual form.
34. A medical apparatus as recited in claim 33, wherein said user interface is adapted to receive user input for use by said processor in generating said information.
35. A medical apparatus as recited in claim 21, wherein said monitoring device is adaptable to provide said monitoring signal as a wireless signal.
36. A medical apparatus as recited in claim 35, further comprising: a receiver, operatively interconnected to said processor, for receiving said wireless monitoring signal and providing said monitoring signal to said processor.
37. A medical apparatus as recited in claim 35, further comprising: a transducer, operatively connected to said processor, for transmitting signals to and receiving signals from said monitoring devise; and wherein said monitoring devise is operable to transduce electrical energy from said signals transmitted by said transceiver and to utilize said electrical energy in the processor of said monitoring signal.
38. A medical apparatus as recited in claim 35, wherein said monitoring device comprises: an on-board power source.
39. A medical apparatus as recited in claim 21, wherein said processor is further operable to use said monitoring signal in the generation of an input signal to a temperature control system for controlling a temperature of a patient.
40. A method for use in controlling a shivering response of a patient during patient cooling, comprising: monitoring at least one physiological response of a patient to a change in temperature of the patient; and generating an automated output based at least in part on the monitored response for use in controlling a patient's shivering response to the patient's temperature change.
41. A method as recited in claim 40, wherein said monitoring step comprises: at least one of: monitoring motion of the patient; monitoring vasoconstriction of the patient; monitoring muscular electrical activity of a patient; monitoring at least one carbon dioxide parameter of a respiratory gas of a patient; and monitoring blood oxygen saturation of the patient.
42. A method as recited in claim 40, further comprising: selectively interconnecting a monitoring device in fixed relation to a patient, wherein said monitoring device is employable in said monitoring step.
43. A method as recited in claim 41, wherein said monitoring device comprises a motion sensor, and wherein said interconnecting step comprises: adhesively attaching said motion sensor to a selected location on a patient.
44. A method as recited in claim 41, wherein said output comprises: information employable for use in administering at least one anti-shivering medicament to a patient.
45. A method as recited in claim 44, wherein said information comprises at least one of dosage information and frequency information corresponding with an anti-shivering medicament.
46. A method as recited in claim 44, further comprising: administering said at least one anti-shivering medicament to a patient.
47. A method as recited in claim 46 further comprising: repeating said monitoring and processing steps at plurality of times; and utilizing data inputted by a user that corresponds with said administering step in a subsequently performed processing step to provide updated information employable in a subsequent administering step.
48. A method as recited in claim 45, wherein said generating step comprises: utilizing patient-specific data provided by a user.
49. A method as recited in claim 48, further comprising: receiving input at a user interface in completing said utilizing step.
50. A method as recited in claim 49, further comprising: outputting said information to a user in at least one of a visual form and an audible form.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0039]
[0040]
[0041]
[0042]
[0043]
[0044]
[0045]
[0046]
[0047]
DETAILED DESCRIPTION
[0048]
[0049] With further reference to
[0050] In one approach, processor and/or logic circuit 20 may be provided to assess the monitoring signal 12 and provide an output 22 employable to indicate at least one measure of a shivering response of a patient. For example, the output 22 may be employable to provide a visual and/or audible output at a user interface 30 or other output device (e.g. one or more lights (e.g. one or more light emitting diodes) co-located with the patient P), wherein such output provide a user with an indication of a magnitude, degree and/or stage of a patient shivering response to a cooling therapy.
[0051] In another approach, an output 22 may be provided that is employable for use in controlling a shivering response of the patient P to changes of the bodily temperature of the patient P. In one embodiment, an output 22 may be provided at user interface 30which comprises information that corresponds with one or more approaches for controlling patient shivering response via the administration of one or more anti-shivering medicaments.
