Surgical fluid and tissue loss monitor

• US 5,709,670 A
• Filed: 05/13/1996
• Issued: 01/20/1998
• Est. Priority Date: 05/03/1994
• Status: Expired due to Fees

• Current Assignee: Thierry G. Vancaillie
• Original Assignee: Aquintel, Inc.
• Inventors: Newton, David W., Vancaillie, Thierry G., Mitchiner, Robert K.
• Primary Examiner(s): Buiz, Michael
• Assistant Examiner(s): Mehta, Bhisma
• Application Number:
  US08/645,349
• Time in Patent Office: 617 Days
• Field of Search: 604/65-67, 604/4, 604/31, 604/246, 128/760, 128/766
• US Class Current: 604/246
• CPC Class Codes: A61B 5/02042 Determining blood loss or bleeding, e.g. during a surgical procedure
• CPC Class Codes: A61M 1/77 Suction-irrigation systems aspiration tips supplying fluids A61M1/85; specific for negative pressure wound therapy A61M1/92; combined with tracheal tubes A61M16/0463
• CPC Class Codes: A61M 1/777 Determination of loss or gain of body fluids due to suction-irrigation, e.g. during surgery
• CPC Class Codes: A61M 2205/3306 Optical measuring means
• CPC Class Codes: A61M 2205/3393 by weighing the reservoir
• CPC Class Codes: A61M 2205/50 with microprocessors or computers
• CPC Class Codes: A61M 2205/502 User interfaces, e.g. screens or keyboards
• CPC Class Codes: A61M 2205/8206 battery-operated
• CPC Class Codes: A61M 2209/082 Mounting brackets, arm supports for equipment
• CPC Class Codes: A61M 2209/084 Supporting bases, stands for equipment
• CPC Class Codes: A61M 3/0204 Physical characteristics of the irrigation fluid, e.g. conductivity or turbidity
• CPC Class Codes: A61M 3/0212 after use
• CPC Class Codes: A61M 3/022 Volume; Flow rate
• CPC Class Codes: A61M 3/0233 characterised by liquid supply means, e.g. from pressurised reservoirs
• CPC Class Codes: A61M 3/0283 with at least two inner passageways, a first one for irrigating and a second for evacuating suction-irrigation systems A61M1/77; aspiration tips with fluid supply means A61M1/85; for negative pressure wound therapy A61M1/92
• CPC Class Codes: A61M 3/0287 with an external liquid collector
• CPC Class Codes: A61M 5/16895 by monitoring weight change, e.g. of infusion container
• CPC Class Codes: G01G 17/04 for weighing fluids, e.g. gases, pastes
• CPC Class Codes: G01G 19/00 Weighing apparatus or methods adapted for special purposes not provided for in the preceding groups electric measuring arrangements involving comparison with a reference value G01R17/00

Abstract

A monitor to provide substantially real-time estimates of fluid absorption rate and tissue loss rate in a patient during a surgical procedure. The monitor estimates fluid source flow rates and waste fluid flow rates based on weight changes per unit time or direct reading fluid flow rate meters. Tissue loss flow rates are estimated based on tissue concentration measurable in waste irrigation fluid using an optical comparator, and are used to correct waste fluid flow rates. Correct waste fluid flow rates are used in turn to obtain estimated fluid absorption rates.

Claims

1. A surgical fluid and blood loss monitor, comprising at least one weight-sensitive fluid source support for simultaneously suspending and weighing a fluid source and producing a signal indicative of fluid source weight;

at least one weight-sensitive waste fluid collector support for simultaneously suspending and weighing a waste fluid collector and producing a signal indicative of waste fluid collector weight;

hemoglobin concentration estimation means, comprising

an optical comparator that has a light source,

adjustable diffuser means proximate said light source and intercepting at least a portion of light from said light source to produce variably scattered light emanating from said adjustable diffuser means,

at least two comparator fluid chambers positioned to intercept at least a portion of said variably scattered light to produce output light emanating from each of said comparator fluid chambers,

