Method for determining flush interference in measurement of chemical and physical parameters with indwelling probe

• US 5,304,495 A
• Filed: 12/29/1992
• Issued: 04/19/1994
• Est. Priority Date: 12/29/1992
• Status: Expired due to Fees

• Current Assignee: Abbott Laboratories
• Original Assignee: Abbott Laboratories
• Inventors: Yim, Jeffrey B.
• Primary Examiner(s): Warden, Robert J.
• Assistant Examiner(s): Carpenter, Robert
• Application Number:
  US07/997,863
• Time in Patent Office: 476 Days
• Field of Search: 436/11, 436/34, 436/68, 436/147, 436/148, 436/163, 436/181, 422/82.12, 422/82.13, 422/93, 422/83, 422/68.1, 128/633, 128/634, 128/664, 128/665, 128/673, 356/39, 356/41
• US Class Current: 436/68
• CPC Class Codes: A61B 5/14539 for measuring pH
• CPC Class Codes: A61B 5/1455 using optical sensors, e.g. spectral photometrical oximeters

Abstract

A system (10) for in vivo measuring chemical and physical parameters of a patient'"'"'s blood includes a probe (12), a sensing system (14), and flush interference warning devices (20). The system measures pH, pCO₂, and temperature values, and determines a base excess value using the measured pH and pCO₂. The time rate of change of the base excess value is also determined, as is the time rate of change of temperature. The warning devices are activated, indicating that the measured parameters are likely affected by the presence of flush solution flowing past the probe, when either: (a) the base excess value is less than a predefined threshold base excess; (b) the absolute value of the time rate of change of the base excess value is greater than a predefined threshold time rate of change of base excess; or, (c) the absolute value of the time rate of change of temperature is greater than a predefined threshold time rate of change of temperature.

Claims

1. A method for detecting an interference during an in vivo measurement of at least one parameter sensed by an indwelling probe, where the interference is caused by introducing a flush fluid proximate said probe, comprising the steps of:

(a) periodically measuring at least one parameter using the indwelling probe, an accuracy with which said parameter is measured being affected by the flush fluid, wherein the step of measuring at least one parameter comprises measurement of at least a pH and a pCO₂ ;

(b) determining a time rate of change of the measured parameter, wherein the step of determining a time rate of change comprises the step of determining a time rate of change of a base excess value calculated using the measured pH and the measured pCO₂ ;

(c) comparing the time rate of change of the measured parameter with a predefined threshold time rate of change; and

(d) activating a warning device if the time rate of change of the measured parameter exceeds the predefined threshold time rate of change to indicate that the flush fluid has substantially affected the accuracy with which the parameter has been measured.

2. The method of claim 1, wherein:

(a) an absolute value of the time rate of change of the base excess is determined; and

(b) the step of comparing the calculated time rate of change comprises the step of comparing the absolute value of the time rate of change of the base excess to a predefined threshold time rate of change of the base excess.

3. The method of claim 2, further comprising the step of comparing the calculated base excess to a threshold base excess, wherein the step of activating the warning device comprises the step of activating the warning output device if either:

(a) the absolute value of the time rate of change of the base excess exceeds the threshold time rate of change of the base excess;

or

(b) the calculated base excess is less than the threshold base excess.

4. The method of claim 3, further comprising the steps of:

(a) periodically measuring a temperature with the probe;

(b) determining an absolute value of a time rate of change of the measured temperature;

(c) comparing the absolute value of the time rate of change of the measured temperature to a predefined threshold time rate of change of the temperature; and

(d) activating the warning device if either;

(i) the base excess is less than the predefined threshold base excess;

(ii) the absolute value of the time rate of change of the base excess exceeds the predefined threshold time rate of change of the base excess;

or

(iii) the absolute value of the time rate of change of the measured temperature exceeds the predefined threshold time rate of change of temperature.

5. The method of claim 2, further comprising the steps of:

(a) periodically measuring a temperature with the probe;

(b) determining an absolute value of the time rate of change of the measured temperature;

(c) comparing the absolute value of the time rate of change of the measured temperature to a predefined threshold time rate of change of temperature; and

(d) activating the warning device if either;

(i) the absolute value of the time rate of change of the base excess exceeds the predefined threshold time rate of change of the base excess;

or

(ii) the absolute value of the time rate of change of the measured temperature exceeds the predefined threshold time rate of change of temperature.

6. The method of claim 1, wherein:

(a) the step of measuring at least one parameter further comprises the step of measuring a temperature;

(b) the step of determining a time rate of change further comprises the step of determining an absolute value of the time rate of change of the measured temperature;

(c) the step of comparing comprises the step of comparing the absolute value of the time rate of change of the measured temperature with a predefined threshold time rate of change of temperature; and

(d) the warning device is activated if the absolute value of the time rate of change of the measured temperature is greater than the predefined threshold time rate of change of temperature.

7. The method of claim 6, wherein the step of measuring at least one parameter further comprises the step of measuring a pH and a partial pressure of carbon dioxide, further comprising the steps of:

(a) determining a base excess value; and

(b) comparing the base excess value to a predefined threshold base excess value, wherein the step of activating the warning device comprises the step of activating the warning device if either;

(i) the base excess value is less than the predefined threshold base excess;

or

(ii) the absolute value of the time rate of change of the measured temperature exceeds the predefined threshold time rate of change of temperature.

