Method and apparatus for coordinating an event to desired points in one or more physiological cycles

• US 6,597,939 B1
• Filed: 05/20/1998
• Issued: 07/22/2003
• Est. Priority Date: 02/20/1998
• Status: Expired due to Fees

• Current Assignee: University of Florida (State University System of Florida)
• Original Assignee: University of Florida (State University System of Florida)
• Inventors: Lampotang, Samsun, Langevin, Paul B.
• Primary Examiner(s): Smith, Ruth S.
• Application Number:
  US09/081,725
• Time in Patent Office: 1,889 Days
• Field of Search: 600/411, 600/413, 600/427, 600/428, 600/529, 600/534, 600/538, 600/539, 128/200.24, 128/202.13, 128/202.16, 378/95, 378/98, 378/117, 378/147, 601/2-6
• US Class Current: 600/427
• CPC Class Codes: A61B 5/7285 for synchronising or triggering a physiological measurement or image acquisition with a physiological event or waveform, e.g. an ECG signal A61B6/5205, A61B6/541, A61B8/5207, A61B8/543 take precedence
• CPC Class Codes: A61B 6/507 for determination of haemodynamic parameters, e.g. perfusion CT
• CPC Class Codes: A61B 6/541 involving acquisition triggered by a physiological signal
• CPC Class Codes: A61N 5/1037 taking into account the movement of the target, e.g. 4D-image based planning
• CPC Class Codes: A61N 5/1064 for adjusting radiation treatment in response to monitoring

Abstract

The subject invention pertains to a novel method and apparatus for improving the efficacy of a medical treatment or diagnostic procedure by coordinating such treatment or procedure with at least one physiological cycle of a patient. In a specific embodiment, the subject invention pertains to a novel method of coordinating a chest x-ray with a patient'"'"'s ventilatory cycle. In a specific example, this invention concerns a novel device for interfacing a ventilator and an x-ray machine to ensure that an x-ray chest image can be taken at peak insufflation of the patient. The subject invention also relates to other medical procedures including, but not limited to, cardiac output measurement, chest imaging, inhalation therapy, oxygen delivery, blood pressure measurement, extracorporel shock wave lithotripsy, and pulse oximeter optoplethysmograms. By coordinating certain medical treatments and diagnostic procedures with a patient'"'"'s physiological cycle(s), the subject invention improves the quality of medical care received by the patient.

Claims

1. A device for improving the efficacy of the taking of a chest image, comprising:

a means for receiving a signal from a ventilator, wherein said signal carries information relating to the ventilation of the patient with a sigh breath;

a means for effecting the taking of a chest image with respect to the patient, wherein said device improves the efficacy of the taking of a chest image by coordinating the taking of a chest image with the delivery of a sigh breath to the patient; and

a means for causing the ventilator to ventilate the patient with a sigh breath, wherein said means for effecting the taking of a chest image effects the taking of a chest image when the signal indicates the patient is ventilated with a sigh breath such that a chest image of the patient is taken at peak lung inflation.

2. A device for improving the efficacy of the taking of an image, comprising:

a means for receiving a signal, wherein said signal carries information relating to a patient'"'"'s breathing cycle,

a means for effecting the taking of an image with respect to the patient,

wherein said device improves the efficacy of the taking of an image by coordinating the taking of an image to the patient'"'"'s breathing cycle wherein said device can determine at least one point in the breathing cycle of the patient based on the information carried by said signal, wherein said means for effecting the taking of an image with respect to said patient effects the taking of an image based on said point(s) in the breathing cycle, wherein said means for effecting the taking of an image effects the taking of an image at a desired point in the breathing cycle of the patient wherein said means for effecting the taking of an image comprises;

a means for sending a rotor-up signal to an x-ray machine;

a means for sending an output signal to the x-ray machine; and

;

a means for receiving caregiver input, wherein a caregiver can input a rotor-up command, wherein upon the input of the rotor-up command, said means for sending a rotor-up signal to an x-ray machine sends a rotor-up signal to the x-ray machine which initiates the charging of a capacitor of the x-ray machine in order to prepare for firing, and wherein the caregiver can input a fire command wherein upon the input of the fire command said means for sending an output signal to the x-ray machine sends an output signal to the x-ray machine when said signal indicates the desired point in the breathing cycle wherein the sending of the output signal to the x-ray machine effects the taking of an image at the desired point in the breathing cycle.

3. The device, according to claim 2, wherein said means for receiving caregiver input is a firing handle.

4. The device, according to claim 3, wherein the means for receiving caregiver input is adapted to receive input of the rotor-up and fire commands simultaneously.

