System and method for determining pulmonary performance from transthoracic impedance measures

• US 8,795,189 B2
• Filed: 02/11/2008
• Issued: 08/05/2014
• Est. Priority Date: 07/06/2004
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Ni, Quan, Hartley, Jesse W., Lee, Kent, Stahmann, Jeffrey E.
• Primary Examiner(s): Kahelin, Michael
• Assistant Examiner(s): TRAN, THO Q
• Application Number:
  US12/029,422
• Publication Number:
  US 20080132802A1
• Time in Patent Office: 2,367 Days
• Field of Search: 600/536, 600/538, 600/547, 607/20
• US Class Current: 600/536
• CPC Class Codes: A61B 5/0002 Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network A61B5/07 takes precedence; transmission systems for measured values G08C; transmission H04B; transmission of digital information H04L; wireless communication networks H04W
• CPC Class Codes: A61B 5/0535 Impedance plethysmography for measuring blood flow A61B5/0295
• CPC Class Codes: A61B 5/0809 by impedance pneumography
• CPC Class Codes: A61N 1/36521 the parameter being derived from measurement of an electrical impedance
• 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

A system and method for determining pulmonary performance from transthoracic impedance measures is provided. Transthoracic impedance measures collected by an implantable medical device are correlated to pulmonary functional measures. The pulmonary functional measures are grouped by respiratory pattern. Pulmonary performance is evaluated. Differences are determined by comparing the pulmonary functional measures for each respiratory pattern to the pulmonary functional measures for at least one previous respiratory pattern. A trend is identified from the differences. An alert is generated upon sufficient deviation of the trend from a threshold criteria.

Claims

1. A system for determining pulmonary performance from transthoracic impedance measures, comprising:

an implantable medical device comprising a transthoracic impedance sensor configured to record one or more physiological measurements comprising transthoracic impedance measures;

a correlation component to correlate the physiological measurements to pulmonary functional measures, wherein the pulmonary functional measures are selected from forced vital capacity (FVC), forced expiratory volume (FEV), FEV to FVC ratio and combinations thereof;

a database module configured to store the correlated physiological measurements; and

an evaluation component to evaluate pulmonary performance, the evaluation component comprising;

an analysis subcomponent to determine differences in pulmonary performance by comparing the correlated physiological measurements to previously correlated and stored physiological measurements including physiological measurements taken during an initial observation period in which the transthoracic impedance sensor is calibrated and a baseline is established for the transthoracic impedance sensor; and

an identification module to identify a trend from the differences;

a processor programmed with the above components.

2. A system according to claim 1, further comprising:

a collection component to collect a different set of physiological measures by a device other than the implantable medical device; and

a measure component to analyze the physiological measures against a threshold criteria.

3. A system according to claim 2, wherein the physiological measures comprise one or more of a functional residual capacity and a residual volume.

4. A system according to claim 1, wherein the pulmonary functional measures are evaluated on one of the implantable medical device and a server.

5. A system according to claim 1, further comprising:

an identification component to identify the trend comprising at least one of an absence, onset, progression, regression, and status quo of pulmonary disease.

6. A system according to claim 1, further comprising:

a comparison component to compare the pulmonary functional measures to expected pulmonary functional measures for a person not having a pulmonary disease.

7. The system according to claim 1, wherein the analysis subcomponent is configured to interpret the trend against predicted values to differentiate between obstructive and restrictive respiratory patterns.

8. The system according to claim 1, further comprising an alert subcomponent to generate an alert upon sufficient deviation of the trend from a threshold criteria.

9. A system for evaluating pulmonary performance using transthoracic impedance measures, comprising:

an implantable medical device comprising a transthoracic impedance sensor configured to record physiological measurements comprising transthoracic impedance measures;

a collection component to collect a set of physiological measurements;

a profile component to form a pulmonary volume profile comprising pulmonary functional measures derived from the set of physiological measurements;

a trend component to analyze trends by comparing the pulmonary volume profile with one or more previous pulmonary volume profiles; and

an alert component to generate an alert upon substantial deviation of the trends from expected values of the pulmonary functional measures;

wherein the pulmonary functional measures are selected from forced vital capacity (FVC), forced expiratory volume (FEV), FEV to FVC ratio and combinations thereof;

a processor programmed with the above components.

10. A system according to claim 9, further comprising:

a performance component to perform the analysis of the trends on one of the implantable medical device and a server.

11. A system according to claim 9, further comprising:

an identification component to identify an impairment of the pulmonary performance based on the analysis of the trends.

12. A system according to claim 11, wherein the impairment is representative of a respiratory pattern comprising one of an obstructive, restrictive, and obstructive-restrictive combination respiratory pattern.

13. A system according to claim 9, further comprising:

a storage component to store the pulmonary volume profile with a patient record.

14. A system according to claim 9, further comprising:

an expected value component for determining the expected values based on one or more of age, height, and gender.

15. The system according to claim 9, wherein the trend component is configured to interpret the trend to differentiate between obstructive and restrictive respiratory patterns.

16. A system for determining pulmonary performance from transthoracic impedance measures, comprising:

an implantable medical device comprising a transthoracic impedance sensor configured to record one or more physiological measurements comprising transthoracic impedance measures;

a correlation component to correlate the physiological measurements to pulmonary functional measures,

the correlation component configured to determine the start of a breathing maneuver,

wherein the pulmonary functional measures are selected from forced vital capacity (FVC), forced expiratory volume (FEV), FEV to FVC ratio and combinations thereof;

a database module configured to store the correlated physiological measurements; and

an evaluation component to evaluate pulmonary performance, the evaluation component comprising;

an analysis subcomponent to determine differences in pulmonary performance by comparing the correlated physiological measurements to previously correlated and stored physiological measurements including physiological measurements taken during an initial observation period in which the transthoracic impedance sensor is calibrated and a baseline is established for the transthoracic impedance sensor; and

an identification module to identify a trend from the differences;

a processor programmed with the above components.