Infusion pump controller

• US 4,392,849 A
• Filed: 07/27/1981
• Issued: 07/12/1983
• Est. Priority Date: 07/27/1981
• Status: Expired due to Term

• Current Assignee: Cleveland Clinic Foundation
• Original Assignee: Cleveland Clinic Foundation
• Inventors: Cosgrove, Delos M., Petre, John H.
• Primary Examiner(s): Apley, Richard J.
• Assistant Examiner(s): Yanulis, George
• Application Number:
  US06/287,516
• Time in Patent Office: 715 Days
• Field of Search: 128/213 R, 128/630, 128/670, 128/905, 128/272, 128/260, 128/DIG. 13, 364/415, 364/416, 604/50, 604/65, 604/66, 604/67, 604/245
• US Class Current: 604/66
• CPC Class Codes: A61M 5/1723 using feedback of body parameters, e.g. blood-sugar, pressure measurement of body parameters A61B5/00

Abstract

A closed loop medication introduction system controls the rate at which medication is introduced into a patient in response to a monitored physiological condition. The system includes a monitor for monitoring the level or magnitude of the physiological condition and an infusion pump for introducing medication for controlling the selected physiological condition into the patient at a variably controllable rate. A controller controls the infusion pump in response to monitored changes in the physiological condition of the patient. A display means displays various information about the monitored physiological condition and the introduction of medication into the patient. The controller produces a rate control signal for controlling the infusion pump in response to signals from the monitor. After an increase in the medication introduction rate, the controller blocks subsequent increases until a sufficient time has passed for the patient to respond to the increase in the amount of medication. If during this time the patient'"'"'s blood pressure stabilizes, the controller increases the time allowed for the patient to respond to the increased amount of medication. If during this time the patient'"'"'s blood pressure increases still further, the controller makes a small, interim rate increase. If the patient'"'"'s blood pressure decreases below the preselected level, the controller decreases the medication introduction rate.

Claims

1. A medication introduction rate control system comprising:

a blood pressure monitor for monitoring a patient'"'"'s blood pressure;

an analog to digital converter operatively connected with the monitor for producing digital monitor signals which are indicative of the patient'"'"'s blood pressure;

a computer means for deriving from the monitor signals a rate control signal which indicates a rate of medication introduction, the computer means being operatively connected with the analog to digital converter the computer means including;

comparing means for comparing the monitor signals with a preselected blood pressure level;

rate of change means for periodically determining a rate of change of the monitor signals; and

incremental rate selection means for adjusting the rate control signal in preselected increments which preselected increments are independent of a magnitude of a difference between the monitor signals and the preselected blood pressure level, the incremental rate selection means being operatively connected with the comparing means and the rate of change means, whereby the rate control signal is adjusted incrementally in response to the monitor signal and the preselected blood pressure level comparison and in response to the periodic rate of change determination;

a latch means for temporarily storing the rate control signal, the latch means being operatively connected with the computer means.

2. The control system as set forth in claim 1 wherein the computer means is programmed to derive the rate control signal with the steps of:

(a) comparing the monitor signals with the preselected blood pressure level;

(b) if a monitor signal is above the preselected level, determining whether the monitor signals are increasing or decreasing;

(c) if the monitor signals are increasing in step (b), increasing the rate control signal;

(d) after determining whether the monitor signals are increasing or decreasing in step (b), incrementing a response interval count;

(e) comparing the response interval count with a predetermined interval count;

(f) if the response interval count is equal to or greater than the predetermined interval count, increasing the rate control signal;

(g) if the response interval count is less than the predetermined interval count, and after step (f), returning to step (a);

(h) if in step (a) the monitor signal is less than the preselected blood pressure level, determining whether the monitor signals are increasing or decreasing;

(i) if the monitor signals are decreasing in step (h), decreasing the rate control signal;

(j) if the monitor signals are increasing in step (h) and after step (j), returning to step (a).

3. The control system as set forth in claim 1 further including an infusion pump for introducing blood pressure controllng medication into the patient, the infusion pump being operatively connected with said latch means.

4. A closed loop, medication introduction control system for controlling the rate at which a medication is introduced into a patient responsive to changes in a physiological condition of the patient, the system comprising:

a monitor for monitoring the level of the physiological condition, the monitor producing a monitor signal which varies with the changes in the monitored physiological condition level;

means for introducing medication into the patient at a controllable medication introduction rate;

rate controlling means for variably controlling the medication introduction rate, the rate controlling means including incremental rate selection means for increasing the medication introduction rate in preselected increments, the preselected increments being independent of a difference between the monitored physiological condition level and a preselected level of the physiological condition, whereby overmedication in response to a large difference between the monitored and preselected physiological condition levels is inhibited, the rate controlling means being operatively connected with the medication introducing means;

comparator means for comparing the monitor signal with the preselected level of said physiological condition, said comparator means having a first comparator output which is operatively connected with said incremental rate selection means for incrementally increasing the medication introduction rate in the preselected increments when the monitor signal exceeds the preselected level and a second comparator output which is operatively connected with said rate controlling means for decreasing the medication introduction rate when the preselected level exceeds the monitor signal;

limiting means operatively connected with the first comparator output and the rate controlling means for variably adjusting the time between successive medication introduction rate increases to a preselected minimum interval; and

,

rate of change means for determining the rate of change of the monitor signals, the rate of change means producing a first rate of change output when the monitor signals are increasing and a second rate of change output when the monitor signals are decreasing, the rate of change means being operatively connected with the rate controlling means for adjusting the medication introduction rate in response to the determined rate of change.

