Shock probability determination system and method

• US 10,349,901 B2
• Filed: 08/11/2016
• Issued: 07/16/2019
• Est. Priority Date: 08/20/2015
• Status: Active Grant

• Current Assignee: Osypka Medical GmbH
• Original Assignee: Osypka Medical GmbH
• Inventors: Osypka, Markus J., Feige, Clemens, Gestewitz, Marcel D., Petrov, Florin-Viorel, Nassef, Yasser A.
• Primary Examiner(s): Natnithithadha, Navin
• Application Number:
  US15/234,953
• Publication Number:
  US 20170053077A1
• Time in Patent Office: 1,069 Days
• Field of Search: 600481, 600483, 600526
• CPC Class Codes: A61B 5/01 Measuring temperature of body parts ; Diagnostic temperature sensing, e.g. for malignant or inflamed tissue clinical contact thermometers G01K13/20
• CPC Class Codes: A61B 5/02007 Evaluating blood vessel condition, e.g. elasticity, compliance
• CPC Class Codes: A61B 5/02028 Determining haemodynamic parameters not otherwise provided for, e.g. cardiac contractility or left ventricular ejection fraction
• CPC Class Codes: A61B 5/02055 Simultaneously evaluating both cardiovascular condition and temperature
• CPC Class Codes: A61B 5/021 Measuring pressure in heart or blood vessels A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/02108 from analysis of pulse wave characteristics
• CPC Class Codes: A61B 5/029 Measuring or recording blood output from the heart, e.g. minute volume A61B8/065 takes precedence
• CPC Class Codes: A61B 5/0295 using plethysmography, i.e. measuring the variations in the volume of a body part as modified by the circulation of blood therethrough, e.g. impedance plethysmography
• CPC Class Codes: A61B 5/0816 Measuring devices for examining respiratory frequency measuring frequency of electric signals G01R23/00
• CPC Class Codes: A61B 5/7225 Details of analog processing, e.g. isolation amplifier, gain or sensitivity adjustment, filtering, baseline or drift compensation A61B5/30, A61B5/316 take precedence; transformers for specific applications H01F38/00; amplifiers H03F
• CPC Class Codes: A61B 5/7264 Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems neural networks per se G06N3/00; expert systems per se G06N5/00
• 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: A61B 5/7278 Artificial waveform generation or derivation, e.g. synthesising signals from measured signals A61B5/327 takes precedence
• CPC Class Codes: A61B 5/743 Displaying an image simultaneously with additional graphical information, e.g. symbols, charts, function plots
• CPC Class Codes: G16H 40/67 for remote 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 shock probability determination system and method provides an output of probabilities for different types of shock based on input of selected patient demographic parameters and current clinical parameter values as well as normal ranges for each clinical parameter based on patient demographic data. The probability of different types of shock is determined based on comparison of current clinical parameter values of selected patient hemodynamic parameters to a normal range for each hemodynamic parameter. In one aspect, probabilities of cardiogenic shock, hypovolemic shock, septic shock, and anaphylactic shock are determined. In another aspect, a fluid status indicator is determined based on real-time probability of hypovolemic shock.

Claims

1. A computer implemented method of determining shock probabilities for a plurality of shock types, wherein one or more computing devices comprising data storage and a hardware processor are programmed to perform steps comprising, during treatment of a patient by a healthcare provider:

receiving or retrieving demographic data of the patient undergoing treatment;

receiving input of a plurality of currently measured values of selected variable clinical parameters of the patient, comprising at least hemodynamic parameters, from a hemodynamic monitor connected to the patient;

comparing each clinical parameter value to a normal range for that parameter based on input or stored patient demographic data;

determining probabilities of two or more shock types comprising at least cardiogenic shock and hypovolemic shock using some or all of the clinical parameter values relative to the normal range for the respective parameter values, wherein selected groups of clinical parameters are assigned to the respective shock types for determining the shock probability;

displaying a shock probability for each shock type on an output display unit;

determining a patient'"'"'s fluid status indicator FluidDx=1−

P_HYPO, where P_HYPO is the hypovolemic shock probability; and

displaying the fluid status indicator on the output display device and periodically updating the fluid status indicator during the treatment of the patient, so as to alert the healthcare provider to supply fluid to the patient or treat a condition of high blood volume based on a level of the fluid status indicator.

