Automatic infiltration detection system and method

• US 4,846,792 A
• Filed: 03/08/1988
• Issued: 07/11/1989
• Est. Priority Date: 03/08/1988
• Status: Expired due to Term

• Current Assignee: Baxter Travenol Laboratories Incorporated
• Original Assignee: Baxter International Inc.
• Inventors: Bobo, Donald E. Jr., Seguine, Dennis R., Lapp, Theodore R.
• Primary Examiner(s): Pellegrino, Stephen C.
• Application Number:
  US06/165,619
• Time in Patent Office: 490 Days
• Field of Search: 604/50, 604/65-67, 604/118, 604/245, 604/246, 128/DIG. 12, 128/DIG. 13, 128/748
• US Class Current: 604/505
• CPC Class Codes: A61M 5/16854 by monitoring line pressure
• CPC Class Codes: A61M 5/16859 Evaluation of pressure response, e.g. to an applied pulse
• CPC Class Codes: Y10S 128/13 Infusion monitoring

Abstract

An infusion system for infusing a fluid into a patient comprising an infusion device for delivering the fluid in both a normal delivery pattern and a test pulse and a conduit for conducting the fluid from the infusion device to the patient. The test pulse creates a pressure wave response in the conduit. Abnormal infusion can be detected by determining the area between a baseline and at least a portion of a pressure versus time curve representing the pressure wave response.

Claims

1. An infusion system for infusing a fluid into a patient comprising:

an infusion device for delivering the fluid, said infusion device including means for delivering the fluid in a normal delivery pattern and for delivering a test pulse of the fluid with the test pulse being distinguishable from the normal delivery pattern;

conduit means for conducting the fluid from the infusion device to the patient, said test pulse creating a pressure wave response in the conduit means;

means for determining the area between a baseline and at least a portion of a pressure versus time curve representing the pressure wave response; and

means responsive to the magnitude of said area for detecting if the fluid is being improperly supplied by the conduit means to the patient.

2. An infusion system as defined in claim 1 wherein the pressure wave response has a peak value of pressure and a leading portion and a trailing portion on opposite sides of the peak value and said determining means determines the area from an initial point on the leading portion side of the peak value to a truncation point with the truncation point being on a portion of said curve corresponding to the trailing portion of the pressure wave response.

3. An infusion system as defined in claim 2 wherein said determining means establishes the truncation point as a percent of the peak value.

4. An infusion system as defined in claim 1 including means for establishing the baseline as essentially constant for the determination of said area.

5. An infusion system as defined in claim 1 including means for determining the baseline for use in the determination of said area as a function of the pressure in the conduit means when the test pulse is not present.

6. An infusion system as defined in claim 1 including first means responsive to the pressure of the fluid in the conduit means during the normal delivery pattern to ascertain if pressure conditions in the conduit means are suitable for detecting if fluid is being improperly supplied by the conduit means to the patient.

7. An infusion system as defined in claim 1 including ascertaining if pressure conditions in the conduit means are suitable for detecting if fluid is being improperly supplied by the conduit means to the patient.

8. A method for determining if a fluid is being properly supplied to a patient by an infusion system, said method comprising:

delivering the fluid through conduit means to a patient'"'"'s vascular system in a normal delivery pattern and in a test pulse, with the test pulse being distinguishable from the normal delivery pattern and with the test pulse creating a pressure wave response in the conduit means;

determining the area between a baseline and at least a portion of a pressure versus time curve representing the pressure wave response; and

using the magnitude of said area to detect if the fluid is being improperly supplied by the conduit means to the patient.

9. A method as defined in claim 8 wherein the pressure wave response has a peak value of pressure and a leading portion and a trailing portion on opposite sides of the peak value and said step of determining includes determining the area from an initial point on the leading portion side of the peak value to a truncation point with the truncation point being on a portion of said curve corresponding to the trailing portion of the pressure wave response.

10. A method as defined in claim 9 wherein said step of determining includes determining the truncation point as a percent of the peak value.

11. A method as defined in claim 8 including holding the baseline as essentially constant for the determination of said area.

12. A method as defined in claim 8 including establishing the baseline for use in the determination of said area as a function of the pressure in the conduit means when the test pulse is not present.

