Control of neonatal oxygen supply with artifact detection

• US 10,272,219 B2
• Filed: 01/08/2014
• Issued: 04/30/2019
• Est. Priority Date: 01/29/2013
• Status: Active Grant

• Current Assignee: Koninklijke Philips N.V.
• Original Assignee: Koninklijke Philips N.V.
• Inventors: Santhana Naidu, Navaneetha Krishnan, Padukone, Rishab, Ramachandran, Ganesan, Makkapati, Vishnu Vardhan
• Primary Examiner(s): Ditmer, Kathryn E
• Application Number:
  US14/758,808
• Publication Number:
  US 20150335850A1
• Time in Patent Office: 1,938 Days
• CPC Class Codes: A61B 2503/045 Newborns, e.g. premature baby monitoring
• CPC Class Codes: A61B 5/0036 including treatment, e.g., using an implantable medical device, ablating, ventilating
• CPC Class Codes: A61B 5/11 Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb for measuring pulse A61B5/02 ;A61B5/1038 takes precedence; motion detection to correct for motion artifacts in physiological signals A61B5/721
• CPC Class Codes: A61B 5/1116 Determining posture transitions
• CPC Class Codes: A61B 5/14542 for measuring blood gases A61B5/14551 takes precedence
• CPC Class Codes: A61B 5/14551 for measuring blood gases
• CPC Class Codes: A61B 5/4836 Diagnosis combined with treatment in closed-loop systems or methods A61B5/0036 takes precedence
• CPC Class Codes: A61B 5/721 using a separate sensor to detect motion or using motion information derived from signals other than the physiological signal to be measured
• CPC Class Codes: A61M 16/0003 Accessories therefor, e.g. sensors, vibrators, negative pressure
• CPC Class Codes: A61M 16/0051 with alarm devices
• CPC Class Codes: A61M 16/0057 Pumps therefor
• CPC Class Codes: A61M 16/024 including calculation means, e.g. using a processor
• CPC Class Codes: A61M 16/1005 with O2 features or with parameter measurement
• CPC Class Codes: A61M 2016/0027 pressure meter
• CPC Class Codes: A61M 2016/0039 in the inspiratory circuit
• CPC Class Codes: A61M 2202/0007 introduced into the body
• CPC Class Codes: A61M 2202/0208 Oxygen
• CPC Class Codes: A61M 2205/13 with means for the detection of operative contact with patient, e.g. lip sensor
• CPC Class Codes: A61M 2205/17 with redundant control systems
• CPC Class Codes: A61M 2205/3303 Using a biosensor
• CPC Class Codes: A61M 2205/3306 : Optical measuring means
• CPC Class Codes: A61M 2205/3334 : Measuring or controlling the flow rate
• CPC Class Codes: A61M 2205/3561 : local, e.g. within room or hospital
• CPC Class Codes: A61M 2205/3584 : using modem, internet or bluetooth
• CPC Class Codes: A61M 2205/3592 : using telemetric means, e.g. radio or optical transmission
• CPC Class Codes: A61M 2205/42 : Reducing noise
• CPC Class Codes: A61M 2205/50 : with microprocessors or computers
• CPC Class Codes: A61M 2205/505 : Touch-screens; Virtual keyboard or keypads; Virtual buttons; Soft keys; Mouse touches
• 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 2230/50 : Temperature
• CPC Class Codes: A61M 2230/62 : Posture
• CPC Class Codes: A61M 2230/63 : Motion, e.g. physical activity
• CPC Class Codes: A61M 2240/00 : Specially adapted for neonatal use

Abstract

A system and method to control oxygen supply uses determinations whether physiological sensors and/or a subject interface appliance have been displaced in relation to a subject and/or there has been movement of the subject itself. Artifacts that may reduce the accuracy of measurements of physiological parameters, in particular related to a level of arterial oxygen saturation, may be detected through determinations pertaining to sensor displacement, displacement of the subject interface appliance and/or movement of the subject.

