Vibrotactile stimulator system for detecting and interrupting apnea in infants

• US 5,555,891 A
• Filed: 04/17/1995
• Issued: 09/17/1996
• Est. Priority Date: 05/20/1994
• Status: Expired due to Term

• Current Assignee: Hartford Hospital
• Original Assignee: Hartford Hospital
• Inventors: Eisenfeld, Leonard I.
• Primary Examiner(s): Rimell, Sam
• Application Number:
  US08/424,590
• Time in Patent Office: 519 Days
• Field of Search: 128/721, 128/722, 128/774, 128/782, 128/723, 340/573
• US Class Current: 600/534
• CPC Class Codes: A61B 5/0809 by impedance pneumography
• CPC Class Codes: A61B 5/1135 by monitoring thoracic expansion
• CPC Class Codes: A61B 5/4818 Sleep apnoea
• CPC Class Codes: A61B 5/486 Bio-feedback A61B5/375 takes precedence

Abstract

A vibrotactile stimulator system for detecting and interrupting apnea in premature neonates comprises a multi-sensing monitor for detecting the respiration and other physiological characteristics of the neonate, a vibrotactile sensory stimulator in contact with an extremity of the neonate and a computer interface functionally positioned between the monitor and the vibrotactile stimulator. The interface provides a comparison of the monitored data to preprogrammed individualized standards to determine variations from the standard and provides an intervention output signal to the vibrator. The stimulator includes a cutaneous vibrator engaging a peripheral sensory area of the neonate and being operable at a frequency up to about 400 Hz, but optimally about 260 Hz, to stimulate the neonate and interrupt an apneic episode. The system can include time-delayed, backup, audible and/or visual alarms as well as a graphic display with a pre-apneic printout and cribside or remote manual actuation capability.

Claims

1. A vibrotactile stimulator system for detecting and interrupting apnea in infants comprising

(1) a multi-sensing monitor for sensing a plurality of physiological functions including means for detecting the respiratory rate of the infant and signal output means for reporting signals from said detecting means;

(2) a vibrotactile sensory stimulator including a cutaneous vibrator for engaging a peripheral sensory area on the infant, said vibrator being cyclically operable at a frequency above about 150 Hz to stimulate the infant and interrupt the apneic episode; and

(3) a control interface between the multi-sensing monitor and the stimulator for comparing the reported signals from the monitor for each physiological function with a preprogrammed standard to determine variations from the standard, said interface including means for integrating the variations for different functions and assessing a combination of said variations to indicate an apneic condition in the infant and means for triggering a timing means for delaying the transmission of a stimulator actuation until the apneic condition has persisted for a selected period, said interface including intervention output means for signaling actuation of the vibrotactile stimulator.

2. The vibrotactile stimulator system of claim 1 wherein the vibrotactile stimulator includes means for selecting vibrator operating parameters, said selector means being responsive to said control interface to provide manual or automatic selection of the operating parameters.

3. The vibrotactile stimulator system of claim 1 wherein said vibrator operates at a frequency in a range up to 400 Hz.

4. The vibrotactile stimulator system of claim 3 wherein said vibrator frequency sweeps rapidly through said range.

5. The vibrotactile stimulator system of claim 1 wherein the vibrotactile stimulator includes amplifier means for amplifying the input signal to the vibrator.

6. The vibrotactile stimulator system of claim 1 wherein the vibrotactile stimulator includes means for selecting vibrator operating parameters of intensity, frequency and periodicity, and the control interface includes input selection means for selecting individualized and preprogrammed standards.

7. The vibrotactile stimulator system of claim 1 wherein the control interface includes means for selecting standards for the functions being monitored, means for recognizing the variations from the standard, and means for determining the duration of the variations from the standard to initiate activation of the intervention output means.

8. The vibrotactile stimulator system of claim 1 wherein the control interface includes input selection means for controlling the operating of the interface, said input selection means providing for the selection of individualized and preprogrammed standards, means for recognizing the variations from the standard to initiate activation of the intervention output means.

9. The vibrotactile stimulator system of claim 1 wherein the control interface includes input selection means for controlling the operating of the interface to initiate activation of the intervention output means and memory pickup means responsive to a signal from the intervention output means to actuate an event display incorporating the reporting signals from the monitor for a period prior to initiation of the intervention output.

