Methods and system for performing remote ischemic preconditioning

• US 9,119,761 B2
• Filed: 07/06/2012
• Issued: 09/01/2015
• Est. Priority Date: 12/06/2006
• Status: Active Grant

• Current Assignee: Hospital For SICK Children
• Original Assignee: Hospital For SICK Children
• Inventors: Caldarone, Christopher, Redington, Andrew
• Primary Examiner(s): Natnithithadha, Navin
• Application Number:
  US13/542,929
• Publication Number:
  US 20120277789A1
• Time in Patent Office: 1,152 Days
• Field of Search: 600/481, 600/483, 600/485, 600490-504, 606201-203, 334/81, 334/83, 334/85, 33490-504
• US Class Current: 1/1
• CPC Class Codes: A61B 17/132 Tourniquets sphygmomanometer A61B5/022
• CPC Class Codes: A61B 17/135 inflatable for measuring blood pressure A61B5/022; inflatable pressure pads A61F5/34
• CPC Class Codes: A61B 17/1355 Automated control means therefor
• CPC Class Codes: A61B 5/022 by applying pressure to close blood vessels, e.g. against the skin; Ophthalmodynamometers
• CPC Class Codes: A61B 5/02225 using the oscillometric method
• CPC Class Codes: A61B 5/02233 Occluders specially adapted therefor tourniquets A61B17/132
• CPC Class Codes: A61H 2201/165 Wearable interfaces
• CPC Class Codes: A61H 2201/5007 computer controlled
• CPC Class Codes: A61H 2201/5071 Pressure sensors
• CPC Class Codes: A61H 2201/5082 Temperature sensors
• CPC Class Codes: A61H 2230/30 Blood pressure A61H2230/04 takes precedence
• CPC Class Codes: A61H 9/0078 with intermittent or alternately inflated bladders or cuffs mattresses for preventing bed-sores with alternated pressurized chambers A61G7/05776
• CPC Class Codes: A61H 9/0092 Cuffs therefor

Abstract

A system for remote ischemic preconditioning that includes a cuff, and actuator, and a controller that operates the actuator according to a treatment protocol. The treatment protocol includes a plurality of treatment cycles that each comprise cuff actuation, an ischemic duration, cuff release, and a reperfusion duration.

Claims

1. An automatic device for remote ischemic preconditioning treatment, the device comprising:

a single cuff having a single bladder configured to retract about a limb of a subject;

a controller connected to said cuff, said controller being configured to perform a plurality of sequentially actuated treatment cycles, each cycle comprising;

inflating said cuff to a cuff pressure to occlude blood flow of the subject;

maintaining said cuff pressure at a pressure to occlude blood flow for an ischemic duration of one minute or more; and

deflating said cuff;

wherein said cuff is further configured to be retained about said limb and deliver said remote ischemic preconditioning treatment.

2. The device as in claim 1, wherein said controller is connected to an outer side of said cuff over said limb.

3. The device as in claim 2, wherein said controller is connected to an inflatable portion of said cuff and oriented to face a user.

4. The device as in claim 1, wherein said controller is sufficiently powered for at least two remote ischemic preconditioning treatments.

5. The device as in claim 1 further comprising a transducer that identifies reperfusion through the limb, wherein said controller receives a signal from said transducer during the ischemic duration to confirm lack of reperfusion.

6. The system as in claim 5, wherein said controller receives a signal from said transducer during deflating said cuff to confirm reperfusion through the limb.

7. The system as in claim 5, wherein said transducer is selected from a group consisting of:

a photoplethysmographic transducer, an ultrasonic flow transducer, a temperature transducer, an infrared detector, and a near infrared transducer.

8. The system as in claim 1, further comprising a safety release configured to allow blood flow through the limb when a safety criterion is met.

9. The device as in claim 8, wherein the safety criteria include one or more criteria selected from the group consisting of:

a power outage of the device, a power spike in the device, and activation of a manual release switch.

10. The device as in claim 1, wherein said controller is configured to be reprogrammable.

11. The system as in claim 10, wherein said controller includes safeguards to prevent said subject from altering said treatment cycles.

12. The device as in claim 1, further comprising a bleed valve that continuously releases pressure from said cuff.

13. The device as in claim 1, further comprising a data logger for confirmation of subject compliance with a treatment protocol.

14. The device as in claim 1, further comprising a pulse oximeter for detecting a percentage of hemoglobin that is saturated with oxygen.

15. An automatic device for remote ischemic preconditioning treatment, the device comprising:

a single cuff configured to retract about a limb of a subject, the cuff including a single bladder;

an actuator detachably connected to an outer side of said cuff over said limb;

a controller that controls said actuator, said controller being configured to perform a plurality of sequentially actuated treatment cycles, each cycle comprising;

inflating said cuff to a cuff pressure to occlude blood flow of the subject;

maintaining said cuff pressure at a pressure to occlude blood flow for an ischemic duration of one minute or more; and

deflating said cuff;

wherein after initial activation by a user, said controller is further configured to conduct and complete said entire treatment.

16. The device as in claim 15, wherein said initial activation is a single user input.

17. The device as in claim 15, wherein said controller is further configured for automatic hemodynamic surveillance of the subject during said remote ischemic preconditioning treatment.

18. The device as in claim 17, wherein said hemodynamic surveillance is based on measuring pressure in said cuff.

19. The device as in claim 18, wherein said controller is further configured to detect systolic blood pressure of said subject.

20. The device as in claim 19, wherein said controller is further configured to detect systolic blood pressure of said subject at least once during said ischemic duration.

21. A device for remote ischemic preconditioning, the device comprising:

a single cuff sized to retract about a limb of a subject, said cuff including a single bladder;

a controller connected to said cuff, said controller configured to inflate and deflate said cuff according to a remote ischemic preconditioning treatment protocol, said treatment protocol including a plurality of sequentially actuated treatment cycles, each of said treatment cycles comprising;

inflating said cuff to a cuff pressure to occlude blood flow of the subject;

maintaining said cuff pressure at a pressure to occlude blood flow for an ischemic duration of one minute or more; and

deflating said cuff;

wherein during maintaining said cuff pressure at a pressure to occlude blood flow, said controller is further configured to vary said cuff pressure at least once during at least one of said treatment cycles.

22. A device for remote ischemic preconditioning, the device comprising:

a cuff sized to retract about a limb of a subject;

a controller connected to said cuff, said controller configured to inflate and deflate said cuff according to a remote ischemic conditioning treatment protocol, said treatment protocol including a plurality of treatment cycles, each of said treatment cycles comprising;

inflating said cuff to a cuff pressure to occlude blood flow of the subject;

maintaining said cuff pressure at a pressure to occlude blood flow for an ischemic duration of one minute or more; and

deflating said cuff;

wherein during maintaining said cuff pressure at a pressure to occlude blood flow, said controller is further configured to vary said cuff pressure at least once during at least one of said treatment cycles, said controller being further configured to detect a systolic blood pressure of the subject during varying of said cuff pressure.

23. The device as in claim 22, wherein said controller is further configured to inflate said cuff pressure at or above a previously recorded systolic blood pressure during varying of said cuff pressure.

24. The device as in claim 23, wherein said controller is further configured to determine a diastolic pressure of the subject, whereby said subject is under continuous hemodynamic surveillance throughout said ischemic preconditioning treatment.