Extracorporeal renal replacement modeling system

• US 7,785,463 B2
• Filed: 03/17/2006
• Issued: 08/31/2010
• Est. Priority Date: 03/17/2006
• Status: Expired due to Fees

• Current Assignee: Children's Hospital & Medical Center
• Original Assignee: Children's Hospital & Medical Center
• Inventors: Hemasilpin, Nat, Bissler, John J., Polycarpou, Marios M.
• Primary Examiner(s): KIM, SUN U
• Application Number:
  US11/378,051
• Publication Number:
  US 20070215545A1
• Time in Patent Office: 1,628 Days
• Field of Search: 210/85, 210/87, 210/96.2, 210/97, 210/103, 210/134, 210/141, 210/143, 210/252, 210/258, 210/259, 210/321.65, 210/646, 604/4.01, 604/5.04, 604/6.09, 604/6.11, 604/65, 604/66, 604/67
• US Class Current: 210/143
• CPC Class Codes: A61M 1/16 with membranes
• CPC Class Codes: A61M 1/1613 Profiling or modelling of patient or predicted treatment evolution or outcome
• CPC Class Codes: A61M 1/3609 Physical characteristics of the blood, e.g. haematocrit, urea
• CPC Class Codes: A61M 1/3639 Blood pressure control, pressure transducers specially adapted therefor
• CPC Class Codes: A61M 2205/3331 Pressure; Flow
• CPC Class Codes: A61M 2205/3351 Controlling upstream pump pressure
• CPC Class Codes: A61M 2205/3355 Controlling downstream pump pressure
• CPC Class Codes: A61M 2205/3365 Rotational speed
• CPC Class Codes: A61M 2205/3379 Masses, volumes, levels of fluids in reservoirs, flow rates
• CPC Class Codes: A61M 2205/3584 using modem, internet or bluetooth
• CPC Class Codes: A61M 2205/50 with microprocessors or computers
• CPC Class Codes: A61M 2205/52 with memories providing a history of measured variating parameters of apparatus or patient
• CPC Class Codes: A61M 2205/707 Testing of filters for clogging
• CPC Class Codes: A61M 2230/207 hematocrit

Abstract

A system, program product and method continuously optimize an ultrafiltration rate during an extracorporeal renal replacement process by modeling physiological and actual rate data. The system maps the sensed, physiological data to a mathematical model to assess the data in terms of the ultrafiltration rate. The model provides parameters used to predict where the treatment is headed based on current conditions. The system processes the parameters in terms of preset criteria to generate the optimized ultrafiltration rate. Where the system is networked, communication of the data may be accomplished using remote and online communication techniques.

Claims

1. An extracorporeal renal replacement system for fluid removal from the blood of a patient, comprising:

a pump capable of pumping a liquid selected from the group consisting of infusate, drained fluid, and blood in the extracorporeal renal replacement system;

a flow rate sensor for measuring the flow rate of fluid in the system generated by the pump, the flow rate sensor providing flow rate data signals correlated to the fluid flow rate;

a patient sensor for measuring a physiological condition of the patient, the patient sensor providing patient sensor data signals correlated to the physiological condition; and

a controller in communication with the pump, the flow rate sensor and the patient sensor, the controller configured to receive the flow rate data signals and the patient sensor data signals and analyze the flow rate data signals and the patient parameter data signals using a mathematical model to predict a direction of an ultrafiltration rate based on current conditions, and then to automatically initiate generation of a corrective output signal for the pump to adjust the flow rate of liquid generated by the pump for regulating fluid removal from the patient'"'"'s blood.

2. The extracorporeal renal replacement system of claim 1, wherein the controller is further configured to initiate generation of the output signal by using the model to process the flow rate data and the physiological condition to determine a model parameter, and to adjust the flow rate if the model parameter fails to conform with stored criteria.

3. The extracorporeal renal replacement system of claim 2, wherein the model parameter is selected from the group consisting of at least one of:

blood pressure data, transcapillary fluid transfer data, interstitial pressure data, interstitial volume data, interstitial pressure-volume relationship data, lymphatic flow data, arteriole resistance data, mixed venous oxygen compliance data, venous compliance data, interstitial space compliance data, sodium data, urea data, protein data, potassium data in an intracellular and extracellular pool, fluid balance data, systemic hemodynamic data, pulmonary hemodynamic data, arterial pressure control mechanism data, arterial and cardiopulmonary pressoreceptor data, volume data, blood pressure data of a systemic arterial compartment, blood pressure data of a systemic venous compartment, blood pressure data of a pulmonary arterial compartment, blood pressure data of a pulmonary venous compartment, hydrostatic pressure data of a fluid inside a capillary, pulmonary arterial and venous compartment data, systemic arterial compartment data, venous arterial compartment data, hydrostatic pressure data of a fluid in interstitial space, volume data in a systemic venous compartment, systemic arterial and venous resistance data, distribution data relating to fluid between a vascular compartment and an interstitial fluid compartment, capillary filtration data, lymph return rate data and plasma refilling rate data.

4. The extracorporeal renal replacement system of claim 1, wherein the controller is further configured to continuously adjust the flow rate of the liquid.

5. The extracorporeal renal replacement system of claim 1, wherein the physiological condition is selected from the group consisting of at least one of:

heart rate data, blood pressure data, plasma return rate data, systemic arterial pressure data, pulse pressure data, pulse rate data, estimated cardiac ejection time data, estimated stroke volume data, estimated stroke volume index data, estimated cardiac output data, estimated cardiac index data, large artery elasticity index data, small artery elasticity index data, systemic vascular resistance data and total vascular impedance data.

6. The extracorporeal renal replacement system of claim 1, wherein the flow rate comprises an ultrafiltration rate.

7. The extracorporeal renal replacement system of claim 1, wherein the patient sensor is selected from the group consisting of at least one of:

a blood pressure monitor providing blood pressure data signals, and a heart rate monitor providing heart rate data signals.

8. The extracorporeal renal replacement system of claim 1, wherein the mathematical model comprises a series of equations configured to assess the flow rate data signals and the patient parameter data signals in terms of the ultrafiltration rate.

9. The extracorporeal renal replacement system of claim 1, wherein the mathematical model includes a set of variables and a set of quantitative relationships between the set of variables.

10. The extracorporeal renal replacement system of claim 1, wherein the mathematical model includes a series of mathematical equations descriptive of hemodynamic parameters.