Systems and methods to predict the chances of neurologically intact survival while performing CPR

• US 9,811,634 B2
• Filed: 04/25/2014
• Issued: 11/07/2017
• Est. Priority Date: 04/25/2013
• Status: Active Grant

• Current Assignee: Zoll Medical Corporation (Asahi Kasei Corporation)
• Original Assignee: Zoll Medical Corporation (Asahi Kasei Corporation)
• Inventors: Lurie, Keith, Metzger, Anja, Puertas, Laura
• Primary Examiner(s): Brusca, John S
• Assistant Examiner(s): Wise, Olivia
• Application Number:
  US14/262,423
• Publication Number:
  US 20140324763A1
• Time in Patent Office: 1,292 Days
• Field of Search: None
• CPC Class Codes: G16H 20/40 relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
• CPC Class Codes: G16H 50/30 for calculating health indices; for individual health risk assessment

Abstract

According to one aspect, a method for predicting the likelihood of survival of a particular individual with favorable neurological function during a cardiopulmonary resuscitation (CPR) procedure includes obtaining an electroencephalogram (EEG) signal of the particular individual during the CPR procedure. The method also includes obtaining a non-invasive measure of circulation of the particular individual during the CPR procedure and generating a prediction for the likelihood of survival of the particular individual with favorable neurological function based on the EEG signal and the non-invasive measure of circulation.

Claims

1. A method for predicting the likelihood of survival of a particular individual with intact neurological function during a cardiopulmonary resuscitation (CPR) procedure, comprising:

obtaining, with an electroencephalogram (EEG) sensor, an EEG signal of the particular individual during the CPR procedure;

obtaining, with a non-invasive sensor, a non-invasive measure of circulation of the particular individual during the CPR procedure; and

generating, with a processor, a prediction for the likelihood of survival of the particular individual with intact neurological function, based on a mathematical operation based on the EEG signal and the non-invasive measure of circulation.

2. The method of claim 1, wherein the CPR procedure comprises an intrathoracic pressure regulation procedure or a reperfusion injury protection procedure.

3. The method of claim 2, wherein the CPR procedure further comprises a stutter CPR procedure.

4. The method of claim 2, wherein the CPR procedure further comprises administration of an anesthetic.

5. The method of claim 2, wherein the CPR procedure further comprises administration of sodium nitroprusside.

6. The method of claim 1, wherein obtaining the EEG signal comprises measuring the EEG signal using a bispectral index monitor.

7. The method of claim 1, wherein obtaining the non-invasive measure of circulation of the particular individual comprises monitoring the concentration or partial pressure of carbon dioxide in respiratory gases of the particular individual.

8. The method of claim 1, further comprising determining whether sedation is needed during the CPR procedure based on the EEG signal and the non-invasive measure of circulation.

9. The method of claim 1, further comprising determining whether sedation is needed following resuscitation of the particular individual based on the EEG signal and the non-invasive measure of circulation.

10. The method of claim 1, further comprising extracting respiratory gases from the airway of the particular individual to create an intrathoracic vacuum that lowers pressure in the thorax in order to achieve at least one of:

enhancing the flow of blood to the heart of the particular individual;

lowering intracranial pressures of the particular individual;

or

enhancing cerebral profusion pressures of the particular individual.

11. The method of claim 10, further comprising at least periodically delivering a positive pressure breath to the particular individual to provide ventilation.

12. The method of claim 1, further comprising preventing air from at least temporarily entering the particular individual'"'"'s lungs during at least a portion of a relaxation or decompression phase of the CPR procedure to create an intrathoracic vacuum that lowers pressure in the thorax in order to achieve at least one of:

enhanced flow of blood to the heart of the particular individual;

lowered intracranial pressures of the particular individual;

or

enhanced cerebral profusion pressures of the particular individual.

13. The method of claim 12, further comprising at least periodically delivering a positive pressure breath to the particular individual to provide ventilation.

14. A computing system configured for predicting the likelihood of survival of a particular individual with intact neurological function during a cardiopulmonary resuscitation (CPR) procedure, comprising:

a module configured to obtain an electroencephalogram (EEG) signal of the particular individual during the CPR procedure;

a module configured to obtain a non-invasive measure of circulation of the particular individual during the CPR procedure; and

a module configured to output a prediction for the likelihood of survival of the particular individual with intact neurological function based on a mathematical operation based on the EEG signal and the non-invasive measure of circulation.

15. The system of claim 14, further comprising a bispectral index monitor that is configured to calculate a bispectral index value of the particular individual based on the EEG signal.

16. The system of claim 14, wherein the module configured to obtain the non-invasive measure of circulation comprises a capnography monitor that is configured to calculate the non-invasive measure of circulation of the particular individual.

17. The system of claim 14, wherein the module configured to output the prediction for the likelihood of survival comprises a computing device processor, and wherein the prediction is based on a bispectral index value and the non-invasive measure of circulation.

18. The system of claim 14, wherein the module configured to obtain the EEG signal comprises an EEG sensor.

19. The system of claim 14, wherein the non-invasive measure of circulation of the particular individual is a measure of concentration or partial pressure of carbon dioxide in respiratory gases of the particular individual.

