Resuscitation enhancements

• US 10,342,448 B2
• Filed: 07/25/2017
• Issued: 07/09/2019
• Est. Priority Date: 06/11/2012
• Status: Active Grant

• Current Assignee: Zoll Medical Corporation (Asahi Kasei Corporation)
• Original Assignee: Zoll Medical Corporation (Asahi Kasei Corporation)
• Inventors: Freeman, Gary A., Herken, Ulrich
• Primary Examiner(s): Wehrheim, Lindsey G
• Application Number:
  US15/658,908
• Publication Number:
  US 20180000368A1
• Time in Patent Office: 714 Days
• CPC Class Codes: A61B 5/0205 Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
• CPC Class Codes: A61B 5/0245 by using sensing means generating electric signals, i.e. ECG signals
• CPC Class Codes: A61B 5/361 Detecting fibrillation
• CPC Class Codes: A61B 5/4836 Diagnosis combined with treatment in closed-loop systems or methods A61B5/0036 takes precedence
• CPC Class Codes: A61B 5/4839 combined with drug delivery
• CPC Class Codes: A61B 5/4848 Monitoring or testing the effects of treatment, e.g. of medication
• CPC Class Codes: A61B 5/7257 using Fourier transforms
• CPC Class Codes: A61B 5/7275 Determining trends in physiological measurement data; Predicting development of a medical condition based on physiological measurements, e.g. determining a risk factor
• CPC Class Codes: A61H 2230/045 used as a control parameter for the apparatus
• CPC Class Codes: A61H 31/005 with feedback for the user
• CPC Class Codes: A61N 1/3925 Monitoring; Protecting
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems
• CPC Class Codes: G16H 50/30 for calculating health indices; for individual health risk assessment

Abstract

A system including a sensor interface coupled to a processor. The sensor interface is configured to receive and process an analog electrocardiogram signal of a subject and provide a digitized electrocardiogram signal sampled over a first time period and a second time period that is subsequent to the first time period. The processor is configured to receive the digitized electrocardiogram signal, to analyze a frequency domain transform of the digitized electrocardiogram signal sampled over the first and second time periods and determine first and second metrics indicative of metabolic state of a myocardium of the subject during the first and second time periods, respectively, to compare the first and second metrics to determine whether the metabolic state of the myocardium of the subject is improving, and to indicate administration of an intervention to the subject in response to a determination that the metabolic state is not improving.

Claims

1. A system comprising:

a sensor interface configured to receive and process an analog electrocardiogram signal of a subject and provide a digitized electrocardiogram signal; and

a non-transitory computer-readable storage medium encoded with a computer program comprising instructions that, when executed, cause one or more processors coupled to the sensor interface to perform operations comprising;

receiving the digitized electrocardiogram signal from the sensor interface,

analyzing a frequency domain transform of the digitized electrocardiogram signal sampled over a first time period,

determining that ventricular fibrillation waveforms are present within the electrocardiogram signal sampled over the first time period,

determining a first metric indicative of a first metabolic state of a myocardium of the subject based on the ventricular fibrillation waveforms,

causing a recommended administration of an intervention to the subject to be provided by the system in response to a determination that the first metric is outside a predetermined range,

analyzing one or more additional frequency domain transforms of the digitized electrocardiogram signal sampled over one or more corresponding subsequent time periods that are after the first time period,

determining whether subsequent ventricular fibrillation waveforms are present within the electrocardiogram signal sampled over the one or more subsequent time periods,

for at least one of the one or more subsequent time periods, determining a subsequent metric indicative of a subsequent metabolic state of the myocardium of the subject based on the ventricular fibrillation waveforms present within the electrocardiogram signal sampled over the corresponding subsequent time period,

for each of the at least one of the one or more subsequent time periods, comparing the first metric and the subsequent metric to determine a change in the subsequent metabolic state relative to the first metabolic state of the myocardium of the subject, and

causing a recommended modification in the administration of the intervention to the subject to be provided by the system based on the comparison of the first and subsequent metric.

2. The system of claim 1, wherein the recommended intervention or the recommended modified intervention comprises at least one of administration of chest compressions, introduction of a thrombolytic agent, introduction of a metabolite, introduction of a metabolic enhancing agent, and application of electromagnetic energy to the subject.

3. The system of claim 2, wherein the recommended intervention comprises administration of chest compressions to the subject.

4. The system of claim 3, wherein the recommended modified intervention comprises introduction of a thrombolytic agent to the subject.

5. The system of claim 3, wherein the recommended modified intervention comprises introduction of at least one of a metabolite and a metabolic enhancing agent to the subject.

6. The system of claim 3, wherein the recommended modified intervention comprises application of electromagnetic energy to the subject.

7. The system of claim 2, wherein the recommended intervention to the subject comprises introduction of a thrombolytic agent to the subject.

8. The system of claim 7, wherein the recommended modified intervention comprises administration of chest compressions to the subject.

9. The system of claim 7, wherein the recommended modified intervention comprises introduction of at least one of a metabolite and a metabolic enhancing agent to the subject.

10. The system of claim 7, wherein the recommended modified intervention comprises application of electromagnetic energy to the subject.

11. The system of claim 2, wherein the recommended intervention to the subject comprises introduction of at least one of a metabolite and a metabolic enhancing agent to the subject.

12. The system of claim 11, wherein the recommended modified intervention includes a change in an amount or timing of delivery of the metabolic agent or metabolic enhancing agent to the subject.

13. The system of claim 11, wherein the recommended modified intervention comprises administration of chest compressions to the subject.

14. The system of claim 11, wherein the recommended modified intervention comprises introduction of a thrombolytic agent to the subject.

15. The system of claim 11, wherein the recommended modified intervention comprises application of electromagnetic energy to the subject.

16. The system of claim 1, wherein the recommended intervention to the subject comprises application of electromagnetic energy to the subject.

17. The system of claim 16, wherein the recommended modified intervention comprises administration of chest compressions to the subject.

18. The system of claim 16, wherein the recommended modified intervention comprises introduction of a thrombolytic agent to the subject.

19. The system of claim 16, wherein the recommended modified intervention comprises introduction of at least one of a metabolite and a metabolic enhancing agent to the subject.

20. The system of claim 1, wherein the operations further comprise analyzing the one or more additional frequency domain transforms of the digitized electrocardiogram signal at a frequency based on a type of the intervention.

21. The system of claim 1, wherein the first metric comprises an amplitude spectral area of the ventricular fibrillation waveforms of the digitized electrocardiogram signal sampled over the first time period.

22. The system of claim 1, wherein the subsequent metric for each of the at least one of the one or more subsequent time periods comprises a subsequent amplitude spectral area of the ventricular fibrillation waveforms of the digitized electrocardiogram signal sampled over the one or more subsequent time periods.

23. The system of claim 1, further comprising:

a therapy delivery interface to provide a defibrillating shock to a body of the subject, wherein the operations further comprise instructing the therapy delivery interface to apply a defibrillating shock to the subject in response to at least one of the first metric and the subsequent metric for each of the at least one of the one or more subsequent time periods.

24. The system of claim 1, wherein the operations further comprise determining, for each of the at least one of the one or more subsequent time periods, at least one of a probability of successful defibrillation and whether the metabolic state of the myocardium of the subject is improving based on the comparison between the first metric and the subsequent metric.

25. The system of claim 1, wherein the one or more additional frequency domain transforms of the digitized electrocardiogram signal are periodically analyzed.