[0052] By way of example, processor 20 may comprise preprogrammed logic, or algorithms/data, in a treatment module 24 for processing the monitoring signal 12 to provide an output 22 comprising information relating to one or more anti-shivering medicament administration actions that may be followed by medical personnel to treat patient shivering response to bodily cooling. In this regard, the treatment module 24 may comprise stored data/algorithms in relation to a plurality of preset treatment protocols, including protocols that have been established by a user, e.g. via user input at interface 30. For example, each pre-established protocol may include data/algorithms relating to one or more of the following: [0053] Data corresponding with different anti-shivering medicament option(s), including different types and/or combinations of anti-shivering medicaments; and [0054] Dosage/frequency data and/or algorithms for each anti-shivering medicament option.
As may be appreciated, the processor 20 and the user interface 30 may be provided for interactive operations therebetween. More particularly, in conjunction with a given patient cooling procedure, a user may utilize user interface 30 to access and select a given one of a plurality of treatment protocols, e.g. corresponding with a given protocol established at a given user site (e.g. for a particular physician). In turn, such protocol may provide for the selection of a given one of a plurality of different anti-shivering medicament options (e.g. via an interactive menu).
[0055] In turn, for a selected option, the processor 20 may be operative to provide treatment-dosage (e.g. amount) and frequency-of-dosage information to a user at user interface 30. Such information may be provided so as to take into account specific data inputted by a user at a user interface 30 for a given procedure, including for example, patient-specific information (e.g. age, weight, sex etc.), and patient procedure-specific information (e.g. thermotherapy pursuant to stroke, thermotherapy pursuant to head trauma, etc.). Additionally and/or alternatively, the information comprising the output 22 may be based, at least in part, upon a magnitude of the measured patient response R reflected by monitoring signal 12. For example, a magnitude measure may be obtained from the signal 12 and compared with pre-established reference data to assess how much and/or how often a given anti-shivering medicament may be appropriate for administration.
[0056] As illustrated in
[0057] In addition to the above-described functionalities, the processor 20 may be further adapted for providing an input signal 28 to the cooling system 50. Such input signal 28 may employ with a patient temperature sensor 52 output signal 54 to establish a degree of cooling and/or rate of cooling of the given patient P. For example, based upon a measured magnitude of patient response R, a cooling rate may be increased (e.g. when no shivering is detected and more rapid cooling is therapeutically desired) or decreased (e.g. when an undesirably high degree of shivering is detected and therapeutic rapid cooling is realizable at a lower cooling rate).
[0058] Reference is now made to
[0059] In other approaches that correlate shivering to a monitored parameter, a blood flow monitoring device may be attached to a patient to measure a degree of vasoconstriction reflective of a degree of shivering (e.g. by measuring relative blood flow at a fingertip and at a corresponding forearm location). In an additional approach, the monitoring device may comprise one or more electromyography (EMG) surface sensors for monitoring muscular electrical activity. In yet a further approach, the monitoring device may comprise one or more capnography input sensors for concentration and/or partial pressure of carbon dioxide in patient respiratory gases. In yet another correlative approach, a pulse oximeter sensor may be interconnected to a patient to measure a patient's blood oxygen saturation level, wherein such level may be correlated to a degree of shivering.
[0060] With further reference to
[0061] Pursuant to the generation of an output based upon a monitored patient response, the method may encompass use of the output to control a patient shivering response, step 108. For example, information regarding dosage and/or frequency of a given anti-shivering medicament may be employed by a user in conjunction with the actual administration of the medicament.
[0062] As illustrated by
[0063] As further illustrated in
[0064] Referring now to
[0065] By way of example, and with reference to
[0066] In another approach, the transceiver 210 provided with the control unit 202 may be adapted to transmit a query/power signal 212 to the motion sensor 220a. In turn, the motion sensor 220a may transmit a monitoring signal 214 to the transceiver 210 which is indicative of a degree of motion of the patient's chin. More particularly, the motion sensor 220a may comprise a transreceiver and rectifier arrangement for receiving a query/power signal 212, transducing electrical energy therefrom, and using the energy to generate and transmit the monitoring signal 214.
[0067] As may be appreciated, a plurality of motion sensors 220 may be employed. For example, motion sensors 220b and 220c, of like configuration to motion sensor 220a, may be selectively interconnected to different body regions (e.g. an arm and leg of a patient). In such an arrangement, each of the sensors 220a, 220b and 220c may provide a wireless monitoring signal 214.