13. An apparatus for determining if fluid is being properly supplied through a fluid delivery system to a patient, said apparatus comprising:

means for delivering fluid through the delivery system so as to create a pressure wave response in the delivery system;

means for determing the area between a baseline and at least a portion of a pressure versus time curve representing the pressure wave response; and

means responsive to the magnitude of said area for detecting if the fluid is being improperly supplied by the fluid delivery system to the patient.

14. An apparatus as defined in claim 13 wherein the pressure wave response has a peak value of pressure and a leading portion and a trailing portion on opposite sides of the peak value and said determining means determines the area from an initial point on the leading portion side of the peak value to a truncation point with the truncation point being on a portion of said curve corresponding to the trailing portion of the pressure wave response.

15. An apparatus as defined in claim 14 wherein said truncation point is essentially outside the noise range.

16. An apparatus as defined in claim 14 wherein said truncation point is at a time at which the pressure is no less than about 30 percent of the peak value.

17. An apparatus as defined in claim 14 wherein said truncation point is at a time at which the pressure is no greater than about 70 percent of the peak value.

18. An apparatus as defined in claim 14 wherein said truncation point is at a time at which the pressure is between about 30 percent to about 70 percent of the peak value.

19. An apparatus as defined in claim 14 wherein said truncation point is at a time at which the pressure is about 50 percent of the peak value.

20. An apparatus as defined in claim 14 wherein the initial point is essentially at the beginning of the point on said curve corresponding to the beginning of the pressure wave response.

21. An apparatus as defined in claim 14 including first means responsive to the pressure in the delivery system when the pressure wave response is not present to ascertain if pressure conditions in the delivery system are suitable for detecting if fluid is being improperly supplied by the delivery system to the patient.

22. An apparatus as defined in claim 21 wherein said first means includes means for comparing a function of the pressure of the fluid in the conduit means during the normal delivery pattern to a threshold to ascertain if pressure conditions in the conduit means are suitable for detecting if fluid is being improperly supplied by the conduit means to the patient.

23. An apparatus as defined in claim 13 including means for establishing the baseline as essentially constant for the determination of said area.

24. An apparatus as defined in claim 13 including means for determining the baseline for use in the determination of said area as a function of the pressure in the delivery system when the pressure wave response is not present.

25. An apparatus as defined in claim 24 wherein the truncation point is at a time at which the pressure is between about 30 percent to about 70 percent of the peak value, the initial point is essentially at the beginning of the point on said curve corresponding to the beginning of the pressure wave response and said baseline determining means establishes the baseline as essentially constant for the determination of said area.

26. An apparatus as defined in claim 13 including means for establishing the baseline including means for averaging the pressure in the delivery system during at least a portion of the time that the pressure wave response is not present.

27. An apparatus as defined in claim 13 including means for establishing the baseline including means for sampling the pressure in the delivery system during at least a portion of the time that the pressure wave response is not present to provide a plurality of samples, means for averaging said samples and means for excluding from said average at least the portion of any of said samples which exceeds a threshold.

28. An apparatus as defined in claim 13 wherein said detecting means includes means for normalizing said area and comparing the normalized area to a threshold.

29. An apparatus as defined in claim 13 wherein the pressure wave response has a peak value of pressure and a leading portion and a trailing portion on opposite sides of the peak value and said determining means determines the area from an initial point on the leading portion side of the peak value to about the peak value of pressure.

30. An apparatus as defined in claim 29 wherein the area between the initial point and about the peak value is a front end area and the determining means also determines the truncated area between the initial point and a truncation point with the truncation point being on a portion of said curve corresponding to the trailing portion of the pressure wave response and said detecting means is responsive to said front end area and said truncated area to detect if the fluid is being improperly supplied by the conduit means to the patient.

31. An infusion system for infusing a fluid into a patient comprising:

an infusion device for delivering the fluid, said infusion device including means for delivering the fluid in a normal delivery pattern and for delivering the fluid in an altered pattern, said altered pattern including a test pulse and leading and trailing separating regions on opposite sides of the test pulse each of which provides a different flow rate of fluid than the adjacent portions of the test pulse;

conduit means for conducting the fluid from the infusion device to the patient, said test pulse creating a pressure wave response in the conduit means;

means for establishing a baseline as a function of the pressure in the conduit means when the test pulse is not present;

means for determining the area between said baseline and a pressure versus time curve representing the pressure wave response between about the start of the pressure wave response and a truncation point which occurs after a peak value of the pressure wave response and before the end of the pressure wave response; and

means responsive to the magnitude of said area for detecting if the fluid is being improperly supplied by the conduit means to the patient.

