Systems and methods for monitoring clinical procedures using regional blood oxygen saturation

• US 10,213,550 B2
• Filed: 01/21/2015
• Issued: 02/26/2019
• Est. Priority Date: 01/23/2014
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Covidien LP (Medtronic Plc)
• Inventors: Doyle, Peter
• Primary Examiner(s): Price, Nathan R
• Assistant Examiner(s): Zamory, Justin L
• Application Number:
  US14/602,179
• Publication Number:
  US 20150205933A1
• Time in Patent Office: 1,497 Days
• CPC Class Codes: A61M 2205/3306 Optical measuring means
• CPC Class Codes: A61M 2205/3313 used specific wavelengths
• CPC Class Codes: A61M 2230/005 Parameter used as control input for the apparatus
• CPC Class Codes: A61M 2230/205 partial oxygen pressure (P-O2)
• CPC Class Codes: A61M 5/1723 using feedback of body parameters, e.g. blood-sugar, pressure measurement of body parameters A61B5/00
• CPC Class Codes: G16H 20/17 delivered via infusion or injection
• CPC Class Codes: G16Z 99/00 Subject matter not provided for in other main groups of this subclass

Abstract

Methods and systems are presented for monitoring a clinical procedure using regional blood oxygen saturation (rSO₂) of a subject. The rSO₂ of a subject is monitored, and clinical information is received, indicating that the subject is undergoing a clinical procedure (e.g., an infusion pump procedure for sodium nitroprusside administration). A change in the rSO₂ of the subject is detected, which may be indicative of a circulatory system impairment (e.g., elevated venous oxygen saturation) caused by the clinical procedure. Status information, which may be indicative of an increased risk of a physiological event (e.g., cyanide toxicity) is determined for the subject based on the clinical information and the detected change in the rSO₂ of the subject. Corrective actions may be triggered based on the status information in order to reduce the increased risk. The corrective actions may be implemented as smart prompt or closed loop systems.

Claims

1. A physiological monitoring system comprising:

light drive circuitry configured for generating a light drive signal configured to cause one or more light sources to emit a plurality of light signals, wherein the plurality of light signals corresponds to a plurality of wavelengths of light;

one or more signal inputs configured for;

receiving a first plurality of light signals that have been attenuated by a first region of a subject, wherein the first plurality of light signals corresponds to the plurality of wavelengths of light;

receiving a second plurality of light signals that have been attenuated by a second region of the subject, wherein the second plurality of light signals corresponds to the plurality of wavelengths of light; and

receiving clinical information that indicates that the subject is undergoing an infusion pump procedure for sodium nitroprusside administration; and

one or more processors configured for;

monitoring regional blood oxygen saturation (rSO₂) of the subject based on the first received plurality of light signals and the second received plurality of light signals;

detecting a change in the rSO₂ of the subject;

determining status information for the subject that indicates an increased risk of cyanide toxicity associated with the infusion pump procedure when (a) the clinical information indicates that the subject is undergoing an infusion pump procedure and (b) the detected change in the rSO₂ of the subject exceeds a threshold; and

triggering an action based on the status information.

2. The system of claim 1, wherein triggering an action comprises outputting an alert signal indicative of the increased risk.

3. The system of claim 2, wherein triggering an action comprises prompting one or more corrective actions for reducing the increased risk.

4. The system of claim 3, wherein the one or more corrective actions comprise changing the administration dosage of sodium nitroprusside.

5. The system of claim 3, wherein the one or more corrective actions comprise terminating the administration of sodium nitroprusside and substituting an alternative vasodilator.

6. The system of claim 3, further comprising a display configured for displaying the one or more corrective actions.

7. The system of claim 6, wherein the one or more processors are further configured for:

selecting at least one of the one or more corrective actions for reducing the increased risk based on user input; and

performing the at least one selected corrective action.

8. The system of claim 3, wherein triggering an action comprises automatically performing the one or more corrective actions for reducing the increased risk.

9. The system of claim 8, wherein the one or more corrective actions comprise changing the administration dosage of sodium nitroprusside.

10. The system of claim 8, wherein the one or more corrective actions comprise terminating the administration of sodium nitroprusside and substituting an alternative vasodilator.

11. The system of claim 8, wherein the one or more processors are further configured for:

selecting at least one of the one or more corrective actions based on the severity of the increased risk; and

automatically performing the at least one selected corrective action.

12. The system of claim 8, wherein the one or more processors are further configured for:

detecting an updated change in the rSO₂ of the subject based on the one or more corrective actions; and

updating the status information based on the previously determined status information, the clinical information, and the updated change in the rSO₂ of the subject, wherein the updated status information is indicative of a decreased risk of cyanide toxicity for the subject;

the system further comprising a display configured for displaying the updated status information.

13. The system of claim 1, wherein the one or more signal inputs comprises a user input configured for receiving the clinical information from a user.

14. The system of claim 1, wherein the one or more signal inputs comprises an input configured for receiving the clinical information from a hospital information system.

15. The system of claim 1, wherein the one or more signal inputs comprises an input configured for receiving the clinical information from an infusion pump used in the infusion pump procedure.

16. The system of claim 1, further comprising a display configured for displaying the status information.

17. A physiological monitoring system comprising:

a signal input configured for receiving clinical information for a subject that indicates that the subject is undergoing a clinical procedure that affects a circulatory system of the subject; and

one or more processors configured for;

monitoring regional blood oxygen saturation (rSO₂) in a region of the subject that is affected by the clinical procedure;

detecting one or more changes in the rSO₂ in the region of the subject;

determining status information associated with the subject that indicates an increased risk of a physiological event caused by the clinical procedure when (a) the one or more changes in the rSO₂ in the region of the subject exceeds a threshold and (b) the clinical information indicates that the subject is undergoing the clinical procedure; and

triggering an action based on the status information.

18. The system of claim 17, wherein:

the clinical information indicates that the subject is undergoing an infusion pump procedure for sodium nitroprusside administration; and

the status information indicates a risk of cyanide toxicity.

19. The system of claim 17, wherein triggering an action comprises outputting an alert signal indicative of the increased risk.

20. The system of claim 17, wherein triggering an action comprises automatically performing one or more corrective actions for reducing the increased risk.