SHOCK OR SEPSIS EARLY DETECTION METHOD AND SYSTEM

• US 20120220845A1
• Filed: 02/28/2011
• Published: 08/30/2012
• Est. Priority Date: 02/28/2011
• Status: Abandoned Application

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Nellcor Puritan Bennett LLC (Medtronic Plc)
• Inventors: Campbell, Shannon
• Application Number:
  US13/037,069
• Publication Number:
  US 20120220845A1
• Time in Patent Office: Days
• US Class Current: 600/364
• CPC Class Codes: A61B 5/0836 Measuring rate of CO2 production
• CPC Class Codes: A61B 5/14503 invasive, e.g. introduced into the body by a catheter or needle or using implanted sensors A61B5/1459, A61B5/1464, A61B5/1473, A61B5/1482, A61B5/14865 take precedence
• CPC Class Codes: A61B 5/14539 for measuring pH
• CPC Class Codes: A61B 5/14542 for measuring blood gases A61B5/14551 takes precedence
• CPC Class Codes: A61B 5/14551 for measuring blood gases
• CPC Class Codes: A61B 5/1459 invasive, e.g. introduced into the body by a catheter A61B5/1464 takes precedence
• CPC Class Codes: A61B 5/1473 invasive, e.g. introduced into the body by a catheter A61B5/1482 takes precedence
• CPC Class Codes: A61B 5/412 Detecting or monitoring sepsis
• CPC Class Codes: A61M 16/04 Tracheal tubes catheters in general A61M25/00
• CPC Class Codes: A61M 16/0443 Special cuff-wall materials A61M16/0481, A61M16/0422 take precedence
• CPC Class Codes: A61M 16/0445 Special cuff forms, e.g. undulated
• CPC Class Codes: A61M 16/0447 Bell, canopy or umbrella shaped
• CPC Class Codes: A61M 16/0459 one cuff behind another
• CPC Class Codes: A61M 16/0484 at the distal end
• CPC Class Codes: A61M 2016/0413 with detectors of CO2 in exhaled gases
• CPC Class Codes: A61M 2205/3306 Optical measuring means
• CPC Class Codes: A61M 2205/502 User interfaces, e.g. screens or keyboards
• CPC Class Codes: A61M 2230/202 partial carbon oxide pressure, e.g. partial dioxide pressure (P-CO2)
• CPC Class Codes: A61M 2230/208 pH-value
• CPC Class Codes: A61M 2230/432 partial CO2 pressure (P-CO2)

Abstract

According to various embodiments, a medical system and method for early detection of shock and/or sepsis may include devices configured to provide information about carbon dioxide and/or pH levels in a patient'"'"'s tracheal tissue and in a respiratory path. Specifically, a relationship between carbon dioxide and/or pH in the tracheal tissue vs. respiratory gases (e.g., lung gases) may be used to determine if a patient is at risk of developing shock or sepsis. In certain embodiments, if carbon dioxide in the tracheal tissue deviates from end-tidal carbon dioxide, a patient may be experiencing early stages of hypoperfusion associated with shock and/or sepsis.

Claims

1. A method, comprising:

using processing circuitry;

receiving a first signal from a first sensor in contact with a tracheal tissue of a patient, wherein the first signal is representative of a level of carbon dioxide or a pH of the tracheal tissue;

receiving a second signal from a second sensor, wherein the second signal is representative of an end-tidal level of carbon dioxide during respiration of the patient or an arterial level of carbon dioxide or an arterial pH; and

determining whether the patient is at risk for developing shock or sepsis based at least in part on a relationship between the level of carbon dioxide or pH of the tracheal tissue and the end-tidal level of carbon dioxide or the arterial level of carbon dioxide or the arterial pH.

2. The method of claim 1, comprising providing a user-perceptible indication related to a risk of developing shock or sepsis.

3. The method of claim 1, comprising displaying a comparison of the level of carbon dioxide in the tracheal tissue and the end-tidal level of carbon dioxide over time.

