System and method for closed-loop patient-adaptive hemodynamic management

• US 10,434,255 B2
• Filed: 11/20/2013
• Issued: 10/08/2019
• Est. Priority Date: 01/12/2011
• Status: Active Grant

• Current Assignee: Regents of the University of California (University of California)
• Original Assignee: Regents of the University of California (University of California)
• Inventors: Rinehart, Joseph B., Cannesson, Maxime
• Primary Examiner(s): Riggs, II, Larry D
• Application Number:
  US14/085,162
• Publication Number:
  US 20140188072A1
• Time in Patent Office: 2,148 Days
• Field of Search: None
• CPC Class Codes: A61B 5/021 Measuring pressure in heart or blood vessels A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/0245 by using sensing means generating electric signals, i.e. ECG signals
• 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 5/14542 for measuring blood gases A61B5/14551 takes precedence
• CPC Class Codes: A61B 5/4833 Assessment of subject's compliance to treatment
• CPC Class Codes: A61B 5/7203 for noise prevention, reduction or removal
• CPC Class Codes: A61M 2202/0208 Oxygen
• CPC Class Codes: A61M 2205/502 User interfaces, e.g. screens or keyboards
• CPC Class Codes: A61M 2205/52 with memories providing a history of measured variating parameters of apparatus or patient
• CPC Class Codes: A61M 2230/00 Measuring parameters of the user
• CPC Class Codes: A61M 2230/04 Heartbeat characteristics, e.g. ECG, blood pressure modulation
• CPC Class Codes: A61M 5/142 Pressure infusion, e.g. using pumps
• CPC Class Codes: A61M 5/16877 Adjusting flow; Devices for setting a flow rate
• 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

Abstract

A system and method for patient-adaptive hemodynamic management is described. One embodiment includes a system for hemodynamic management including transfusion, volume resuscitation with intravenous fluids, and medications, utilizing monitored hemodynamic parameters including the described dynamic predictors of fluid responsiveness, and including an intelligent algorithm capable of adaptation of the function of the device to specific patients.

Claims

1. A computer-implemented method for providing clinical decision support relating to the administration of proposed fluid to a patient, the method comprising:

intravenously administering one or more fluid boluses to the patient, each of which lacks vasoactive or inotropic medication and, during or after administering the fluid, receiving input information comprising data representing one or more physiologic processes of a patient resulting from response to the administration of the intravenous fluid, and storing said information as one or more bolus log entries;

determining, based at least in part upon the input information, a subgroup of bolus log entries associated with a current state of the patient, the subgroup containing said data;

using a processor to generate a fluid administration signal for intravenously administering a treating fluid for the purpose of intravascular volume expansion, wherein the treating fluid lacks vasoactive or inotropic medication and the signal is based at least in part upon log data included within the subgroup of bolus log entries; and

administering the proposed fluid to the patient.

2. The method of claim 1 in which the fluid boluses are each saline solution.

3. The method of claim 1 in which intravenously administering said one or more boluses to the patient comprises:

providing a first fluid pump coupled to at least one fluid source;

coupling the first fluid pump to the patient to administer a fluid to the patient to provide said input information.

4. The method of claim 3 in which administering a fluid for the purpose of intravascular volume expansion comprises

providing a second fluid pump coupled to said treating fluid;

and

coupling the second fluid pump to the patient to administer the treating fluid to the patient.

5. The method of claim 4 comprising providing a display coupled to the first and second fluid pumps.