METHOD FOR MONITORING AND IMPROVING FORWARD BLOOD FLOW DURING CPR

• US 20150283027A1
• Filed: 10/17/2013
• Published: 10/08/2015
• Est. Priority Date: 10/17/2012
• 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: Becker, Lance, Lampe, Joshua
• Granted Patent: US 11,234,896 B2
• Time in Patent Office: Days
• US Class Current: 1/1
• CPC Class Codes: A61B 5/02028 Determining haemodynamic parameters not otherwise provided for, e.g. cardiac contractility or left ventricular ejection fraction
• CPC Class Codes: A61B 5/0215 by means inserted into the body catheters A61M25/00
• CPC Class Codes: A61B 5/02158 provided with two or more sensor elements
• CPC Class Codes: A61B 5/026 Measuring blood flow A61B3/1233, A61B3/1241 take precedence
• CPC Class Codes: A61H 2230/04 Heartbeat characteristics, e.g. E.G.C., blood pressure modulation
• CPC Class Codes: A61H 2230/255 used as a control parameter for the apparatus
• CPC Class Codes: A61H 2230/305 used as a control parameter for the apparatus A61H2230/045 takes precedence
• CPC Class Codes: A61H 31/005 with feedback for the user
• CPC Class Codes: A61H 31/006 Power driven
• CPC Class Codes: A61M 2205/3334 Measuring or controlling the flow rate
• CPC Class Codes: A61M 2205/3358 Measuring barometric pressure, e.g. for compensation
• CPC Class Codes: A61M 60/148 in line with a blood vessel using resection or like techniques, e.g. permanent endovascular heart assist devices
• CPC Class Codes: A61M 60/274 the inlet and outlet being the same, e.g. para-aortic counter-pulsation blood pumps
• CPC Class Codes: A61M 60/414 transmitted by a rotating cable, e.g. for blood pumps mounted on a catheter
• CPC Class Codes: A61M 60/892 Active valves, i.e. actuated by an external force
• CPC Class Codes: A61M 60/894 Passive valves, i.e. valves actuated by the blood
• CPC Class Codes: A61N 7/00 Ultrasound therapy lithotripsy A61B17/22, A61B17/225; massage using supersonic vibration A61H23/00 ; using ultrasound for introducing media into the body A61M37/0092

Abstract

Devices and methods for blood flow enhancement and hemodynamic power monitoring are provided. A blood flow enhancement device includes a pump system configured to be coupled to a central vasculature of a subject during cardiopulmonary resuscitation (CPR). The pump system includes a pumping mechanism configured to increase forward blood flow generated during the CPR while substantially limiting backward blood flow generated during the CPR. The pumping mechanism being operated concurrently with the CPR. The hemodynamic power monitor is configured to control a chest compression device and an active valve.

Claims

1. A hemodynamic power monitoring system comprising:

a measurement device configured to be positioned in a blood vessel of a subject, the measurement device configured to measure a blood flow and a blood pressure in the blood vessel; and

a power estimation system coupled to the measurement device, the power estimation system configured to determine a hemodynamic power based on the measured blood flow and the measured blood pressure,

wherein the measurement device measures the blood flow based on a measurement technique selected from the group consisting of a pressure gradient, a Doppler shift, a bristle flow, anemometry, thermodilution, a pitot technique, and an electromagnetic flow.

2. The system of claim 1, wherein the power estimation system includes a monitor configured to display the hemodynamic power.

3. The system of claim 1, further comprising a catheter, the measurement device being coupled to the catheter.

4. The system of claim 3, wherein the catheter further comprises a valve.

5. The system of claim 4, wherein the valve is an active valve and is configured to be controlled by a signal passing through the catheter.

6. The system of claim 3, wherein the catheter has a length and includes first and second measurement devices coupled to the catheter along the length of the catheter, wherein the first and second measurement devices are separated by a distance such that, when the catheter is inserted into a blood vessel in a thorax, the first and second measurement devices are positioned on opposite sides of the thorax.

7. The system of claim 6, wherein the catheter further includes first and second valves positioned proximate to the first and second measurement devices, respectively, the first and second valves being positioned along the length of the catheter such that, when the catheter is inserted into the blood vessel, the first and second valves are positioned on opposite sides of the thorax and closer to the thorax than the respective first and second measurement devices.

8. The system of claim 7, wherein the first and second valves are active valves and are configured to be controlled by a signal passing through the catheter.

