Therapy adjustment

• US 8,032,229 B2
• Filed: 06/15/2010
• Issued: 10/04/2011
• Est. Priority Date: 04/30/2007
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Gerber, Martin T., Rondoni, John C.
• Primary Examiner(s): Layno; Carl H
• Assistant Examiner(s): Kimball; Jeremiah T
• Application Number:
  US12/815,834
• Publication Number:
  US 20100256592A1
• Time in Patent Office: 476 Days
• Field of Search: 607/59
• US Class Current: 607/62
• CPC Class Codes: A61N 1/36514 controlled by a physiological quantity other than heart potential, e.g. blood pressure controlled by two or more physical parameters A61N1/36585
• CPC Class Codes: A61N 1/36542 controlled by body motion, e.g. acceleration
• CPC Class Codes: A61N 1/3655 controlled by body or blood temperature
• CPC Class Codes: A61N 1/36557 controlled by chemical substances in blood
• CPC Class Codes: A61N 1/36564 controlled by blood pressure
• CPC Class Codes: A61N 1/36571 controlled by blood flow rate, e.g. blood velocity or cardiac output
• CPC Class Codes: G16H 20/10 relating to drugs or medications, e.g. for ensuring correct administration to patients
• CPC Class Codes: G16H 20/30 relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising
• CPC Class Codes: G16H 40/63 for local operation

Abstract

Systems and methods for adjusting a therapy delivered to a patient include detecting a value of at least one sensed patient parameter and adjusting a therapy parameter value to accommodate different patient parameter values. A data structure including a plurality of patient parameter values and associated therapy parameter values may be stored within a medical device or a programming device. Upon detecting a patient parameter value, an associated therapy parameter value from the data structure may be selected. If no therapy parameter value is associated with the detected patient parameter value, an intermediate therapy parameter value may be generated by interpolating between the most recently implemented therapy parameter value and a stored therapy parameter value. In some embodiments, the rate of shifting between parameters of two stored or interpolated therapy parameter values may be based on the rate of change of the patient parameter value over time.

Claims

1. A method comprising:

sensing a first value of a parameter of a patient;

delivering therapy to the patient according to a first therapy parameter value associated with the first value of the patient parameter in a data structure comprising a plurality of patient parameter values and associated therapy parameter values;

detecting a change from the first value of the patient parameter to a second value of the patient parameter;

identifying a third value of the patient parameter within the data structure that is closest to the second value of the patient parameter, wherein the third value of the patient parameter is associated with a second therapy parameter value within the data structure; and

determining an intermediate therapy parameter value that provides efficacious therapy to the patient when the second value of the patient parameter is observed by interpolating the therapy parameter between the first and second therapy parameter values.

2. The method of claim 1, further comprising comparing a difference between the second and third values of the patient parameter to a threshold value, wherein determining the intermediate therapy parameter value comprises determining the intermediate therapy parameter value if the difference between the second and third values of the patient parameter is greater than the threshold value.

3. The method of claim 1, further comprising delivering the therapy according to the intermediate therapy parameter value.

4. The method of claim 3, further comprising delivering the therapy according to the intermediate therapy parameter value until a change in the parameter of the patient is detected.

5. The method of claim 3, further comprising delivering the therapy according to the second therapy parameter value after delivering the therapy according to the intermediate therapy parameter value.

6. The method of claim 3, further comprising delivering the therapy according to the first therapy parameter value after delivering the therapy according to the intermediate therapy parameter value.

7. The method of claim 1, wherein the first, second, and intermediate therapy parameter values each comprise a respective value of at least one of an electrode configuration, an electrical stimulation pulse rate, an electrical stimulation pulse width, an electrical stimulation current amplitude, a fluid delivery dosage, a cycle of therapy delivery, a rate of change of the electrical stimulation current amplitude, or a fluid delivery rate.

8. The method of claim 1, wherein the parameter of the patient comprises a posture of the patient.

9. The method of claim 1, wherein the parameter of the patient comprises at least one of activity, heart rate, respiration rate, respiratory volume, core temperature, blood pressure, blood oxygen saturation, partial pressure of oxygen within blood, partial pressure of oxygen within cerebrospinal fluid, muscular activity, arterial blood flow, electromyogram (EMG), an electroencephalogram (EEG), an electrocardiogram (ECG), or galvanic skin response.

10. The method of claim 1, further comprising determining a first rate of the change from the first patient parameter value to the second patient parameter value, wherein delivering the therapy according to the intermediate therapy parameter value comprises adjusting the delivery of the therapy to the patient from the first therapy parameter value to the intermediate therapy parameter value at a second rate based on the first rate.

