FLUID TITRATION SYSTEM

• US 20180103905A1
• Filed: 10/26/2017
• Published: 04/19/2018
• Est. Priority Date: 09/13/2007
• Status: Active Application

• Current Assignee: Masimo Corporation
• Original Assignee: Masimo Corporation
• Inventors: Kiani, Massi Joe E.
• Application Number:
  US15/794,838
• Publication Number:
  US 20180103905A1
• Time in Patent Office: Days
• 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 5/14551 for measuring blood gases
• CPC Class Codes: A61B 5/6826 Finger
• CPC Class Codes: A61B 5/6838 Clamps or clips
• CPC Class Codes: A61M 2205/3306 Optical measuring means
• CPC Class Codes: A61M 2205/3313 used specific wavelengths
• CPC Class Codes: A61M 5/142 Pressure infusion, e.g. using pumps

Abstract

A fluid titration system has an optical sensor, a physiological monitor, a titration controller and an infusion device. The optical sensor transmits multiple wavelengths of light into a tissue site of a person and detects the optical radiation after attenuation by pulsatile blood flowing within the tissue site. The physiological monitor receives a resulting sensor signal and derives a plethysmograph that corresponds to the pulsatile blood flow. The monitor also calculates a plethysmograph variability measure that is responsive to changes in perfusion at the tissue site. A titration controller generates a fluid control output according to the variability measure. The infusion device administers a liquid solution via an intravenous (IV) connection to the person according to the fluid control output so as to regulate at least one of a fluid flow start, rate and stop.

Claims

1-19. -19. (canceled)

20. A method of managing a blood volume of a patient, the method comprising:

noninvasively detecting, with a detector of an optical sensor, light attenuated by tissue of the patient at a measurement site;

outputting, with the optical sensor, a signal responsive to the light;

determining, with one or more hardware processors, a first measure of variability from at least a ratio of a pulsatile component to a nonpulsatile component of the signal, the pulsatile component and the nonpulsatile component being indicative of a blood volume in the tissue, the pulsatile component being responsive to variable absorption and the nonpulsatile component being responsive to static absorption;

determining, with the one or more hardware processors, that the first measure of variability indicates a need for the patient to receive a liquid solution; and

in response to determining that the first measure of variability indicates the need, outputting a first infusion indication for presentation to a caregiver, the first infusion indication indicating to administer the liquid solution to the patient.

21. The method of claim 20, further comprising:

determining, with the one or more hardware processors, a second measure of variability from at least the ratio of the pulsatile component to the nonpulsatile component of the signal at a first time, the first time being different from a second time at which the first measure of variability is determined;

determining, with the one or more hardware processors, that the second measure of variability does not indicate the need; and

in response to determining that the second measure of variability does not indicate the need, outputting a second infusion indication for presentation to the caregiver, the second infusion indication indicating not to administer the liquid solution to the patient.

22. The method of claim 21, further comprising visually presenting the first infusion indication and the second infusion indication to the caregiver on a display.

23. The method of claim 21, further comprising:

visually presenting the first infusion indication to the caregiver on a display as , on, increase, or start; and

visually presenting the second infusion indication to the caregiver on the display as −

, off, decrease, or stop.

24. The method of claim 21, further comprising audibly presenting the first infusion indication and the second infusion indication to the caregiver.

25. The method of claim 21, further comprising:

comparing the first measure of variability with a threshold to determine whether the first measure of variability indicates the need; and

comparing the second measure of variability with the threshold to determine whether the second measure of variability indicates the need.

26. The method of claim 20, further comprising visually presenting the first infusion indication to the caregiver on a display as , on, increase, or start.

27. The method of claim 20, wherein the first measure of variability is responsive to a dehydration condition of the patient.

28. The method of claim 20, wherein the first measure of variability is responsive to a hemorrhaging condition of the patient.

29. The method of claim 20, wherein the liquid solution comprises blood products.

30. The method of claim 20, wherein the liquid solution comprises nutrient fluids.

31. The method of claim 20, further comprising administering the liquid solution to the patient subsequent to said outputting the first infusion indication for presentation to the caregiver.

32. The method of claim 31, wherein said administering the liquid solution to the patient is performed using an infusion device separate from a patient monitor comprising the one or more hardware processors.

33. The method of claim 20, further comprising comparing the first measure of variability with a threshold to determine whether the first measure of variability indicates the need.

34. The method of claim 20, wherein said determining the first measure of variability comprises processing a respiration-induced cyclical variation in the signal.

35. The method of claim 20, wherein said determining the first measure of variability comprises determining the first measure of variability from at least a change in the ratio of the pulsatile component to the nonpulsatile component.

36. The method of claim 20, wherein the first measure of variability comprises a measure of perfusion index variability of the signal.

37. The method of claim 20, further comprising irradiating, with one or more emitters of the optical sensor, the tissue with red and infrared wavelengths.

38. The method of claim 20, wherein the measurement site comprises a finger.

39. The method of claim 20, further comprising determining, with the one or more hardware processors, a parameter measurement from the signal, the parameter measurement comprising carboxyhemoglobin or methemoblobin.