Apparatus and method for determining a physiological parameter

• US 20090204012A1
• Filed: 02/05/2009
• Published: 08/13/2009
• Est. Priority Date: 02/07/2008
• Status: Abandoned Application

• Current Assignee: PULSION Medical Systems SE (Getinge AB)
• Original Assignee: Pulsion Medical Systems AG
• Inventors: Joeken, Stephan
• Application Number:
  US12/322,652
• Publication Number:
  US 20090204012A1
• Time in Patent Office: Days
• US Class Current: 600/504
• 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 5/0215 by means inserted into the body catheters A61M25/00
• CPC Class Codes: A61B 5/024 Detecting, measuring or recording pulse rate or heart rate A61B5/0205, A61B5/021 take precedence
• 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 5/7257 using Fourier transforms

Abstract

An apparatus for determining a physiological parameter of a patient, such as cardiac output, comprises a sensor device providing readings of a blood variable, memory means storing the readings as a curve over time, evaluation means determining a mean value from the curve and determining the physiological parameter using the mean value is provided. The evaluation means determine a spectral density of the curve and/or a variance. The evaluation means also determine at least one model parameter representing an effective value of a heart beat using the mean value and the spectral density and/or variance. The effective value is selected from an effective amplitude of the heart beat, an effective duration of the heart beat and an effective area under the heart beat. The physiological parameter is determined using at least one of the model parameters.

Claims

1. Apparatus for determining at least one physiological parameter of a patient, said apparatus comprising:

a sensor device adapted to provide readings of an blood variable of said patient,

memory means for storing said readings as a curve representing said variable over time t,

evaluation means adapted to determine a mean value from said curve and to determine said at least one physiological parameter using said mean value,

wherein

said evaluation means are further adapted

to determine at least one of a spectral density S(ω

) of said curve and a variance of said blood variable,

to determine at least one model parameter representing an effective value of a heart beat using said mean value and at least one of said spectral density S(ω

) and said variance, said effective value being selected from an effective amplitude A_eff of said heart beat, an effective duration d_eff of said heart beat and an effective area F_eff under said heart beat, and

to determine said at least one physiological parameter using at least one said model parameter.

2. Apparatus according to claim 1, wherein said at least one physiological parameter includes at least one of stroke volume SV, cardiac output CO and ejection fraction EF.

3. Apparatus according to claim 2, wherein said evaluation means are adapted to determine said stroke volume SV as a product of a first model parameter representing said effective amplitude A_eff and a second model parameter representing said effective duration d_eff.

4. Apparatus according to claim 2, wherein said evaluation means are adapted to determine said ejection fraction EF as a product of a model parameter representing said effective duration d_eff and a heart rate HR of said patient.

5. Apparatus according to claim 2, wherein said evaluation means are adapted to determine said cardiac output CO as a product of a first model parameter representing said effective amplitude A_eff, a second model parameter representing said effective duration d_eff and an approximation of a heart rate of said patient.

6. Apparatus according to claim 5, wherein said approximation of said heart rate is selected from an actual measured heart rate HR and an approximate function λ

_eff, said approximate function λ

_eff including a quotient with a dividend comprising the square of the mean value and a divisor comprising the spectral density S(ω

) at ω

=0.

7. Apparatus according to claim 1, wherein said evaluation means are adapted to use a correction parameter α

in determining said model parameter, said correction parameter α

assuming values greater than or equal to 1, said values being the higher, the less the patient'"'"'s heart frequency deviates from a rhythmic condition.

8. Apparatus according to claim 7, wherein said evaluation means are adapted to use a monotonous correction function a depending on said correction parameter α

and assuming values from 0 to 1, wherein said correction function σ

assumes the value of 0 if said correction parameter α

equals 1 and said correction function σ

assumes the value of 1 for said correction parameter α

tending to infinity.

9. Apparatus according to claim 8, wherein said effective amplitude A_eff is provided as a quotient with a dividend comprising the sum of said variance and the product of said correction function σ

and the square of the mean value and a divisor comprising the mean value.

10. Apparatus according to claim 8, wherein said effective amplitude d_eff is provided as a quotient with a dividend comprising the spectral density S(ω

) at ω

=0 and a divisor comprising the sum of said variance and the product of said correction function σ and

the square of the mean value.

11. Apparatus according to claim 1 comprising Fourier Transformation means for determining said spectral density S(ω

) as the Fourier Transformation of the autocorrelation of said curve.

12. Apparatus according to claim 1, wherein the spectral density S(ω

) at ω

=0 is provided as said variance multiplied by a constant factor.

13. Apparatus according to claim 1, wherein said evaluation unit is further adapted to determine a comparative value of at least one of said physiological parameters using pulse contour algorithms.

14. Apparatus according to claim 1, further comprising

means for administering a traveling deviation of an intrinsic physical quantity to the blood stream of said patient at a first location of the blood circulation of said patient, and

sensor means for measuring said physical quantity at a second location of the blood circulation of said patient over the course of time,

wherein said memory means are adapted to record said physical quantity measured over the course of time at said second location as a dilution curve, and said evaluation unit is adapted to determine a comparative value of at least one of said physiological parameters from said dilution curve using dilution algorithms.

15. Apparatus according to claim 13, wherein said evaluation unit is adapted to use said comparative value for calibration.

16. Apparatus according to claim 15, wherein calibration includes determining, using said comparative value, correction parameter α

used in determining said model parameter, said correction parameter α

assuming values greater than or equal to 1, said values being the higher the less the patient'"'"'s heart frequency deviates from a rhythmic condition.