9. The system of claim 1, wherein the measurement device includes a pressure gradient device configured to determine the blood flow based a change in pressure in the blood vessel.

10. The system of claim 9, wherein the pressure gradient device includes at least two transducers spaced apart by a predetermined distance, the at least two transducers configured to measure the change in a blood pressure over the predetermined distance.

11. The system of claim 9, wherein at least one of the at least two transducers is configured to measure the blood pressure.

12. A blood flow enhancement device comprising:

a valving system including at least one element configured to be coupled invasively or non-invasively to a central vasculature of a subject during cardiopulmonary resuscitation (CPR), the at least one element configured to substantially reduce blood flow in at least one blood vessel of the central vasculature,

wherein the at least one element is configured to increase forward blood flow generated during the CPR in the central vasculature without substantially reducing the forward blood flow through a brain of the subject.

13. The blood flow enhancement device of claim 12, wherein the at least one element includes a one-way valve positioned in a superior vena cava of the subject.

14. The blood flow enhancement device of claim 12, wherein the at least one blood vessel includes at least one of a superior vena cava, an inferior vena cava, an aorta, a jugular vein or a carotid artery of the subject.

15. The blood flow enhancement device of claim 12, wherein the at least one element includes a one-way valve configured to be positioned in the at least one blood vessel.

16. The blood flow enhancement device of claim 12, wherein the at least one element is externally coupled to the at least one blood vessel.

17. The blood flow enhancement device of claim 16, wherein the at least one element includes a cervical collar configured to be coupled to carotid arteries and jugular veins of the subject.

18. The blood flow enhancement device of claim 17, further including an abdominal binding configured to be positioned on an abdomen of the subject.

19. The blood flow enhancement device of claim 16, wherein the at least one element includes at least two ultrasound transducers configured to be coupled to the at least one blood vessel, the at least two ultrasound transducers being configured to generate ultrasound waves to reduce the blood flow in the at least one blood vessel.

20. The blood flow enhancement device of claim 12, wherein the at least one element is a passive device.

21. The blood flow enhancement device of claim 12, wherein the at least one element is an active device configured to be activated synchronously with a CPR chest compression.

22. The blood flow enhancement device of claim 12 further comprising:

a chest compression device having a plurality of adjustable parameters; and

a hemodynamic power measurement system including;

a measurement device configured to be positioned in a blood vessel of a subject, the measurement device configured to measure a blood flow and a blood pressure in the blood vessel; and

a power estimation system coupled to the measurement device, the power estimation system configured to determine a hemodynamic power based on the measured blood flow and the measured blood pressure,

wherein the determined hemodynamic power is applied to the chest compression device to adjust at least one of the adjustable parameters.

23. The blood flow enhancement device of claim 22, wherein the adjustable parameters of the chest compression device include at least one of:

chest compression frequency, chest compression duty cycle, chest compression depth, chest compression release time, and time to complete sternal compression.

24. The blood flow enhancement device of claim 23, wherein the valving system is an active valving system and the determined hemodynamic power is applied to the valving system to control timing of opening and closing at least one of the valving elements.

25. A blood flow enhancement device comprising:

a valving system including at least one element configured to be coupled invasively or non-invasively to a central vasculature of a subject during cardiopulmonary resuscitation (CPR), the at least one element configured to reduce blood flow in at least one blood vessel of the central vasculature; and

an abdominal binding configured to be positioned on an abdomen of the subject,

wherein the at least one element is configured to increase forward blood flow generated during the CPR in the central vasculature without substantially reducing the forward blood flow through a brain of the subject.

26. A blood flow enhancement device comprising:

a pump system configured to be coupled to a central vasculature of a subject during cardiopulmonary resuscitation (CPR), the pump system including a pumping mechanism configured to increase forward blood flow generated during the CPR while limiting backward blood flow generated during the CPR, the pumping mechanism being operated concurrently with the CPR.

27. The blood flow enhancement device of claim 26, wherein the pumping mechanism is coupled to at least one of a femoral vein or a femoral artery of the subject.

28. The blood flow enhancement device of claim 26, wherein the pumping mechanism includes an infusion pump configured to receive a intravascular solution, the infusion pump being coupled to a femoral vein of the subject, the infusion pump injecting the saline solution during the CPR to increase the forward blood flow.

