Transbronchial reflectance oximetric measurement of mixed venous oxygen saturation, and device therefor

• US 20030181797A1
• Filed: 02/12/2003
• Published: 09/25/2003
• Est. Priority Date: 02/13/2002
• Status: Active Grant

• Current Assignee: Trustees Of The University Of Pennsylvania (University of Pennsylvania)
• Original Assignee: Trustees Of The University Of Pennsylvania (University of Pennsylvania)
• Inventors: Kohl, Benjamin A., Rosen, Noah A.
• Granted Patent: US 6,961,600 B2
• Time in Patent Office: Days
• US Class Current: 600/323
• CPC Class Codes: A61B 5/1459 invasive, e.g. introduced into the body by a catheter A61B5/1464 takes precedence
• CPC Class Codes: A61B 5/412 Detecting or monitoring sepsis

Abstract

Provided are methods and a system for the transbronchial reflectance oximetric measurement of mixed venous oxygen saturation in the pulmonary artery of a patient, and a device therefor. Thus, provided is a quick, minimally invasive, method and system for determining an important endpoint of resuscitation, particularly for a patient in shock, because the probe used to measure the venous oxygen saturation is configured to permit insertion through an endotracheal tube until the probe is placed in contact with the bronchial luminus mucosa of the patient'"'"'s right bronchus, left bronchus or distal trachea, directly adjacent to the patient'"'"'s pulmonary artery.

Claims

1. A reflectance oximeter probe device for continuously measuring hemodynamic state of a patient, comprising venous oxygen saturation, wherein the measurement is made transbronchially of oxygen saturation in the pulmonary artery of the patient.

2. The device of claim 1, wherein venous oxygen saturation comprises mixed venous oxygen saturation in the pulmonary artery of the patient.

3. The device of claim 1, wherein the probe is a fiber-optic, near-infrared reflectance spectroscopy source detector.

4. The device of claim 3, wherein the patient is intubated and the probe is configured to permit insertion into the patient through the endotracheal tube until the probe is placed in contact with the bronchial luminus mucosa of the patient'"'"'s right bronchus, left bronchus or distal trachea, directly adjacent to the patient'"'"'s pulmonary artery, and to which the probe is temporarily affixed.

5. The device of claim 4, further comprising a means for measuring scatter of light reflected by oxygenated hemoglobin, from which deoxygenated hemoglobin is subtracted, to quantitatively determine mixed venous oxygen saturation in the pulmonary artery of the patient.

6. The device of claim 5, wherein the patient is in shock.

7. The device of claim 6, wherein the patient is in need of resuscitation.

8. A method for continuously measuring hemodynamic state of a patient in terms of venous oxygen saturation, the method comprising measuring the oxygen saturation transbronchially in the pulmonary artery of the patient.

9. The method of claim 8, wherein measuring venous oxygen saturation comprises measuring mixed venous oxygen saturation in the pulmonary artery of the patient.

10. The method of claim 8, wherein measuring is via a fiber-optic, near-infrared reflectance oximetric, spectroscopy source detector probe

11. The method of claim 9, wherein the patient is intubated, and wherein the method further comprises:

inserting the probe into the patient through the endotracheal tube, and

placing and temporarily affixing the probe in contact with the bronchial luminus mucosa of the patient'"'"'s right bronchus, left bronchus or distal trachea, directly adjacent to the patient'"'"'s pulmonary artery.

12. The method of claim 11, further comprising:

measuring the scatter of light reflected by oxygenated hemoglobin;

subtracting deoxygenated hemoglobin from the measured oxygenated hemoglobin; and

thereby

quantitatively determining mixed venous oxygen saturation in the pulmonary artery of the patient.

13. The method of claim 12, further comprising measuring mixed venous oxygen saturation in the pulmonary artery, wherein the patient is in shock.

14. The method of claim 12, further comprising measuring mixed venous oxygen saturation in the pulmonary artery of the patient, wherein the patient is in need of resuscitation.

15. The method of claim 12, wherein by repeating the quantitative measurement steps, a pattern is created indicating a change in oxygen consumption in the patient.

16. The method of claim 12, wherein by repeating the quantitative measurement steps, a pattern is created indicating a change in hemoglobin concentration in the patient.

17. The method of claim 12, wherein by repeating the quantitative measurement steps, a pattern is created indicating a change in cardiac output in the patient.

18. A system for continuously measuring hemodynamic state of a patient in terms of venous oxygen saturation, the system comprising:

a computer means for quantitatively determining mixed venous oxygen saturation in the pulmonary artery of the patient as measured transbronchially by a fiber-optic, near-infrared reflectance oximetric spectroscopy source detector probe;

the fiber-optic reflectance oximetric probe for measuring the scatter of light reflected by oxygenated hemoglobin, from which deoxygenated hemoglobin is subtracted; and

an algorithm by which mixed venous oxygen saturation is calculated.

19. The system of claim 18, wherein the calculation is made when arterial oxygen saturation, oxygen consumption and hemoglobin concentration are held constant.

20. The algorithm used in the system of claim 18 that is used to continuously measure the hemodynamic state of a patient in terms of venous oxygen saturation.