17. Apparatus according to claim 13, wherein said evaluation unit is adapted to reject and re-calculate said physiological parameter, if the difference between the determined physiological parameter and the respective comparative value exceeds a threshold value.

18. Apparatus according to claim 1, wherein said sensor device includes a pressure sensor device, said blood variable is an arterial blood pressure, said curve representing said variable over time is a pressure curve P(t) over time t, and said mean value is a mean arterial blood pressure <

P>

.

19. Apparatus according to claim 1, wherein said sensor device includes a plethysmography and/or pulse-oximetry sensor setup.

20. Method for determining at least one physiological parameter of a patient, said method comprising the steps of:

importing readings of a blood variable of said patient,

storing said readings as a curve representing said blood variable over time t,

determining a mean value from said curve and determining at least one physiological parameter using said mean value

wherein

said method further includes

determining at least one of a spectral density S(ω

) of said curve and a variance of said blood variable,

determining at least one model parameter representing an effective value of a heart beat using said mean value and at least one of said spectral density S(ω

) and said variance, said effective value being selected from an effective amplitude A_eff of said heart beat, an effective duration d_eff of said heart beat and an effective area F_eff under said heart beat, and

determining said at least one physiological parameter using at least one said model parameter.

21. Method according to claim 20, wherein said at least one physiological parameter includes at least one of stroke volume SV, cardiac output CO and ejection fraction EF.

22. Method according to claim 21, wherein said stroke volume SV is determined as a product of a first model parameter representing said effective amplitude A_eff and a second model parameter representing said effective duration d_eff.

23. Method according to claim 21, wherein said ejection fraction EF is determined as a product of a model parameter representing said effective duration d_eff and a heart rate HR of said patient.

24. Method according to claim 21, wherein said cardiac output CO is determined as a product of a first model parameter representing said effective amplitude A_eff, a second model parameter representing said effective duration d_eff and an approximation of a heart rate of said patient.

25. Method according to claim 24, wherein said approximation of said heart rate is selected from an actual measured heart rate HR and an approximate function λ

_eff, said approximate function λ

_eff including a quotient with a dividend comprising the square of the mean value and a divisor comprising the spectral density S(ω

) at ω

=0.

26. Method according to claim 20, wherein a correction parameter α

is used in determining said model parameter, said correction parameter α

assuming values greater than or equal to 1, said values being the higher the less the patient'"'"'s heart frequency deviates from a rhythmic condition.

27. Method according to claim 26, wherein a monotonous correction function σ

is used depending on said correction parameter α and

assuming values from 0 to 1, wherein said correction function σ

assumes the value of 0 if said correction parameter α

equals 1 and said correction function σ

assumes the value of 1 for said correction parameter α

tending to infinity.

28. Method according to claim 27, wherein said effective amplitude A_eff is provided as a quotient, the dividend of said quotient comprising the sum of said variance and the product of said correction function σ

and the square of the mean value and the divisor of said quotient comprising the mean value.

29. Method according to claim 27, wherein said effective amplitude d_eff is provided as a quotient with a dividend comprising the spectral density S(ω

) at ω

=0 and a divisor comprising the sum of said variance and the product of said correction function σ and

the square of the mean value.

30. Method according to claim 20, wherein said spectral density S(ω

) is determined as the Fourier Transformation of the autocorrelation of said curve.

31. Method according to claim 20, wherein the spectral density S(ω

) at ω

=0 is provided as said variance multiplied by a constant factor.

32. Method according to claim 20, wherein a comparative value of at least one of said physiological parameters is determined using pulse contour algorithms.

33. Method according to claim 20, further comprising

inputting information about a traveling deviation of an intrinsic physical quantity administered to the blood stream of said patient at a first location of the blood circulation of said patient, and

reading in measurement readings of said physical quantity at a second location of the blood circulation of said patient over the course of time,

wherein, said measurement readings of said physical quantity at said second location of the blood circulation of said patient are recorded as a dilution curve, and said comparative value of at least one of said physiological parameters is determined from said dilution curve using dilution algorithms.

34. Method according to claim 32, wherein said comparative value is used for calibration.

35. Method according to claim 34, wherein calibration includes determining, using said comparative value, correction parameter α

used in determining said model parameter, said correction parameter α

assuming values greater than or equal to 1, said values being the higher the less the patient'"'"'s heart frequency deviates from a rhythmic condition.

36. Method according to claim 32, wherein said physiological parameter is rejected and re-calculated, if the difference between the determined physiological parameter and the respective comparative value exceeds a threshold value.

37. Method according to claim 20, wherein said blood variable is an arterial blood pressure, said curve representing said variable over time t is a pressure curve P(t) over time t, and said mean value is a mean arterial blood pressure <

P>

.

38. Method according to claim 20, wherein said imported readings are readings obtained through plethysmographic and/or pulsoximetric measurement techniques.

39. Physical storage medium having stored thereon a computer program which, when executed on a computer system, causes the computer system to perform a method for determining at least one physiological parameter of a patient, said method comprising the steps of:

importing readings of a blood variable of said patient,

storing said readings as a curve representing said blood variable over time t,

determining a mean value from said curve and determining at least one physiological parameter using said mean value

wherein

said method further includes

determining at least one of a spectral density S(ω

) of said curve and a variance of said blood variable,

determining at least one model parameter representing an effective value of a heart beat using said mean value and at least one of said spectral density S(ω

) and said variance <

(δ

P)²>

, said effective value being selected from an effective amplitude A_eff of said heart beat, an effective duration d_eff of said heart beat and an effective area F_eff under said heart beat, and

determining said at least one physiological parameter using at least one said model parameter.