Claims

1. A system for controlling oxygen supply for a subject having an airway, the system comprising:

a pressure generator configured to generate a pressurized flow of breathable gas for delivery to the airway of the subject, wherein the pressurized flow of breathable gas is delivered through a subject interface appliance;

a plurality of physiological sensors configured to generate output signals conveying physiological information related to one or more physiological parameters of the subject;

one or more position sensors configured to generate output signals conveying position information related to one or more of the physiological sensors with respect to the subject, the subject interface appliance, and/or to other ones of the physiological sensors, wherein the one or more position sensors are not coupled to the subject and output video data;

one or more processors configured to execute computer program modules, the computer program modules comprising;

a parameter determination module configured to determine a level of arterial oxygen saturation of the subject based on the output signals generated by the physiological sensors;

an artifact module configured to detect displacement of the physiological sensors that could result in artifacts in determinations of the level of arterial oxygen saturation by the parameter determination module, wherein the artifact module is configured to detect such displacement based on the output signals generated by the one or more position sensors, wherein detecting displacement comprises detecting individual sensors of the plurality of physiological sensors in the video data, determining distances between the plurality of physiological sensors, and comparing those determinations with historical averages for the distances between the plurality of physiological sensors; and

an oxygen control module configured to adjust one or more of the pressurized flow of breathable gas and/or a fraction of oxygen in the pressurized flow of breathable gas based on the determined level of arterial oxygen saturation and detections of displacement by the artifact module.

2. The system of claim 1, further comprising a position module configured to determine one or more positions of individual ones of the physiological sensors based on the output signals generated by the one or more position sensors.

3. The system of claim 1, wherein the one or more position sensors include an image capture device configured to capture image data such that, after the image capture device and the subject are arranged in suitable proximity, the captured image data include position information, wherein detections by the artifact module are further based on the captured image data.

4. The system of claim 3, wherein the image capture device is configured to capture a top-view of the subject and insert, add, and/or superimpose a grid on a captured image to determine, relative to the grid, the position information related to one or more of the physiological sensors, and/or the subject interface appliance.

5. The system of claim 1, further comprising a flow and/or pressure sensor configured to generate output signals conveying information related to the delivery of the pressurized flow of breathable gas to the subject, wherein the artifact module is further configured to detect whether delivery of the pressurized flow of breathable gas is obstructed based on the output signals generated by the flow and/or pressure sensor.

6. The system of claim 1, wherein the artifact module is configured to detect whether individual ones of the physiological sensors have been displaced by tracking locations of individual ones of the physiological sensors over time.

7. The system of claim 1, wherein the one or more position sensors is located on a structure spaced apart from the subject such that the one or more positions is not carried by the subject.

8. The system of claim 7, wherein the one or more position sensors includes a first position sensor attached to a subject-supporting body configured to support the subject, and a second position sensor attached to a stand configured to carry the second position sensor.

9. The system of claim 1, wherein the artifact module is further configured to:

detect displacement by segmenting the video data, and labeling the plurality of physiological sensors within frames of the video data;

associate the plurality of physiological sensors to each other, parts of the subject, and/or other visible reference objects; and

track positions of the plurality of physiological sensors relative to each other, the parts of the subject, and/or the other visible reference objects between multiple frames of video data.

10. The system of claim 1, wherein the oxygen control module is further configured to adjust the one or more of the pressurized flow of breathable gas and/or the fraction of oxygen in the pressurized flow of breathable gas in response to a detection by the artifact module that a particular physiological sensor has been displaced in relation to other sensors of the plurality of physiological sensors.

11. The system of claim 1, wherein the oxygen control module is further configured to adjust the one or more of the pressurized flow of breathable gas and/or the fraction of oxygen in the pressurized flow of breathable gas in a feedback manner such that a target level of oxygen saturation is maintained.

12. The system of claim 1, wherein detecting displacement further comprises determining a configuration between the plurality of physiological sensors, and comparing the determination with historical averages for the configuration between the plurality of physiological sensors.

