Systems, devices, and methods including infection-fighting and monitoring shunts

• US 8,282,593 B2
• Filed: 05/21/2010
• Issued: 10/09/2012
• Est. Priority Date: 08/17/2007
• Status: Expired due to Fees

• Current Assignee: Gearbox LLC (Intellectual Ventures LLC)
• Original Assignee: The Invention Science Fund I, L.L.C. (Intellectual Ventures LLC)
• Inventors: Dacey, Ralph G. Jr., Hyde, Roderick A., Ishikawa, Muriel Y., Kare, Jordin T., Leuthardt, Eric C., Myhrvold, Nathan P., Rivet, Dennis J., Smith, Michael A., Sweeney, Elizabeth A., Tegreene, Clarence T., Wood, Lowell L. Jr., Wood, Victoria Y. H.
• Primary Examiner(s): DEAK, LESLIE R
• Application Number:
  US12/800,791
• Publication Number:
  US 20100249692A1
• Time in Patent Office: 872 Days
• Field of Search: 604/6.08, 604/8, 604/9, 604/20
• US Class Current: 604/8
• CPC Class Codes: A61B 18/20 using laser
• CPC Class Codes: A61B 5/0084 for introduction into the body, e.g. by catheters A61B5/1459 takes precedence
• CPC Class Codes: A61B 5/053 Measuring electrical impedance or conductance of a portion of the body
• CPC Class Codes: A61B 5/145 Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissuemeasuring of blood pressure or blood flow A61B5/02; non-radiation detecting or locating of foreign bodies in blood A61B5/06
• CPC Class Codes: A61B 5/14503 invasive, e.g. introduced into the body by a catheter or needle or using implanted sensors A61B5/1459, A61B5/1464, A61B5/1473, A61B5/1482, A61B5/14865 take precedence
• CPC Class Codes: A61B 5/14532 for measuring glucose, e.g. by tissue impedance measurement
• CPC Class Codes: A61B 5/14539 for measuring pH
• CPC Class Codes: A61B 5/14546 for measuring analytes not otherwise provided for, e.g. ions, cytochromes
• CPC Class Codes: A61B 5/1459 invasive, e.g. introduced into the body by a catheter A61B5/1464 takes precedence
• CPC Class Codes: A61B 5/1473 invasive, e.g. introduced into the body by a catheter A61B5/1482 takes precedence
• CPC Class Codes: A61B 5/412 Detecting or monitoring sepsis
• CPC Class Codes: A61L 2/0011 using physical methods
• CPC Class Codes: A61L 2/08 Radiation
• CPC Class Codes: A61L 2/14 Plasma, i.e. ionised gases
• CPC Class Codes: A61L 2202/24 Medical instruments, e.g. endoscopes, catheters, sharps
• CPC Class Codes: A61M 27/006 Cerebrospinal drainage; Accessories therefor, e.g. valves
• CPC Class Codes: A61M 5/14276 specially adapted for implantation
• CPC Class Codes: A61N 1/205 for promoting a biological process
• CPC Class Codes: A61N 1/37252 Details of algorithms or data aspects of communication system, e.g. handshaking, transmitting specific data or segmenting data
• CPC Class Codes: A61N 1/3785 generated by biological activity or substance, e.g. body movement
• CPC Class Codes: A61N 1/3787 : from an external energy source
• CPC Class Codes: A61N 1/40 : Applying electric fields by inductive or capacitive coupling microwave apparatus A61N5/00; Applying radio-frequency signals
• CPC Class Codes: A61N 1/403 : for thermotherapy, e.g. hyperthermia
• CPC Class Codes: A61N 2005/0651 : Diodes
• CPC Class Codes: A61N 2005/0652 : Arrays of diodes
• CPC Class Codes: A61N 2005/0661 : ultraviolet
• CPC Class Codes: A61N 5/02 : using microwaves
• CPC Class Codes: A61N 5/0601 : Apparatus for use inside the body
• CPC Class Codes: A61N 5/0624 : for eliminating microbes, germs, bacteria on or in the body
• CPC Class Codes: A61N 5/10 : X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy A61N5/01 takes precedence
• CPC Class Codes: A61N 7/00 : Ultrasound therapy lithotripsy A61B17/22, A61B17/225; massage using supersonic vibration A61H23/00 ; using ultrasound for introducing media into the body A61M37/0092

Abstract

Systems, devices, methods, and compositions are described for providing an actively controllable shunt configured to, for example, monitor, treat, or prevent an infection.

