Hemodynamics-based monitoring and evaluation of a respiratory condition

• US 9,492,095 B2
• Filed: 12/01/2010
• Issued: 11/15/2016
• Est. Priority Date: 12/02/2009
• Status: Active Grant

• Current Assignee: Neetour Medical Ltd.
• Original Assignee: Neetour Medical Ltd.
• Inventors: Hornick, Ofer
• Primary Examiner(s): Thomson, William
• Assistant Examiner(s): Archer, Marie
• Application Number:
  US13/513,020
• Publication Number:
  US 20120238834A1
• Time in Patent Office: 2,176 Days
• US Class Current: 1/1
• CPC Class Codes: A61B 5/002 Monitoring the patient using a local or closed circuit, e.g. in a room or building A61B5/0017 takes precedence
• 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 5/02416 using photoplethysmograph signals, e.g. generated by infrared radiation A61B5/14552 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 5/0816 Measuring devices for examining respiratory frequency measuring frequency of electric signals G01R23/00
• CPC Class Codes: A61B 5/0823 Detecting or evaluating cough events
• CPC Class Codes: A61B 5/14542 for measuring blood gases A61B5/14551 takes precedence
• CPC Class Codes: A61B 5/14551 for measuring blood gases
• CPC Class Codes: A61B 5/1477 non-invasive
• CPC Class Codes: A61B 5/6801 specially adapted to be attached to or worn on the body surface
• CPC Class Codes: A61B 5/6824 Arm or wrist
• CPC Class Codes: A61B 5/6831 Straps, bands or harnesses
• CPC Class Codes: A61B 5/6833 Adhesive patches
• 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 7/003 Detecting lung or respiration noise
• CPC Class Codes: G16H 40/60 for the operation of medical equipment or devices

Abstract

Assessment of a respiratory condition of a subject, by acquiring a temporally varying hemodynamic waveform signal related to blood flow in a tissue; deriving from the hemodynamic waveform signal an evaluation of blood CO₂; acquiring at least one more signal; and determining the medical condition based on the blood CO₂ and the at least one more signal. A device for performing the assessment may include an implement disposable on the subject'"'"'s skin and structured to acquire a temporally varying hemodynamic waveform signal and derive from the signal a blood CO₂ value or a close approximation thereof; an oximeter disposable on the subject'"'"'s skin and structured to provide an oxygen saturation value of the blood of the subject or a close approximation thereof; and an apparatus structured to evaluate the medical condition of the subject based on the blood CO₂ and oxygen saturation or close approximations thereof.

Claims

1. A counter-implemented method for assessment of a respiratory condition of a subject, the method comprising:

(a) acquiring from the subject a temporally varying hemodynamic waveform signal related to blood flow in a tissue of the subject, and generating a representative cycle indicative of blood flow during a cardiac cycle therefrom;

(b) deriving from the representative cycle an evaluation of blood carbon dioxide (CO₂) of the subject by configuring a processing circuitry for;

generating a derivative cycle by computing a time derivative of the representative cycle;

determining key points and features in the derivative cycle; and

determining a CO₂ level from the key points and features determined in the derivative cycle;

wherein determining key points and features in the derivative cycle comprises determining a first point of maximum and determining a temporal distance between a first point and a second point;

(c) acquiring from the subject at least one more signal relating to the respiratory or cardiovascular condition of the subject; and

(d) determining the respiratory condition of the subject based on the blood CO₂, the at least one more signal and a relationship between the blood CO₂ and the at least one more signal.

2. The method according to claim 1, wherein the hemodynamic waveform signal is acquired during an exacerbation of an existing, previously known condition of the subject.

3. The method according to claim 2, wherein the existing, previously known condition of the subject comprises one or more of asthma, Chronic Obstructive Pulmonary Disease (COPD), cystic fibrosis, a chronic respiratory disease, metabolic derangement, a chronic cardiac condition and head trauma.

4. The method according to claim 2, wherein the existing, previously known condition of the subject comprises one or more of mechanical ventilation of the subject, supplemental oxygen intake by the subject, and medication use by the subject.

5. The method according to claim 1, wherein the respiratory condition comprises an asthma exacerbation and determining the respiratory condition comprises detecting and determining the asthma exacerbation.

