Medical microprocessor system and method for providing a ventilation indexed oximetry value

• US 6,609,016 B1
• Filed: 07/28/2000
• Issued: 08/19/2003
• Est. Priority Date: 07/14/1997
• Status: Expired due to Term

• Current Assignee: Lawrence A. Lynn
• Original Assignee: Lawrence A. Lynn
• Inventors: Lynn, Lawrence A.
• Primary Examiner(s): Winakur, Eric F.
• Assistant Examiner(s): KREMER, MATTHEW J
• Application Number:
  US09/628,655
• Time in Patent Office: 1,117 Days
• Field of Search: 600/309-310, 600/322-324, 600/300, 600/484, 600/529, 600/533
• US Class Current: 600/323
• CPC Class Codes: A61B 5/0833 Measuring rate of oxygen consumption
• CPC Class Codes: A61B 5/0836 Measuring rate of CO2 production
• CPC Class Codes: A61B 5/0871 Peak expiratory flowmeters
• CPC Class Codes: A61B 5/091 Measuring volume of inspired or expired gases, e.g. to determine lung capacity
• CPC Class Codes: A61B 5/097 Devices for facilitating collection of breath or for directing breath into or through measuring devices
• CPC Class Codes: A61B 5/14551 for measuring blood gases
• CPC Class Codes: A61B 5/4818 Sleep apnoea
• CPC Class Codes: A61B 5/7278 Artificial waveform generation or derivation, e.g. synthesising signals from measured signals A61B5/327 takes precedence
• CPC Class Codes: C07C 233/36 having the carbon atom of the carboxamide group bound to a hydrogen atom or to a carbon atom of an acyclic saturated carbon skeleton
• CPC Class Codes: C07C 233/38 having the carbon atom of the carboxamide group bound to a carbon atom of an acyclic unsaturated carbon skeleton
• CPC Class Codes: G16H 20/40 relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
• CPC Class Codes: G16H 40/60 for the operation of medical equipment or devices
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16H 50/30 for calculating health indices; for individual health risk assessment

Abstract

Pathologic relationship trending of an oxygen saturation time series relative to a corresponding ventilation time series is identified used a medical microprocessor system, and an increasing difference between the two time series is detected and displayed. That increasing difference is provided for evaluating a patient and for detecting early evidence of serious illness. A patient'"'"'s normal predicted time ventilation may also be calculated using one or more of the patient'"'"'s height, weight, sex, and body surface area. A relationship is determined between measured blood oxygen saturation, measured time ventilation, and predicted time ventilation. The microprocessor preferably determines the presence of an interval of steady state ventilation and measures the timed ventilation during that interval. The microprocessor also measures the oxygen saturation corresponding to that determined, steady state ventilation interval. The microprocessor then calculates a Ventilation Oximetry Index (VOI) of minute ventilation and oxygen saturation as measured by pulse oximetry. The VOI assists the medical clinician in judging the potential effect of the measured minute ventilation on the oxygen saturation value and in identifying when additional testing (such as an arterial blood gas) is indicated.

Claims

1. A microprocessor system for an evaluation of a patient, the system comprising a processor programmed to:

(a) receive a first input indicative of said patient'"'"'s measured timed ventilation;

(b) receive a second input indicate of said patient'"'"'s measured arterial oxygen saturation, said saturation corresponding to said timed ventilation;

(c) receive a third input of at least one of said patient'"'"'s height, weight, sex, and body surface area;

(d) calculate said patient'"'"'s normal predicted timed ventilation based at least on said third input; and

(e) determine a relationship between at least said measured arterial saturation, said measured timed ventilation and said predicted timed ventilation.

2. A system as in claim 1 wherein said relationship is an index of said measured oxygen saturation relative to a mathematical comparison of said measured ventilation and said predicted ventilation.

3. A system as in claim 1 wherein said relationship is a calculated index derived from at least said first, second and third inputs.

4. A system as in claim 1 wherein said processor is sized to be handheld.

5. A system as in claim 4 wherein said system further includes a handheld display, said processor being programmed to output at least said relationship to said handheld display.

6. A system as in claim 5 wherein said processor is further programmed to output said first input and said second input to said handheld display.

7. A system as in claim 3 wherein said system further includes a ventilation measurement device for measuring said first input.

8. A system as in claim 2 wherein said ventilation measurement device is a pneumotachometer.

9. A system as in claim 2 wherein said system further includes an oxygen saturation measurement device for measuring said second input.

10. A system as in claim 9 wherein said system is sized to be handheld.

11. A system as in claim 10 wherein said system further includes a display, said system being programmed to output at least said relationship to said display.

12. A system as in claim 11 wherein said processor is further programmed, to output said first input and said second input to said display.

