METHODS AND SYSTEMS FOR DETERMINING FLUID ADMINISTRATION

• US 20160220756A1
• Filed: 01/25/2016
• Published: 08/04/2016
• Est. Priority Date: 02/04/2015
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Covidien LP (Medtronic Plc)
• Inventors: Doyle, Peter, Addison, Paul S., Watson, James N.
• Granted Patent: US 10,328,202 B2
• Time in Patent Office: Days
• US Class Current: 1/1
• CPC Class Codes: A61B 5/02416 using photoplethysmograph signals, e.g. generated by infrared radiation A61B5/14552 takes precedence
• CPC Class Codes: A61B 5/02438 with portable devices, e.g. worn by the patient
• CPC Class Codes: A61B 5/08 Detecting, measuring or recording devices for evaluating the respiratory organs A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/0816 Measuring devices for examining respiratory frequency measuring frequency of electric signals G01R23/00
• CPC Class Codes: A61B 5/14551 for measuring blood gases
• CPC Class Codes: A61B 5/4848 Monitoring or testing the effects of treatment, e.g. of medication
• CPC Class Codes: A61B 5/4875 Hydration status, fluid retention of the body
• CPC Class Codes: A61M 5/1723 using feedback of body parameters, e.g. blood-sugar, pressure measurement of body parameters A61B5/00

Abstract

Methods and systems are provided for determining fluid administration. The system may determine fluid administration based on the fluid responsiveness and regional oxygen saturation of a subject. The system may receive the fluid responsiveness and regional oxygen saturation from external sources or may determine one or both based on received physiological signals. In some embodiments, the system may determine whether to administer fluid based on the fluid responsiveness and regional oxygen saturation. In some embodiments, the system may determine the amount of fluid to administer based on the fluid responsiveness and regional oxygen saturation. In some embodiments, the system may determine the effectiveness of fluid administration. In some embodiments, the system may provide an indication of the determined fluid administration so that a care-giver can implement the appropriate fluid administration. In some embodiments, the system may control the fluid administration based on its determination.

Claims

1. A physiological monitoring system comprising:

a light detecting sensor configured to;

detect at least one wavelength of light absorbed through tissue of a subject; and

generate at least one physiological signal based on the detected at least one wavelength of light; and

a processor coupled to the light detecting sensor configured to;

receive the at least one physiological signal;

determine a value indicative of fluid responsiveness of the subject based on the at least one physiological signal;

receive a value indicative of regional oxygen saturation in a region of the subject'"'"'s tissue; and

determine whether to administer fluid to the subject based on the value indicative of regional oxygen saturation and the value indicative of fluid responsiveness.

2. The system of claim 1, wherein the value indicative of fluid responsiveness is determined based on respiratory variations identified in the at least one physiological signal.

3. The system of claim 1, wherein the value indicative of fluid responsiveness is determined based on amplitude variations in the at least one physiological signal.

4. The system of claim 1, wherein the value indicative of fluid responsiveness is determined based on variations of a percent modulation of the at least one physiological signal.

5. The system of claim 1, wherein the value indicative of regional oxygen saturation is indicative of oxygen saturation in at least one of the subject'"'"'s brain, kidney, and abdomen.

6. The system of claim 1 further comprising a fluid administration mechanism coupled to the processor configured to administer fluid to the subject based on the processor'"'"'s determination of whether to administer fluid.

7. The system of claim 6, wherein the fluid administration mechanism comprises a syringe and an automated pump mechanism coupled to the syringe that actuates the syringe to administer fluid to the subject based on the processor'"'"'s determination of whether to administer fluid.

8. The system of claim 1, wherein the processor is configured to determine whether to administer fluid to the subject by:

comparing the value indicative of fluid responsiveness to a fluid responsiveness threshold;

comparing the value indicative of regional oxygen saturation to a regional oxygen saturation threshold; and

determining whether to administer fluid to the subject based on both comparisons.

9. The system of claim 8, wherein the regional oxygen saturation threshold is indicative of adequate perfusion of a region associated with the value indicative of regional oxygen saturation.

10. The system of claim 1, wherein the processor is configured to determine the amount of fluid to administer to the subject based on the value indicative of regional oxygen saturation and the value indicative of fluid responsiveness.

11. The system of claim 1, wherein the processor is configured to determine whether to administer fluid to the subject based on the value indicative of regional oxygen saturation, the value indicative of fluid responsiveness, and the region of the subject'"'"'s tissue.

12. A physiological monitoring system comprising:

an input configured to receive a plurality of physiological signals, wherein the plurality of physiological signals are indicative of light absorbed by the subject;

a saturation calculator coupled to the input configured to calculate regional oxygen saturation in a region of the subject'"'"'s tissue based on at least two of the plurality of physiological signals;

a fluid responsiveness calculator coupled to the input configured to calculate a parameter indicative of fluid responsiveness based on at least one of the plurality of physiological signals; and

a fluid administration calculator configured to provide an indication regarding the administration of fluid to the subject based on the regional oxygen saturation and the parameter indicative of fluid responsiveness.

13. The system of claim 12, wherein the fluid responsiveness calculator is configured to calculate the parameter indicative of fluid responsiveness based on respiratory-induced amplitude variations identified in at least one of the plurality of physiological signals.

14. The system of claim 12, wherein the fluid responsiveness calculator is configured to calculate the parameter indicative of fluid responsiveness based on variations of a percent modulation of at least one of the plurality of physiological signals.

15. The system of claim 12, wherein the fluid administration calculator is configured to determine whether to administer fluid to the subject based on the regional oxygen saturation and the parameter indicative of fluid responsiveness.

16. The system of claim 12, wherein the fluid administration calculator is configured to determine an amount of fluid to be administered to the subject based on the regional oxygen saturation and the parameter indicative of fluid responsiveness.

17. The system of claim 12, wherein the fluid administration calculator is configured to determine the effectiveness of fluid administration based on a change in at least one of the regional oxygen saturation and the parameter indicative of fluid responsiveness.

18. The system of claim 12, wherein the region of a subject'"'"'s tissue for which regional oxygen saturation is calculated is at least one of the subject'"'"'s brain, kidney, and abdomen.

19. The system of claim 12, wherein the fluid administration calculator is configured to control the fluid administration of the subject based on the regional oxygen saturation and the parameter indicative of fluid responsiveness.

20. The system of claim 17, wherein the fluid administration calculator is configured to control the fluid administration of the subject based on the effectiveness of the fluid administration.