[0068] The monitoring signal(s) 214 may be processed at the control unit 202 in accordance with the described functionalities to provide an output (e.g. a visual or auditory output) at a user interface 230. As previously noted, the output may provide an indication of a magnitude or stage of patient shivering. Additionally or alternatively, such output may provide anti-shivering medicament related information, e.g. dosage and/or frequency information for use by medical personnel in the administration of an anti-shivering medicament. As further reflected by
[0069] As further reflected by
[0070] In further relation to the above-described functionality, reference is now made to
[0071] As shown in
[0072] In relation to the target patient temperature plot 320, the control unit 202 may include an on-board processor pre-programmed or otherwise programmable to facilitate automated control over patient temperature adjustment therapy. In the later regard, the control unit 202 may be provided with a pre-programmed control module to facilitate automated control over the temperature of the circulated fluid so as to cool a patient in accordance with programmable protocol data during a first phase of treatment, and to re-warm a patient in accordance with another programmable protocol during a second phase of treatment.
[0073] As shown by
[0074] As may be appreciated, by visually monitoring the magnitude of shivering response displayed in the second region 314 of the screen 300, medical personnel may assess the need and/or desirability for taking responsive action. For example, such responsive action may include the administration of anti-shivering medicaments and/or the application of surface warming therapy to selected patient body regions and/or a modification to the patient cooling/warming protocol discussed hereinabove (e.g. decreasing a target patient cooling rate and/or a increasing targeted temperature for patient cooling).
[0075] As reflected by
[0076] Reference is now made to
[0077] Referring again now to
[0078] As shown in
[0079] As shown in
[0080] In this regard, reference is now made to
[0081] Of particular interest is the spectral data corresponding with the second frequency band of about 5.5 Hz to about 12.5 Hz. In this regard, it has been recognized that shivering is most frequently reflected by a patient motion component that is centered at about 9.5 Hz. In the example of
[0082] As may be appreciated from the example shown in
[0083] By way of example, in one approach the mean square energy values and crest factor values for two or more frequency bands may be compared (e.g. a low frequency band of about 0 Hz to 5.5 Hz, a middle frequency band of about 5.5 Hz to 12.5 Hz, and an upper frequency band of about 12.5 Hz to 16 Hz), wherein a calculated mean square energy value of the lower band which is greater than or equal to a calculated mean square energy value for the upper band, together with a crest factor value for all three bands that is less than a predetermined value (e.g. a relatively low value), may indicate the absence of or a relatively low level of patient motion. Further, a rise in the mean square energy value and crest factor value for each of the bands may indicate patient motion. And, a rise in the mean square energy value for the middle band (e.g. encompassing the 9.5 Hz level typically related to shivering) relative to the low and high bands, together with a decrease in the crest factor value for the middle band, may indicate the presence and/or a degree of patient shivering.
[0084] As noted above, a monitoring signal 12 may also be processed via time domain processing. In one embodiment shown in
[0085] As further reflected by
[0086] In turn, the above-noted values may be utilized to assess shivering. For example, in one approach the below-shiver band, above-shiver band and shiver-band power values may be compared, wherein a below-shiver band power value that is greater than or equal to that of the other bands, together with a condition ratio that is less than a predetermined value (e.g. a relatively low value), may indicate the absence of or a relatively low level of patient motion. Further, a rise in the shiver-band power value, a rise in the condition ratio, and a rise in a shiver-band power value-to-prediction error power value ratio, (e.g. shiver-band power value/prediction error power valve) may combinatively indicate patient motion. Further, a rise in the shiver-band power value, coupled with a decrease in the condition ratio and a decrease in the shiver-band power value-to-prediction error power value ratio, may indicate the presence and/or a degree of patient shivering.
[0087] Additional embodiments to those described above will be apparent. For example, in relation to the motion sensor 400 of
[0088] The embodiment descriptions provided above are for purposes illustration and are not intended to limit the scope of the present invention. Additions and modifications will be apparent to those skilled in the art.