a detector comprising a plurality of light receptors, at least a portion of output light emanating from each of said comparator fluid chambers impinging on a light receptor corresponding to each of said comparator fluid chambers, and each said corresponding light receptor producing a signal substantially proportional to a parameter of said intercepted portion of output light impinging on said receptor, and

comparing means for comparing each said light receptor signal to at least one other said light receptor signal to produce a comparator signal,

said hemoglobin concentration estimation means for estimating hemoglobin concentration in waste fluid and for producing a signal indicative of estimated hemoglobin concentration in waste fluid;

computing means coupled to said fluid source weight signal, to said waste fluid collector weight signal, and to said hemoglobin concentration signal for calculating an estimated fluid source flow rate, an estimated waste fluid flow rate, an estimated blood loss flow rate, a corrected waste fluid flow rate equal to said estimated waste fluid flow rate minus said estimated blood loss flow rate, and an estimated fluid absorption rate equal to said estimated fluid source flow rate minus said corrected waste fluid flow rate, and for producing first and second display signals indicative of said estimated fluid absorption rate and said estimated blood loss flow rate respectively; and

display means coupled to said computing means for transducing for human observation said fluid absorption rate display signal and said blood loss flow rate display signal.

3. The surgical monitor of claim 1 or 2 wherein each said at least one weight-sensitive fluid source support and each said at least one weight-sensitive waste fluid collector support comprise at least one solid-state load cell.

4. The surgical monitor of claim 1 or 2 additionally comprising integration means within said computing means for estimating absorbed fluid volume, said computing means additionally producing a display signal indicative of said absorbed fluid volume, and said display means additionally transducing for human observation said absorbed fluid volume display signal.

5. The surgical fluid and blood loss monitor of claim 1 additionally comprising integration means within said computing means for estimating blood loss volume, said computing means additionally producing a display signal indicative of said blood loss volume, and said display means additionally transducing for human observation said blood loss volume display signal.

2. A surgical fluid and fat loss monitor, comprising

at least one weight-sensitive fluid source support for simultaneously suspending and weighing a fluid source and producing a signal indicative of fluid source weight;

at least one weight-sensitive waste fluid collector support for simultaneously suspending and weighing a waste fluid collector and producing a signal indicative of waste fluid collector weight;

concentration estimation means for fat, comprising

an optical comparator that has a light source,

adjustable diffuser means proximate said light source and intercepting at least a portion of light from said light source to produce variably scattered light emanating from said adjustable diffuser means,

at least two comparator fluid chambers positioned to intercept at least a portion of said variably scattered light to produce output light emanating from each of said comparator fluid chambers,

a detector comprising a plurality of light receptors, at least a portion of output light emanating from each of said comparator fluid chambers impinging on a light receptor corresponding to each of said comparator fluid chambers, and each said corresponding light receptor producing a signal substantially proportional to a parameter of said intercepted portion of output light impinging on said receptor, and

comparing means for comparing each said light receptor signal to at least one other said light receptor signal to produce a comparator signal,

said fat concentration estimation means for estimating fat concentration in waste fluid and for producing a signal indicative of estimated fat concentration in waste fluid;

computing means coupled to said fluid source weight signal, to said waste fluid collector weight signal, and to said fat concentration signal for calculating an estimated fluid source flow rate, an estimated waste fluid flow rate, an estimated fat loss rate, a corrected waste fluid flow rate equal to said estimated waste fluid flow rate minus said estimated fat loss rate, and an estimated fluid absorption rate equal to said estimated fluid source flow rate minus said corrected waste fluid flow rate, and for producing first and second display signals indicative of said estimated fluid absorption rate and said estimated fat loss flow rate respectively; and

display means coupled to said computing means for transducing for human observation said fluid absorption rate display signal and said fat loss flow rate display signal.

