SYSTEM FOR PERFORMING REMOTE ISCHEMIC PRECONDITIONING

• US 20100305607A1
• Filed: 05/28/2010
• Published: 12/02/2010
• Est. Priority Date: 12/06/2006
• Status: Active Grant

• Current Assignee: Hospital For SICK Children
• Original Assignee: Hospital For SICK Children
• Inventors: Redington, Andrew, Caldarone, Christopher
• Granted Patent: US 9,119,759 B2
• Time in Patent Office: Days
• US Class Current: 606/202
• CPC Class Codes: A61B 17/132 Tourniquets sphygmomanometer A61B5/022
• CPC Class Codes: A61B 17/135 inflatable for measuring blood pressure A61B5/022; inflatable pressure pads A61F5/34
• CPC Class Codes: A61B 17/1355 Automated control means therefor
• CPC Class Codes: A61B 5/022 by applying pressure to close blood vessels, e.g. against the skin; Ophthalmodynamometers
• CPC Class Codes: A61B 5/02225 using the oscillometric method
• CPC Class Codes: A61B 5/02233 Occluders specially adapted therefor tourniquets A61B17/132
• CPC Class Codes: A61H 2201/165 Wearable interfaces
• CPC Class Codes: A61H 2201/5007 computer controlled
• CPC Class Codes: A61H 2201/5071 Pressure sensors
• CPC Class Codes: A61H 2201/5082 Temperature sensors
• CPC Class Codes: A61H 2230/30 Blood pressure A61H2230/04 takes precedence
• CPC Class Codes: A61H 9/0078 with intermittent or alternately inflated bladders or cuffs mattresses for preventing bed-sores with alternated pressurized chambers A61G7/05776
• CPC Class Codes: A61H 9/0092 Cuffs therefor

Abstract

A system for remote ischemic preconditioning that includes a cuff, and actuator, and a controller that operates the actuator according to a treatment protocol. The treatment protocol includes a plurality of treatment cycles that each comprise cuff actuation, an ischemic duration, cuff release, and a reperfusion duration.

Claims

1-22. -22. (canceled)

23. A method for reducing ischemic injury in a subject by performing remote ischemic preconditioning.

24. The method of claim 23, wherein the ischemic injury is in heart, brain, kidney, pancreas, lung, intestine, or liver of the subject.

25. The method of claim 23, wherein the remote ischemic preconditioning is performed as a treatment protocol.

26. The method of claim 25, wherein the treatment protocol comprises a treatment cycle that is repeated one, two, three, or four times.

27. The method of claim 25, wherein each treatment cycle comprises occluding blood flow through a limb and then allowing blood flow through the limb.

28. The method of claim 27, wherein blood is occluded for at least 5 seconds.

29. The method of claim 27, wherein blood is occluded for as long as 20 minutes.

30. The method of claim 27, wherein blood is occluded for less than 1 minute.

31. The method of claim 27, wherein blood is occluded for more than 1 minute.

32. The method of claim 27, wherein blood is occluded for a period of time that ranges from at least 5 seconds to up to 20 minutes.

33. The method of claim 27, wherein blood is occluded for a period of time that ranges from less than 1 minute to up to 20 minutes.

34. The method of claim 27, wherein blood is occluded for a period of time that ranges from more than 1 minute to up to 20 minutes.

35. The method of claim 27, wherein blood is allowed to flow through the limb for 5 seconds, 1 minute, at least 1 minute, or for as long as 20 minutes.

36. The method of claim 27, wherein blood is allowed to flow through the limb for a period of time that ranges from at least 5 seconds to up to 20 minutes.

37. The method of claim 27, wherein blood is allowed to flow through the limb for a period of time that ranges from 1 minute to up to 20 minutes.

38. The method of claim 25, wherein the treatment cycle is performed one or more times and comprises at least 1 minute, at least 2 minutes, at least 3 minutes, at least 4 minutes, or at least or about 5 minutes of occlusion.

39. The method of claim 38, wherein the treatment cycle is performed 2 or more times and comprises at least 1 minute, at least 2 minutes, at least 3 minutes, at least 4 minutes, or at least or about 5 minutes of blood flow/reperfusion through the limb after occlusion.

40. The method of claim 23, wherein the remote ischemic preconditioning is performed using a cuff system configured to be positioned about a limb of the subject.

41. The method of claim 23, further comprising detecting percentage of haemoglobin that is saturated with oxygen using a pulse oximeter.

42. The method of claim 40, wherein the cuff system comprises

a cuff configured to retract about a limb of a subject;

an actuator connected to the cuff and that, when actuated, causes the cuff to contract about the limb of the subject to reduce blood flow there through; and

a controller that controls the actuator to operate according to a treatment protocol that includes a plurality of sequentially actuated treatment cycles, each treatment cycle comprising

cuff actuation, during which the actuator contracts the cuff about the limb of the subject to a pressure above systolic pressure to occlude blood flow through the limb;

an ischemic duration, during which the actuator maintains the cuff contracted about the limb at a set point above systolic pressure to occlude blood flow through the limb;

cuff release, during which the actuator releases the cuff to allow blood flow through the limb; and

a reperfusion duration, during which the cuff is maintained about the limb in an at least partially relaxed state to allow blood flow through the limb.

43. The method of claim 42, wherein ischemic duration is 5 seconds up to 20 minutes.

44. The method of claim 42, wherein the ischemic duration is at least 1 minute up to 20 minutes.

45. The method of claim 42, wherein the reperfusion duration is 5 seconds up to 20 minutes.

46. The method of claim 42, wherein the reperfusion duration is 1 minute up to 20 minutes.

47. The method of claim 42, wherein the plurality of treatment cycles is 2, 3, 4, or 5 cycles.

48. A method for modulating a vascular condition by administering a program of ischemic conditioning.

49-54. -54. (canceled)

55. A method for assessing an ischemic conditioning treatment comprising:

measuring one or more baseline hemodynamic parameters of a patient,

applying an ischemic conditioning treatment in the patient by occluding and releasing arterial flow in one or more extremities of the patient on a scheduled, repeated basis,

measuring post-ischemia parameters in the patient, and

comparing the baseline and post-ischemia parameters to provide an assessment of the ischemic conditioning treatment over time.