5. The device, according to claim 4, wherein the means for receiving caregiver input is adapted to receive input of the rotor-up and fire commands by the pressing of a single button.

6. The device, according to claim 3, wherein said firing handle further comprises an abort input means, wherein said abort input means enables the caregiver to abort the sending of the output signal.

7. The device, according to claim 2, wherein the means for effecting a diagnostic procedure is adapted such that, after the caregiver inputs the fire command, the means for effecting a diagnostic procedure will delay sending the output signal for at least a predetermined period of time after selection of the rotor-up command.

8. The device, according to claim 7, wherein said predetermined period of time is at least three seconds.

9. The device, according to claim 7, wherein the means for receiving caregiver input is adapted such that the caregiver inputs the fire command by pressing a fire button, and wherein the means for effecting a diagnostic procedure is adapted such that the caregiver must continuously press the fire button until said means for effecting a diagnostic procedure sends the output signal or the sending of the output signal will be aborted.

10. The device, according to claim 2, wherein said means for receiving caregiver input is a graphical user interface.

11. A device for improving the efficacy of a medical treatment or diagnostic procedure, comprising:

a means for receiving a signal from a ventilator, wherein said signal carries information relating to a patient'"'"'s breathing cycle,

a means for effecting a medical treatment or diagnostic procedure with respect to the patient, wherein said device improves the efficacy of the medical treatment or diagnostic procedure by coordinating the medical treatment or diagnostic procedure to the patient'"'"'s breathing cycle, and

a ventilator model selector switch comprising settings corresponding to specific ventilators such that said device can interpret the signal indicating the point in the breathing cycle of the patient received from a selected ventilator.

12. A device for improving the efficacy of a medical treatment or diagnostic procedure, comprising:

a means for receiving a signal, wherein said signal carries information relating to a patient'"'"'s breathing cycle,

a means for effecting a medical treatment or diagnostic procedure with respect to the patient, wherein said device improves the efficacy of the medical treatment or diagnostic procedure by coordinating the medical treatment or diagnostic procedure to the patient'"'"'s breathing cycle, and a means for determining whether the patient is spontaneously breathing or under positive pressure ventilation, wherein said means for determining whether the patient is spontaneously breathing or under positive pressure ventilation interprets the information relating to the patient'"'"'s breathing cycle to make such determination.

13. The device, according to claim 12, wherein said signal carries information with respect to the flow of gases into or out of the patient'"'"'s airway and the pressure at the patient'"'"'s airway.

14. The device, according to claim 13, wherein said means for determining whether the patient is spontaneously breathing or under positive pressure ventilation determines that the patient is spontaneously breathing when the flow of gases is into the patient'"'"'s airway and the pressure at the patient'"'"'s airway is below a baseline airway pressure for the patient.

15. The device, according to claim 14, further comprising a means for detecting peak lung inflation, wherein for a patient determined to be spontaneously breathing, said means for detecting peak lung inflation determines peak lung inflation is detected when a falling zero flow crossing and a rising pressure trend occurs.

16. The device, according to claim 15, wherein said means for detecting peak lung inflation also requires the patient to have inspired a minimum volume of gases in order to determine peak lung inflation is detected.

17. The device, according to claim 13, wherein said means for determining whether the patient is spontaneously breathing or under positive pressure ventilation determines that the patient is under positive pressure ventilation when the flow of gases is into the patient'"'"'s airway and the pressure at the patient'"'"'s airway is above a baseline airway pressure for the patient.

18. The device, according to claim 17, further comprising a means for detecting peak lung inflation, wherein for a patient determined to be under positive pressure ventilation, said means for detecting peak lung inflation determines peak lung inflation is detected when a falling zero flow crossing and a falling pressure trend occurs.

19. The device, according to claim 18, wherein said means for detecting peak lung inflation also requires that the pressure at the patient'"'"'s airway is at least a minimum amount above a baseline airway pressure for the patient in order to determine peak lung inflation is detected.

20. A method for improving the efficacy of the taking of a chest image, comprising the following steps:

receiving a signal from a ventilator, wherein said signal carries information relating to a patient'"'"'s breathing cycle effecting the taking of a chest image with respect to said patient based on the information carried by said signal, wherein said method improves the taking of a chest image by coordinating the taking of a chest image to the patient'"'"'s breathing cycle, and

causing the ventilator to ventilate the patient with a sigh breath,

wherein the taking of a chest image is effected when the patient is ventilated with a sigh breath such that the chest image of the patient is taken at peak lung inflation.

