System and method for continuously monitoring and presenting body substances

• US 9,763,610 B2
• Filed: 12/22/2010
• Issued: 09/19/2017
• Est. Priority Date: 12/30/2009
• Status: Active Grant

• Current Assignee: Maquet Critical Care AB (Getinge AB)
• Original Assignee: Maquet Critical Care Mb
• Inventors: Karlsson, Anton, Carlsson, Anders, Broman, Andreas
• Primary Examiner(s): Cheng, Jacqueline
• Assistant Examiner(s): PREMRAJ, ANGELINE L
• Application Number:
  US13/519,943
• Publication Number:
  US 20130041242A1
• Time in Patent Office: 2,463 Days
• CPC Class Codes: A61B 2560/0276 Determining malfunction
• CPC Class Codes: A61B 5/14528 invasively
• CPC Class Codes: A61B 5/14546 for measuring analytes not otherwise provided for, e.g. ions, cytochromes
• CPC Class Codes: A61B 5/14865 invasive, e.g. introduced into the body by a catheter or needle or using implanted sensors
• CPC Class Codes: A61B 5/412 Detecting or monitoring sepsis
• CPC Class Codes: A61B 5/686 Permanently implanted devices, e.g. pacemakers, other stimulators, biochips A61B5/6861 takes precedence
• CPC Class Codes: A61B 5/7445 Display arrangements, e.g. multiple display units
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16Z 99/00 Subject matter not provided for in other main groups of this subclass

Abstract

A medical monitoring unit for continuously monitoring a glucose value and a lactate value is provided. The monitoring unit comprises: a display unit, a first unit adapted to: receive a glucose/lactate/pyruvate signal based on a measured glucose/lactate/pyruvate value, transform the glucose signal into a graphically displayable glucose/lactate/pyruvate signal, and transmit the graphically displayable glucose/lactate/pyruvate signal to the display unit of the monitoring unit, and a second unit adapted to: receive a glucose/lactate/pyruvate signal based on a measured glucose/lactate/pyruvate value, transform the glucose/lactate/pyruvate signal into a graphically displayable glucose/lactate/pyruvate signal, and transmit the graphically displayable glucose/lactate/pyruvate signal to the display unit of the monitoring unit. Furthermore, a system comprising the monitoring unit, and a sensor unit for sensing glucose and/or lactate and/or pyruvate values, is provided, as well as a method for performing the steps made possible through the provided unit and method.

Claims

1. A medical monitoring system for continuous monitoring of the glucose level and the lactate level of a critical care patient, wherein the monitoring system comprises:

a display unit,

a microdialysis or ultrafiltration catheter comprising an intracorporeal membrane,

a first extracorporeal sensor in connection with the catheter, said sensor comprising at least one glucose electrode, at least one lactate electrode, and at least first and second blank electrodes, wherein in the direction of liquid flow past the sensor, the first blank electrode precedes the glucose electrode and the lactate electrode, and the second blank electrode follows the glucose electrode and the lactate electrode,

a first unit, connected to the sensor and the display unit, adapted to;

receive a first glucose signal based on the level of glucose in an analyte from the patient measured by the sensor,

transform the glucose signal into a graphically displayable glucose signal, and

transmit the graphically displayable glucose signal to the display unit of the monitoring system,

a second unit, connected to the sensor and the display unit, adapted to;

receive a first lactate signal based on the level of lactate in an analyte from the patient measured by the sensor,

transform the lactate signal into a graphically displayable lactate signal, and

transmit the graphically displayable lactate signal to the display unit of the monitoring system,

an alarm system related to at least one of the glucose value and the lactate value, wherein the alarm system has a definable threshold value and is adapted to be triggered by a glucose or lactate value being above, on or below the threshold value, and

a cross-talk alarm system related to cross-talk between the first blank electrode and the second blank electrode, wherein the cross-talk alarm system has a first predefined cross-talk threshold value and is adapted to be triggered by a difference between first and second values, based on signals from the first blank electrode and the second blank electrode, the difference being greater than the first predefined cross-talk threshold value.

2. The medical monitoring system according to claim 1, wherein the monitoring system further comprises a user operable switch having a first and second state, wherein the switch is adapted to:

in the first state, enable the display unit to display the graphically displayable glucose signal, and

in the second state, enable the display unit to display the graphically displayable lactate signal.

3. The medical monitoring unit according to claim 1, wherein the monitoring system is adapted to display the graphically displayable glucose signal and the graphically displayable lactate signal simultaneously.

