Device for determining the regional distribution of a parameter for lung perfusion

• US 10,064,568 B2
• Filed: 08/08/2013
• Issued: 09/04/2018
• Est. Priority Date: 08/20/2012
• Status: Active Grant

• Current Assignee: Dragerwerk AG & Company KGaA (FPS Vermögensverwaltung GmbH)
• Original Assignee: Dragerwerk AG & Company KGaA (FPS Vermögensverwaltung GmbH)
• Inventors: Baier-Lowenstein, Tim, Garber, Yvo, Mersmann, Stefan, Teschner, Eckhard, Leonhardt, Steffen, Pikkemaat, Robert
• Primary Examiner(s): Brutus, Joel F
• Application Number:
  US14/421,228
• Publication Number:
  US 20150216443A1
• Time in Patent Office: 1,853 Days
• Field of Search: None
• CPC Class Codes: A61B 5/028 by thermo-dilution
• CPC Class Codes: A61B 5/0536 Impedance imaging, e.g. by tomography
• CPC Class Codes: A61B 5/08 Detecting, measuring or recording devices for evaluating the respiratory organs A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/0813 Measurement of pulmonary parameters by tracers, e.g. radioactive tracers
• CPC Class Codes: A61B 5/742 using visual displays A61B5/339 takes precedence
• CPC Class Codes: A61B 5/746 Alarms related to a physiological condition, e.g. details of setting alarm thresholds or avoiding false alarms alarms per se G08B
• CPC Class Codes: A61M 2205/3368 Temperature
• CPC Class Codes: A61M 2205/3576 with non implanted data transmission devices, e.g. using external transmitter or receiver
• CPC Class Codes: A61M 5/007 for contrast media
• CPC Class Codes: A61M 5/1452 pressurised by means of pistons
• CPC Class Codes: A61M 5/1723 using feedback of body parameters, e.g. blood-sugar, pressure measurement of body parameters A61B5/00

Abstract

A device for determining the regional distribution of a parameter for lung perfusion includes an electrical impedance tomography unit with electrodes (E1, . . . EN), which can be placed on the thorax, that are connected to a control and analysis unit (2) and an administering device (4) for the intravenous administration of a conductivity contrast medium. The control and analysis unit (2) is configured to display changes in impedance distribution occurring as a consequence of the administration of conductivity contrast medium as a parameter for lung perfusion in the section plane as a function of time. The administering device (4) has a controllable dispensing device. The control and analysis unit and the dispensing device are connected with one another via a data link (3). A start time and an end time and a quantity of an administered bolus of the conductivity contrast medium are available to the control and analysis unit (2).

Claims

1. A device for determining a regional distribution of a parameter for lung perfusion in a section plane of the thorax, the device comprising:

an electrical impedance tomography unit comprising a plurality of electrodes, which can be placed on the thorax distributed around a circumference of the section plane, and a control and analysis unit, which is connected with the plurality of electrodes and is configured to consecutively feed alternating current or alternating voltage to each pair of electrodes to record voltage or current signals of other of the plurality of electrodes as measured signals and to reconstruct an impedance distribution in the section plane from the measured signals;

an administering device for intravenous administration of a conductivity contrast medium, wherein;

the control and analysis unit is further configured to display changes in the impedance distribution occurring as a consequence of the intravenous administration of conductivity contrast medium as a parameter for lung perfusion in the section plane as a function of time;

the administering device has a controllable dispensing device and the control and analysis unit and the controllable dispensing device are connected with one another via a data link and are configured to make available at least a start time and an end time and a quantity of an administered bolus of the conductivity contrast medium to the control and analysis unit, the control and analysis unit being configured to actuate the controllable dispensing device to administer a bolus of the conductivity contrast medium at a preset start time, in a preset quantity and with a preset time course via the data link, the controllable dispensing device being configured to send data concerning the start time, quantity and time course of the intravenous administration of a bolus to the control and analysis unit via the data link if the controllable dispensing device is triggered to administer a bolus directly or by an external device, the control and analysis unit being further configured to repeat the intravenous administration of the bolus of the conductivity contrast medium at preset time intervals and to display the changes of the parameter of the lung perfusion over time as a function of the time as a trend graph.

2. A device in accordance with claim 1, wherein the control and analysis unit and/or the controllable dispensing device is further configured to trigger the intravenous administration of the bolus of the conductivity contrast medium repeatedly upon repeated manual actuation of a switch by a user and to display the changes in the parameter of the lung perfusion over time as a function of time as a trend graph.

3. A device in accordance with claim 1, wherein at least one of the control and analysis unit and the controllable dispensing device is configured to be triggered by a signal fed by one or more external devices via an external device data link to administer the bolus of the conductivity contrast medium.

