Fluid deficit monitoring in a fluid management system

• US 8,597,228 B2
• Filed: 03/09/2010
• Issued: 12/03/2013
• Est. Priority Date: 03/09/2009
• Status: Active Grant

• Current Assignee: Stryker Corporation
• Original Assignee: Thermedx, LLC (Stryker Corporation)
• Inventors: Pyles, Kenneth R., Williams, Jeffrey B.
• Primary Examiner(s): Mehta, Bhisma
• Application Number:
  US12/720,496
• Publication Number:
  US 20100228224A1
• Time in Patent Office: 1,365 Days
• Field of Search: 604/28, 604/503, 177/25.13, 177/25.19
• US Class Current: 604/28
• CPC Class Codes: A61M 1/72 Cassettes forming partially or totally the fluid circuit
• CPC Class Codes: A61M 1/77 Suction-irrigation systems aspiration tips supplying fluids A61M1/85; specific for negative pressure wound therapy A61M1/92; combined with tracheal tubes A61M16/0463
• CPC Class Codes: A61M 1/777 Determination of loss or gain of body fluids due to suction-irrigation, e.g. during surgery
• CPC Class Codes: A61M 2205/123 with incorporated reservoirs
• CPC Class Codes: A61M 2205/127 with provisions for heating or cooling
• CPC Class Codes: A61M 2205/3331 Pressure; Flow
• CPC Class Codes: A61M 2205/3334 Measuring or controlling the flow rate
• CPC Class Codes: A61M 2205/3344 Measuring or controlling pressure at the body treatment site
• CPC Class Codes: A61M 2205/368 by electromagnetic radiation, e.g. IR waves
• CPC Class Codes: A61M 2205/502 User interfaces, e.g. screens or keyboards
• CPC Class Codes: A61M 2205/505 Touch-screens; Virtual keyboard or keypads; Virtual buttons; Soft keys; Mouse touches
• CPC Class Codes: A61M 3/0201 Cassettes therefor
• CPC Class Codes: A61M 3/0202 with electronic control means or interfaces
• CPC Class Codes: A61M 3/0208 before use
• CPC Class Codes: A61M 3/0216 Pressure
• CPC Class Codes: A61M 3/022 Volume; Flow rate
• CPC Class Codes: A61M 3/0245 Containers therefor, e.g. with heating means or with storage means for cannula
• CPC Class Codes: A61M 3/0258 by means of electric pumps
• CPC Class Codes: A61M 5/142 Pressure infusion, e.g. using pumps
• CPC Class Codes: A61M 5/172 electrical or electronic A61M5/16804, A61M5/16831 take precedence
• CPC Class Codes: A61M 5/36 : with means for eliminating or preventing injection or infusion of air into body dialysis systems, blood oxygenators A61M1/14; haemofiltration equipment A61M1/34; automatic tube cut-off A61M39/281
• CPC Class Codes: A61M 5/44 : having means for cooling or heating the devices or media
• CPC Class Codes: G01G 17/04 : for weighing fluids, e.g. gases, pastes
• CPC Class Codes: G01G 19/414 : using electronic computing means only

Abstract

Surgical fluid management systems and methods of operating surgical fluid management systems which may provide one or more functions associated with suction, irrigation, distention, deficit monitoring, infusion, fluid warming, and the like. Some example embodiments may include infra-red lamps arranged to heat fluid flowing through a disposable cartridge. Some example embodiments may provide a three-dimensional fluid path through the cartridge and/or multi-stage heating capabilities. Some example fluid management systems may be selectable between pressure control and flow control modes.

Claims

1. A method of monitoring a fluid deficit in a fluid management system, the method comprising:

measuring an initial weight held by a fluid supply container support, the fluid supply container support supporting a first fluid supply container;

measuring an initial weight held by a fluid collection container support, the fluid collection container support supporting a first fluid collection container;

calculating an initial reference total weight, the initial reference total weight including a sum of the initial weight held by the fluid supply container support and the initial weight held by the fluid collection container support;

supplying fluid from the first fluid supply container to a site, said site being a surgical site or a patient;

collecting at least some of the fluid from the site into the first fluid collection container;

measuring a first current weight held by the fluid supply container support;

measuring a first current weight held by the fluid collection container support;

calculating a first current total weight, the first current total weight including a sum of the first current weight held by the fluid supply container support and the first current weight held by the fluid collection container support; and

calculating a first fluid deficit by determining a difference between the first current total weight and the initial reference total weight.

2. The method of claim 1, further comprising

priming a tubing set prior to (a) measuring the initial weight held by the fluid supply container support and (b) measuring the initial weight held by the fluid collection container support.