32. An infusion system as defined in claim 31 wherein said determining means establishes the truncation point as a percent of the peak value.

33. An infusion system as defined in claim 32 wherein said determining means establishes the truncation point as the first to occur of said percent of peak value and the end of said trailing valley.

34. An infusion system as defined in claim 33 wherein the baseline establishing means establishes said baseline as substantially constant for the measurement of said area.

35. An infusion system as defined in claim 31 wherein the test pulse provides a greater flow rate of fluid than the normal delivery pattern and the separating regions are valleys each of which provides a lesser flow rate of fluid than said adjacent portions of the test pulse.

36. An infusion system as defined in claim 35 wherein the detecting means includes means for dividing said area by a divisor which is a function of the difference between the flow rate during at least one of the valleys and the test pulse to provide a quotient and means for comparing the quotient to a threshold.

37. An infusion system as defined in claim 31 including first means responsive to the pressure of the fluid in the conduit means during the normal delivery pattern to ascertain if pressure conditions in the conduit means are suitable for detecting if fluid is being improperly supplied by the conduit means to the patient.

38. An infusion system as defined in claim 37 wherein said first means includes means for comparing a function of the pressure of the fluid in the conduit means during the normal delivery pattern to a threshold to ascertain if pressure conditions in the conduit means are suitable for detecting if fluid is being improperly supplied by the conduit means to the patient.

39. An infusion system as defined in claim 38 wherein said function of the pressure equals B1+K(B2) where B1 is the baseline pressure at an instant prior to the test pulse, K is a constant and B2 is the rms value of a plurality of segments of the baseline pressure prior to the test pulse and with at least one of said segments being prior to said instant.

40. An infusion system for infusing a fluid into a patient comprising:

an infusion device for delivering the fluid, said infusion device including means for delivering the fluid in a normal delivery pattern and for delivering a test pulse of the fluid with the test pulse being distinguishable from the normal delivery pattern;

conduit means for conducting the fluid from the infusion device to the patient, said test pulse creating a pressure wave response in the conduit means;

first means responsive to the pressure of the fluid in the conduit means during the normal delivery pattern to ascertain if pressure conditions in the conduit means are suitable for detecting if fluid is being improperly supplied by the conduit means to the patient; and

means responsive to the pressure wave response for detecting if fluid is being improperly supplied by the conduit means to the patient.

41. An infusion system as defined in claim 40 wherein said first means includes means for comparing a function of the pressure of the fluid in the conduit means during the normal delivery pattern to a threshold to ascertain if pressure conditions in the conduit means are suitable for detecting if fluid is being improperly supplied by the conduit means to the patient.

42. An infusion system as defined in claim 41 wherein said function of the pressure equals B1+K(B2) where B1 is the baseline pressure at an instant prior to the test pulse, K is a constant and B2 is the rms value of a plurality of segments of the baseline pressure prior to the test pulse and with at least one of said segments being prior to said instant.

43. An apparatus for determining if fluid is being properly supplied through a fluid delivery system to a patient, said apparatus comprising:

means for delivering fluid through the delivery system so as to create a pressure wave response in the delivery system;

first means responsive to the pressure in the delivery system when the pressure wave response is not present to ascertain if pressure conditions in the delivery system are suitable for detecting if fluid is being improperly supplied by the delivery system to the patient; and

means responsive to the pressure wave response for detecting if fluid is being improperly supplied by the delivery system to the patient.

44. An apparatus as defined in claim 43 wherein said first means includes means for comparing a function of the pressure of the fluid in the delivery system during the normal delivery pattern to a threshold to ascertain if pressure conditions in the delivery system are suitable for detecting if fluid is being improperly supplied by the delivery system to the patient.

45. An apparatus as defined in claim 44 wherein said function of the pressure equals B1+K(B2) where B1 is the baseline pressure at an instant prior to the test pulse, K is a constant and B2 is the rms value of a plurality of segments of the baseline pressure prior to the test pulse and with at least one of said segments being prior to said instant.