System and method for closed-loop patient-adaptive hemodynamic management

• US 9,022,974 B2
• Filed: 01/12/2012
• Issued: 05/05/2015
• Est. Priority Date: 01/12/2011
• Status: Active Grant

• Current Assignee: Regents of the University of California (University of California)
• Original Assignee: Regents of the University of California (University of California)
• Inventors: Rinehart, Joseph B., Cannesson, Maxime
• Primary Examiner(s): BERDICHEVSKY, AARTI
• Application Number:
  US13/349,058
• Publication Number:
  US 20120179093A1
• Time in Patent Office: 1,209 Days
• Field of Search: 604 65- 67, 604/503
• US Class Current: 604/66
• CPC Class Codes: A61B 5/021 Measuring pressure in heart or blood vessels A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/0245 by using sensing means generating electric signals, i.e. ECG signals
• 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 5/0295 using plethysmography, i.e. measuring the variations in the volume of a body part as modified by the circulation of blood therethrough, e.g. impedance plethysmography
• CPC Class Codes: A61B 5/14542 for measuring blood gases A61B5/14551 takes precedence
• CPC Class Codes: A61B 5/4833 Assessment of subject's compliance to treatment
• CPC Class Codes: A61B 5/7203 for noise prevention, reduction or removal
• CPC Class Codes: A61M 2202/0208 Oxygen
• CPC Class Codes: A61M 2205/502 User interfaces, e.g. screens or keyboards
• CPC Class Codes: A61M 2205/52 with memories providing a history of measured variating parameters of apparatus or patient
• CPC Class Codes: A61M 2230/00 Measuring parameters of the user
• CPC Class Codes: A61M 2230/04 Heartbeat characteristics, e.g. ECG, blood pressure modulation
• CPC Class Codes: A61M 5/142 Pressure infusion, e.g. using pumps
• CPC Class Codes: A61M 5/16877 Adjusting flow; Devices for setting a flow rate
• CPC Class Codes: A61M 5/1723 using feedback of body parameters, e.g. blood-sugar, pressure measurement of body parameters A61B5/00
• CPC Class Codes: G16H 20/17 delivered via infusion or injection

Abstract

A system and method for patient-adaptive hemodynamic management is described. One embodiment includes a system for hemodynamic management including transfusion, volume resuscitation with intravenous fluids, and medications, utilizing monitored hemodynamic parameters including the described dynamic predictors of fluid responsiveness, and including an intelligent algorithm capable of adaptation of the function of the device to specific patients.

Claims

1. A device, comprising:

one or more processors; and

a memory operatively coupled to the one or more processors, the memory storing signals which, when executed by the one or more processors, cause the one or more processors to receive input information relating to one or more physiologic processes of a patient, determine a predicted change in a physiologic parameter of the patient in response to intravenous administration of a fluid bolus to the patient for the purpose of intravascular volume expansion wherein the predicted change is based at least in part on the input information, and generate a fluid administration signal in response to the predicted change wherein the fluid administration signal is useable to control the administration of an intravenous fluid to the patient in order to effect intravascular volume expansion.

2. The device of claim 1 wherein the intravenous fluid comprises a crystalloid solution.

3. The device of claim 1 wherein the intravenous fluid comprises a colloidal solution.

4. The device of claim 1 wherein the signals further cause the one or more processors to provide a control signal useable to control the administration of a medication.

5. The device of claim 1 wherein the predicted change is based at least in part upon response information associated with a patient population.

6. An infusion system, comprising:

a pump apparatus configured to control intravenous delivery of fluid to a patient in order to effect intravascular volume expansion; and

a controller that receives input information relating to one or more physiologic processes of a patient, determines a predicted change in a physiologic parameter of the patient in response to intravenous administration of a fluid bolus to the patient for the purpose of intravascular volume expansion wherein the predicted change is based at least in part on the input information, and provides a fluid administration signal to the pump apparatus in response to the predicted change.

7. The infusion system of claim 6 wherein the intravenous fluid comprises a crystalloid solution.

8. The infusion system of claim 6 wherein the intravenous fluid comprises a colloidal solution.

9. The infusion system of claim 6 wherein the controller is further configured to provide an additional fluid administration signal to the pump apparatus in order to control the administration of a medication.

10. The infusion system of claim 6 wherein the predicted change is based at least in part upon response information associated with a patient population.

11. An intelligent pump apparatus for delivering an intravenous fluid to a patient, the apparatus comprising:

an infusion pump device; and

a controller in electrical communication with the infusion pump device, the controller determining a predicted change in a physiologic parameter of the patient in response to intravenous administration of a fluid bolus to the patient for the purpose of intravascular volume expansion and providing a pump control signal to the infusion pump device in response to the predicted change wherein the infusion pump device is configured to infuse the intravenous fluid to the patent in order to effect intravascular volume expansion,

wherein the controller is further configured to provide an additional pump control signal to the infusion pump device in order to control the administration of a medication.

12. An intelligent pump apparatus for delivering an intravenous fluid to a patient, the apparatus comprising:

an infusion pump device; and

a controller in electrical communication with the infusion pump device, the controller determining a predicted change in a physiologic parameter of the patient in response to intravenous administration of a fluid bolus to the patient for the purpose of intravascular volume expansion and providing a pump control signal to the infusion pump device in response to the predicted change wherein the infusion pump device is configured to infuse the intravenous fluid to the patent in order to effect intravascular volume expansion,

wherein the predicted change is based at least in part upon response information associated with a patient population.