Method for determining hemodynamic effects

• US 8,551,006 B2
• Filed: 09/17/2009
• Issued: 10/08/2013
• Est. Priority Date: 09/17/2008
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Covidien LP (Medtronic Plc)
• Inventors: Karst, Edward, Vandine, Joseph Douglas, Porges, Charles E., Baker, Clark Raymond Jr.
• Primary Examiner(s): Kahelin, Michael
• Assistant Examiner(s): TRAN, THO Q
• Application Number:
  US12/561,960
• Publication Number:
  US 20100069761A1
• Time in Patent Office: 1,482 Days
• Field of Search: 600/483, 600/484, 600/481, 600/504, 600/507, 600/526
• US Class Current: 600/484
• CPC Class Codes: A61B 5/0205 Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
• CPC Class Codes: A61B 5/029 Measuring or recording blood output from the heart, e.g. minute volume A61B8/065 takes precedence
• CPC Class Codes: A61B 5/0806 by whole-body plethysmography measuring blood flow using plethysmography A61B5/0295; impedance plethysmography A61B5/053; measuring volume of the body or parts thereof A61B5/1073
• CPC Class Codes: A61B 5/14551 for measuring blood gases
• CPC Class Codes: A61B 5/4035 Evaluating the autonomic nervous system

Abstract

The present disclosure relates, in some embodiments, to devices, systems, and/or methods for collecting, processing, and/or displaying stroke volume and/or cardiac output data. For example, a device for assessing changes in cardiac output and/or stroke volume of a subject receiving airway support may comprise a processor; an airway sensor in communication with the processor, wherein the airway sensor is configured and arranged to sense pressure in the subject'"'"'s airway, lungs, and/or intrapleural space over time; a blood volume sensor in communication with the processor, wherein the blood volume sensor is configured and arranged to sense pulsatile volume of blood in a tissue of the subject over time; and a display configured and arranged to display a representative of an airway pressure, a pulsatile blood volume, a photoplethysmogram, a photoplethysmogram ratio, the determined cardiac output and/or stroke volume, or combinations thereof. A method of assessing changes in cardiac output or stroke volume of a subject receiving airway support from a breathing assistance system may comprise sensing pressure in the subject'"'"'s airway as a function of time, sensing pulsatile volume of blood in a tissue of the subject as a function of time, producing a photoplethysmogram from the sensed pulsatile volume, determining the ratio of the amplitude of the photoplethysmogram during inhalation to the amplitude of the photoplethysmogram during exhalation, and determining the change in cardiac output or stroke volume of the subject using the determined ratio.

Claims

1. A device for assessing changes in cardiac output and/or stroke volume of a subject receiving airway support from a breathing assistance system, the device comprising:

a processor;

an airway sensor in communication with the processor, wherein the airway sensor is configured and arranged to sense pressure in the subject'"'"'s airway, lungs, and/or intrapleural space over time;

a blood volume sensor in communication with the processor, wherein the blood volume sensor is configured and arranged to sense pulsatile volume of blood in a tissue of the subject over time; and

a display configured and arranged to display a representative of an airway pressure, a pulsatile blood volume, a photoplethysmogram, a photoplethysmogram ratio, the determined cardiac output and/or stroke volume, or combinations thereof,

wherein the processor is configured and arranged to (a) produce a photoplethysmogram, (b) determine a photoplethysmogram ratio of the amplitude of the photoplethysmogram during inhalation to the amplitude of the photoplethysmogram during exhalation, and (c) determine the change in cardiac output and/or stroke volume of the subject using the ratio of the amplitude of the photoplethysmogram during inhalation to the amplitude of the photoplethysmogram during exhalation.

2. A device for assessing changes in cardiac output or stroke volume of a subject receiving airway support from a breathing assistance system, the device comprising:

an airway sensor configured and arranged to sense pressure in the subject'"'"'s airway, lungs, and/or intrapleural space over time;

a blood volume sensor configured and arranged to sense pulsatile volume of blood in a tissue of the subject over time;

a processor configured and arranged (a) to receive input from the airway sensor and the blood volume sensor, (b) to produce a photoplethysmogram;

(c) to determine a photoplethysmogram ratio of the amplitude of the photoplethysmogram during inhalation to the amplitude of the photoplethysmogram during exhalation, and (d) to determine the change in cardiac output and/or stroke volume of the subject using the determined ratio; and

a display configured and arranged to display a representative of a parameter selected from the group consisting of the sensed airway pressure, the sensed pulsatile blood volume, the photoplethysmogram, the determined ratio, the determined cardiac output and/or stroke volume, combinations thereof.

3. A device for assessing changes in cardiac output or stroke volume of a subject according to claim 2, wherein the airway sensor is configured and arranged to sense pressure in the subject'"'"'s airway, lungs, and/or intrapleural space intermittently.