Claims

1. An implantable shunt device, comprising:

a body structure having an outer surface and an inner surface defining one or more fluid-flow passageways configured to receive a cerebrospinal fluid of a biological subject;

one or more energy emitters configured to direct an energy stimulus to at least one of an interior and an exterior of at least one of the one or more fluid-flow passageways, the energy stimulus of a character and for a duration sufficient to induce programmed cell death without substantially inducing necrosis of at least a portion of cells proximate at least one of the outer surface and the inner surface of the body structure; and

a disinfecting agent assembly including at least one disinfecting agent reservoir, the disinfecting agent assembly configured to deliver one or more disinfecting agents from the at least one disinfecting agent reservoir to an interior of at least one of the one or more fluid-flow passageways.

2. The implantable shunt device of claim 1, wherein the one or more disinfecting agents include one or more energy-activatable disinfecting agents.

3. The implantable shunt device of claim 1, wherein the one or more disinfecting agents include one or more photoactive agents.

4. The implantable shunt device of claim 1, wherein the one or more disinfecting agents include one or more X-ray absorbers.

5. The implantable shunt device of claim 1, wherein the one or more disinfecting agents include one or more radiation absorbers.

6. The implantable shunt device of claim 1, wherein the one or more disinfecting agents include one or more active agents that selectively target bacteria.

7. The implantable shunt device of claim 1, wherein the one or more disinfecting agents include one or more antimicrobial agents.

8. The implantable shunt device of claim 1, wherein the one or more disinfecting agents include one or more antimicrobial peptides.

9. The implantable shunt device of claim 1, wherein the one or more disinfecting agents include one or more antibacterial agents.

10. The implantable shunt device of claim 1, wherein one or more antibacterial agents include one or more antibacterial drugs.

11. The implantable shunt device of claim 1, wherein the disinfecting agent assembly is configured to deliver the one or more disinfecting agents in a spatially patterned distribution.

12. The implantable shunt device of claim 1, wherein the disinfecting agent assembly is configured to deliver the one or more disinfecting agents in a temporally patterned distribution.

13. The implantable shunt device of claim 1, wherein further comprising:

a plurality of spaced apart release ports; and

at least one controller operably coupled to one or more of the plurality of spaced-apart release ports and configured to actuate one or more of the plurality of spaced apart release ports between an active agent discharge state and an active agent retention state.

14. The implantable shunt device of claim 1, further comprising:

at least one controller operably coupled to the disinfecting agent assembly and configured to control at least one of a delivery rate, a delivery amount, a delivery composition, and a delivery pattern associated with the delivery of the one or more disinfecting agents from the at least one disinfecting agent reservoir to an interior of at least one of the one or more fluid-flow passageways.

15. The implantable shunt device of claim 1, wherein the disinfecting agent assembly is further configured to deliver one or more disinfecting agents from the at least one disinfecting agent reservoir to an exterior of at least one of the one or more fluid-flow passageways.

16. The implantable shunt device of claim 1, further comprising:

at least one controller operably coupled to the disinfecting agent assembly and configured to control at least one of a delivery rate, a delivery amount, a delivery composition, and a delivery pattern associated with the delivery of the one or more disinfecting agents from the at least one disinfecting agent reservoir to an exterior of at least one of the one or more fluid-flow passageways.

17. The implantable shunt device of claim 1, wherein the disinfecting agent assembly includes a plurality of spaced apart release ports adapted to deliver the one or more disinfecting agents in a spatially patterned distribution.

18. The implantable shunt device of claim 1, further comprising:

at least one controller operably coupled to one or more of the plurality of spaced apart release ports and configured to actuate one or more of the plurality of spaced apart release ports between a disinfecting agent discharge state and a disinfecting agent retention state.

19. The implantable shunt device of claim 1, wherein the disinfecting agent assembly includes a plurality of spaced-apart controllable-release ports adapted to deliver the one or more disinfecting agents in a spatially patterned distribution.

