System and method for generating an adjusted fluid responsiveness metric

• US 9,763,585 B2
• Filed: 04/22/2014
• Issued: 09/19/2017
• Est. Priority Date: 04/25/2013
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Covidien LP (Medtronic Plc)
• Inventors: Addison, Paul Stanley, Wang, Rui, McGonigle, Scott, Watson, James N.
• Primary Examiner(s): WESTON, TIFFANY C
• Application Number:
  US14/258,141
• Publication Number:
  US 20140323822A1
• Time in Patent Office: 1,246 Days
• CPC Class Codes: A61B 5/022 by applying pressure to close blood vessels, e.g. against the skin; Ophthalmodynamometers
• 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 5/14551 for measuring blood gases

Abstract

The present invention relates to physiological signal processing, and in particular to methods and systems for processing physiological signals to predict a fluid responsiveness of a patient. A medical monitor for monitoring a patient includes an input receiving a photoplethysmograph (PPG) signal representing light absorption by a patient'"'"'s tissue. The monitor also includes a perfusion status indicator indicating a perfusion status of the PPG signal, and a fluid responsiveness predictor (FRP) calculator programmed to calculate an FRP value based on a respiratory variation of the PPG signal. The FRP calculator applies a correction factor based on the perfusion status indicator.

Claims

1. A medical monitor for monitoring a patient, comprising:

a sensor port configured to receive a photoplethysmograph (PPG) signal representing light absorption by a patient'"'"'s tissue from a PPG sensor;

a processor configured to;

calculate a perfusion metric based on the PPG signal;

determine a perfusion status of the patient based on the perfusion metric, wherein the perfusion status is one of a low perfusion status and a good perfusion status;

calculate a fluid responsiveness predictor (FRP) value based on a respiratory variation of the PPG signal; and

apply a correction factor to the FRP value when the perfusion status is a low perfusion status; and

a display configured to display the corrected FRP value.

2. The monitor of claim 1, wherein the correction factor is proportional to the patient'"'"'s perfusion metric.

3. The monitor of claim 1, wherein the FRP value is calculated based on a difference between maximum upstroke amplitude and a minimum upstroke amplitude divided by an average of the maximum upstroke amplitude and the minimum upstroke amplitude.

4. The monitor of claim 3, wherein the perfusion metric is calculated based on a modulation metric of the PPG signal.

5. The monitor of claim 4, wherein the modulation metric comprises a percent modulation of the PPG signal.

6. The monitor of claim 5, wherein applying the correction factor comprises adjusting the FRP value in proportion to the percent modulation.

7. The monitor of claim 1, wherein the perfusion metric is calculated based on a modulation metric of the PPG signal.

8. The monitor of claim 1, wherein the perfusion status is determined to be a low perfusion status when the perfusion metric is below a threshold.

9. The monitor of claim 1, further comprising a pre-processor coupled to the sensor port to process the PPG signal.

10. The monitor of claim 9, wherein the pre-processor comprises a filter.

11. A medical monitor for monitoring a patient, comprising:

a sensor port configured to receive a photoplethysmography (PPG) signal responsive to light absorption by a patient'"'"'s tissue from a PPG sensor;

a processor comprising a;

a perfusion calculator configured to calculate a perfusion value based on the PPG signal;

a fluid responsiveness calculator configured to calculate a fluid responsiveness value based on a respiratory variation of the PPG signal; and

a scaling unit configured to determine that the perfusion value is below a threshold and calculate a scaled fluid responsiveness value based on the perfusion value when the perfusion value is below the threshold; and

a display configured to display the scaled fluid responsiveness value.

12. The medical monitor of claim 11, wherein the fluid responsiveness value is calculated based on a difference between maximum upstroke amplitude and a minimum upstroke amplitude divided by an average of the maximum upstroke amplitude and the minimum upstroke amplitude.

13. The medical monitor of claim 11, wherein the perfusion responsiveness value comprises a percent modulation of the PPG signal.

14. The medical monitor of claim 11, wherein the respiratory variation of the PPG signal comprises an amplitude modulation of the PPG signal.

15. The medical monitor of claim 11, wherein the fluid responsiveness calculator comprises alternate settings based on a sensor type.

16. A medical monitor for monitoring vital signs of a patient, comprising:

a sensor port configured to receive a photoplethysmography (PPG) signal responsive to light absorption by a patient'"'"'s tissue from a PPG sensor, wherein the PPG signal comprises an AC signal portion and a baseline signal portion;

a processor configured to;

calculate a percent modulation of the PPG signal by comparing amplitude of the AC signal portion and amplitude of the baseline signal portion;

calculate a fluid responsiveness value based on a respiratory variation of the PPG signal; and

calculate a scaled fluid responsiveness value when the percent modulation is below a threshold; and

a display configured to display the scaled fluid responsiveness value.

17. A method for monitoring vital signs of a patient, the method comprising:

receiving, using a sensor port of a medical monitor, a photoplethysmography (PPG) signal responsive to light absorption by a patient'"'"'s tissue from a PPG sensor, wherein the PPG signal comprises an AC signal portion and a baseline signal portion;

calculating, using a processor of the medical monitor, a percent modulation of the PPG signal by comparing amplitude of the AC signal portion and amplitude of the baseline signal portion;

calculating, using the processor of the medical monitor, a fluid responsiveness value based on a respiratory variation of the PPG signal;

determining, using the processor of the medical monitor, that the percent modulation of the PPG signal is below a threshold;

calculating, using the processor of the medical monitor, a scaled fluid responsiveness value, based on the percent modulation, in response to determining that the percent modulation is below the threshold;

displaying, using a display of the medical monitor, the scaled fluid responsiveness value.