13. A method of controlling oxygen supply for a subject, the subject having an airway, the method using a system that includes a pressure generator, a plurality of physiological sensors, and one or more position sensors, the method comprising:

generating, by the pressure generator, a pressurized flow of breathable gas for delivery to the airway of the subject through a subject interface appliance;

generating, by the plurality of physiological sensors, output signals conveying physiological information related to one or more physiological parameters of the subject;

generating, by the one or more position sensors, output signals conveying position information related to one or more of the physiological sensors with respect to the subject, the subject interface appliance, and/or to other ones of the physiological sensors, wherein the one or more position sensors are not coupled to the subject and output video data;

determining a level of arterial oxygen saturation of the subject based on the output signals generated by the physiological sensors;

detecting displacement of the physiological sensors, subject interface appliance, and/or detect movement of the subject that could result in artifacts in determinations of the level of arterial oxygen supply, wherein the detections are based on the output signals generated by the one or more position sensors, wherein detecting displacement comprises detecting individual sensors of the plurality of physiological sensors in the video data, determining distances between the plurality of physiological sensors, and comparing those determinations with historical averages for distances between the plurality of physiological sensors; and

adjusting one or more of the pressurized flow of breathable gas and/or a fraction of oxygen in the pressurized flow of breathable gas based on the determined level of arterial oxygen saturation and the detections of displacement.

14. The method of claim 13, further comprising:

determining one or more positions of individual ones of the physiological sensors based on the generated output signals conveying position information.

15. The method of claim 14, further comprising:

capturing image data such that the captured image data includes position information related to the subject,

wherein detecting whether individual ones of the physiological sensors have been displaced is further based on the captured image data.

16. The method of claim 14, further comprising:

generating output signals conveying information related to the delivery of the pressurized flow of breathable gas to the subject, and

detecting whether delivery of the pressurized flow of breathable gas is obstructed based on the generated output signals conveying information related to the pressurized flow of breathable gas.

17. The method of claim 14, wherein determining whether individual ones of the physiological sensors have been displaced is accomplished by tracking locations of individual ones of the physiological sensors over time.

18. The method of claim 13, wherein the one or more position sensors include an image capture device configured to capture a top-view of the subject and insert, add, and/or superimpose a grid on a captured image to determine, relative to the grid, the position information related to one or more of the physiological sensors, and/or the subject interface appliance.

19. A system configured to control oxygen supply for a subject having an airway, the system comprising:

means for generating a pressurized flow of breathable gas for delivery to the airway of the subject through a subject interface appliance;

first means for generating output signals conveying physiological information related to one or more physiological parameters of the subject;

second means for generating output signals conveying position information related to one or more of the first means with respect to the subject, the subject interface appliance, and/or the first means, wherein the second means for generating output signals conveying position information are not coupled to the subject and output video data;

first means for determining a level of arterial oxygen saturation of the subject based on the output signals generated by the first means for generating;

second means for detecting whether the first means for generating has been displaced in a way that could result in artifacts in determinations by the first means, wherein operation of the second means for detecting is based on the output signals generated by the second means for generating, wherein detecting displacement comprises detecting individual means of the first means for generating output signals conveying physiological information in individual frames of video data obtained from the second means for generating output signals conveying position information, determining the distances between the first means for generating output signals conveying physiological information, and comparing those determinations with historical averages for the distances between the first means for generating output signals conveying physiological information; and

means for adjusting one or more of the pressurized flow of breathable gas and/or a fraction of oxygen in the pressurized flow of breathable gas based on determinations by the first means for determining and detections by the second means for detecting.

20. The system of claim 19, further comprising:

third means for determining one or more positions of the first means for generating based on the output signals generated by the first means for determining.

21. The system of claim 19, further comprising:

means for capturing image data such that the captured image data includes position information,

wherein operation of the second means for detecting is further based on the captured image data.

22. The system of claim 19, further comprising:

third means for generating output signals conveying information related to the delivery of the pressurized flow of breathable gas to the subject,

wherein the second means for detecting further detects whether delivery of the pressurized flow of breathable gas is obstructed based on the output signals generated by the third means for generating.

23. The system of claim 19, wherein operation of the second means for detecting is accomplished by tracking one or more locations of the first means for generating over time.

24. The system of claim 19, wherein the second means for detecting is configured to capture a top-view of the subject and insert, add, and/or superimpose a grid on a captured image to determine, relative to the grid, the position information related to one or more of the physiological sensors, and/or the subject interface appliance.