Intra-abdominal pressure monitoring device and method
First Claim
1. An apparatus for measuring hydraulic pressure in the bladder of a medical patient to infer intra-abdominal pressure in that patient, the apparatus comprising:
- a catheter adapted for draining urine from the bladder;
a container of infusion fluid;
a first fluid path providing fluid communication between said container and a drain portion of said catheter;
a pump disposed to urge fluid flow, under dynamic fluid flow conditions that inherently generate friction loss and consequently require elevated pressure, compared to true bladder pressure, to be induced by the pump to overcome the friction loss, through said first fluid path;
a pressure transducer disposed in fluid communication with the bladder and sufficiently hydraulically isolated from the pressure induced by said pump effective to generate a signal responsive substantially to true gage pressure of fluid in the bladder during operation of said pump to urge said fluid flow; and
a urine valve, arranged in-circuit effective at a first configuration to resist a draining discharge from said catheter while a bolus of said infusion fluid is infused into the bladder, and effective at a second configuration to permit a draining discharge from said catheter.
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Accused Products
Abstract
An apparatus for monitoring the intra-abdominal pressure of a patient includes a urinary catheter (102) connected to a urine valve (250) providing selectable communication between a discharge end of the urinary catheter (102) and either a drain (224) or a fluid source (104). Preferably, the urine valve (250) is adapted for remote actuation and has a housing adapted to resist patient discomfort from leg-valve (250) contact. Plumbing structure desirably maintains fluid supply (225) and drain (223) conduits in a substantially parallel arrangement to assist routing those conduits (225, 223) between a patient'"'"'s legs. When the urine valve (250) is oriented to permit communication with the fluid source (104), an infusion pump (116′) may be used to infuse a known quantity of fluid through the urine valve (250) and into the patient'"'"'s bladder (216). A pressure transducer (218) desirably is connected in-circuit to indicate the fluid'"'"'s pressure and avoid pressure fluctuations induced by system components. To facilitate the infusion process, an automatic flow control device may be included in a fluid supply path (225) and arranged to permit repetitive operation of a syringe (116′) to inject a bolus of fluid into the patient'"'"'s bladder (216). Subsequent to making a pressure measurement, the urine valve (250) is returned to the bladder (216) draining position.
90 Citations
20 Claims
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1. An apparatus for measuring hydraulic pressure in the bladder of a medical patient to infer intra-abdominal pressure in that patient, the apparatus comprising:
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a catheter adapted for draining urine from the bladder; a container of infusion fluid; a first fluid path providing fluid communication between said container and a drain portion of said catheter; a pump disposed to urge fluid flow, under dynamic fluid flow conditions that inherently generate friction loss and consequently require elevated pressure, compared to true bladder pressure, to be induced by the pump to overcome the friction loss, through said first fluid path; a pressure transducer disposed in fluid communication with the bladder and sufficiently hydraulically isolated from the pressure induced by said pump effective to generate a signal responsive substantially to true gage pressure of fluid in the bladder during operation of said pump to urge said fluid flow; and a urine valve, arranged in-circuit effective at a first configuration to resist a draining discharge from said catheter while a bolus of said infusion fluid is infused into the bladder, and effective at a second configuration to permit a draining discharge from said catheter. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11)
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12. A method for measuring hydraulic pressure in the bladder of a medical patient to infer intra-abdominal pressure in that patient, the method comprising:
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a) providing a catheter adapted for draining urine from the bladder, a container of infusion fluid, a pump, a pressure transducer; and
a urine valve;b) placing said urine valve in-circuit between a drain portion of said catheter and a receptacle; c) placing said pump in-circuit between said urine valve and said container; d) placing said pressure transducer in-circuit with said catheter effective to substantially hydraulically isolate said pressure transducer from pressure fluctuations associated with actuation of said valve; e) bleeding air from the circuit; f) placing said urine valve into a draining configuration, for a first period of time, to permit flow between said catheter and said receptacle while resisting flow between said container and said catheter; g) placing said urine valve into an infusion configuration, for a second period of time, to resist flow between said catheter and said receptacle while permitting flow between said container and said catheter; h) infusing a desired bolus of said infusion fluid into the bladder during said second period of time; i) measuring a pressure in the bladder at least once during a third period of time while said urine valve is in a pressure-reading configuration; and j) returning said urine valve to said draining configuration subsequent to lapse of said third period of time. - View Dependent Claims (13, 14, 15, 16, 17, 18)
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19. An apparatus for measuring hydraulic pressure through a catheter adapted to drain urine from the bladder of a medical patient to infer intra-abdominal pressure in that patient, the apparatus comprising:
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structure defining a first fluid path to provide fluid communication between a container of infusion fluid and a drain end of said catheter; a pump disposed to urge fluid flow through said first fluid path; structure adapted to place a pressure transducer in fluid communication with fluid downstream of said pump; and a urine valve, arranged in-circuit effective at a first configuration to resist a draining discharge from said catheter while a bolus of infusion fluid is infused into the bladder, and effective at a second configuration to permit a draining discharge from said catheter, said urine valve comprising a time-delay mechanism adapted to permit said urine valve to resist said draining discharge for a first period of time comprising at least about 20 seconds subsequent to termination of a valve-closing command input and, subsequent to expiration of said first period of time, to autonomically return to said second configuration. - View Dependent Claims (20)
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Specification