5. The system as set forth in claim 4 wherein said introducing means is an infusion pump.

6. The system as set forth in claim 5 wherein said monitor is a blood pressure monitor for monitoring the patient'"'"'s blood pressure level whereby the physiological condition is the patient'"'"'s blood pressure.

7. The system as set forth in claim 4 wherein the first rate of change means output is operatively connected with the incremental rate selection means for increasing the medication introduction rate in the preselected intervals and wherein the second rate of change output is operatively connected with said limiting means for lengthening said preselected minimum interval.

8. The system as set forth in claim 7 wherein said rate of change means includes temporary storage means for storing a preceding monitor signal and a comparing means for comparing the precedingly monitor signal with a currently monitor signal to determine whether the monitor signal is increasing or decreasing.

9. The system as set forth in claim 8 wherein the rate of change means further includes means for averaging a plurality of monitor signals, the temporary storage means being operatively connected with the averaging means for storing the averaged monitor signal for comparison with a subsequent averaged monitor signal and wherein said comparing means is operatively connected with the averaging means as well as the temporary storage means, whereby the rate of change is determined from an averaged plurality of monitor signals and a preceding averaged plurality of monitor signals.

10. The system as set forth in claim 7 further including difference means for determining the difference between the monitor signal and preselected level, the difference means being enabled by the second comparator output, a decrement rate selection means for selecting an amount of decrease in the medication introduction rate, the decrement rate selection means being operatively connected with said difference means and with said rate controlling means, whereby when the monitor signal is below the preselected level, the medication introduction rate is decreased by an amount corresponding to the difference between the monitor signal and preselected level.

11. The system as set forth in claim 10 further including a second rate of change means for enabling the difference means when the monitor signals are decreasing and for disabling the difference means when the monitor signals are increasing, the second rate of change means being operatively connected with the second comparator output.

12. The system as set forth in claim 7 further including rate decreasing means for causing the rate controlling means to decrease the controlled medication introduction rate when the preselected level exceeds the monitor signal, the rate decresing means being operatively connected with the second comparator output.

13. The system as set forth in claim 12 wherein the rate controlling means further includes an up-down counter means, the output of the counter means indicating the controlled medication introduction rate.

14. The system as set forth in claim 7 further including a monitor signal averaging means for averaging a plurality of monitor signals, the monitor signal averaging means being operatively connected with the monitor and the comparator means.

15. The system as set forth in claim 14 further including an analog to digital conversion means operatively connected with the monitor for converting the monitor signals from analog to digital.

16. A medication introduction control system comprising:

an analog to digital converter which is adapted to convert sampled analog signals from a physiological condition monitor to digital monitor signals;

averaging means for averaging a plurality of the digital monitor signals, the averaging means being operatively connected with analog to digital converter;

comparator means for comparing the averaged digital monitor signals with a preselected level, said comparator means having a first comparator output which indicates that an averaged digital monitor signal is above the preselected level and a second comparator output which indicates that the averaged digital monitor signal is below the preselected level, the comparator means being operatively connected with the averaging means;

rate increasing means for increasing the rate of medication introduction, the rate increasing means being operatively connected said first comparator output for increasing the rate by a first amount in response thereto;

rate controlling means for producing a rate signal which is adapted to control the rate of an infusion pump, the rate controlling means being operatively connected with the rate increasing means, whereby the rate signal is increased when the averaged digital monitor signal is above the preselected level;

limiting means operatively connected with the first comparator output and the rate increasing means for variably adjusting the time duration between successive increases to a preselected minimum time interval;

rate of change means for determining the rate of change of the averaged digital monitor signals, the rate of change means having a first rate of change output which indicates that the averaged digital monitor signals are increasing and a second rate of change output which indicates that the averaged digital monitor signals are decreasing, the rate of change means being operatively connected with the averaging means, the first rate of change output being operatively connected with the rate increasing means for increasing the rate by a second amount, the second rate of change output being operatively connected with the limiting means for increasing said preselected minimum time interval; and

,

rate decreasing means for decreasing the rate of medication introduction, the rate decreasing means being operatively connected with the comparator second output and with the rate controlling means whereby the rate signal is decreased when the averaged digital monitor signal is below the preselected level.

17. A method of controlling a rate at which a medication is introduced into a patient responsive to changes in a physiological condition of the patient, the method comprising:

(A) introducing the medication into the patient substantially continuously at a controllable medication rate;

(B) monitoring the physiological condition as the medication is introduced into the patient and producing a monitor signal which indicate a monitored level of the physiological condition;

(C) comparing the monitor signal with a preselected level of the physiological condition to determine whether the monitored level exceeds the preselected level;

(1) if the monitored level fails to exceed the preselected level;

(a) determining whether the monitored level is decreasing;

(i) if the monitored condition is decreasing, decreasing the medication rate and returning to step B;

(ii) if the monitored condition is not decreasing, returning to step B;

(2) if the monitored levels exceeds the preselected level;

(a) increasing the medication rate by a preselected first incremental amount, which first incremental amount is independent of the magnitude of a difference between the monitored level and the predetermined level, whereby increases in the medication rate are independent from the magnitude by which the monitored level exceeds the predetermined level; and

,

(b) determining whether the monitored level is increasing;

(i) if the monitored levels is increasing, further increasing the medication rate by a second incremental amount and returning to step B;

(ii) if the monitored levels is not increasing, returning to step B.

18. The method as set forth in claim 17 wherein the monitoring step (B) includes averaging a predetermined plurality of monitor signals such that in step (C) an averaged monitor signal is compared with the preselected level.

19. The method as set forth in claim 18 further including after step (C)(2)(b)(ii), the step of decreasing a time interval between step (C) comparisons.