Method and system for detection of respiratory variation in plethysmographic oximetry

• US 9,757,043 B2
• Filed: 06/17/2013
• Issued: 09/12/2017
• Est. Priority Date: 12/06/2007
• Status: Active Grant

• Current Assignee: Los Angeles Biomedical Research Institute At Harbor-Ucla Medical Center (University of California)
• Original Assignee: Los Angeles Biomedical Research Institute At Harbor-Ucla Medical Center (University of California)
• Inventors: Mason, Gregory R., Criley, John M., Criley, Stuart R.
• Primary Examiner(s): JANG, CHRISTIAN YONGKYUN
• Application Number:
  US13/919,878
• Publication Number:
  US 20130281805A1
• Time in Patent Office: 1,548 Days
• 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 5/0816 Measuring devices for examining respiratory frequency measuring frequency of electric signals G01R23/00
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle

Abstract

A method and system for detection of pulsus paradoxus are provided. In one embodiment, the method includes determining a power spectrum density for a plethysmographic waveform and identifying pulsus paradoxus based on the power spectrum density. The power spectrum density may include a first wave peak indicative of a respiratory rate and a second wave peak indicative of a heart rate. Pulsus paradoxus can be identified by comparing a height of the first wave peak and a height of the second wave peak.

Claims

1. A method comprising:

retrieving, from a storage element by a waveform analysis application, a plurality of samples representing a plethysmographic waveform of a patient;

calculating, by the waveform analysis application, a power spectrum density for the plurality of samples representing the plethysmographic waveform of the patient;

detecting, by the waveform analysis application, a first wave peak of the power spectrum density and a second wave peak of the power spectrum density, wherein the first wave peak is indicative of a respiratory activity of the patient and the second wave peak is indicative of a heart rate of the patient;

determining, by the waveform analysis application, a proportion of the first wave peak to the second wave peak, and

triggering, by the waveform analysis application and responsive to the determined proportion being within a predetermined range, an alarm to alert the patient or a health care provider to the presence of pulsus paradoxus.

2. The method of claim 1, wherein determining the proportion comprises comparing a height of the first wave peak to a height of the second wave peak and the predetermined range is from 0.6 to 3.

3. The method of claim 1, wherein determining the proportion of the first wave to the second wave comprises comparing an area under the first wave peak to an area under the second wave peak.

4. The method of claim 1, further comprising:

retrieving, from the storage element by the waveform analysis application, a second plurality of samples representing an electrocardiogram (ECG) waveform of a patient; and

comparing the plurality of samples representing the plethysmographic waveform and the second plurality of samples representing the ECG waveform to confirm the presence of pulsus paradoxus.

5. The method of claim 1, further comprising comparing the power spectrum density for the plurality of samples representing the plethysmographic waveform to a power spectrum density for a plurality of samples representing a respiratory waveform to confirm the presence of pulsus paradoxus.

6. A system comprising:

at least one patient monitoring device to record data representing a physiological condition of a patient over a period of time, wherein the data comprises a plurality of samples corresponding to a respiratory activity and a plurality of samples corresponding to a heart rate;

a database to store the data generated by the at least one patient monitoring device; and

a waveform analysis application to;

retrieve, from the database, the plurality of samples corresponding to the respiratory activity and the plurality of sample corresponding to the heart rate;

calculate, using fast-Fourier transform analysis, a first wave peak of the plurality of samples corresponding to the respiratory activity and a second wave peak of the plurality of samples corresponding to the heart rate;

compare a height of the first wave peak and to a height of the second wave peak;

detect an abnormality indicative of pulsus paradoxus based on the comparison; and

triggering, responsive to detecting the abnormality, an alarm to alert a health care provider of the abnormality.

7. The system of claim 6, wherein the abnormality indicative of pulsus paradoxus is identified when a proportion of the height of the first wave peak to the height of the second wave peak is from 0.6 to 3.

8. The system of claim 6, wherein an abnormality indicative of pulsus paradoxus is detected when the height of the first wave peak from a baseline is different than the height of the second wave peak from the baseline.

9. The system of claim 6, further comprising:

an interface for displaying the first wave peak and the second wave peak.

10. The system of claim 6, wherein the at least one patient monitoring device is a pulse oximeter.

11. The system of claim 6, further comprising a first patient monitor configured to record plurality of samples corresponding to the respiratory activity and a second patient monitor configured to record the plurality of samples corresponding to the heart rate.

12. The system of claim 6, wherein the first wave peak and the second wave peak are in the form of a power spectrum density.

13. The system of claim 6, wherein the at least one patient monitor is an electrocardiogram.

14. The system of claim 6, wherein the plurality of samples corresponding to the heart rate form a plethysmographic waveform and the plethysmographic waveform is compared to data corresponding to a sinus rhythm to confirm the presence of the abnormality indicative of pulsus paradoxus.