SYSTEM AND METHOD FOR PROVIDING BLOOD PRESSURE SAFE ZONE INDICATION DURING AUTOREGULATION MONITORING

• US 20170105631A1
• Filed: 10/18/2016
• Published: 04/20/2017
• Est. Priority Date: 10/19/2015
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Covidien LP (Medtronic Plc)
• Inventors: Addison, Paul Stanley, Watson, James N., Montgomery, Dean
• Granted Patent: US 10,499,818 B2
• Time in Patent Office: Days
• CPC Class Codes: A61B 5/0059 using light, e.g. diagnosis by transillumination, diascopy, fluorescence A61B5/0093, A61B5/1455, A61B5/02416 and A61B5/0261 take precedence
• 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 5/0205 Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
• CPC Class Codes: A61B 5/021 Measuring pressure in heart or blood vessels A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/026 Measuring blood flow A61B3/1233, A61B3/1241 take precedence
• CPC Class Codes: A61B 5/0261 using optical means, e.g. infrared light
• CPC Class Codes: A61B 5/031 Intracranial pressure
• CPC Class Codes: A61B 5/14546 for measuring analytes not otherwise provided for, e.g. ions, cytochromes
• CPC Class Codes: A61B 5/14553 specially adapted for cerebral tissue
• CPC Class Codes: A61B 5/4064 Evaluating the brain A61B5/031, A61B5/369, A61B5/14553 take precedence
• CPC Class Codes: A61B 5/7246 using correlation, e.g. template matching or determination of similarity
• CPC Class Codes: A61B 5/742 using visual displays A61B5/339 takes precedence
• CPC Class Codes: A61B 5/7425 Displaying combinations of multiple images regardless of image source, e.g. displaying a reference anatomical image with a live image geometric transforms for image registration G06T3/14; enhancement using image fusion G06T5/50; algorithms for registration of images G06T7/30
• CPC Class Codes: A61B 5/743 Displaying an image simultaneously with additional graphical information, e.g. symbols, charts, function plots
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems
• CPC Class Codes: G16H 50/30 for calculating health indices; for individual health risk assessment

Abstract

A method for monitoring autoregulation includes, using a processor, using a processor to execute one or more routines on a memory. The one or more routines include receiving one or more physiological signals from a patient, determining a correlation-based measure indicative of the patient'"'"'s autoregulation based on the one or more physiological signals, and generating an autoregulation profile of the patient based on autoregulation index values of the correlation-based measure. The autoregulation profile includes the autoregulation index values sorted into bins corresponding to different blood pressure ranges. The one or more routines also include designating a blood pressure range encompassing one or more of the bins as a blood pressure safe zone indicative of intact regulation and providing a signal to a display to display the autoregulation profile and a first indicator of the blood pressure safe zone.

Claims

1. A monitor for monitoring autoregulation, comprising:

a display;

a memory encoding one or more processor-executable routines; and

a processor configured to access and execute the one or more routines encoded by the memory, wherein the routines, when executed cause the processor to;

receive one or more physiological signals from a patient;

determine a correlation-based measure indicative of the patient'"'"'s autoregulation based on the one or more physiological signals;

generate an autoregulation profile of the patient based on autoregulation index values of the correlation-based measure, wherein the autoregulation profile comprises the autoregulation index values sorted into bins corresponding to different blood pressure ranges;

designate a blood pressure range encompassing one or more of the bins as a blood pressure safe zone indicative of intact autoregulation; and

provide a first signal to the display to display the autoregulation profile and a first indicator of the blood pressure safe zone.

2. The monitor of claim 1, wherein the correlation-based measure is one of a cerebral oximetry index, a hemoglobin volume index, and a mean velocity index.

3. The monitor of claim 1, wherein the one or more routines, when executed cause the processor to receive patient specific inputs, the patient specific input being physical characteristics of the patient, to designate the blood pressure range encompassing one or more of the bins as an initial blood pressure safe zone indicative of intact autoregulation utilizing at least historical population data based on the patient specific inputs, and to provide the first signal to the display to display the first indicator of the initial blood pressure safe zone.

4. The monitor of claim 3, wherein the one or more routines, when executed cause the processor to designate the blood pressure range encompassing one or more of the bins as the initial blood pressure safe zone indicative of intact autoregulation utilizing both historical population data based on the patient specific inputs and initially measured baselines of physiological parameters of the patient.

5. The monitor of claim 3, wherein the one or more routines, when executed cause the processor to determine if there is sufficient data within the autoregulation profile, and if there is sufficient data to subsequently designate the blood pressure range encompassing one or more of the bins as a subsequent patient specific blood pressure safe zone indicative of intact autoregulation utilizing the autoregulation index values and corresponding blood pressure levels, and to provide the first signal to the display to display the first indicator of the subsequent patient specific blood pressure safe zone.

