NON-INVASIVE INTRAVASCULAR VOLUME INDEX MONITOR

• US 20120179006A1
• Filed: 01/10/2012
• Published: 07/12/2012
• Est. Priority Date: 01/10/2011
• Status: Active Grant

• Current Assignee: Masimo Corporation
• Original Assignee: Masimo Corporation
• Inventors: Jansen, Paul, O'Reilly, Michael
• Granted Patent: US 9,579,039 B2
• Time in Patent Office: Days
• US Class Current: 600/301
• 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 5/053 Measuring electrical impedance or conductance of a portion of the body
• CPC Class Codes: A61B 5/0537 Measuring body composition by impedance, e.g. tissue hydration or fat content
• CPC Class Codes: A61B 5/103 Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes A61B5/08 takes precedence; measuring aids for tailors A41H1/00; measuring instruments specially adapted for dentistry A61C19/04
• CPC Class Codes: A61B 5/14542 for measuring blood gases A61B5/14551 takes precedence
• CPC Class Codes: A61B 5/1455 using optical sensors, e.g. spectral photometrical oximeters
• CPC Class Codes: A61B 5/14551 for measuring blood gases
• CPC Class Codes: A61B 5/412 Detecting or monitoring sepsis
• CPC Class Codes: A61B 5/4878 Evaluating oedema
• 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 5/746 Alarms related to a physiological condition, e.g. details of setting alarm thresholds or avoiding false alarms alarms per se G08B

Abstract

A non-invasive electronic patient monitor tracks one or more physiological parameters of a patient, such as intravascular volume index (IVI), extravascular volume index (EVI), total hemoglobin (SpHb), impedance, and/or weight. The patient monitor determines if one or more of the physiological parameters are within a predetermined range. The patient monitor activates an alarm if one or more of the physiological parameters are outside the predetermined range and indicates a patient can be experiencing edema and/or heart failure, or sepsis.

Claims

1. A non-invasive multi-parameter patient monitoring system configured to detect edema, the non-invasive multi-parameter patient monitoring system comprising

a sensor having at least one emitter and an associated detector configured to attach to a tissue site, said detector providing a detector signal responsive to the intensity of energy from said emitter after it has passed through said tissue site;

and

a patient monitor comprising;

a sensor interface configured to receive said detector signal from said sensor; and

a processor configured to determine intravascular volume index (IVI) levels of a patient based on the received detector signal, wherein

the patient monitor is configured to track the determined IVI levels, and further configured to detect and/or monitor the progress of edema based on the determined IVI levels.

2. The system of claim 1, wherein the IVI levels are determined based on at least one of a hematocrit and total hemoglobin (SpHb).

3. The system of claim 1, wherein the IVI levels are determined based on an amount of light detected by the detector.

4. The system of claim 1, wherein the patient monitor is configured to detect and/or monitor the progress of edema by comparing the tracked IVI levels with a first predetermined threshold.

5. The system of claim 4, further comprising a host instrument configured to activate an alert if the computed IVI levels are approximately equal to or greater than the predetermined threshold.

6. The system of claim 1, wherein the edema is caused by heart failure.

7. The system of claim 1, wherein the patient monitor is further configured to track impedance of the patient and track weight levels of the patient.

8. The system of claim 7, wherein the patient monitor is configured to detect and/or monitor the progress of edema by comparing the tracked IVI levels with a first predetermined threshold, comparing tracked impedance with a second predetermined threshold, and comparing tracked weight levels with a third predetermined threshold.

9. The system of claim 8, further comprising a host instrument configured to activate an alert if the computed IVI levels are approximately equal to or greater than the predetermined threshold, the current tracked impedance is approximately equal to or greater than the second predetermined threshold and the current tracked weight levels are greater than or approximately equal to the third predetermined threshold.

10. A non-invasive multi-parameter patient monitoring system configured determine a termination range for administering a diuretic, the non-invasive multi-parameter patient monitoring system comprising

a first and second emitter configured to emit light of at least two wavelengths through tissue;

a detector configured to sense the light after it has passed through the tissue and to generate a signal indicative of the sensed light; and

a patient monitor comprising;

a sensor interface configured to receive said generated signal from said detector; and

a processor configured to determine intravascular volume index (IVI) levels of a patient based on the received generated signal, wherein

the patient monitor is configured to track the determined IVI levels, and further configured to indicate that administration of the diuretic can be terminated once current IVI levels are at or below a predetermined threshold.