6. The method according to claim 5, wherein determining the asthma exacerbation comprises comparing the blood CO₂ and the at least one more signal with obtained guidelines and values.

7. The method according to claim 6, wherein the obtained guidelines and values comprise at least one of Global Initiative for Asthma (GINA) and National Institutes of Health (NIH).

8. The method of claim 1, wherein determining a CO₂ level from the key points and features determined in the derivative cycle further comprises:

determining a tangent to a slope following the first point of maximum;

determining an intersection of the tangent with a time axis to obtain a third point; and

computing an integral of an interval starting from the third point and having a length equivalent to the determined a temporal distance between a first point and a second point.

9. A device for evaluating a respiratory condition of a subject, the device comprising:

(a) an implement disposable on the subject'"'"'s skin comprising a processing circuitry, and structured to acquire a temporally varying hemodynamic waveform signal, generate therefrom a representative cycle indicative of blood flow during a cardiac cycle and derive from the representative cycle a blood CO₂ value of the subject or a close approximation thereof by configuring a processing circuitry for;

generating a derivative cycle by computing a time derivative of the representative cycle;

determining key points and features in the derivative cycle; and

determining a CO₂ level from the key points and features determined in the derivative cycle;

wherein determining key points and features in the derivative cycle comprises determining a first point of maximum and determining a temporal distance between a first point and a second point;

(b) an oximeter disposable on the subject'"'"'s skin and structured to provide an oxygen saturation value of the blood of the subject or a close approximation thereof; and

(c) an apparatus structured to evaluate the respiratory condition of the subject based on the blood CO₂, oxygen saturation of the blood of the subject or close approximations thereof, and a relationship between the blood CO₂ and the oxygen saturation of the blood.

10. The device according to claim 9, wherein the respiratory condition comprises one or more of asthma, Chronic Obstructive Pulmonary Disease (COPD), cystic fibrosis, a chronic respiratory disease, metabolic derangement, a chronic cardiac condition and head trauma.

11. The device according to claim 9, wherein the apparatus is structured to evaluate the respiratory condition of the subject based on the blood CO₂ and oxygen saturation of the blood of the subject or close approximations thereof, and at least one of a provided respiration rate, heart rate, wheeze sound, pulsus paradoxus, or close approximations thereof.

12. The device according to claim 9, further comprising equipment providing one or more additional signals of the subject, or a close approximation thereof, and wherein the apparatus is further structured to evaluate the respiratory condition of the subject based also on the one or more additional signals.

13. The device according to claim 12, wherein the apparatus is structured to provide the respiration rate of the subject, or a close approximation thereof, from the temporally varying hemodynamic waveform signal.

14. The device according to claim 12, wherein the oximeter is structured to provide the heart rate of the subject, or a close approximation thereof.

15. The device according to claim 12, wherein the apparatus is structured to provide the heart rate of the subject, or a close approximation thereof, from a photoplethysmography signal provided by the oximeter.

16. The device according to claim 12, wherein the apparatus is structured to provide the heart rate of the subject, or a close approximation thereof, from the hemodynamic waveform signal.

17. The device according to claim 12, further comprising equipment to provide at least one of a respiration rate or heart rate of the subject, or close approximations thereof.

18. The device according to claim 12, further comprising equipment to provide a representation of wheeze sound of the subject, or a close approximation thereof.

19. The device according to claim 12, further comprising equipment to provide a representation of pulsus paradoxus of the subject, or a close approximation thereof.

20. The device according to claim 9, wherein the apparatus is structured to evaluate the respiratory condition of the subject by comparing the blood CO₂ and the oxygen saturation of the blood with provided guidelines and values.

21. The device according to claim 9, wherein the device comprises notification equipment for notifying the respiratory condition, and the apparatus is structured to provide a notification according to the respiratory condition.

22. The device of claim 9, wherein determining a CO₂ level from the key points and features determined in the derivative cycle further comprises:

determining a tangent to a slope following the first point of maximum;

determining an intersection of the tangent with a time axis to obtain a third point; and

computing an integral of an interval starting from the third point and having a length equivalent to the determined a temporal distance between a first point and a second point.