6. A surgical fluid monitor, comprising

at least one fluid source comprising a direct-reading fluid flow rate meter and producing a signal indicative of fluid source flow rate;

at least one waste fluid collector comprising a direct-reading fluid flow rate meter and producing a signal indicative of waste fluid flow rate;

hemoglobin concentration estimation means, comprising

an optical comparator that has a light source,

adjustable diffuser means proximate said light source and intercepting at least a portion of light from said light source to produce variably scattered light emanating from said adjustable diffuser means,

at least two comparator fluid chambers positioned to intercept at least a portion of said variably scattered light to produce output light emanating from each of said comparator fluid chambers,

a detector comprising a plurality of light receptors, at least a portion of output light emanating from each of said comparator fluid chambers impinging on a light receptor corresponding to each of said comparator fluid chambers, and each said corresponding light receptor producing a signal substantially proportional to a parameter of said intercepted portion of output light impinging on said receptor, and

comparing means for comparing each said light receptor signal to at least one other said light receptor signal to produce a comparator signal,

said hemoglobin concentration estimation means for estimating hemoglobin concentration in waste fluid and for producing a signal indicative of estimated hemoglobin concentration in waste fluid;

computing means coupled to said fluid source flow rate signal, to said waste fluid flow rate signal, and to said hemoglobin concentration signal for calculating an estimated blood loss flow rate, a corrected waste fluid flow rate equal to said waste fluid flow rate minus said blood loss flow rate, and an estimated fluid absorption rate equal to said fluid source flow rate minus said corrected waste fluid flow rate, and for producing a display signal indicative of said estimated fluid absorption rate and a display signal indicative of said estimated blood loss flow rate; and

display means coupled to said computing means for transducing for human observation said fluid absorption rate display signal and said blood loss flow rate display signal.

8. The surgical fluid monitor of claim 6 or 7 additionally comprising integration means within said computing means for estimating absorbed fluid volume, said computing means additionally producing a display signal indicative of said absorbed fluid volume, and said display means additionally transducing for human observation said absorbed fluid volume display signal.

9. The surgical fluid monitor of claim 6 additionally comprising integration means within said computing means for estimating blood loss volume, said computing means additionally producing a display signal indicative of said blood loss volume, and said display means additionally transducing for human observation said blood loss volume display signal.

7. A surgical fluid monitor, comprising

at least one fluid source comprising a direct-reading fluid flow rate meter and producing a signal indicative of fluid source flow rate;

at least one waste fluid collector comprising a direct-reading fluid flow rate meter and producing a signal indicative of waste fluid flow rate;

concentration estimation means for fat, comprising

an optical comparator that has a light source,

adjustable diffuser means proximate said light source and intercepting at least a portion of light from said light source to produce variably scattered light emanating from said adjustable diffuser means,

at least two comparator fluid chambers positioned to intercept at least a portion of said variably scattered light to produce output light emanating from each of said comparator fluid chambers,

a detector comprising a plurality of light receptors, at least a portion of output light emanating from each of said comparator fluid chambers impinging on a light receptor corresponding to each of said comparator fluid chambers, and each said corresponding light receptor producing a signal substantially proportional to a parameter of said intercepted portion of output light impinging on said receptor, and

comparing means for comparing each said light receptor signal to at least one other said light receptor signal to produce a comparator signal,

said fat concentration estimation means for estimating fat concentration in waste fluid and for producing a signal indicative of estimated fat concentration in waste fluid;

computing means coupled to said fluid source flow rate signal, to said waste fluid flow rate signal, and to said fat concentration signal for calculating an estimated fat loss rate, an corrected waste fluid flow rate equal to said waste fluid flow rate minus said estimated fat loss rate, and an estimated fluid absorption rate equal to said fluid source flow rate minus said corrected waste fluid flow rate, and for producing first and second display signals indicative of said estimated fluid absorption rate and said estimated fat loss rate respectively; and

display means coupled to said computing means for transducing for human observation said fluid absorption rate display signal and said fat loss rate display signal.