Automated interpretive medical care system and methodology

• US 8,679,029 B2
• Filed: 06/23/2008
• Issued: 03/25/2014
• Est. Priority Date: 12/07/2000
• Status: Active Grant

• Current Assignee: Children's Medical Center Corporation, Oridion Medical 1987 Limited (Medtronic Plc), Physio-Control Incorporated (Stryker Corporation)
• Original Assignee: Children's Medical Center Corporation, Oridion Medical (1987) Ltd. (Medtronic Plc)
• Inventors: Hampton, David Robert, Carlebach, Ephraim, Krauss, Baruch Schlomo
• Primary Examiner(s): Matthews, Christine
• Assistant Examiner(s): Reddy, Sunita
• Application Number:
  US12/213,619
• Publication Number:
  US 20090143694A1
• Time in Patent Office: 2,101 Days
• Field of Search: 600/532, 600/529, 600/353, 128/898, 128/897
• US Class Current: 600/532
• CPC Class Codes: A61B 2560/0431 Portable apparatus, e.g. comprising a handle or case
• CPC Class Codes: A61B 2560/0437 Trolley or cart-type apparatus
• CPC Class Codes: A61B 5/0006 ECG or EEG signals
• CPC Class Codes: A61B 5/0022 Monitoring a patient using a global network, e.g. telephone networks, internet
• 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 5/021 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 5/024 Detecting, measuring or recording pulse rate or heart rate A61B5/0205, A61B5/021 take precedence
• CPC Class Codes: A61B 5/02438 with portable devices, e.g. worn by the patient
• CPC Class Codes: A61B 5/08 Detecting, measuring or recording devices for evaluating the respiratory organs A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/0816 Measuring devices for examining respiratory frequency measuring frequency of electric signals G01R23/00
• CPC Class Codes: A61B 5/082 Evaluation by breath analysis, e.g. determination of the chemical composition of exhaled breath A61B5/083, A61B5/091 take precedence
• CPC Class Codes: A61B 5/0836 Measuring rate of CO2 production
• CPC Class Codes: A61B 5/1455 using optical sensors, e.g. spectral photometrical oximeters
• CPC Class Codes: A61B 5/14552 Details of sensors specially adapted therefor
• CPC Class Codes: A61B 5/14553 specially adapted for cerebral tissue
• CPC Class Codes: A61B 5/318 Heart-related electrical modalities, e.g. electrocardiography [ECG]
• CPC Class Codes: A61B 5/369 Electroencephalography [EEG] devices for psychotechnics A61B5/16
• CPC Class Codes: A61B 5/411 Detecting or monitoring allergy or intolerance reactions to an allergenic agent or substance
• CPC Class Codes: A61B 5/6835 Supports or holders, e.g., articulated arms
• CPC Class Codes: A61B 5/7264 : Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems neural networks per se G06N3/00; expert systems per se G06N5/00
• CPC Class Codes: A61B 5/7275 : Determining trends in physiological measurement data; Predicting development of a medical condition based on physiological measurements, e.g. determining a risk factor
• CPC Class Codes: A61B 5/7282 : Event detection, e.g. detecting unique waveforms indicative of a medical condition A61B5/4094, A61B5/4818, A61B5/349, A61B5/0823 take precedence
• CPC Class Codes: A61B 5/7425 : Displaying combinations of multiple images regardless of image source, e.g. displaying a reference anatomical image with a live image geometric transforms for image registration G06T3/14; enhancement using image fusion G06T5/50; algorithms for registration of images G06T7/30
• CPC Class Codes: A61B 5/746 : Alarms related to a physiological condition, e.g. details of setting alarm thresholds or avoiding false alarms alarms per se G08B
• CPC Class Codes: G16H 40/63 : for local operation
• CPC Class Codes: G16H 40/67 : for remote operation
• CPC Class Codes: G16H 50/30 : for calculating health indices; for individual health risk assessment

Abstract

Improved apparatus and methods for monitoring, diagnosing and treating at least one medical respiratory condition of a patient are provided, including a medical data input interface adapted to provide at least one medical parameter relating at least to the respiration of the patient, and a medical parameter interpretation functionality (104, 110) adapted to receive the at least one medical parameter relating at least to the respiration (102) of the patient and to provide at least one output indication (112) relating to a degree of severity of at least one medical condition indicated by the at least one medical parameter.

