Method and system for determining a cerebrovascular autoregulation state of a patient

• US 8,556,811 B2
• Filed: 01/04/2008
• Issued: 10/15/2013
• Est. Priority Date: 02/02/2007
• Status: Active Grant

• Current Assignee: Johns Hopkins University
• Original Assignee: Johns Hopkins University
• Inventors: Brady, Ken M.
• Primary Examiner(s): Mallari, Patricia
• Assistant Examiner(s): D'ANGELO, MICHAEL J
• Application Number:
  US12/525,029
• Publication Number:
  US 20100010322A1
• Time in Patent Office: 2,111 Days
• Field of Search: 600300-301, 600309-310, 600322-324, 600/364, 600/481, 600483-486
• US Class Current: 600/301
• CPC Class Codes: A61B 5/02028 Determining haemodynamic parameters not otherwise provided for, e.g. cardiac contractility or left ventricular ejection fraction
• CPC Class Codes: A61B 5/021 Measuring pressure in heart or blood vessels A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/022 by applying pressure to close blood vessels, e.g. against the skin; Ophthalmodynamometers
• CPC Class Codes: A61B 5/0261 using optical means, e.g. infrared light
• CPC Class Codes: A61B 5/031 Intracranial pressure
• CPC Class Codes: A61B 5/14553 specially adapted for cerebral tissue
• CPC Class Codes: A61B 5/1459 invasive, e.g. introduced into the body by a catheter A61B5/1464 takes precedence
• CPC Class Codes: A61B 5/4064 Evaluating the brain A61B5/031, A61B5/369, A61B5/14553 take precedence

Abstract

A method of diagnosing cerebrovascular autoregulation in a patient includes measuring blood pressure of the patient, measuring, non-invasively, venous oxygen content of the patient'"'"'s brain substantially simultaneously with the measuring blood pressure, correlating the blood pressure and the venous oxygen content measurements in a time domain, and determining a cerebrovascular autoregulation state of the patient based on the correlating the blood pressure and the venous oxygen content measurements.

Claims

1. A method of diagnosing cerebrovascular autoregulation in a patient, comprising:

measuring blood pressure of said patient;

measuring, non-invasively, venous oxygen content of said patient'"'"'s brain substantially simultaneously with said measuring blood pressure;

correlating said blood pressure and said venous oxygen content measurements in a time domain; and

determining, using a data processing unit, a cerebrovascular autoregulation state of said patient based on said correlating said blood pressure and said venous oxygen content measurements.

2. A method of diagnosing cerebrovascular autoregulation in a patient according to claim 1, wherein said measuring blood pressure comprises low-pass filtering said blood pressure measurements to allow measurement of only time-dependent blood pressure variations having a frequency lower than a threshold frequency.

3. A method of diagnosing cerebrovascular autoregulation in a patient according to claim 1, wherein said measuring blood pressure comprises sampling values of said patient'"'"'s arterial blood pressure at a substantially periodic sampling rate, wherein said substantially periodic sampling rate is selected to have a value to provide low-pass filtering of said arterial blood pressure to allow measurement of only time-dependent blood pressure variations having a frequency lower than a threshold frequency.

4. A method of diagnosing cerebrovascular autoregulation in a patient according to claim 3, wherein said measuring, non-invasively, venous oxygen content comprises sampling values of said patient'"'"'s venous oxygen content synchronously with said sampling values of said patient'"'"'s blood pressure.

5. A method of diagnosing cerebrovascular autoregulation in a patient according to claim 4, wherein said correlating said arterial blood pressure and said venous oxygen content measurements comprises calculating a linear correlation coefficient having a value that is indicative of said autoregulation state of said patient.

6. A method of diagnosing cerebrovascular autoregulation in a patient according to claim 5, further comprising displaying said linear correlation coefficient as a function of arterial blood pressure to provide a pattern that is indicative of said autoregulation state of said patient.

7. A method of diagnosing cerebrovascular autoregulation in a patient according to claim 5, further comprising measuring an intracranial pressure of said patient and displaying said linear correlation coefficient as a function of a cerebral perfusion pressure of said patient to provide a pattern that is indicative of said autoregulation state of said patient, said cerebral perfusion pressure being calculated as a difference between said arterial blood pressure and said intracranial pressure.

8. A method of diagnosing cerebrovascular autoregulation in a patient according to claim 1, wherein said measuring, non-invasively, venous oxygen content of said patient'"'"'s brain comprises measuring differential absorption of near-infra-red radiation directed into said patient'"'"'s brain from a source of near-infra-red radiation disposed proximate an external position of said patient'"'"'s head.