3. The method of claim 1, further comprising

after calculating the first fluid deficit, supplying fluid from the first fluid supply container to the site and collecting at least some of the fluid from the site into the first collection container;

measuring a second current weight held by the fluid supply container support;

measuring a second current weight held by the fluid collection container support;

calculating a second current total weight, the second current total weight including a sum of the second current weight held by the fluid supply container support and the second current weight held by the fluid collection container support; and

calculating a second fluid deficit by determining a difference between the second current total weight and the initial reference total weight.

4. The method of claim 3, further comprising

after calculating the second fluid deficit, accounting for replacement of the first fluid supply container with a second fluid supply container by:

measuring a pre-replacement weight held by the fluid supply container support prior to replacement of the first fluid supply container with the second fluid supply container,

measuring a post-replacement weight held by the fluid supply container support after replacement of the first fluid supply container by the second fluid supply container,

calculating a fluid supply container weight difference by subtracting the pre-replacement weight from the post-replacement weight, and

calculating an updated reference total weight, the updated reference total weight including the sum of the initial reference total weight and the fluid supply container weight difference.

5. The method of claim 4, further comprising

after calculating the updated total reference weight, supplying fluid from the second fluid supply container to the site and collecting at least some of the fluid from the site into the first collection container;

measuring a third current weight held by the fluid supply container support;

measuring a third current weight held by the fluid collection container support;

calculating a third current total weight, the third current total weight including a sum of the third current weight held by the fluid supply container support and the third current weight held by the fluid collection container support; and

calculating a third fluid deficit by determining a difference between the third current total weight and the updated reference total weight.

6. The method of claim 5, further comprising

detecting replacement of the first fluid supply container by the second fluid supply container by ascertaining a substantial weight difference between the pre-replacement weight and the post-replacement weight.

7. The method of claim 6, wherein the substantial weight difference corresponds approximately to a predetermined expected fluid supply container replacement weight difference.

8. The method of claim 6, wherein ascertaining the substantial weight difference includes waiting for a period of time to allow dissipation of transient weight signals present due to inadvertent motion of the fluid management system.

9. The method of claim 6, wherein detecting replacement of the first fluid supply container by the second fluid supply container includes detecting replacement of a partially depleted first fluid supply container by a substantially full second fluid supply container.

10. The method of claim 3, further comprising

after calculating the second fluid deficit, accounting for replacement of the first fluid collection container with a second fluid collection container by:

measuring a pre-replacement weight held by the fluid collection container support prior to replacement of the first fluid collection container with the second fluid collection container,

measuring a post-replacement weight held by the fluid collection container support after replacement of the first fluid collection container by the second fluid collection container,

calculating a fluid collection container weight difference by subtracting the pre-replacement weight from the post-replacement weight, and

calculating an updated reference total weight, the updated reference total weight including the sum of the initial reference total weight and the fluid collection container weight difference.

11. The method of claim 10, further comprising

after calculating the updated total reference weight, supplying fluid from the first fluid supply container to the site and collecting at least some of the fluid from the site into the second collection container;

measuring a third current weight held by the fluid supply container support;

measuring a third current weight held by the fluid collection container support;

calculating a third current total weight, the third current total weight including a sum of the third current weight held by the fluid supply container support and the third current weight held by the fluid collection container support; and

calculating a third fluid deficit by determining a difference between the third current total weight and the updated reference total weight.

12. The method of claim 10, further comprising

detecting replacement of the first fluid collection container by the second fluid collection container by ascertaining a substantial weight difference between the pre-replacement weight and the post-replacement weight.

13. The method of claim 12, wherein the substantial weight difference corresponds approximately to a predetermined expected fluid collection container replacement weight difference.

14. A method of monitoring a fluid deficit in a fluid management system, the method comprising:

measuring an initial weight held by a fluid supply container support, the fluid supply container support supporting at least one fluid supply container;

measuring an initial weight held by a fluid collection container support, the fluid collection container support supporting at least one fluid collection container;

calculating an initial reference total weight, the initial reference total weight including a sum of the initial weight held by the fluid supply container support and the initial weight held by the fluid collection container support;

supplying fluid from the at least one fluid supply container to a site, said site being a surgical site or a patient;

collecting at least some of the fluid from the site into the at least one fluid collection container;

monitoring a current weight held by the fluid supply container support;

monitoring a current weight held by the fluid collection container support;

calculating a current total weight, the current total weight including a sum of the current weight held by the fluid supply container support and the current weight held by the fluid collection container support; and

calculating a current fluid deficit by determining a difference between the current total weight and the initial reference total weight.

15. The method of claim 14, further comprising accounting for replacement of the at least one fluid supply container with a new fluid supply container including

sensing a significant difference between a pre-replacement fluid supply container support weight and a post-replacement fluid supply container support weight;

calculating a fluid supply container weight difference by subtracting the pre-replacement fluid supply container support weight from the post-replacement fluid supply container support weight;

calculating an updated reference total weight, the updated reference total weight including the sum of the initial reference total weight and the fluid supply container weight difference; and

using the updated reference total weight in subsequent fluid deficit calculations.

