Detecting and Responding to Preshivering

• US 20160058613A1
• Filed: 04/08/2014
• Published: 03/03/2016
• Est. Priority Date: 04/10/2013
• Status: Active Grant

• Current Assignee: Zoll Circulation Incorporated (Asahi Kasei Corporation)
• Original Assignee: Zoll Circulation Incorporated (Asahi Kasei Corporation)
• Inventors: Helkowski, Richard A., Freeman, Gary A., Palazzolo, James
• Granted Patent: US 10,537,466 B2
• Time in Patent Office: Days
• US Class Current: 1/1
• 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 5/037 Measuring oesophageal pressure
• CPC Class Codes: A61B 5/0816 Measuring devices for examining respiratory frequency measuring frequency of electric signals G01R23/00
• CPC Class Codes: A61B 5/1101 Detecting tremor
• CPC Class Codes: A61B 5/1107 Measuring contraction of parts of the body, e.g. organ, muscle apparatus for measuring work or force in general G01L
• CPC Class Codes: A61B 5/1126 using a particular sensing technique
• CPC Class Codes: A61B 5/14542 for measuring blood gases A61B5/14551 takes precedence
• CPC Class Codes: A61B 5/24 Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
• CPC Class Codes: A61B 5/316 Modalities, i.e. specific diagnostic methods
• CPC Class Codes: A61B 5/389 Electromyography [EMG]
• CPC Class Codes: A61B 5/4052 efferent nerves, i.e. nerves that relay impulses from the central nervous system
• CPC Class Codes: A61B 5/4836 Diagnosis combined with treatment in closed-loop systems or methods A61B5/0036 takes precedence
• CPC Class Codes: A61B 5/4866 Evaluating metabolism A61B5/083 takes precedence
• CPC Class Codes: A61B 5/6823 Trunk, e.g., chest, back, abdomen, hip
• CPC Class Codes: A61B 5/6824 Arm or wrist
• CPC Class Codes: A61B 5/725 using specific filters therefor, e.g. Kalman or adaptive filters A61B5/316 take precedence
• CPC Class Codes: A61B 5/746 Alarms related to a physiological condition, e.g. details of setting alarm thresholds or avoiding false alarms alarms per se G08B
• CPC Class Codes: A61F 2007/0054 with a closed fluid circuit, e.g. hot water
• CPC Class Codes: A61F 2007/0056 for cooling
• CPC Class Codes: A61F 2007/0093 programmed
• CPC Class Codes: A61F 2007/126 : for invasive application, e.g. for introducing into blood vessels
• CPC Class Codes: A61F 7/10 : Cooling bags, e.g. ice-bags
• CPC Class Codes: A61F 7/12 : Devices for heating or cooling internal body cavities
• CPC Class Codes: A61N 1/36003 : of motor muscles, e.g. for walking assistance
• CPC Class Codes: A61N 1/36014 : External stimulators, e.g. with patch electrodes external pacemakers A61N1/3625
• CPC Class Codes: A61N 1/36017 : with leads or electrodes penetrating the skin
• CPC Class Codes: A61N 1/36025 : for treating a mental or cerebral condition
• CPC Class Codes: A61N 2/006 : for magnetic stimulation of nerve tissue
• CPC Class Codes: A61N 2/02 : using magnetic fields produced by coils, including single turn loops or electromagnets A61N2/12 takes precedence

Abstract

A method of reducing the likelihood of shivering comprises monitoring at least one physiological characteristic in a human or animal subject to detect preshivering and acting to reduce the likelihood of shivering when preshivering is detected.

Claims

1. A system for reducing the likelihood of shivering, the system comprising:

a subject cooling device;

sensor for monitoring at least one physiological characteristic and generating data representing said at least one characteristic;

a compiler for receiving and analyzing said data representing said characteristic from said sensor and making a determination whether preshivering exists; and

a means for acting on said determination.

2. A system as in claim 1, wherein said sensor comprises a skin sensor connected to an EMG machine, pulse meter and oxymeter.

3. A system as in claim 1, wherein said analyzer comprises a programmable computer.

4. A system as in claim 1, wherein said cooling system comprises and endovascular cooling system.

5. A system as in claim 1, wherein said cooling system comprises a surface cooling device.

6. A system as in claim 1, wherein the means for acting is selected from group comprising:

an alarm, a message screen, a drug pump, a warning light, means of control of an endovascular cooling system, and a means of warming a subject.