11. The system of claim 10, wherein the predetermined threshold is based on previously tracked IVI levels of the patient.

12. The system of claim 10, wherein the predetermined threshold is approximately 61 for adult males and 64 for adult females.

13. The system of claim 10, wherein the predetermined threshold is a first predetermined threshold and the patient monitor is further configured to activate an alarm if the current SpHb levels are at or above a second predetermined threshold.

14. The system of claim 10, wherein the patient monitor is further configured to alert a user once the current SpHb levels are at or above the predetermined threshold.

15. A method for detecting and/or monitoring the progression of edema, the method comprising:

receiving at a non-invasive multi-parameter patient monitor data indicative of intravascular volume index (IVI) levels of a patient, wherein the data is obtained by detecting light from a light emitting element after the light has been attenuated by tissue;

determining IVI levels using the non-invasive multi-parameter patient monitor;

tracking the determined IVI levels of the patient; and

detecting and/or monitoring the progress of edema based on the tracked SpHb levels.

16. The method of claim 15, wherein detecting and/or monitoring the progress of edema comprises determining if current tracked IVI levels are approximately equal to or greater than a predetermined threshold.

17. The method of claim 16, further comprising indicating edema if the current tracked IVI levels are equal to or greater than the predetermined threshold.

18. The method of claim 15, further comprising:

tracking at least one of the weight levels and impedance of the patient; and

detecting and/or monitoring the progress of edema is based on the tracked at least one of weight levels and impedance of the patient.

19. A non-invasive multi-parameter patient monitor configured to detect and/or measure the progression of edema, the non-invasive multi-parameter patient monitoring system comprising

a sensor interface configured to receive a signal from a sensor, wherein the signal is responsive to the intensity of energy from an emitter after it has passed through a tissue site and the signal is indicative of intravascular volume index (IVI) levels at the tissue site;

a processor configured to determined IVI levels of a patient based on the signal, wherein

the patient monitor is configured to track the determined IVI levels of the patient and further configured to activate an alert if the determined IVI levels are approximately equal to or greater than a predetermined threshold.

20. A method for detecting and/or monitoring the progression of edema using a non-invasive multi-parameter patient monitor, the method comprising:

emitting light of at least two different wavelengths from a light emitting element;

detecting light from the light emitting element after the light has been attenuated by tissue;

measuring intravascular volume index (IVI) levels of a patient based on the detected light using a non-invasive multi-parameter patient monitor;

tracking the measured IVI levels of the patient;

detecting and/or monitoring the progress of edema based on the tracked IVI levels; and

alerting a user of the detection and/or progression of edema based on the tracked IVI levels.

21. A method for determining a termination range for administering a diuretic using a non-invasive multi-parameter patient monitor, the method comprising:

computing intravascular volume index (IVI) levels of a patient based on an intensity signal indicative of IVI levels at a tissue site upon administration of a diuretic to the patient;

tracking the computed IVI levels of the patient using a non-invasive multi-parameter patient monitor; and

indicating administration of the diuretic can be terminated once tracked IVI levels are at or below a predetermined threshold.

22. A non-invasive multi-parameter patient monitoring system configured to detect sepsis, the non-invasive multi-parameter patient monitoring system comprising:

a sensor having at least one emitter and an associated detector configured to attach to a tissue site, said detector providing a detector signal responsive to the intensity of energy from said emitter after it has passed through said tissue site; and

a patient monitor comprising;

a sensor interface configured to receive said detector signal from said sensor; and

a processor configured to determine intravascular volume index (IVI) levels of a patient based on the received detector signal, wherein

the patient monitor is configured to track the determined IVI, and further configured to monitor the progress of sepsis based on the tracked IVI.

23. The non-invasive multi-parameter patient monitoring system of claim 22, wherein the sensor is a first sensor and further comprising an impedance sensor configured to transmit impedance signals of the patient to the processor, wherein the processor is further configured to determine impedance levels of the patient and compute an extravascular volume index (EVI) using the impedance measurements.