2. A system for determining probabilities of a plurality of different shock types based on patient clinical parameters, the system comprising:

a non-transitory computer readable medium configured to store executable programmed modules;

a processor communicatively coupled with the non-transitory computer readable medium and configured to execute programmed modules stored therein;

an output display unit; and

one or more programmed modules stored in the non-transitory computer readable medium and configured to be executed by the processor, the one or more programmed modules configured to, during treatment of a patient by a healthcare provider;

receive or retrieve demographic data of the patient undergoing treatment;

receive input of a plurality of currently measured values of selected clinical parameters of the patient, comprising at least hemodynamic parameters, from a hemodynamic monitor connected to the patient;

assign selected groups of clinical parameters to respective different shock types;

compare each currently measured clinical parameter value to a normal range for that parameter based on determined or stored patient demographic data;

determine probabilities of the respective different shock types based on the comparison of each current clinical parameter value in the respective group to the normal range for the respective clinical parameter; and

display a shock probability for each shock type on an output display unit,

wherein the one or more programmed modules are further configured to determine a generic shock probability M (generic shock condition “

improbable”

) using at least two selected clinical parameters indicative of any type of shock condition being present, and to compute a restricted probability of at least some shock types based on the determined generic shock probability if M(generic shock condition “

improbable”

) is greater than zero according to the following;

P*(shock type)=P(shock type)*(1−

M(generic shock condition,‘

improbable’

)),

where P*(shock type)=restricted shock probability due to a generic shock condition ‘

improbable’

, and P(shock type)=unrestricted probability of the respective shock type prior to generic shock restriction,

where one of the shock types is hypovolemic shock, and

wherein the one or more programmed modules are further configured to determine a patient'"'"'s fluid status indicator FluidDx=1−

P_HYPO, where P_HYPO is the unrestricted hypovolemic shock probability, display the fluid status indicator on the output display device, and periodically update the fluid status indicator during treatment of the patient, so as to alert the healthcare provider to supply fluid to the patient or treat a condition of high blood volume based on a level of the fluid status indicator.

3. The system of claim 2, wherein the one or more programmed modules are further configured to determine updated shock probabilities and an updated fluid status indicator at periodic intervals based on changes in the input clinical parameter values over time, and to display updated shock probabilities and fluid status indicators on the output display device in the form of one or more of numeric values, a bar chart and a trend graph illustrating variation in the probability of each shock type and the fluid status indicator over time.

4. A system for monitoring a patient'"'"'s fluid status indicator for fluid management, the system comprising:

a non-transitory computer readable medium configured to store executable programmed modules;

a processor communicatively coupled with the non-transitory computer readable medium and configured to execute programmed modules stored therein;

an output display unit; and

one or more programmed modules stored in the non-transitory computer readable medium and configured to be executed by the processor, the one or more programmed modules configured to, during treatment of a patient by a healthcare provider;

receive demographic data or retrieve stored demographic data of a patient undergoing treatment;

receive input of a plurality of currently measured values of selected variable clinical parameters of the patient, comprising at least hemodynamic parameters, from a hemodynamic monitor connected to the patient, the clinical parameters being selected for determining a current probability of hypovolemic P(shock_hypovolemic);

compare each received clinical parameter value to a normal range for that parameter based on input or stored patient demographic data;

determine the probability of hypovolemic shock based on the comparison of each received clinical parameter value with the normal range for the respective clinical parameter;

determine a fluid status indicator FluidDx indicative of blood volume from the following relationship;

FluidDx=1−

P(shock_hypovolemic); and

display the fluid status indicator on the output display unit and periodically update the fluid status indicator during the treatment of the patient, so as to alert the healthcare provider to supply fluid to the patient or treat a condition of high blood volume based on a level of the fluid status indicator.

5. The system of claim 4, wherein the programmed modules are further configured to monitor the selected clinical parameter values, to determine updated probabilities of hypovolemic shock and updated fluid status indicators on an ongoing basis based on current clinical parameter values, and to display updated fluid status parameters on the output display unit, wherein the output display comprises one or more of a numeric display, a bar chart, and a trend graph illustrating variation in the fluid status parameter over time.