Apparatuses and methods for titrating drug delivery
First Claim
1. A system for providing drug delivery to a patient, wherein said system comprises:
- a user interface for accepting input from a user;
a drug delivery device that delivers an amount of drug to a patient;
two or more patient health monitors adapted so as to be coupled to a patient and generate a signal reflecting at least one health condition of the patient; and
a processor that integrates the user interface, drug delivery device, and patient health monitors according to a hierarchy of software algorithms defining different drug states that seamlessly allow for drug level adjustments by the user such that the amount of drug delivered to the patient by the delivery device is modulated based on an input from the user and based on a signal generated by the patient health monitors to achieve a target effect site concentration (ESC),wherein said hierarchy of software algorithms include a drug state model and a flow control algorithm and an interface algorithm, said interface algorithm being one of a rate controlled infusion algorithm and a target controlled infusion algorithm that run in real time and said interface algorithm being capable of producing different time profiles of a target drug concentration at different effect sites, andwherein automated actions initiated by said processor will not increase overall drug levels automatically without an explicit request for a higher drug level by said user.
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Accused Products
Abstract
A method and apparatus for reducing the workload of titrating drug to effect while leaving clinician users in control of a related procedure is described. A drug delivery device is controlled to achieve a target drug concentration at a selected site in the patient or a predetermined infusion rate waveform. The time profile of the target drug concentration or a predetermined infusion rate waveform is controlled by a drug state model that uses clinical heuristics to implement safe, pre-defined changes in the target drug concentration or infusion rate and user-commanded changes in target drug concentration or infusion rate. The invention allows time to assess the response of the patient to changes in drug level by making small incremental and conservative changes in drug level over time.
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Citations
33 Claims
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1. A system for providing drug delivery to a patient, wherein said system comprises:
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a user interface for accepting input from a user; a drug delivery device that delivers an amount of drug to a patient; two or more patient health monitors adapted so as to be coupled to a patient and generate a signal reflecting at least one health condition of the patient; and a processor that integrates the user interface, drug delivery device, and patient health monitors according to a hierarchy of software algorithms defining different drug states that seamlessly allow for drug level adjustments by the user such that the amount of drug delivered to the patient by the delivery device is modulated based on an input from the user and based on a signal generated by the patient health monitors to achieve a target effect site concentration (ESC), wherein said hierarchy of software algorithms include a drug state model and a flow control algorithm and an interface algorithm, said interface algorithm being one of a rate controlled infusion algorithm and a target controlled infusion algorithm that run in real time and said interface algorithm being capable of producing different time profiles of a target drug concentration at different effect sites, and wherein automated actions initiated by said processor will not increase overall drug levels automatically without an explicit request for a higher drug level by said user. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12)
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13. A method for providing drug delivery to a patient, wherein said method comprises the steps of:
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accepting input from a user via a user interface; delivering an amount of drug to a patient via a drug delivery device; generating a signal reflecting at least one health condition of the patient via two or more patient health monitors adapted so as to be coupled to a patient; and integrating the user interface, drug delivery device, and patient health monitors according to a hierarchy of software algorithms defining different drug states that account for the event of additional input from the user using a clinician-knows-best logic such that the amount of drug delivered to the patient by the delivery device is modulated based on an input from the user and based on a signal generated by the patient health monitors to achieve a target ESC; wherein said hierarchy of software algorithms include a drug state model and a flow control algorithm and an interface algorithm, said interface algorithm being one of a rate controlled infusion algorithm and a target controlled infusion algorithm that run in real time and are capable of producing different time profiles of a target drug concentration at different effect sites, and wherein said hierarchy of algorithms will not result in an increase in overall drug levels to said patient without an explicit request for a higher drug level by said user. - View Dependent Claims (14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24)
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25. A system for providing computer-assisted drug delivery, wherein said system comprises:
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a user interface for accepting input from a user; a drug delivery device that delivers an amount of drug to a patient, wherein said drug is at least one of a sedative, amnestic and analgesic drug; two or more patient health monitors adapted so as to be coupled to a patient and generate a signal reflecting at least one health condition of the patient, wherein one of said two or more patient health monitors is an automated responsiveness test; and a processor that integrates the user interface, drug delivery device, and patient health monitors according to a hierarchy of software algorithms defining different drug states that account for the event of drug level adjustments by the user such that the amount of drug delivered to the patient by the delivery device is modulated based on an initial input from the user and based on a signal generated by the patient health monitors without further user input, if the automated action will maintain or decrease a drug level, and automatically altering said drug states to incorporate said drug level adjustments by the user;
wherein said system determines a drug level limit based on automated responsiveness test data received during a gradual drug increase initiated by the user, and wherein said drug level limit does not exceed the initial user input level, and wherein said automated responsiveness test query cycle frequency is set to FAST during said gradual drug increase. - View Dependent Claims (26, 27, 28, 29, 30, 31, 32, 33)
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Specification