16. The method of claim 14, further comprising accounting for replacement of the at least one fluid collection container with a new fluid collection container including

sensing a significant difference between a pre-replacement fluid collection container support weight and a post-replacement fluid collection container support weight;

calculating a fluid collection container weight difference by subtracting the pre-replacement fluid collection container support weight from the post-replacement fluid collection container support weight;

calculating an updated reference total weight, the updated reference total weight including the sum of the initial reference total weight and the fluid collection container weight difference; and

using the updated reference total weight in subsequent fluid deficit calculations.

17. The method of claim 14, further comprising repeating the following steps to provide a substantially continuously updated fluid deficit calculation:

monitoring the current weight held by the fluid supply container support,

monitoring the current weight held by the fluid collection container support,

calculating the current total weight, and

calculating the current fluid deficit.

18. The method of claim 14, further comprising

priming a tubing set prior to (a) measuring the initial weight held by the fluid supply container support and (b) measuring the initial weight held by the fluid collection container support.

19. A method of operating a fluid management device comprising:

calculating an initial reference total weight, the initial reference total weight including a sum of an initial weight of a fluid supply container and an initial weight of a fluid collection container;

supplying fluid from the fluid supply container to a site, said site being a surgical site or a patient;

collecting at least some of the fluid from the site into the fluid collection container;

calculating a current total weight, the current total weight including a sum of a current weight of the fluid supply container and a current weight of the fluid collection container; and

calculating a deficit by determining a difference between the current total weight and the initial reference total weight.

20. The method of claim 19, further comprising

detecting replacement of the fluid supply container by a replacement fluid supply container by ascertaining a substantial weight difference between a pre-replacement weight of the fluid supply container and a post-replacement weight of the replacement fluid supply container;

and

calculating an updated reference total weight, the updated reference total weight including the sum of (a) the initial reference total weight and (b) a difference between the post-replacement weight of the replacement fluid supply container and the pre-replacement weight of the fluid supply container.

21. The method of claim 20, further comprising

supplying fluid from the replacement fluid supply container to the site;

collecting at least some of the fluid from the site into the fluid collection container;

calculating an updated current total weight, the updated current total weight including a sum of an updated current weight of the replacement fluid supply container and an updated current weight of the fluid collection container; and

calculating an updated deficit by determining a difference between the updated current total weight and the updated reference total weight.

22. The method of claim 21, further comprising

detecting replacement of the fluid collection container by a replacement fluid collection container by ascertaining a substantial weight difference between a pre-replacement weight of the fluid collection container and a post-replacement weight of the replacement fluid collection container;

and

calculating an updated reference total weight, the updated reference total weight including the sum of (a) the initial reference total weight and (b) a difference between the post-replacement weight of the replacement fluid collection container and the pre-replacement weight of the fluid collection container.

23. The method of claim 22, further comprising

supplying fluid from the fluid supply container to the site;

collecting at least some of the fluid from the site into the replacement fluid collection container;

calculating an updated current total weight, the updated current total weight including a sum of an updated current weight of the fluid supply container and an updated current weight of the replacement fluid collection container; and

calculating an updated deficit by determining a difference between the updated current total weight and the updated reference total weight.

24. The method of claim 19, further comprising

priming a tubing set prior to summing (a) the initial weight of the fluid supply container and (b) the initial weight of the fluid collection container.

25. A method of monitoring fluid flow in a fluid management system, wherein fluid is supplied from at least one fluid supply container to a site, said site being a surgical site or a patient, the method comprising:

generating a first electrical signal associated with a weight held by a fluid supply container support, the fluid supply container support supporting the at least one fluid supply container;

generating a second electrical signal associated with a weight held by a fluid collection container support, the fluid collection container support supporting at least one fluid collection container, and

determining a fluid deficit using the first and second electrical signals, including;

calculating a difference between (1) an initial total system weight comprised of a sum of an initial weight held by the fluid supply container support and an initial weight held by the fluid collection container support and (2) a current total system weight comprised of a sum of a current weight held by the fluid supply container support and a current weight held by the fluid collection container support.

26. The method of claim 25, further comprising

establishing a deficit alarm limit indicative of a maximum fluid deficit;

and

activating a deficit alarm when the fluid deficit exceeds the maximum fluid deficit.

27. The method of claim 26, further comprising

adjusting the deficit alarm limit within a predetermined range.

28. The method of claim 25, further comprising

selecting enablement or disablement of fluid deficit monitoring.

29. The method of claim 25, further comprising

establishing a perforation alarm limit indicative of a maximum rate of change of said fluid deficit;

and

activating a perforation alarm when the rate of change of said fluid deficit exceeds the maximum rate of change of said fluid deficit.

30. The method of claim 29, further comprising

adjusting the perforation alarm limit within a predetermined range.