4. A device in accordance with claim 1, wherein the control and analysis unit is further configured to display the parameter for the perfusion spatially over the lung surface in the section plane through the thorax two-dimensionally.

5. A device in accordance with claim 1, wherein the control and analysis unit is further configured to determine surfaces in which the parameter for perfusion is above a preset threshold as a perfused surface in the section plane and to display perfused surfaces that arise from the intravenous administration of a bolus of the conductivity contrast medium as a trend graph as a function of the time of intravenous administrations of the boli of the conductivity contrast medium.

6. A device in accordance with claim 1, wherein the control and analysis unit is further configured to determine the regional distribution of ventilation in the section plane of the thorax during times without intravenous administration of conductivity contrast medium from the impedance distributions and to display the regional distribution of the ventilation in the section plane of the thorax as a function of time.

7. A device in accordance with claim 6, wherein the control and analysis unit is further configured to identify lung areas in which determined ventilation is above a preset threshold value and determined perfusion is below another, preset threshold value as dead spaces and to display the dead spaces in a shown tomogram of the lung.

8. A device in accordance with claim 7, wherein the control and analysis unit is further configured to display the changes in the dead spaces over time as a trend graph over a time period.

9. A device in accordance with claim 6, wherein the control and analysis unit is further configured to determine lung areas in which perfusion is above a preset threshold value and the ventilation is below another, preset threshold value as shunts and to display the shunts in a tomogram of the lung.

10. A device in accordance with claim 9, wherein the control and analysis unit is further configured to display the changes in dead spaces over time as a trend graph over a time period.

11. A device in accordance with claim 1, wherein:

the controllable dispensing device is provided with a temperature sensor for the conductivity contrast medium or with a temperature-regulating device for the conductivity contrast medium, which device can be controlled by the control and analysis unit; and

the control and analysis unit is configured to calibrate in absolute terms the cardiac output volume from determined or set temperature of the conductivity contrast medium on a basis of a dilution principle and the parameter for lung perfusion on the basis of the determined cardiac output volume.

12. A device in accordance with claim 11, wherein the control and analysis unit is further configured to at least one of:

determine a ratio of ventilation to perfusion spatially and to display the ratio of ventilation to perfusion; and

determine and display the ratio of ventilation to perfusion averaged over the lung area in the section plane of the thorax.

13. A device in accordance with claim 12, wherein the control and analysis unit is further configured to determine the ratio of ventilation to perfusion spatially and to store it in case of a plurality of consecutive intravenous administrations of boli and/or to determine the ratio of ventilation to perfusion averaged over the lung area in the section plane of the thorax and to store it and to display ratios of ventilation to perfusion together as a trend graph.

14. A device in accordance with claim 1, wherein the control and analysis unit is configured to monitor variables derived or calculated from determined lung perfusion, for preset criteria and to trigger an alarm when a determination is made that a preset criterion is not met any longer;

said control and analysis unit generates the impedance distribution as a function of the start time, the end time and the quantity.

15. A device for determining a regional distribution of a parameter for lung perfusion in a section plane of a thorax of a patient, the device comprising:

an electrical impedance tomography unit comprising a plurality of electrodes, which can be placed on the thorax, and distributed around a circumference of the section plane;

an administering device for selective intravenous administration of a plurality of boli of conductivity contrast medium to the patient at selectable and defined start times, defined end times and defined quantities;

a control and analysis unit connected to said plurality of electrodes, said control and analysis unit being configured to consecutively feed alternating current or alternating voltage to each pair of said electrodes to record voltage or current signals of other of the plurality of electrodes as measured signals and to reconstruct an impedance distribution in the section plane from the measured signals for each time window in which each of the boluses act, said control and analysis unit being further configured to display changes in the impedance distribution occurring as a consequence of intravenous administration of conductivity contrast medium as a parameter for lung perfusion in the section plane as a function of time;

a data link connecting said administering device and said control and analysis unit, said administering device and said control and analysis unit being configured to transmit the defined start time, end time, and quantity of each of the administered boli of the conductivity contrast medium to said control and analysis unit, said control and analysis unit being configured to have each impedance distribution correspond to the defined start time, end time and quantity.

16. A device in accordance with claim 15, wherein:

said control and analysis unit is configured to control the start time, the end time and the quantity of the conductivity contrast medium administered to the patient by said administering device.

17. A device in accordance with claim 16, wherein:

said control and analysis unit is configured to control the start time, the end time and the quantity of the conductivity contrast medium administered to the patient, said control and analysis unit is configured to generate the impedance distribution as a function of an outside device.

18. A device in accordance with claim 17, wherein:

said outside device is a respirator or monitor.