4. The medical monitoring system according to claim 1, wherein the monitoring system further comprises a third unit, connected to the sensor and the display unit, adapted to:

receive a first pyruvate signal based on the level of pyruvate in an analyte from the patient measured by the sensor,

transform the pyruvate signal into a graphically displayable pyruvate signal, and

transmit the graphically displayable pyruvate signal to the display unit of the monitoring unit.

5. The medical monitoring system according to claim 4, wherein the monitoring system further comprises a user operable switch having a first, second and third state, wherein the switch is adapted to:

in the first state enable the display unit to display the graphically displayable glucose signal,

in the second state, enable the display unit to display the graphically displayable lactate signal, and

in the third state, enable the display unit to display the graphically displayable pyruvate signal.

6. The medical monitoring system according to claim 4, wherein the monitoring system is adapted to display:

the graphically displayable glucose signal,

the graphically displayable lactate signal, and

the graphically displayable pyruvate signal simultaneously.

7. The medical monitoring system according to claim 4, wherein the monitoring system is adapted to update at least one of:

the graphically displayable glucose signal, the graphically displayable lactate signal, and the graphically displayable pyruvate signal, with an interval shorter than 10 seconds.

8. The medical monitoring system according to claim 4, wherein the monitoring system further comprises a calculation unit adapted to:

receive a lactate signal based on the level of lactate in an analyte from the patient measured by the sensor,

receive a pyruvate signal based on the level of pyruvate in an analyte from the patient measured by the sensor,

calculate a second ratio based on the lactate signal and the pyruvate signal,

transform the second ratio into a graphically displayable second ratio signal, and

transmit the graphically displayable second ratio signal to the display unit of the monitoring system.

9. The medical monitoring system according to claim 8, wherein the medical monitoring system further comprises an alarm system related to the second ratio, and wherein the alarm system is adapted to have a definable second ratio threshold value, and wherein the alarm system is adapted to be triggered by the second ratio being above, on or below the second ratio threshold value.

10. The medical monitoring unit according to claim 4, wherein the third unit is further adapted to:

receive a second pyruvate signal based on a measured pyruvate value,

calculate a mean pyruvate signal based on the first pyruvate signal and the second pyruvate signal,

transform the mean pyruvate signal into a graphically displayable mean pyruvate signal, and

transmit the graphically displayable mean pyruvate signal to the display unit of the monitoring unit.

11. The monitoring system according to claim 4, wherein the monitoring system further comprises a calculation unit, and wherein the calculation unit is adapted to receive a first pyruvate signal at a first instance in time, and receive a second pyruvate signal at a second instance in time, and wherein the calculation unit is adapted to calculate a mean pyruvate value from the first and second pyruvate signals.

12. The monitoring system according to claim 4, wherein the system further comprises a second sensor and a calculation unit and wherein the calculation unit is adapted to receive the first pyruvate signal from the first sensor, and to receive a second pyruvate signal from the second sensor, and wherein the calculation unit is adapted to calculate a mean pyruvate value from the first pyruvate signal and the second pyruvate signal.

13. The monitoring system according to claim 4, wherein the sensor comprises consecutively the first blank electrode, a first lactate electrode, a first glucose electrode, a first pyruvate electrode, the second blank electrode, a second lactate electrode, a second glucose electrode and a second pyruvate electrode.

14. The medical monitoring system according to claim 1, wherein the monitoring system further comprises a calculation unit adapted to:

receive a glucose signal based on the level of glucose in an analyte from the patient measured by the sensor,

receive a lactate signal based on the level of lactate in an analyte from the patient measured by the sensor,

calculate a first ratio based on the glucose signal and the lactate signal,

transform the first ratio into a graphically displayable first ratio signal, and

transmit the graphically displayable first ratio signal to the display unit of the monitoring system.

15. The medical monitoring system according to claim 14, wherein the medical monitoring system further comprises an alarm system related to the first ratio, and wherein the alarm system is adapted to have a definable first ratio threshold value, and wherein the alarm system is adapted to be triggered by the first ratio being above, on or below the first ratio threshold value.

16. The medical monitoring system according to claim 1, wherein the medical monitoring system further comprises an alarm system related to a pyruvate value, and wherein the alarm system is adapted to have a definable pyruvate threshold value, and wherein the alarm system is adapted to be triggered by the pyruvate value being above or below the pyruvate threshold value.

17. The medical monitoring system according to claim 1, wherein the first unit is further adapted to:

receive a second glucose signal based on a measured glucose value,

calculate a mean glucose signal based on the first glucose signal and the second glucose signal,

transform the mean glucose signal into a graphically displayable mean glucose signal, and

transmit the graphically displayable mean glucose signal to the display unit of the monitoring unit.