7. A method for detecting preshivering in a subject undergoing cooling, the method comprising:

a) stimulating a nerve of the subject;

b) sensing a response resulting from said stimulation;

c) recording data representing said response;

d) cooling said subject;

e) repeating steps a-c;

f) deriving a nominal value for data received in several repetitions of step c);

g) comparing the data received from the most recent repetition of step c) to said nominal value to make a determination whether change has occurred; and

h) acting in response to said determination.

8. A method as in claim 7, wherein the cooling is induced by infusing cold IV fluid.

9. A method as in claim 7, wherein the cooling comprises use of an intravascular cooling system.

10. A method as in claim 7, wherein said determination is that no change has occurred and wherein acting comprises waiting a predetermined period of time and then repeating all steps in said method.

11. A method as in claim 7, wherein said determination is that change has occurred and wherein the step of acting includes taking an action taken from the group comprising:

reducing the rate of cooling, stopping cooling, initiating anti-shivering mechanisms, increasing the anti-shivering methods, sounding an alarm, providing a visual alert, or transmitting a signal to a control unit which controls said cooling.

12. A method for detecting preshivering in a subject that has suffered cardiac arrest, the method comprising:

a) applying resuscitation efforts to the subject;

b) stimulating a nerve of the subject;

c) sensing a response resulting from said stimulation;

d) recording data representing a response to said stimulation;

e) repeating steps b)-d);

f) deriving a nominal value for the data received in several prior repetitions of step d);

g) comparing the value received from the most recent repetition of step d) with said nominal value to make a determination if a change has occurred; and

h) acting in response to said determination.

13. A method as in claim 12, further comprising the step of cooling the subject.

14. A device for detecting preshivering in a subject, the device comprising:

a stimulator for stimulating a nerve of a subject;

a sensor capable of detecting a response resulting when said nerve of the subject is stimulated and generating data representing at least part of said response;

a data analyzing device, said data analyzing device capable of receiving data from said sensor, compiling said data from a series of responses generated, determining a nominal value for said series, determining when change has occurred between said nominal value and said data, and transmitting a signal representing said determination.

15. A device as in claim 14, wherein said stimulator is at least one of an electrode and magnetic stimulator.

16. A method of reducing the likelihood of shivering, the method comprising:

monitoring at least one physiological characteristic in a human or animal subject to detect preshivering; and

acting to reduce the likelihood of shivering when preshivering is detected.

17. A method as in claim 16, wherein the at least one physiological characteristic comprises at least one of muscle tone, breathing rate, pulse, oxygen consumption in at least part of the body and spontaneous nerve activity.

18. A method as in claim 16, wherein said monitoring further comprises:

generating a series of data points over time, said data points representing the at least one physiological characteristic; and

analyzing the data points using at least one mathematical analyzing method taken from the group comprising;

mean, mode, auto-regressive moving average, or change point analysis techniques comprising at least one of Basseville, Schuhart, Kalman estimation, and particle filters.

19. A method as in claim 16, wherein acting comprises delivering a visual signal.

20. A method as in claim 16, wherein acting comprises at least one of delivering an audible signal, performing a task on the subject, delivering a drug, warming the subject, administering warm fluid to the subject.

21. A method as in claim 20, wherein the warm fluid is a liquid.

22. A method as in claim 21, wherein the warm fluid is administered orally.

23. A method as in claim 21, wherein the warm liquid is warm IV fluid.

24. A method of reducing the likelihood of shivering of a subject, the method comprising:

cooling the subject;

monitoring a physiological characteristic to detect preshivering; and

acting in response to a determination of preshivering.

25. A method as in claim 24, wherein the method of cooling comprises exposure to ambient temperature.

26. A method as in claim 24, further comprising administration of a substance that reduces normal physiological temperature control.

27. A method as in claim 26, wherein the substance comprises one of anesthesia and a sedative.

28. A method as in claim 24, wherein the physiological characteristic monitored comprises one of muscle tone, pulse, breathing rate, oxygen consumption and spontaneous nerve activity.

29. A method as in claim 24, wherein said monitoring comprises generating data representing the physiological condition monitored, generating a series of data points and analyzing the data points using mathematical analyzing methods taken from the group comprising:

mean, mode, auto-regressive moving average, or change point analysis techniques such as Basseville, Schuhart, Kalman estimation, particle filters.

30. A method as in claim 24, wherein the subject has suffered at least one of cardiac arrest, stroke, traumatic injury, brain injury, spinal injury, myocardial infarct.