20. The system of claim 14, further comprising a module configured to determine whether sedation is needed during the CPR procedure based on the non-invasive measure of circulation and a bispectral index value calculated from the EEG signal.

21. The system of claim 20, wherein the module configured to determine whether sedation is needed comprises a computing device processor.

22. The system of claim 14, further comprising a module configured to determine whether sedation is needed following resuscitation of the particular individual based on the non-invasive measure of circulation and a bispectral index value calculated from the EEG signal.

23. The system of claim 22, wherein the module configured to determine whether sedation is needed following resuscitation of the particular individual comprises a computing device processor.

24. An apparatus configured for predicting the likelihood of survival of a particular individual with intact neurological function during a cardiopulmonary resuscitation (CPR) procedure, comprising:

a circulation enhancement device that is configured to enhance the particular individual'"'"'s circulation during the CPR procedure;

an electroencephalogram (EEG) sensor that is configured to measure an EEG signal of the particular individual;

a non-invasive sensor that is configured to measure circulation data of the particular individual; and

a computing device having a processor that is configured to receive and process the EEG signal and the circulation data, and to produce a prediction of the likelihood of survival of the particular individual with intact neurological function based on a mathematical product of the EEG signal and the circulation data.

25. The apparatus of claim 24, wherein the EEG sensor comprises a bispectral index monitor for measuring the EEG signal, and wherein the non-invasive sensor comprises a capnography monitor.

26. The apparatus of claim 24, wherein the circulation enhancement device includes either or both a vacuum source or a pressure responsive valve.

27. The apparatus of claim 24, further comprising a vacuum source configured to extract respiratory gases from the airway of the particular individual to create an intrathoracic vacuum to lower pressures in the thorax, wherein the vacuum source comprises an impeller that creates the vacuum, and wherein the pressures are lowered in the thorax in order to achieve at least one of:

enhanced flow of blood to the heart of the particular individual;

lower pressures in the thorax in order to lower intracranial pressures of the particular individual; and

lower pressures in the thorax in order to enhance cerebral profusion pressures of the particular individual.

28. The apparatus of claim 24, further comprising a pressure responsive valve configured to prevent respiratory gases from entering the lungs during at least a portion of a relaxation or decompression phase of CPR to create an intrathoracic vacuum that lowers pressure in the thorax in order to achieve at least one of:

enhanced flow of blood to the heart of the particular individual;

lowered intracranial pressures of the particular individual; and

enhanced cerebral profusion pressures of the particular individual.

29. A method for determining whether sedation is needed while performing cardiopulmonary resuscitation (CPR) on a particular individual, comprising:

obtaining an electroencephalogram (EEG) signal of the particular individual during a CPR procedure;

obtaining a non-invasive measure of circulation of the particular individual during the CPR procedure; and

determining whether to sedate the individual while performing CPR based upon a mathematical operation based on the EEG signal and the non-invasive measure of circulation.

30. A method for determining whether sedation is needed after concluding cardiopulmonary resuscitation (CPR) on a particular individual, comprising:

obtaining an electroencephalogram (EEG) signal of the particular individual during a CPR procedure;

obtaining a non-invasive measure of circulation of the particular individual during the CPR procedure; and

determining whether to sedate the individual after performing CPR based upon a mathematical operation based on the EEG signal and the non-invasive measure of circulation.

31. A device configured to predict the likelihood of survival of a particular individual with intact neurological function during a cardiopulmonary resuscitation (CPR) procedure, comprising:

an electroencephalogram (EEG) sensor that is configured to measure an EEG signal of the particular individual during the CPR procedure; and

a non-invasive sensor that is configured to measure circulation data of the particular individual during the CPR procedure; and

a processor configured or programmed to receive and process the EEG signal and the circulation data to generate a prediction for the likelihood of survival of the particular individual with intact neurological function based on a mathematical operation based on the EEG signal and the circulation data.

32. The device of claim 31, wherein the EEG sensor comprises a bispectral index monitor for measuring the EEG signal, and wherein the non-invasive sensor comprises a capnography monitor.

33. The device of claim 31, further comprising a vacuum source configured to extract respiratory gases from the airway of the particular individual to create an intrathoracic vacuum to lower pressures in the thorax, wherein the vacuum source comprises an impeller that creates the vacuum, and wherein the pressures are lowered in the thorax in order to achieve at least one of:

enhanced flow of blood to the heart of the particular individual;

lower pressures in the thorax in order to lower intracranial pressures of the particular individual; and

lower pressures in the thorax in order to enhance cerebral profusion pressures of the particular individual.

34. The device of claim 31, further comprising a pressure responsive valve configured to prevent respiratory gases from entering the lungs during at least a portion of a relaxation or decompression phase of CPR to create an intrathoracic vacuum that lowers pressure in the thorax in order to achieve at least one of:

enhanced flow of blood to the heart of the particular individual;

lowered intracranial pressures of the particular individual; and

enhanced cerebral profusion pressures of the particular individual.