18. The medical monitoring system according to claim 1, wherein the second unit is further adapted to:

receive a second lactate signal based on a measured lactate value,

calculate a mean lactate signal based on the first lactate signal and the second lactate signal,

transform the mean lactate signal into a graphically displayable mean lactate signal, and

transmit the graphically displayable mean lactate signal to the display unit of the monitoring unit.

19. The monitoring system according to claim 1, wherein the monitoring system further comprises a calculation unit, and wherein the calculation unit is adapted to receive a first glucose signal at a first instance in time, and receive a second glucose signal at a second instance in time, and wherein the calculation unit is adapted to calculate a mean glucose value from the first and second glucose signals.

20. The monitoring system according to claim 1, wherein the monitoring system further comprises a calculation unit, and wherein the calculation unit is adapted to receive a first lactate signal at a first instance in time, and receive a second lactate signal at a second instance in time, and wherein the calculation unit is adapted to calculate a mean lactate value from the first and second lactate signals.

21. The monitoring system according to claim 1, wherein the monitoring system further comprises a second sensor and a calculation unit, and wherein the calculation unit is adapted to receive the first glucose signal from the first sensor, and to receive a second glucose signal from the second sensor, and wherein the calculation unit is adapted to calculate a mean glucose value from the first glucose signal and the second glucose signal.

22. The monitoring system according to claim 1, wherein the system further comprises a second sensor and a calculation unit, and wherein the calculation unit is adapted to receive the first lactate signal from the first sensor, and to receive a second lactate signal from the second sensor, and wherein the calculation unit is adapted to calculate a mean lactate value from the first lactate signal and the second lactate signal.

23. The monitoring system according to claim 1, wherein the sensor comprises at least two lactate electrodes and at least two glucose electrodes.

24. The monitoring system according to claim 1, further comprising a projection alarm system related to a projected value of at least one of:

the glucose value,

the lactate value, and

a the pyruvate value, and

wherein the projection alarm system has a definable projected threshold value, and wherein the projection alarm system is adapted to be triggered by a projected glucose value, a projected lactate value or a projected pyruvate value being above, on or below the definable projected threshold value.

25. A method of using a microdialysis or ultrafiltration catheter for continuously monitoring a glucose level and a lactate level of a critical care patient, wherein the method comprises the steps of:

obtaining a liquid flow of analyte through an intracorporeal membrane into the catheter,

transporting the liquid flow of analyte from the catheter to an extracorporeal sensor, wherein the extracorporeal sensor is capable of sensing glucose and lactate and comprises at least one glucose electrode, at least one lactate electrode, and at least first and second blank electrodes, wherein in the direction of liquid flow past the sensor, the first blank electrode precedes the glucose electrode and the lactate electrode, and the second blank electrode follows the glucose electrode and the lactate electrode,

measuring the glucose level at the extracorporeal sensor,

receiving, at a first unit, a first glucose signal based on the measured level of glucose,

transforming the glucose signal to a graphically displayable glucose signal, and

transmitting the graphically displayable glucose signal to a display unit,

measuring the lactate level at the extracorporeal sensor,

receiving, at a second unit, a first lactate signal based on the measured level of lactate,

transforming the lactate signal into a graphically displayable lactate signal, and

transmitting the graphically displayable lactate signal to the display unit, and

receiving a first signal from the first blank electrode,

receiving a second signal from the second blank electrode,

converting the first signal and the second signal into a first value and a second value,

comparing the first value and the second value, and

detecting if the difference between the first value and second value is equal to or larger than a first predefined cross-talk threshold, and triggering a crosstalk signal when the difference is equal to or larger than the first predefined cross-talk threshold value.

26. The method according to claim 25, wherein the method further comprises the step of displaying, at the display unit, the graphically displayable glucose signal and the graphically displayable lactate signal simultaneously.

27. The method according to claim 25, wherein the method further comprises the step of:

measuring a pyruvate level at the extracorporeal sensor,

receiving at a third unit, a first pyruvate signal based on the measured level of pyruvate,

transforming the pyruvate signal into a graphically displayable pyruvate signal, and

transmitting the graphically displayable pyruvate signal to the display unit.

28. The method according to claim 27, wherein the method further comprises the step of displaying:

the graphically displayable glucose signal, the graphically displayable lactate signal, and the graphically displayable pyruvate signal simultaneously.

29. The method according to claim 27, wherein the method further comprises the step of updating at least one of:

the graphically displayable glucose signal, the graphically displayable lactate signal, and the graphically displayable pyruvate signal, with an interval shorter than 10 seconds.