8. A method for detecting an interference during the in vivo measurement of a parameter using an indwelling probe, where said interference is caused by introducing a flush fluid proximate said probe, comprising the steps of:

(a) periodically measuring a pH and a pCO₂ using said probe;

(b) determining a base excess value using the measured pH and measured pCO₂ ;

(c) comparing the base excess value to a predefined threshold base excess; and

(d) activating a warning device if the base excess value is less than the predefined threshold base excess.

9. The method of claim 8, further comprising the steps of:

(a) determining an absolute value of the time rate of change of the base excess value;

(b) comparing the absolute value of the time rate of change of base excess to a predefined threshold time rate of change of base excess; and

(c) activating the warning device if either;

(i) the base excess value is less than the predefined threshold base excess;

or

(ii) the absolute value of the time rate of change of the base excess exceeds the predefined threshold time rate of change of the base excess.

10. The method claim 9, further comprising the steps of:

(a) periodically measuring a temperature with the probe;

(b) determining an absolute value of the time rate of change of the measured temperature;

(c) comparing the absolute value of the time rate of change of the measured temperature to a predefined threshold time rate of change of the temperature; and

(d) activating the warning device if either;

(i) the base excess value is less than the predefined threshold base excess;

(ii) the absolute value of the time rate of change of the base excess exceeds the predefined threshold time rate of change of the base excess;

or

(iii) the absolute value of the time rate of change of the measured temperature excess the predefined threshold time rate of change of temperature.

11. A method for detecting an interference during an in vivo measurement of a parameter using an indwelling probe, where said interference is caused by introducing a flush fluid proximate said probe, comprising the steps of:

(a) periodically measuring a temperature with the probe;

(b) determining an absolute value of the time rate of change of the measured temperature;

(c) comparing the absolute value of the time rate of change of the measured temperature with a predefined threshold time rate of change of temperature; and

(d) activating a warning device if the absolute value of the time rate of change of measured temperature is greater than the predefined threshold time rate of change of temperature.

12. In a system for in vivo monitoring a plurality of parameters of a patient'"'"'s blood, apparatus for providing a warning when a flush fluid interferes with the accuracy with which said plurality of parameters are monitored, comprising:

(a) a probe for sensing a pH and a pCO₂ in the blood, producing a pH signal and a pCO₂ signal that are respectively indicative thereof;

(b) means coupled to the probe to receive the pH and pCO₂ signals, for determining a measured pH and measured pCO₂ in response to said signals, and for determining a base excess value using the measured pH and measured pCO₂ ;

(c) means for comparing the base excess value to a predefined threshold base excess;

(d) a warning device; and

(e) means for activating the warning device if the base excess value is less than the predefined threshold base excess.

13. The system of claim 12, further comprising:

(a) means for determining an absolute value of the time rate of change of the base excess value;

(b) means for comparing the absolute value of the time rate of change of the base excess value to a predefined threshold time rate of change of the base excess; and

(c) the means for activating the warning device do so if either;

(i) the base excess value is less than the predefined threshold base excess;

or

(ii) the absolute value of the time rate of change of the base excess value is greater than the predefined threshold time rate of change of the base excess.

14. The system of claim 13, wherein the probe includes a temperature sensor, further comprising:

(a) means for computing an absolute value of the time rate of change of measured temperature;

(b) means for comparing the absolute value of the time rate of change of measured temperature with a predefined threshold time rate of change of temperature; and

(c) the means for activating the warning device do so if either;

(i) the base excess value is less than the predefined threshold base excess;

(ii) the absolute value of the time rate of change of the base excess value is greater than the predefined threshold time rate of change of the base excess value;

or

(iii) the absolute value of the time rate of change of measured temperature is greater than the predefined threshold time rate of change of temperature.

15. The system of claim 12, wherein the probe further comprises a temperature sensor, further comprising:

(a) means for determining an absolute value of the time rate of change of measured temperature;

(b) means for comparing the absolute value of the time rate of change of measured temperature with a predefined threshold time rate of change of temperature; and

(c) the means for activating the warning device do so if either;

(i) the base excess value is less than the predefined threshold base excess;

or

(ii) the absolute value of the time rate of change of measured temperature is greater than the predefined threshold time rate of change of temperature.

16. A method for detecting an interference during an in vivo measurement of at least one parameter sensed by an indwelling probe, where the interference is caused by introducing a flush fluid proximate said probe, comprising the steps of:

(a) periodically measuring at least one parameter using the indwelling probe, an accuracy with which said parameter is measured being affected by the flush fluid, wherein the step of measuring at least one parameter comprises measurement of a pH;

(b) determining a time rate of change of the measured parameter, wherein the step of determining a time rate of change comprises determining the time rate of change of the measured pH;

(c) comparing the time rate of change of the measured parameter with a predefined threshold time rate of change; and

(d) activating a warning device if the time rate of change of the measured parameter exceeds the predefined threshold time rate of change to indicate that the flush fluid has substantially affected the accuracy with which the parameter has been measured.