End-tidal carbon dioxide and amplitude spectral area as non-invasive markers of coronary perfusion pressure

• US 10,835,175 B2
• Filed: 03/21/2018
• Issued: 11/17/2020
• Est. Priority Date: 05/30/2013
• Status: Active Grant

• Current Assignee: Zoll Medical Corporation (Asahi Kasei Corporation)
• Original Assignee: Zoll Medical Corporation (Asahi Kasei Corporation)
• Inventors: Lurie, Keith G.
• Primary Examiner(s): Mahmood, Nadia A
• Application Number:
  US15/927,607
• Publication Number:
  US 20180206785A1
• Time in Patent Office: 972 Days
• Field of Search: 607 6
• CPC Class Codes: A61B 5/082 Evaluation by breath analysis, e.g. determination of the chemical composition of exhaled breath A61B5/083, A61B5/091 take precedence
• CPC Class Codes: A61B 5/318 Heart-related electrical modalities, e.g. electrocardiography [ECG]
• CPC Class Codes: A61B 5/4836 Diagnosis combined with treatment in closed-loop systems or methods A61B5/0036 takes precedence
• CPC Class Codes: A61B 5/74 Details of notification to user or communication with user or patient indicating measured values G01D7/00; user input means input or output arrangements for computers G06F3/00
• CPC Class Codes: A61H 2230/206 used as a control parameter for the apparatus
• CPC Class Codes: A61H 31/00 Artificial respiration or heart stimulation, e.g. heart massage artificial respiration by treatment with gas or air, e.g. mouth-to-mouth respiration A61M16/00; applying electric currents by contact electrodes for stimulation, e.g. heart pace-makers A61N1/36 ; teaching or training models, demonstration models for medical purposes G09B23/288
• CPC Class Codes: A61H 31/005 with feedback for the user
• CPC Class Codes: A61N 1/3987 characterised by the timing or triggering of the shock

Abstract

End-tidal carbon dioxide (ETCO₂) measurements may be used alone as a guide to determine when to defibrillate an individual. Alternatively, ETCO₂ measurements may be used in combination with amplitude spectral area measurements as a guide to determine when to defibrillate an individual.

Claims

1. A defibrillation device for guiding defibrillation therapy of an individual during resuscitation, comprising:

an end-tidal carbon dioxide (ETCO₂) sensor for obtaining signals representing ETCO₂ of the individual;

an electrocardiogram (ECG) sensor for obtaining signals representing ECG of the individual; and

a processor in communication with the ETCO₂ sensor and the ECG sensor and configured to;

receive and process the signals representing ETCO₂ from the ETCO₂ sensor to generate ETCO₂ data,

receive and process the signals representing ECG from the ECG sensor to generate ECG data,

analyze the ETCO₂ data and the ECG data, the analysis of the ECG data being frequency-based,

determine, based on the analysis of the ETCO₂ data and the ECG data, whether a defibrillation shock should be delivered to the individual, and

provide an indication that designates whether the defibrillation shock should be delivered.

2. The device of claim 1, wherein the determination is based on whether the ETCO₂ data is higher or lower than a first predetermined threshold value.

3. The device of claim 2, wherein the predetermined threshold value is from 5 mmHg to 20 mmHg.

4. The device of claim 1, wherein the processor is configured to perform a frequency domain transform on the ECG data.

5. The device of claim 4, wherein the frequency domain transform results in an amplitude spectrum area (AMSA) value.

6. The device of claim 5, wherein the determination is further based on whether the AMSA value is higher or lower than a second predetermined threshold value.

7. The device of claim 6, wherein the second predetermined threshold value is from 31 mV-Hz to 45 mV-Hz.

8. The device of claim 1, wherein the determination is based on analysis of both the ECG data and the ETCO₂ data.

9. The device of claim 8, wherein the determination is based on a comparison of the ECG data to a first predetermined threshold and a comparison of the ETCO₂ data to a second predetermined threshold value.

10. The device of claim 1, further comprising a display, and wherein the processor is configured to provide the indication of whether the defibrillation shock should be delivered on the display.

11. The device of claim 10, wherein the indication comprises a prompt on the display instructing a user as to the proper time to deliver the defibrillating shock.

12. The device of claim 1, further comprising one or more speakers for providing the indication of whether the defibrillation shock should be delivered.

13. The device of claim 12, wherein the indication comprises a prompt instructing a user as to a proper time to deliver the defibrillating shock.

14. The device of claim 1, further comprising a defibrillator.

15. The device of claim 14, further comprising further comprising defibrillation electrodes.

16. The device of claim 14, wherein the processor is configured to instruct the defibrillator to provide the defibrillating shock based on the determination.

17. The device of claim 1, further comprising one or more additional sensors.

18. The device of claim 17, wherein the one or more additional sensors are one or more of a heart rate sensor, a blood pressure sensor, a temperature sensor, a bispectral index sensor, an oxygen sensor, a blood lactate sensor, a blood pH sensor, a tissue lactate sensor, a tissue pH sensor, an intracardiac pressure sensor, an intrathoracic pressure sensor, a positive end expiratory pressure sensor, a respiratory rate sensor, an intracranial pressure sensor, an intraocular pressure sensor, a respiratory flow sensor, an oxygen delivery sensor, a tissue CO₂ sensor, and a cardiac output sensor.

19. The device of claim 1, wherein the processor is in communication with one or more circulation enhancement devices.

20. The device of claim 19, wherein the circulation enhancement device is configured to generate a negative intrathoracic pressure within a patient.