30. The method according to claim 27, wherein the method further comprises the steps of:

receiving, at a calculation unit, a lactate signal based on the measured level of lactate,

receiving, at the calculation unit, a pyruvate signal based on the measured level of pyruvate,

calculating, at the calculation unit, a first ratio based on the lactate signal and the pyruvate signal,

transforming the first ratio into a graphically displayable first ratio signal, and

transmitting the graphically displayable first ratio signal to the display unit.

31. The method according to claim 27, wherein the method further comprises the steps of:

receiving, at a third unit, a second pyruvate signal based on a measured pyruvate value,

calculating a mean pyruvate signal based on the first pyruvate signal and the second pyruvate signal,

transforming the mean pyruvate signal into a graphically displayable mean pyruvate signal, and

transmitting the graphically displayable mean pyruvate signal to the display unit.

32. The method according to claim 27, wherein the method further comprises the steps of:

receiving, at a calculation unit, a first pyruvate signal at a first instance in time,

receiving, at the calculation unit, a second pyruvate signal at a second instance in time, and

calculating, at the calculation unit, a mean pyruvate value from the first and second pyruvate signals.

33. The method according to claim 27, wherein the method further comprises the steps of:

receiving, at a calculation unit, a first pyruvate signal from the sensor,

receiving, at the calculation unit, a second pyruvate signal from the sensor, and

calculating, at the calculation unit, a mean pyruvate value from the first pyruvate signal and the second pyruvate signal.

34. The method according to claim 27, wherein the sensor comprises consecutively the first blank electrode, a first lactate electrode, a first glucose electrode, a first pyruvate electrode, the second blank electrode, a second lactate electrode, a second glucose electrode and a second pyruvate electrode.

35. The method according to claim 25, wherein the method further comprises the steps of:

receiving, at a calculation unit, a glucose signal based on the measured level of glucose,

receiving, at the calculation unit, a lactate signal based on the measured level of lactate,

calculating, at the calculation unit, a first ratio based on the glucose signal and the lactate signal,

transforming the first ratio into a graphically displayable first ratio signal, and

transmitting the graphically displayable first ratio signal to the display unit.

36. The method according to claim 25, wherein the method further comprises the step of setting an alarm system related to a threshold value of at least one of:

the glucose level,

the lactate level, and

a pyruvate level,

such that the alarm system is triggered by the at least one level being above or below the threshold value.

37. The method according to claim 25, wherein the method further comprises the step of setting a projection alarm system related to a threshold level of at least one of:

the glucose level,

the lactate level, and

a pyruvate level,

such that the alarm system is triggered by the at least one level being above or below the threshold level.

38. The method according to claim 25, wherein the method further comprises the steps of transmitting at least one of:

the glucose signal, the lactate signal and a pyruvate signal to a central system.

39. The method according to claim 25, wherein the method further comprises the steps of:

receiving, at the first unit, a second glucose signal based on a measured glucose value,

calculating a mean glucose signal based on the first glucose signal and the second glucose signal,

transforming the mean glucose signal into a graphically displayable mean glucose signal, and

transmitting the graphically displayable mean glucose signal to the display unit.

40. The method according to claim 25, wherein the method further comprises the steps of:

receiving at the second unit, a second lactate signal based on a measured lactate value,

calculating a mean lactate signal based on the first lactate signal and the second lactate signal,

transforming the mean lactate signal into a graphically displayable mean lactate signal, and

transmitting the graphically displayable mean lactate signal to the display unit.

41. The method according to claim 25, wherein the method further comprises the steps of:

receiving, at a calculation unit, a first glucose signal at a first instance in time,

receiving, at the calculation unit, a second glucose signal at a second instance in time, and

calculating, at the calculation unit, a mean glucose value from the first and second glucose signals.

42. The method according to claim 25, wherein the method further comprise the steps of:

receiving, at a calculation unit, a first lactate signal at a first instance in time,

receiving, at the calculation unit, a second lactate signal at a second instance in time, and

calculating, at the calculation unit, a mean lactate value from the first and second lactate signals.

43. The method according to claim 25, wherein the method further comprises the steps of:

receiving, at a calculation unit, a first glucose signal from the sensor,

receiving, at the calculation unit, a second glucose signal from the sensor, and

calculating, at the calculation unit, a mean glucose value from the first glucose signal and the second glucose signal.

44. The method according to claim 25, wherein the method further comprises the steps of:

receiving, at a calculation unit, a first lactate signal from the sensor,

receiving, at the calculation unit, a second lactate signal from the sensor, and

calculating, at the calculation unit, a mean lactate value from the first lactate signal and the second lactate signal.

45. The method according to claim 25, wherein the sensor comprises at least two lactate electrodes and at least two glucose electrodes.