20. The implantable shunt device of claim 1, wherein the disinfecting agent assembly includes a plurality of spaced-apart controllable-release ports adapted to deliver the one or more disinfecting agents in a temporally patterned distribution.

21. The implantable shunt device of claim 20, further comprising:

at least one controller operably coupled to one or more of the spaced-apart controllable-release ports and configured to control at least one of a port release rate, a port release amount, or a port release pattern

associated with a delivery of the one or more disinfecting agents.

22. The implantable shunt device of claim 20, further comprising:

at least one processor, the processor operably coupled to the disinfecting agent assembly and configured to control at least one of

a port release rate, a port release amount, or a port release pattern

associated with the delivery of the one or more disinfecting agents from the at least one disinfecting agent reservoir to an interior of at least one of the one or more fluid-flow passageways.

23. A method, comprising:

selectively energizing one or more regions of an indwelling shunt having body structure defining one or more fluid-flow passageways configured to receive a biological fluid of a biological subject via one or more one or more energy emitters, and

delivering an active agent composition to the one or more regions proximate at least one of an outer surface and an inner surface of the indwelling shunt via one or more disinfecting agent assemblies including at least one disinfecting agent reservoir, in response to an automatically detected measurand associated with a cerebrospinal fluid received within at least one of the one or more fluid-flow passageway.

24. The method of claim 23, wherein selectively energizing the one or more regions includes delivering an electromagnetic energy stimulus to one or more regions proximate at least one of the outer surface and the inner surface of the indwelling shunt determined to have an infectious agent presence, the electromagnetic energy stimulus at a dose sufficient to attenuate an activity of the infectious agent.

25. The method of claim 23, wherein selectively energizing the one or more regions includes delivering at least one of an electromagnetic energy stimulus, an electrical energy stimulus, an ultrasonic energy stimulus, and a thermal energy stimulus in response to automatically detected measurand associated with biological sample proximate the at least one of the outer surface and the inner surface of the indwelling shunt.

26. The method of claim 23, wherein selectively energizing the one or more regions includes delivering at least a first energy stimulus and a second energy stimulus to the one or more regions, the second energy stimulus having at least one of an emission intensity, an emission phase, an emission polarization, and an emission wavelength different from the first energy stimulus.

27. The method of claim 23, wherein selectively energizing the one or more regions includes concurrently or sequentially delivering at least a first energy stimulus to a first region and a second energy stimulus to a second region.

28. The method of claim 23, wherein selectively energizing the one or more regions includes concurrently or sequentially delivering at least a first spatially patterned energy stimulus to a first region and a second spatially patterned energy stimulus to a second region.

29. The method of claim 23, wherein selectively energizing the one or more regions includes delivering a temporally patterned energy stimulus to the one or more regions.

30. The method of claim 23, wherein selectively energizing the one or more regions includes concurrently or sequentially delivering a first energy stimulus to at least a first region and a second energy stimulus to at least a second region, the first energy stimulus comprising one of an electromagnetic energy stimulus, an electrical energy stimulus, an ultrasonic energy stimulus, or a thermal energy stimulus, and the second energy stimulus comprising a different one of an electromagnetic energy stimulus, an electrical energy stimulus, an ultrasonic energy stimulus, or a thermal energy stimulus.

31. The method of claim 23, wherein delivering the active agent composition includes delivering an antimicrobial agent composition at a dose sufficient to attenuate an activity of the infectious agent in response to an automatically detected measurand associated with the biological sample.

32. The method of claim 23, wherein delivering the active agent composition includes delivering an energy-activatable antimicrobial agent composition including at least one photoactive agent, or a metabolic precursor thereof.

33. The method of claim 23, wherein delivering the active agent composition includes delivering an energy-activatable antimicrobial agent composition including at least one X-ray absorber.

34. The method of claim 23, wherein delivering the active agent composition includes delivering an energy-activatable antimicrobial agent composition including at least one radiation absorber.

35. The method of claim 23, wherein delivering the active agent composition includes delivering an energy-activatable antimicrobial agent composition including at least one active agent that selectively targets bacteria.

36. The method of claim 23, wherein delivering the active agent composition includes delivering a superoxide-forming composition.