11. The method of claim 10, wherein the second rate of change is substantially equal to the first rate of change.

12. The method of claim 1, further comprising:

determining whether the second value of the patient parameter is stable;

delivering therapy according to the intermediate therapy parameter value if the second value is stable; and

delivering therapy according to a safe mode or suspending therapy if the second value is not stable.

13. A system comprising:

a medical device that is configured to deliver a therapy to a patient;

a sensor that is configured to sense a patient parameter of the patient;

a memory that stores a data structure comprising a plurality of patient parameter values and associated therapy parameter value; and

a processor configured to control the medical device to deliver the therapy to the patient according to a first therapy parameter value associated with a first value of the patient parameter sensed via the sensor, detect a change in the first value to a second value of the patient parameter sensed via the sensor, identify a third value of the patient parameter within the data structure that is closest to the second value, wherein the third value is associated with a second therapy parameter value within the data structure, and interpolate the therapy parameter between the first and second therapy parameter values to determine an intermediate therapy parameter value that provides efficacious therapy to the patient when the second value of the patient parameter is observed.

14. The system of claim 13, wherein the processor compares a difference between the second and third values of the patient parameter to a threshold value, and determines the intermediate therapy parameter value if the difference between the second and third values of the patient parameter is greater than the threshold value.

15. The system of claim 13, wherein the therapy parameter values each comprise respective values of at least one of an electrode configuration, an electrical stimulation pulse rate, an electrical stimulation pulse width, an electrical stimulation current amplitude, a fluid delivery dosage, a cycle of therapy delivery, a rate of change of the electrical stimulation current amplitude, or a fluid delivery rate.

16. The system of claim 13, wherein the patient parameter comprises a posture of the patient.

17. The system of claim 13, wherein the patient parameter comprises at least one of activity, heart rate, respiration rate, respiratory volume, core temperature, blood pressure, blood oxygen saturation, partial pressure of oxygen within blood, partial pressure of oxygen within cerebrospinal fluid, muscular activity, arterial blood flow, electromyogram (EMG), an electroencephalogram (EEG), an electrocardiogram (ECG), or galvanic skin response.

18. The system of claim 13, wherein the processor is configured to control the medical device to deliver the therapy according to the intermediate therapy parameter value.

19. The system of claim 13, wherein the processor further determines a first rate of the change from the first patient parameter value to the second patient parameter value and controls the medical device to adjust the delivery of the therapy to the patient from the first therapy parameter value to the intermediate therapy parameter value at a second rate based on the first rate.

20. The system of claim 19, wherein the second rate is substantially equal to the first rate.

21. The system of claim 13, wherein the processor determines whether the second value of the patient parameter is stable prior to determining the intermediate therapy parameter value, delivers therapy according to the intermediate therapy parameter value if the second value is stable, and delivers therapy according to a safe mode or suspends therapy if the second value is not stable.

22. A non-transitory computer-readable medium comprising instructions that cause a processor to control a therapy delivery device to:

deliver therapy to the patient according to a first therapy parameter value associated with a first value of the patient parameter in a data structure comprising a plurality of patient parameter values and associated therapy parameter values;

detect a change from the first value of the patient parameter to a second value of the patient parameter;

identify a third value of the patient parameter within the data structure that is closest to the second value, wherein the third value is associated with a second therapy parameter value within the data structure; and

determine an intermediate therapy parameter value that provides efficacious therapy to the patient when the second value of the patient parameter is observed by interpolating the therapy parameter between the first and second therapy parameter values.

23. The computer-readable medium of claim 22, further comprising instructions that cause the programmable processor to compare a difference between the second and third values of the patient parameter to a threshold value, wherein the instructions cause the programmable processor to determine the intermediate therapy parameter value if the difference between the second and third values of the patient parameter is greater than the threshold value.

24. A system comprising:

means for delivering therapy to the patient according to a first therapy parameter value associated with the first value of the patient parameter in a data structure comprising a plurality of patient parameter values and associated therapy parameter values;

means for detecting a change from the first value of the patient parameter to a second value of the patient parameter;

means for identifying a third value of the patient parameter within the data structure that is closest to the second value of the patient parameter, wherein the third value of the patient parameter is associated with a second therapy parameter value within the data structure; and

means for determining an intermediate therapy parameter value that provides efficacious therapy to the patient when the second value of the patient parameter is observed by interpolating the therapy parameter between the first and second therapy parameter values.

25. The system of claim 24, further comprising means for comparing a difference between the second and third values of the patient parameter to a threshold value, wherein the means for determining the intermediate therapy parameter value determines the intermediate therapy parameter value if the difference between the second and third values of the patient parameter is greater than the threshold value.