4. A device for assessing changes in cardiac output or stroke volume of a subject according to claim 2, wherein the airway sensor is configured and arranged to sense pressure in the subject'"'"'s airway, lungs, and/or intrapleural space continuously.

5. A device for assessing changes in cardiac output or stroke volume of a subject according to claim 2, wherein the blood volume sensor is configured and arranged to sense pulsatile volume of blood in a tissue of the subject intermittently.

6. A device for assessing changes in cardiac output or stroke volume of a subject according to claim 2, wherein the blood volume sensor is configured and arranged to sense pulsatile volume of blood in a tissue of the subject continuously.

7. A device for assessing changes in cardiac output or stroke volume of a subject according to claim 2, wherein the blood volume sensor is comprised in a pulse oximeter.

8. A device for assessing changes in cardiac output or stroke volume of a subject according to claim 2, wherein the representative of a parameter is the actual parameter value.

9. A device for assessing changes in cardiac output or stroke volume of a subject according to claim 2, wherein the representative of a parameter is a graphical representation of the actual parameter value.

10. A device for assessing changes in cardiac output or stroke volume of a subject according to claim 2 further comprising a pulse rate sensor in communication with the processor.

11. A device for assessing changes in cardiac output or stroke volume of a subject according to claim 10, wherein the processor is configured and arranged to calculate cardiac output by multiplying the stroke volume by the pulse rate.

12. A system for assessing changes in cardiac output or stroke volume of a subject, the system comprising:

(a) a breathing assistance system comprising

(1) a ventilation system,

(2) an airway connection system configured and arranged to link the ventilation system and the subject'"'"'s airway, and

(3) an airway pressure sensor configured and arranged to detect pressure in the ventilation system and/or the subject'"'"'s airway;

(b) a display system;

(c) a pulse oximeter comprising a blood volume sensor; and

(d) a processor in communication with the breathing assistance system, the display system, and the pulse oximeter,

wherein the processor is configured and arranged to (a) produce a photoplethysmogram, (b) determine the ratio of the amplitude of the photoplethysmogram during inhalation to the amplitude of the photoplethysmogram during exhalation, and (c) determine the change in cardiac output or stroke volume of the subject using the ratio of the amplitude of the photoplethysmogram during inhalation to the amplitude of the photoplethysmogram during exhalation.

13. A system for assessing changes in cardiac output or stroke volume of a subject according to claim 12, wherein the airway sensor is configured and arranged to sense pressure in the subject'"'"'s airway intermittently.

14. A system for assessing changes in cardiac output or stroke volume of a subject according to claim 12, wherein the airway sensor is configured and arranged to sense pressure in the subject'"'"'s airway continuously.

15. A system for assessing changes in cardiac output or stroke volume of a subject according to claim 12, wherein the blood volume sensor is configured and arranged to sense pulsatile volume of blood in a tissue of the subject intermittently.

16. A system for assessing changes in cardiac output or stroke volume of a subject according to claim 12, wherein the blood volume sensor is configured and arranged to sense pulsatile volume of blood in a tissue of the subject continuously.

17. A system for assessing changes in cardiac output or stroke volume of a subject according to claim 12, wherein the breathing assistance system is selected from the group consisting of a ventilator, a respirator, a CPAP device, a BiPAP device, and combinations thereof.

18. A system for assessing changes in cardiac output or stroke volume of a subject according to claim 17, wherein the processor is configured and arranged to calculate cardiac output by multiplying the stroke volume by the pulse rate.

19. A method of assessing changes in cardiac output or stroke volume of a subject receiving airway support from a breathing assistance system, the method comprising:

sensing pressure in the subject'"'"'s airway as a function of time;

sensing pulsatile volume of blood in a tissue of the subject as a function of time;

producing a photoplethysmogram from the sensed pulsatile volume;

determining the ratio of the amplitude of the photoplethysmogram during inhalation to the amplitude of the photoplethysmogram during exhalation; and

determining the change in cardiac output or stroke volume of the subject using the determined ratio.

20. A method according to claim 19 further comprising displaying a representative of the sensed pressure, the sensed pulsatile blood volume, the photoplethysmogram, the determined ratio, the determined cardiac output or stroke volume, or combinations thereof.

21. A method according to claim 19 further comprising sensing the subject'"'"'s pulse.

22. A method according to claim 21 further comprising calculating the change in cardiac output by multiplying the change in cardiac output or stroke volume by the sensed pulse.

23. A method according to claim 19, wherein sensing pulsatile volume of blood in a tissue of the subject comprises sensing pulsatile volume of blood in a subject'"'"'s finger, ear, forehead or foot.

24. A method of according to claim 19 further comprising referencing the stroke volume to a parameter selected from the group consisting of zero end-expiratory pressure, current active breathing assistance system control settings, and combinations thereof.