Claims

1. A method employing at least signal processing of a CO2 waveform for providing an output indication relating to at least one respiratory disorder of a patient, the method comprising:

receiving, from a capnograph, a CO2 waveform indicative of partial-pressure CO2 values of the patient;

receiving from a second sensing unit a second signal indicative of a second medical parameter; and

using a processor;

defining at least one section of the CO2 waveform;

wherein the parameter comprises a slope of a CO2 concentration curve, an angle of rise, a time to rise, run time of the rise, curvature,

acceleration, or area under the curve of said at least one section of the CO2 waveform, or any combination of these parameters;

computing at least one parameter relating to the CO2 waveform; and

wherein computing at least one parameter relating to the CO2 waveform comprises computing an initial slope and an angle of rise to a predetermined percentage of a maximum concentration of CO2;

diagnosing a type and a degree of severity of said at least one respiratory disorder indicated by said at least one parameter relating to the CO2 waveform, wherein diagnosing the type of said respiratory disorder comprises

identifying respiration impairment based on said at least one parameter relating to the CO2 waveform and said second medical parameter; and

if respiration impairment is identified;

distinguishing between an upper airway obstruction and a lower airway obstruction;

wherein distinguishing between said upper airway obstruction and said lower airway obstruction comprises determining a time duration to reach a predetermined percentage of a maximum CO2 concentration; and

providing an output indication responsive to a pattern of changes in the degree of severity of said respiration impairment over time.

2. The method of claim 1, wherein defining at least one section of a CO₂ waveform comprises defining a region between two boundary points on the CO₂ waveform.

3. The method of claim 1, comprising defining at least two sections of the waveform.

4. The method of claim 1, comprising defining at least three sections of the waveform.

5. The method of claim 4, wherein a first section of the at least three sections comprises a rising section, a second section of the at least three sections comprises a plateau and a third section of the at least three sections comprises a declining section.

6. The method of claim 1, further comprising defining a baseline section.

7. The method of claim 1, further comprising comparing a value of said at least one parameter relating to the CO2 waveform and said second medical parameter to a predetermined value.

8. The method of claim 7, further comprising determining whether the value of the parameter exceeds the predetermined value.

9. The method of claim 7, further comprising determining whether the value of the parameter is at or below the predetermined value.

10. The method of claim 1, further comprising comparing a value of

said at least one parameter relating to the CO2 waveform and said second medical parameter to a predetermined range of values.

11. The method of claim 10, further comprising determining whether the value of the parameter exceeds the predetermined range of values.

12. The method of claim 11, further comprising determining whether the value of the parameter is within or below the predetermined range of values.

13. The method of claim 1, further comprising comparing a value of a parameter to a previously computed value of the parameter.

14. The method of claim 13, further comprising determining whether the value of said at least one parameter relating to the CO2 waveform and said second medical parameter exceeds the previously computed value of the parameter.

15. The method of claim 13, further comprising determining whether the value of the parameter is at or below the previously computed value of the parameter.

16. The method of claim 1, further comprising comparing a value of

said at least one parameter relating to the CO2 waveform and said second medical parameter to a range of previously computed values of the parameter.

17. The method of claim 16, further comprising determining whether the value of the parameter exceeds the range of previously computed values of the parameter.

18. The method of claim 16, further comprising determining whether the value of the parameter is within or below the range of previously computed values of the parameter.

19. The method of claim 16, further comprising determining whether the value of the parameter exceeds a baseline value.

20. The method of claim 16, further comprising determining whether the value of the parameter exceeds a varying baseline value in a statistically significant way.

21. The method of claim 20, wherein the determining of whether the value of the parameter exceeds the varying baseline value in a statistically significant way comprises determining a Z-score for the value of the parameter against the varying baseline value, and using the Z-score to determine whether the varying baseline value and the value of the parameter are significantly different.

22. The method of claim 1, further comprising computing a trend of the at least one parameter relating to the waveform.

23. The method of claim 22, further comprising comparing a value of the trend to a predetermined value.

24. The method of claim 23, further comprising determining whether the value of the trend is at or below the predetermined value.

25. The method of claim 24, further comprising determining whether the value of the trend exceeds a varying baseline value in a statistically significant way.

26. The method of claim 25, further comprising the steps of calculating a variation of a trend, and determining a Z-score for a measured value against the variation of the trend, then using the Z-score to determine whether the variation of the trend and the measured value are significantly different.

27. The method of claim 22, further comprising determining whether the value of the trend exceeds the predetermined value.

28. The method of claim 22, further comprising comparing a value of the trend to a predetermined range of values.

29. The method of claim 28, further comprising determining whether the value of the trend exceeds the predetermined range of values.

30. The method of claim 28, further comprising determining whether the value of the trend is within or below the predetermined range of values.

31. The method of claim 1, further comprising storing said at least one parameter relating to the CO2 waveform and said second medical parameter.