9. A system for diagnosing cerebrovascular autoregulation in a patient, comprising:

a cerebral oximeter arranged proximate an external position of said patient'"'"'s head;

a blood pressure monitoring device adapted to be attached to said patient; and

a signal processing unit in communication with said cerebral oximeter and said blood pressure monitoring device,

wherein said cerebral oximeter obtains oxygen content measurements of blood within said patient'"'"'s brain taken at a plurality of times and outputs an oxygen content signal to said signal processing unit,

wherein said blood pressure monitoring device obtains arterial blood pressure measurements of said patient at a plurality of times substantially synchronously with said oxygen content measurements and outputs an arterial blood pressure signal to said signal processing unit, and

wherein said signal processing unit calculates a linear correlation coefficient based on said oxygen content signal and said arterial blood pressure signal in a time domain for a plurality of times.

10. A system for diagnosing cerebrovascular autoregulation in a patient according to claim 9, wherein at least one of said cerebral oximeter or said signal processor provides low-pass filtering of said oxygen content signal.

11. A system for diagnosing cerebrovascular autoregulation in a patient according to claim 9, wherein at least one of said blood pressure monitoring device or said signal processor provides low-pass filtering of said blood pressure signal.

12. A system for diagnosing cerebrovascular autoregulation in a patient according to claim 9, wherein said oximeter is a near-infra-red spectrometer.

13. A system for diagnosing cerebrovascular autoregulation in a patient according to claim 9, further comprising a display unit to display said linear correlation coefficient values with respect to other biophysical data of said patient.

14. A system for diagnosing cerebrovascular autoregulation in a patient according to claim 13, wherein said other biophysical data of said patient with respect to which said linear correlation coefficient is displayed is at least one of arterial blood pressure or cerebral perfusion pressure of said patient.

15. A system for diagnosing cerebrovascular autoregulation in a patient according to claim 9, wherein said blood pressure monitoring device comprises an arterial blood pressure monitoring device.

16. A system for diagnosing cerebrovascular autoregulation in a patient according to claim 15, wherein said blood pressure monitoring device comprises an intracranial pressure monitoring device.

17. A system for diagnosing cerebrovascular autoregulation in a patient according to claim 16, wherein said signal processing unit calculates cerebral perfusion pressure of said patient based on measured arterial blood pressure and measured intracranial pressure of said patient.

18. A system for diagnosing cerebrovascular autoregulation in a patient according to claim 17, wherein said other biophysical data of said patient with respect to which said linear correlation coefficient is displayed is cerebral perfusion pressure of said patient.

19. A method of treating a patient, comprising:

measuring blood pressure of said patient;

measuring, non-invasively, venous oxygen content of said patient'"'"'s brain substantially simultaneously with said measuring blood pressure;

correlating said blood pressure and said venous oxygen content measurements;

determining, using a data processing unit, a cerebrovascular autoregulation state of said patient based on said correlating said blood pressure and said venous oxygen content measurements; and

causing a change of blood pressure of said patient based on said cerebrovascular state of said patient determined based on said correlating.

20. A method of treating a patient according to claim 19, wherein said causing a change of said blood pressure comprises administering a substance to said patient that causes said patient'"'"'s body to react with a change in blood pressure.

21. A data processing unit for use with a system for diagnosing cerebrovascular autoregulation in a patient, comprising:

at least one signal input port adapted to receive an arterial blood pressure signal from measured arterial blood pressure data from said patient and to receive a venous oxygen content signal from externally measured venous oxygen content data of said patient'"'"'s brain;

a signal correlation component adapted to receive and correlate said arterial blood pressure signal with said venous oxygen content signal to provide a correlation coefficient indicative of a cerebrovascular autoregulation state of said patient; and

a signal output port to output said correlation coefficient to indicate said cerebrovascular autoregulation state of said patient based on said correlation coefficient.

22. A data processing unit for use with a system for diagnosing cerebrovascular autoregulation in a patient according to 21, further comprising a low pass filter adapted to filter at least one of said measured arterial blood pressure data and said externally measured venous oxygen content data prior to being correlated by said signal correlation component.

23. A data processing unit for use with a system for diagnosing cerebrovascular autoregulation in a patient according to 21, wherein said at least one signal input port is adapted to also receive an intracranial pressure signal from measured intracranial pressure data from said patient.

24. A data processing unit for use with a system for diagnosing cerebrovascular autoregulation in a patient according to 23, further comprising a cerebral perfusion pressure calculating unit adapted to calculate cerebral perfusion pressure based on said measured arterial blood pressure data and said measured intracranial pressure data.

25. A non-transient computer readable medium programmed to process data for a system for diagnosing cerebrovascular autoregulation in a patient, comprising:

at least one signal receiving component adapted to receive a blood pressure signal from measured blood pressure data from said patient and to receive a venous oxygen content signal from externally measured venous oxygen content data of said patient'"'"'s brain;

a signal correlation component adapted to receive and correlate said arterial blood pressure signal with said venous oxygen content signal to provide a correlation coefficient indicative of a cerebrovascular autoregulation state of said patient; and

a signal output component adapted to output said correlation coefficient to indicate said cerebrovascular autoregulation state of said patient based on said correlation coefficient.