29. The blood flow enhancement device of claim 26, wherein the pumping mechanism includes an infusion pump configured to receive blood from a femoral artery and to output the blood to a femoral vein of the subject.

30. The blood flow enhancement device of claim 26, wherein the pumping mechanism includes at least one turbine impeller pump configured to be positioned in the central vasculature of the subject.

31. A method of enhancing forward blood flow during cardiopulmonary resuscitation (CPR), the method comprising:

coupling a valving system including at least one element to a central vasculature of a subject, the valving system being coupled invasively or non-invasively, the at least one element configured to reduce blood flow in at least one blood vessel of the central vasculature; and

initiating the at least one element during the CPR such that the at least one element is configured to increase the forward blood flow generated during the CPR in the central vasculature without substantially reducing the forward blood flow through a brain of the subject.

32. The method of claim 31, wherein the at least one element includes a one-way valve, and the coupling of the valving system including positioning the one-way valve in a superior vena cava of the subject.

33. The method of claim 31, wherein the at least one blood vessel includes at least one of a superior vena cava, an inferior vena cava, an aorta, a jugular vein or a carotid artery of the subject.

34. The method of claim 31, wherein the at least one element includes a one-way valve, and the coupling of the valving system includes positioning the one-way valve in the at least one blood vessel.

35. The method of claim 31, wherein the coupling of the valving system includes externally coupling the at least one element to the at least one blood vessel.

36. The method of claim 35, wherein the at least one element includes a cervical collar, and the coupling of the valving system including coupling the cervical collar to carotid arteries and jugular veins of the subject.

37. The method of claim 36, wherein the coupling of the valving system further including positioning an abdominal binding on an abdomen of the subject, the cervical collar and the abdominal binding being activated synchronous with the CPR.

38. The method of claim 35, wherein the at least one element includes at least two ultrasound transducers,

the coupling of the valving system including coupling the at least two ultrasound transducers to the at least one blood vessel, and

the initiating of the at least one element including generating interfering ultrasound waves by the at least two ultrasound transducers, to reduce the blood flow in the at least one blood vessel.

39. The method of claim 31, the method further including synchronously activating the at least one element with chest compressions during the CPR.

40. A method for monitoring hemodynamic power, the method comprising:

positioning a measurement device in a blood vessel of a subject, the measurement device;

measuring a blood flow and a blood pressure in the blood vessel via the measurement device; and

determining a hemodynamic power based on the measured blood flow and the measured blood pressure,

wherein the measurement device measures the blood flow based on a measurement technique selected from the group consisting of a pressure gradient, a Doppler shift, a bristle flow, anemometry, thermodilution, a pitot technique, and an electromagnetic flow.

41. The method of claim 40, the method further comprising displaying the hemodynamic power.

42. The method of claim 40, wherein the measurement device is coupled to a catheter, the positioning of the measurement device including positioning the catheter in the blood vessel.

43. The method of claim 40, wherein the blood flow is determined using the pressure gradient.

44. The method of claim 43, wherein the measurement device includes at least two transducers spaced apart by a predetermined distance, pressure gradient being determined from a change in the blood pressure measured via the at least two transducers.

45. The method of claim 40, wherein the blood pressure is measured via at least one of the at least two transducers.

46. A method of enhancing blood flow during cardiopulmonary resuscitation (CPR), the method comprising:

coupling a pump system including a pumping mechanism to a central vasculature of a subject; and

operating the pumping mechanism concurrently with the CPR such that forward blood flow generated during the CPR is increased while backward blood flow generated during the CPR is substantially limited.

47. The method of claim 46, wherein the coupling of the pump system includes coupling the pumping mechanism to at least one of a femoral vein or a femoral artery of the subject.

48. The method of claim 46, wherein the pumping mechanism includes an infusion pump configured to receive a saline solution, the method including:

coupling the infusion pump to a femoral vein of the subject, and

injecting the saline solution by the infusion pump during the CPR to increase the forward blood flow.

49. The method of claim 46, wherein the pumping mechanism includes an infusion pump, the method including:

coupling the infusion pump to a femoral vein and a femoral artery of the subject, and

draining blood from the femoral artery and to returning the blood to the femoral vein of the subject during the CPR.

50. The method of claim 46, wherein the pumping mechanism includes at least one turbine impeller pump, the coupling of the pump system includes positioning the at least one turbine impeller pump in the central vasculature of the subject.