4. The method of claim 1, wherein the relationship comprises a difference between the level of carbon dioxide in the tracheal tissue and the end-tidal level of carbon dioxide.

5. The method of claim 4, comprising triggering an alarm when the difference between the level of carbon dioxide in the tracheal tissue and the end-tidal level of carbon dioxide is greater than a threshold.

6. The method of claim 1, wherein the relationship comprises a rate of change in a difference between the level of carbon dioxide in the tracheal tissue and the end-tidal level of carbon dioxide.

7. The method of claim 1, comprising providing a user perceptible indication that shock or sepsis therapy should be started if the patient is at risk for developing shock or sepsis.

8. A monitor, comprising:

processing circuitry configured to execute instructions for;

receiving a first signal from a first carbon dioxide sensor in contact with a tracheal tissue of an intubated patient;

determining a level of carbon dioxide in the tracheal tissue based on the first signal;

receiving a second signal from a second carbon dioxide sensor in fluid communication with a respiratory circuit of the intubated patient;

determining an end-tidal level of carbon dioxide during respiration based on the second signal; and

determining a clinical condition of the patient based at least in part on a relationship between the level of carbon dioxide in the tracheal tissue and the end-tidal level of carbon dioxide.

9. The monitor of claim 8, wherein the processor comprises instructions to trigger an alarm when a difference between the level of carbon dioxide in the tracheal tissue and the end-tidal level of carbon dioxide is greater than a predetermined level.

10. The monitor of claim 8, comprising a display for displaying a user perceptible indication related to the clinical condition of the patient.

11. The monitor of claim 10, wherein the clinical condition of the patient comprises shock or sepsis.

12. The monitor of claim 8, wherein the relationship comprises a difference between the level of carbon dioxide in the tracheal tissue and the end-tidal level of carbon dioxide.

13. The monitor of claim 8, wherein the relationship comprises a rate of change of a difference between the level of carbon dioxide in the tracheal tissue and the end-tidal level of carbon dioxide.

14. The monitor of claim 8, wherein the processor comprises instructions for correcting for a higher baseline level of carbon dioxide in the tracheal tissue relative to the end-tidal level of carbon dioxide.

15. The monitor of claim 8, wherein determining the end-tidal level of carbon dioxide during respiration comprises determining an average end-tidal carbon dioxide level over a predetermined number of breaths.

16. The monitor of claim 8, wherein processor comprises instructions for receiving a third signal related to a pH of the tracheal tissue, and wherein between the level of carbon dioxide in the tracheal tissue and the end-tidal level of carbon dioxide is based at least in part on the pH of the tracheal tissue.

17. A respiratory system, comprising:

a tracheal tube comprising a passageway for conveying gases to a patient;

a first sensor associated with an exterior of the tracheal tube and configured to contact a tracheal tissue when the tracheal tube is inserted in the patient;

a second sensor in fluid communication with the passageway; and

a monitor operatively coupled to the first sensor and the second sensor, the monitor comprising;

processing circuitry configured to execute instructions for;

receiving a first signal from the first sensor, wherein the first signal is representative of a level of carbon dioxide or a pH of the tracheal tissue;

receiving a second signal from the second sensor, wherein the second signal is representative of an end-tidal level of carbon dioxide during respiration of the patient; and

determining whether the patient is at risk for developing shock or sepsis based at least in part on a relationship between the level of carbon dioxide or pH of the tracheal tissue and the end-tidal level of carbon dioxide.

18. The respiratory system of claim 17, wherein the first sensor is disposed on a non-sealing portion of an inflatable balloon cuff associated with the tracheal tube.

19. The respiratory system of claim 17, wherein the first sensor is disposed on a deployable member associated with the exterior of the tracheal tube.

20. The respiratory system of claim 17, wherein the exterior of the tracheal tube comprises a recess adapted to accommodate the deployable member in an undeployed state.