Physiological trend monitor
A physiological trend monitor has a sensor signal responsive to multiple wavelengths of light transmitted into a tissue site. The transmitted light is detected after attenuation by pulsatile blood flow within the tissue site. A processor has an input responsive to the sensor signal and a physiological parameter output. Features are extracted from the physiological parameter output. Criteria are applied to the features. An alarm output is generated when the criteria are satisfied.
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This application is an application for reissue of U.S. Pat. No. 9,636,056, issued on May 2, 2017 and titled “Physiological Trend Monitor,”; more than one reissue application has been filed for the reissue of U.S. Pat. No. 9,636,056, including U.S. patent application Ser. No. 16/385,846 (the present application), and U.S. patent application Ser. No. 17/665,400, which is a reissue divisional application.Any and all applications, if any, for which a foreign or domestic priority claim is identified in the Application Data Sheet of the present application are hereby incorporated by reference under 37 CFR 1.57.
BACKGROUNDPhysiological measurement instruments employed in healthcare environments often feature visual and audible alarm mechanisms that alert a caregiver when a patient's vital signs are outside of predetermined limits. One example is a pulse oximeter, which measures the oxygen saturation level of arterial blood, an indicator of oxygen supply. A typical pulse oximeter displays a numerical readout of the patient's oxygen saturation, a numerical readout of pulse rate, and a plethysmograph, which is indicative of a patient's pulse. In addition, a pulse oximeter provides an alarm that warns of a potential desaturation event.
One aspect of a physiological trend monitor comprises transmitting light into a patient tissue site, generating a sensor signal, detecting a blood parameter trend according to the sensor signal and generating an alarm according to the blood parameter trend. The transmitted light has multiple wavelengths. The sensor signal is responsive to the light after attenuation by pulsatile arterial blood flow within the tissue site. In various embodiments, the detecting comprises deriving a curve-fitting blood parameter measurement. A blood parameter slope is calculated from the blood parameter measurement. The alarm is responsive to a negative value of the blood parameter slope. A smoothed blood parameter measurement is derived. A threshold value is set for the smoothed blood parameter measurement. The alarm is responsive to the smoothed blood parameter measurement crossing the threshold value.
Another aspect of a physiological trend monitor comprises a sensor signal responsive to multiple wavelengths of light transmitted into a tissue site and detected after attenuation by pulsatile blood flow within the tissue site. A processor has an input responsive to the sensor signal and a physiological parameter output. Features are extracted from the physiological parameter output. Criteria are applied to the features. An alarm output is generated when the criteria are satisfied. In various embodiments a pattern memory stores feature values and a comparator compares the features with the stored feature values. The criteria determine a match between the features and the stored feature values so as to trigger the alarm output. At least one of the features relate to the number of threshold crossings over a specified time period. At least one of the features relate to a duration of a threshold crossing by the physiological parameter output. At least one of the features relate to a trend in the physiological parameter and a slope of that trend over a specified time period.
A further aspect of a physiological trend monitor comprises a detector responsive to multiple wavelengths of light transmitted into a tissue site after attenuation by pulsatile blood flow within the tissue site so as to generate a sensor signal. A processor means calculates a physiological measurement in response to the sensor signal. A pattern extractor means identifies features of the physiological measurement. A pattern memory means stores a reference pattern. A pattern comparator means triggers an alarm if the identified features match the reference pattern. In various embodiments, a threshold is input to the pattern extractor. The identified features comprise at least the number of times the physiological measurement crosses the threshold within a predetermined time period. The identified features comprise at least the duration of each time the physiological measurement crosses the threshold. The physiological measurement comprises a predictive oxygen saturation measurement. A second processor means calculates an integrator oxygen saturation measurement.
The integrator SpO.sub.2 processor 410, advantageously, provides a smoothed measurement of oxygen saturation suitable for threshold detection. The predictor SPO.sub.2 processor 420, advantageously, provides a curve-fitting or a predictive measurement of oxygen saturation that detects trends in oxygen saturation, as described in further detail with respect to
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Although some alarm processor embodiments were described above in terms of pulse oximetry and oxygen saturation measurements, one of ordinary skill in the art will recognize that an alarm processor as disclosed herein is also applicable to the measurement and monitoring of other blood constituents, for example blood glucose and total hemoglobin concentration to name a few, and other physiological parameters such as blood pressure, pulse rate, respiration rate, and EKG to name a few.
In an embodiment, multiple pattern processors, each including a pattern extractor, pattern memory and pattern comparator, such as described with respect to
A physiological trend monitor has been disclosed in detail in connection with various embodiments. These embodiments are disclosed by way of examples only and are not to limit the scope of the claims that follow. One of ordinary skill in the art will appreciate many variations and modifications.
Claims
1. A system for non-invasively monitoring physiological trends, the system comprising:
- a processor comprising a sensor signal input and a display driver, wherein the processor is configured to: receive, at the sensor signal input, a sensor signal from an optical sensor coupled with a patient, the sensor signal responsive to light attenuated by body tissue of the patient; calculate a physiological parameter and a physiological parameter trend based on the sensor signal; output, by the display driver, a value of the physiological parameter for presentation on a display; and output an audible alarm once the physiological parameter reaches a threshold if the physiological parameter trend is not trending upward.
2. The system of claim 1, wherein the processor is further configured to suppress the audible alarm once the smoothed physiological parameter rises above the threshold, even if the physiological parameter trend is flat or trending downward.
3. The system of claim 1, wherein the processor is further configured to suppress the audible alarm once the physiological parameter trend begins to trend upward, even if the physiological parameter is under the threshold.
4. The system of claim 1, wherein the processor is further configured to calculate the physiological parameter by smoothing physiological parameter values.
5. The system of claim 1, wherein the processor is further configured to calculate the physiological parameter by integrating physiological parameter values.
6. The system of claim 1, wherein the processor is further configured to calculate the physiological parameter trend using a curve-fitting technique.
7. The system of claim 1, wherein the processor is further configured to output the audible alarm responsive to the physiological parameter trend being negative.
8. The system of claim 1, wherein the processor is further configured to output the audible alarm responsive to the physiological parameter trend being zero.
9. The system of claim 1, wherein the physiological parameter is selected from the group consisting of oxygen saturation, blood glucose, total hemoglobin concentration, blood pressure, pulse rate, and respiration rate.
10. A system for non-invasively monitoring physiological trends, the system comprising:
- a processor comprising a sensor signal input and a display driver, wherein the processor is configured to: receive, at the sensor signal input, a sensor signal from an optical sensor coupled with a patient, the sensor signal responsive to light attenuated by body tissue of the patient; calculate a physiological parameter based on the sensor signal; output, by the display driver, a value of the physiological parameter for presentation on a display; and output an audible alarm once the physiological parameter reaches a threshold if a physiological parameter trend of physiological parameter values is not trending upward.
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Type: Grant
Filed: Apr 16, 2019
Date of Patent: Apr 19, 2022
Assignee: Masimo Corporation (Irvine, CA)
Inventor: Ammar Al-Ali (San Juan Capistrano, CA)
Primary Examiner: Nick Corsaro
Application Number: 16/385,846
International Classification: A61B 5/1455 (20060101); A61B 5/08 (20060101); A61B 5/00 (20060101); A61B 5/021 (20060101); A61B 5/145 (20060101); A61B 5/318 (20210101); A61B 5/316 (20210101);