Decision-assist method for resuscitation of patients

• US 7,879,020 B1
• Filed: 03/19/2008
• Issued: 02/01/2011
• Est. Priority Date: 03/19/2007
• Status: Active Grant

• Current Assignee: Board of Regents of the University of Texas System (University of Texas System), U.S. Army Medical Research And Materiel Command
• Original Assignee: The United States Of America As Represented By The Secretary Of The Army
• Inventors: Chung, Kevin, Salinas, Jose, Drew, Guy A., Mann, Elizabeth, Cancio, Leopoldo C., Wolf, Steven E., Kramer, George C.
• Primary Examiner(s): Sirmons; Kevin C
• Assistant Examiner(s): CARPENTER, WILLIAM R
• Application Number:
  US12/076,555
• Time in Patent Office: 1,049 Days
• Field of Search: 604/31, 604/65, 604/66, 604/131, 604/151, 604/503, 604/504, 600/582
• US Class Current: 604/503
• CPC Class Codes: A61B 5/20 for measuring urological functions restricted to the evaluation of the urinary system A61B5/4375 takes precedence
• CPC Class Codes: A61B 5/412 Detecting or monitoring sepsis
• CPC Class Codes: A61M 2202/0496 Urine
• CPC Class Codes: A61M 5/1723 using feedback of body parameters, e.g. blood-sugar, pressure measurement of body parameters A61B5/00
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 20/17 delivered via infusion or injection
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

A method for providing decision-assist to medical staff resuscitating a burn patient includes receiving patient information, calculating an infusion rate, outputting the infusion rate, obtaining a urinary output, calculating a new infusion rate using infusion rate model based constants, and outputting the new infusion rate. In some embodiments, the method includes notifying medical staff when problems arise, displaying information regarding the resuscitation, and setting limits regarding the infusion rates.

Claims

1. A method for providing decision-assist during resuscitation of a patient, the method comprising:

receiving patient data including percentage of total body surface area;

calculating an initial infusion rate based on at least the patient data;

outputting the initial infusion rate;

obtaining a current urinary output;

calculating a new infusion rate based on at least the current infusion rate, the current urinary output, an infusion rate constant, an urinary constant, and a Gaussian function centered on a desired urinary output; and

outputting the new infusion rate.

2. The method according to claim 1, further comprising:

repeating obtaining the current urinary output, calculating the new infusion rate, and outputting the infusion rate until receiving a notification to terminate the method.

3. The method according to claim 1, further comprising:

analyzing the urinary output for at least one problem;

notifying medical staff when at least one problem exists; and

after notifying, receiving instructions to continue or terminate the method.

4. The method according to claim 3, further comprising continuing with the method when no instruction is received and a predetermined time has elapsed since the notification.

5. The method according to claim 3, wherein analyzing the urinary output includes determining whether the urinary output is below a predetermined threshold.

6. The method according to claim 5, wherein analyzing the urinary output includes determining whether a time threshold is satisfied prior to notifying medical staff.

7. The method according to claim 5, wherein analyzing the urinary output includes determining whether the current infusion rate exceeds an infusion rate threshold before notifying medical staff.

8. The method according to claim 3, wherein notifying includes providing at least one of an identification of the problem and a recommended course of action.

9. The method according to claim 1, further comprising waiting for a period of time prior to obtaining the urinary output.

10. The method according to claim 9, wherein the period of time is determined on current physiological information regarding the patient.

11. The method according to claim 1, wherein outputting the infusion rate includes displaying the set infusion rate.

12. The method according to claim 1, wherein outputting the infusion rate includes displaying a graphical representation of the infusion rate over time.

13. The method according to claim 12, further comprising displaying a graphical representation of urinary output over time.

14. The method according to claim 1, wherein calculating the new infusion rate is based further on at least one of a patient'"'"'s weight and the percentage total body surface area.

15. The method according to claim 1, further comprising selecting the desired urinary output from an end of a target urinary output range closest to the current urinary output when urinary output is outside of the target urinary output range.

16. The method according to claim 1, wherein the infusion rate constant is selected based on hours past burn and the urinary constant is set to a predetermined value.

17. The method according to claim 1, further comprising calculating the new infusion rate to a predetermined infusion rate when the new infusion rate is below the predetermined infusion rate.

18. The method according to claim 1, further comprising selecting a function for calculating the new infusion rate based on hours post burn.

19. The method according to claim 1, wherein obtaining the current urinary output includes reading of a urine flow from a sensor.

20. A method for providing decision-assist during resuscitation of a patient, the method comprising:

receiving patient data including percentage of total body surface area, a patient'"'"'s weight, and hours post burn;

calculating an initial infusion rate based on at least the patient data;

outputting the initial infusion rate;

obtaining a current urinary output;

calculating a new infusion rate based on at least the current infusion rate, the current urinary output, an infusion rate constant, an urinary constant, a Gaussian function centered on a desired urinary output, the patient'"'"'s weight, and the percentage of total body surface area where the patient'"'"'s weight and the percentage total body surface area provide modifier values for calculating the new infusion rate;

displaying the new infusion rate; and

receiving a different infusion rate or an acceptance of the new infusion rate.

21. A method for providing decision-assist during resuscitation of a patient, the method comprising:

receiving patient data including percentage of total body surface area, a patient'"'"'s weight, hours post burn;

calculating an initial infusion rate based on at least the patient data;

outputting the initial infusion rate;

obtaining a current urinary output;

calculating a new infusion rate based on at least the current infusion rate, the current urinary output, infusion rate model based constants, the patient'"'"'s weight, the percentage of total body surface area, and a Gaussian function centered on a target urinary output; and

outputting the new infusion rate.