21. A method for improving the efficacy of the taking of an image, comprising the following steps:

receiving a signal, wherein said signal carries information relating to a patient'"'"'s breathing cycle;

effecting the taking of an image with respect to said patient based on the information carried by said signal,

wherein said method improves the efficacy of the taking of an image by coordinating the taking of an image to the patient'"'"'s breathing cycle, wherein the step of effecting the taking of an image effects the taking of an image at a desired point in the breathing cycle of the patient, wherein said step of effecting the taking of an image effects the sending of an output signal to an x-ray machine, and receiving input from a caregiver, wherein a caregiver can input a rotor-up command which initiates the charging of a capacitor of the x-ray machine in order to prepare for firing and wherein the caregiver can input a fire command such that said output signal is sent to the x-ray machine when said signal indicates the desired point in the breathing cycle.

22. The method, according to claim 21, wherein said input is inputted via a firing handle.

23. The method, according to claim 22, wherein said firing handle is emulated by a graphical user interface.

24. The method, according to claim 21, wherein after the caregiver inputs the fire command, further comprising the step of:

delaying the sending of the output signal until at least a predetermined period of time after input of the rotor-up command has lapsed.

25. The method, according to claim 24, wherein input of the rotor-up and fire commands is simultaneous.

26. The method, according to claim 25, wherein input of the rotor-up and fire commands is accomplished by pressing a single button.

27. The method, according to claim 24, wherein said predetermined period of time is at least three seconds.

28. The method, according to claim 21, wherein said caregiver can input an abort command which aborts the sending of the output signal.

29. The method, according to claim 21, wherein the caregiver selects the fire command by pressing a fire button, and wherein the caregiver must continuously press the fire button until said output signal is sent to the x-ray machine or the sending of the output signal will be aborted.

30. A method for improving the efficacy of a medical treatment or diagnostic procedure, comprising the following steps:

receiving a signal from a ventilator, wherein said signal carries information relating to a patient'"'"'s breathing cycle,

effecting a medical treatment or diagnostic procedure with respect to said patient based on the information carried by said signal,

wherein said method improves the efficacy of said medical treatment or diagnostic procedure by coordinating said medical treatment or diagnostic procedure to the patient'"'"'s breathing cycle, and selecting a specific ventilator model, corresponding to the patient'"'"'s ventilator, on a ventilator model selector switch comprising settings corresponding to specific ventilator models such that said signal carrying information relating to the breathing cycle of the patient received from the ventilator can be interpreted.

31. A method for improving the efficacy of a medical treatment or diagnostic procedure, comprising the following steps:

receiving a signal, wherein said signal carries information with respect to the flow of gases into or out of the patient'"'"'s airway,

receiving a second signal, wherein said second signal indicates the pressure at the patient'"'"'s airway,

effecting a medical treatment or diagnostic procedure with respect to said patient based on the information carried by said signal,

wherein said method improves the efficacy of said medical treatment or diagnostic procedure by coordinating said medical treatment of diagnostic procedure to the patient'"'"'s breathing cycle based on the flow of gases into or out of the patient'"'"'s airway and on the pressure at the patient'"'"'s airway, wherein the medical treatment or diagnostic procedure is effected when the signal and the second signal indicate a desired point in the patient'"'"'s breathing cycle; and

determining whether the patient is spontaneously breathing or under positive pressure ventilation, wherein said step of determining whether the patient is spontaneously breathing or under positive pressure ventilation utilizes the information relating to the patient'"'"'s breathing activity to make such a determination.

32. The method, according to claim 31, wherein said step for determining whether the patient is spontaneously breathing or under positive pressure ventilation determines that the patient is spontaneously breathing when the flow of gases is into the patient'"'"'s airway and the pressure at the patient'"'"'s airway is below a baseline airway pressure for the patient.

33. The method, according to claim 32, wherein for a patient determined to be spontaneously breathing, peak lung inflation is detected when a falling zero flow crossing and a rising pressure trend simultaneously occurs.

34. The method, according to claim 33, wherein peak lung inflation detection also requires the patient to have inspired a minimum volume of gases.

35. The method, according to claim 31, wherein said step for determining whether the patient is spontaneously breathing or under positive pressure ventilation determines that the patient is under positive pressure ventilation when the flow of gases is into the patient'"'"'s airway and the pressure at the patient'"'"'s airway is above a baseline airway pressure for the patient.

36. The method, according to claim 35, wherein for a patient determined to be under positive pressure ventilation, peak lung inflation is detected when a falling zero flow crossing and a falling pressure trend simultaneously occur.

37. The method, according to claim 36, wherein peak lung inflation detection also requires that the pressure at the patient'"'"'s airway is at least a minimum amount above a baseline airway pressure for the patient.