13. A system as in claim 2 wherein said ventilation measurement device is a spirometer.

14. A system as in claim 3 wherein said system further includes an oxygen saturation measurement device for measuring said second input.

15. A system as in claim 14 wherein said oxygen saturation measurement device is a pulse oximeter.

18. A patient monitor as in claim 12 wherein said housing is attached with said oximeter.

19. A patient monitor as in claim 18 wherein said housing further contains at least a portion of said device for measuring ventilation.

20. A patient monitor as in claim 12 wherein said housing contains at least a portion of said oximeter.

21. A patient monitor as in claim 12 wherein said housing is attached with said device for measuring ventilation.

22. A patient monitor as in claim 21 wherein said ventilation measurement device is configured for communication with an airflow receiver for receiving the flow of gas from at least one of a patient'"'"'s mouth and nose, said monitor including a communication port for communicating with at least one of said ventilation measurement device and said airflow receiver.

23. A patient monitor as in claim 21 wherein said device for measuring ventilation is a pneumotachometer.

24. A patient monitor as in claim 12 wherein said oximeter is configured for communication with a probe for mounting with a patient'"'"'s body part, said monitor including a communication port for communicating with said probe.

16. A patient monitor for evaluating a patient, the monitor having a display, the monitor comprising:

(a) a device for measuring ventilation capable of producing a first output of timed ventilation;

(b) a pulse oximeter capable of producing a second output indicative of said patient'"'"'s arterial oxygen saturation;

(c) an input device capable of receiving an input of at least one of a patient'"'"'s body dimensions; and

(d) a processor programmed to;

(d1) determine the presence of an interval of steady state ventilation and the timed ventilation during said interval to generate a first output,

(d2) measure oxygen saturation corresponding to said interval to generate a second output,

(d3) calculate said patient'"'"'s predicted ventilation based on at least one of said body dimensions, and

(d4) display at least said first output, said second output, and said predicted ventilation.

17. A patient monitor as in claim 16 further including a housing for containing at least said processor, said housing being sized to be easily held in a human hand.

25. A patient monitor as in claim 16 wherein said processor is further programmed to:

(d5) compare said first output and said predicted timed ventilation to render a third output, and

(d6) display said third output.

26. A patient monitor as in claim 16 wherein said processor is further programmed to:

(d5) compare said first output, said predicted ventilation, and said second output to render a fourth output,

(d6) display said fourth output.

27. A patient monitor as in claim 16 wherein said first output is the average minute ventilation during said interval of steady state ventilation.

28. A patient monitor as in claim 16 wherein said processor is further programmed to identify a second time interval for measuring said oxygen saturation, said second time interval corresponding with said time interval of steady state ventilation.

29. A patient monitor as in claim 28 wherein said second output is the average arterial oxygen saturation measured during said second time interval, said first time interval and said second time interval corresponding such that said second output is the average oxygen saturation generated by the gas exchange of the patient during said interval of steady state ventilation.

30. A patient monitor as in claim 29 wherein said time interval of steady state ventilation defines a first onset and said time interval for measuring said oxygen saturation defines a second onset, said first onset occurring before said second onset.

31. A microprocessor system for evaluating a patient and for detecting early evidence of serious illness in said patient by the identification of pathologic relational trending of an oxygen saturation time series relative to a corresponding ventilation time series, the system comprising a processor programmed to:

(a) receive a first input of a time series of measured ventilation values to derive a first output indicative of a first trend of timed ventilation,

(b) receive a second input of time series of measured arterial oxygen saturation to derive an output indicative of a second trend of oxygen saturation, said first time series corresponding to said second time series,

(c) compare said first trend and said second trend to identify a increasing difference between said first trend and said second trend; and

(d) output an indication of said increasing difference.

32. A system as in claim 31 wherein said comparing comprises calculating a relationship between said first input and said second input to derive a calculated index.

33. A system as in claim 32 wherein said processor is further programmed to derive a third trend of said index.

34. A patient monitor for evaluating a patient, the monitor having a display, the monitor comprising:

(a) a device for measuring ventilation capable of producing a first output of timed ventilation;

(b) a pulse oximeter capable of producing a second output indicative of said patient'"'"'s arterial oxygen saturation;

(c) an input device capable of receiving an input of at least one of a patient'"'"'s body dimensions; and

(d) a processor programmed to;

(d1) determine the presence of an interval of steady state ventilation and the timed ventilation during said interval to generate a first output,

(d2) measure oxygen saturation corresponding to said interval to generate a second output, and

(d3) display at least said first output and said second output.

35. A patient monitor as in claim 34 wherein said processor is further programmed to calculate an index of said first and second outputs.

36. A patient monitor as in claim 34 wherein said timed ventilation is a volume of gas ventilated per unit time.

37. A patient monitor as in claim 34 wherein said timed ventilation is a total volume of room air ventilated per unit time.