10. The vibrotactile stimulator system of claim 1 including a manual actuator for actuating the vibrotactile stimulator.

11. The vibrotactile stimulator system of claim 10 wherein the manual actuator includes a remote control unit.

12. The vibrotactile stimulator system of claim 1 wherein the monitor includes means for selecting the detecting means being monitored and display means for displaying the reporting signals.

13. The vibrotactile stimulator system of claim 1 wherein the monitor includes means for detecting oxygen saturation.

14. The vibrotactile stimulator system of claim 1 wherein the monitor includes means for detecting nasal air flow.

15. The vibrotactile stimulator system of claim 1 wherein the monitor includes means for selecting the detecting means being monitored and displaying the reporting signals;

the vibrotactile stimulator includes means for selecting vibrator operating parameters and the control interface includes input selection means for controlling the operating of the interface, said input selection means providing for the selection of individualized and preprogrammed standards.

16. The vibrotactile stimulator system of claim 1 wherein the monitor includes means for detecting oxygen saturation and display means for displaying the reporting signals;

and the vibrotactile stimulator includes means for selecting vibrator operating parameters, including intensity, frequency and periodicity, and amplifier means for amplifying the input signal to the vibrator, said selector means being controlled by said control interface to provide manual or automatic selection of the operating parameters.

17. A method for the detection and vibrotactile interruption of apnea in infants comprising the steps of

(1) monitoring at least the heart rate and respiratory rate functions of the infant;

(2) applying to the infant a vibrotactile sensory stimulator including a cutaneous vibrator for engaging a peripheral sensory area on the infant, said vibrator being operable at a frequency above about 150 Hz to stimulate the infant and interrupt the apneic episode;

(3) providing a control interface between the monitor and the stimulator for comparing signals from the monitor with a preprogrammed standard to determine variations from the standard, the interface including an intervention decisions mode for integrating the variations for different functions and assessing a combination of said variations to indicate an apneic condition in the infant and delaying transmission of a stimulator activation signal by actuation of a timer until the apneic condition has persisted for a selected period; and

(4) actuating the cutaneous vibrator in response to the detection of an apneic condition to stimulate the infant and interrupt the apneic condition.

18. The method of claim 17 including the steps of monitoring the infant'"'"'s oxygen saturation level, selecting the standards for the functions being monitored, recognizing the variations from the standard, and determining the duration of the variations from the standard to initiate activation of the vibrator.

19. The method of claim 17 wherein said vibrator operates at a frequency in a range up to 400 Hz.

20. The method of claim 17 including the step of monitoring nasal air flow.

21. The method of claim 17 including the step of displaying the monitored signals on a recording media for a period extending back to prior to onset of the apneic condition.

22. A multi-sensing system for detecting apnea in infants while obviating false apneic signals comprising

(1) a multi-sensing monitor for sensing a plurality of physiological functions including means for detecting the respiratory rate of the infant and signal output means for reporting signals from said detecting means;

(2) intervention output means for signaling an apneic condition; and

(3) a control interface between the multi-sensing monitor and the intervention output means for comparing the reported signals from the monitor for each physiological function with a preprogrammed standard to determine variations from the standard, said interface including means for integrating the variations for different functions and assessing a combination of said variations to indicate an apneic condition in the infant and means for triggering a timing means for delaying the transmission of an intervention actuation until the apneic period has persisted for a selected period, said interface including means for activating said intervention output means.

23. The multi-sensing system of claim 22 wherein the control interface includes means for selecting standards for the functions being monitored, means for recognizing the variations from the standard, and means for determining the duration of the variations from the standard to initiate activation of the intervention output means.

24. The multi-sensing system of claim 22 wherein the control interface includes input selection means for controlling the operating of the interface, said input selection means providing for the selection of individualized and default standards, means for recognizing the variations from the standard to initiate activation of the intervention output means.

25. The multi-sensing system of claim 22 wherein the control interface includes input selection means for controlling the operating of the interface to initiate activation of the intervention output means and memory pickup means responsive to a signal from the intervention output means to actuate an event display incorporating the reporting signals from the monitor for a period prior to initiation of the intervention output.

26. The multi-sensing system of claim 22 wherein the monitor includes means for detecting oxygen saturation.

27. The multi-sensing system of claim 22 wherein the monitor includes means for detecting nasal air flow.

28. The multi-sensing system of claim 22 wherein the intervention output means for signaling an apneic condition includes a sensory alerting signal.