6. The monitor of claim 5, wherein the indicator of the initial blood pressure safe zone comprises a first color and the indicator of the subsequent patient specific blood pressure safe zone comprises a second color different from the first color.

7. The monitor of claim 1, wherein the one or more routines, when executed cause the processor to provide a second signal to the display to display a second indicator of a target blood pressure within the blood pressure safe zone for the patient.

8. The monitor of claim 7, wherein the one or more routines, when executed cause the processor to change a color of the second indicator or change a level of a blip bar displayed on the display based on a distance of a current blood pressure of the patient derived from the target blood pressure.

9. The monitor of claim 7, wherein the one or more routines, when executed cause the processor to receive a user input of the target blood pressure.

10. The monitor of claim 7, wherein the one or more physiological signals comprise a regional oxygen saturation signal and a blood pressure signal, and wherein the one or more routines, when executed cause the processor to generate a curve from the regional oxygen saturation signal and the blood pressure signal, to determine both a lower limit (LLA) and an upper limit (ULA) of autoregulation from the curve, and to determine the target blood pressure based on the curve.

11. The monitor of claim 10, wherein the one or more routines, when executed cause the processor to designate a point equidistant between the LLA and ULA as the target blood pressure.

12. The monitor of claim 10, wherein the one or more routines, when executed cause the processor to determine a first gradient of the curve at a first blood pressure portion of the curve lower than the LLA, to determine a second gradient of the curve at a second blood pressure portion of the curve higher than the ULA, and to utilize the first gradient, the second gradient, or a combination thereof to determine the target blood pressure.

13. The monitor of claim 10, wherein the one or more routines, when executed cause the processor to designate a point of inflection of the curve as the target blood pressure.

14. The monitor of claim 1, wherein the one or more routines, when executed cause the processor to provide a second signal to the display or other output device to provide an audible or visual indication that a current blood pressure of the patient is outside the blood pressure safe zone.

15. The monitor of claim 14, wherein the audible or visual indication comprises a first audible or visual indication that indicates that the current blood pressure is higher than the blood pressure safe zone and a second audible or visual indication that the current blood pressure is lower than the blood pressure safe zone, wherein the first audible or visual indication is different from the second audible or visual indication.

16. The monitor of claim 1, wherein the one or more routines, when executed cause the processor to cause the display to flash the autoregulation profile and the first indicator of the blood pressure safe zone on and off.

17. The monitor of claim 1, wherein the one or more routines, when executed cause the processor to provide the first signal to the display to display a blood pressure history of the patient, wherein the blood pressure history depicts an amount of time blood pressure measurements within the bins are within the blood pressure safe zone.

18. The monitor of claim 17, wherein the first indicator of the blood pressure safe zone overlays a portion of the autoregulation profile corresponding to the blood pressure safe zone.

19. A monitor for monitoring autoregulation, comprising:

a display;

a memory encoding one or more processor-executable routines; and

a processor configured to access and execute the one or more routines encoded by the memory, wherein the routines, when executed cause the processor to;

receive one or more physiological signals from a patient;

determine a correlation-based measure indicative of the patient'"'"'s autoregulation based on the one or more physiological signals;

generate an autoregulation profile of the patient based on autoregulation index values of the correlation-based measure, wherein the autoregulation profile comprises the autoregulation index values sorted into bins corresponding to different blood pressure ranges;

designate a blood pressure range encompassing one or more of the bins as a blood pressure safe zone indicative of intact autoregulation;

provide a first signal to the display to display the autoregulation profile, a first indicator of the blood pressure safe zone, and a second indicator of a target blood pressure within the blood pressure safe zone for the patient; and

provide a second signal to the display or another output device to provide a first visual or audible indication of a current blood pressure of the patient is outside the blood pressure safe zone, to provide a second visual or audible indication of a distance the current blood pressure is from the target blood pressure, or a

combination thereof.

20. A method for monitoring autoregulation, comprising:

utilizing a processor to execute one or more routines encoded on a memory for;

receiving one or more physiological signals from a patient;

determining a correlation-based measure indicative of the patient'"'"'s autoregulation based on the one or more physiological signals;

generating an autoregulation profile of the patient based on autoregulation index values of the correlation-based measure, wherein the autoregulation profile comprises the autoregulation index values sorted into bins corresponding to different blood pressure ranges;

designating a blood pressure range encompassing one or more of the bins as a blood pressure safe zone indicative of intact autoregulation; and

providing a signal to a display to display the autoregulation profile and a first indicator of the blood pressure safe zone.