The present invention relates to detection and interruption devices for infusion leakage during IV therapy and the monitoring system thereof, in particular, relates to an infusion-leakage detection device, an infusion interruption device and an infusion-leakage monitoring system.
When a light emits into a biological organization, it can be partially absorbed, reflected, scattered or can partially penetrate the organization, and the absorbing feature can be presented by a coefficient μα(cm−1), and the reciprocal of the coefficient is defined as the propagation depth of the light penetrating into an absorbing medium (mean free path). The scattering of photons in the organization decides the distribution of a 3-D volume of light intensity thereof. Scattered photons are simply changed in the path but not losing the energy. Scattering coefficient can be represented by μs(cm−1), and the reciprocal of the coefficient represents an average free path from the present scattering point to the next one. Isotropy is not the feature of light-scattering in a biological organization. Instead, forward scattering occupies higher proportion of light-scattering in a biological organization. Such feature can be represented by anisotropy “g”, and g is an absolute value from 0 (isotropy) to 1 (fully forward scattering). In a biological organization, the value of g is usually between 0.7 and 0.95. When practical scattering conditions are considered by the g value, the original scattering coefficient attenuates to μs'(cm−1) wherein μx′=μs(1-g), and the sum of μs and βαis called total attenuation coefficient μt(cm−1): βt=μs+βα.
The energy-transferring in an organization can be described by transport theory (referring to Chandrasekhar S., Radiative Transfer. New York, N.Y., Dover Publications Inc. 1960.), represented by the formula below:
s·∇L(r, s)=−(μαμs)L(r, s)+μs∫4πp(s, s′)L(r, s′)dω′
The formula states that the intensity of the radiance L(r, s) located at a point “r” with a unit directional vector “s” in a space may decrease resulting from the absorbing and scattering by the medium when the light emits into the medium. Sometimes the radiance intensity may increase resulting from other light scattered from another directional vector s' so that the intensities are added up. The light radiance describes that the amount of light that travels through a particular area or from a particular area and falls within a specified solid angle. Where d⋅′ is the difference in solid angle in the s′ direction, and p (s, s′) is the phase function. Since μα, μs and p (s, s′) are required to calculate the distribution of light according to the above formula in the biological organization, and these parameters are not fixed in a biological tissue [heterogeneity], it is indeed a considerable difficulty to calculate the distribution of the radiance. The Monte Carlo method is a computational method that relies on repeated random sampling to obtain numerical results. The basic idea is to use randomness to solve problems that may have been identified in principle. When physics and mathematics problems are hard to solve or cannot find other available methods, it can be the most useful way to reasonably solve the problem mentioned above by simulation.
Monte Carlo simulation has been used by many people in the behavioral analysis of photon absorption and diffusion in different tissues [Wilson B C, Adam G (1983) A Monte Carlo model for the absorption and flux distributions of light in tissue. Med Phys 10:824-830.]. In addition, the article “Monte Carlo simulation of photon migration in tissue” [Chapter 2, in “Application of Near Infrared Spectroscopy in Biomedicine”. Springer, ISBN: 978-1-4614-6251-4] describes the simulation of photon migration in different thickness layers in fat tissue. When the distance between the light-emitting element and the light detector is fixed, and the thickness of tissue is varied, the number of the photons moving to the detector is different. According to this, suppose that the thickness of the tissue is also fixed, then the number of the photons moves to the detector is nearly constant so that the output signal of the detector is also nearly constant. However, when a substance (such as the leaking liquid during IV therapy) infiltrates on the path of the photon migration between the light source and the detector, the detector's signal decreases.
The main content within the liquid medicine for IV therapy is water.
Currently, there are some examples applying such optic technology for detecting infusion leakage. In patent U.S. Pat. No. 7,826,890 a package of a light-emitting device surrounded by four light-receiving devices was designed for infiltration detection (
In addition, in column 5, lines 49-60 of U.S. Pat. No. 7,826,890, it emphasizes that a light having 850 nm wavelength may penetrate deeper organization, and the light having such wavelength is not easily absorbed by water and ordinary pigments. The application of the “first biological window” of optics for biological organization is used, and the wavelength range of the first biological window is between 650 and 950 nm. The definition of the so-called biological window of a biologic organization is that a light may more easily penetrate the organization under the wavelength range (i.e. less absorbed by the organization). However the paper “The Complex Refractive Index of Water” by D. J. Segelstein (MS thesis, University of Missouri, 1981) and the paper “Near-infrared spectroscopy as an index of brain and tissue oxygenation” Br. J. Anaesth. (2009) 103 (suppl 1): i3-i13 doi:10.1093/bja/aep299, indicated that light has less absorptivity in water below 850 nm than those above it, as shown in
Accordingly, a design for infusion-leakage detection that contains a light-emitting and light-detecting elements having specific wavelengths within or covering the second biological window should achieve the aim of infusion-leakage detection. If the technology of wireless data communication can be applied in this task, the spurred-wire problem mentioned above can be avoided. Again, the body movement sensing and the body movement error signal eliminating is a key factor to have a successful and accurate infusion-leakage detection. The extended functions of this design are that the signal of infusion-leakage can be in real time remotely monitored, the infusion conduit (tubing) can be automatically blocked by an interruption device when leakage is sensed by the device.
To achieve aforesaid objects, the present application provides an infusion-leakage detection device, an infusion-leakage interruption device and an alarm and remote monitoring system. The present application can not only detect infusion-leakage during IV therapy, also and it can interrupt the flow of the infusion conduit in time to stop extending tissue damage when leakage occurs. The status signal of infusion leakage/no-leakage in patient is sent to the computer of nurse station and to the smart phone/tablet of the on-duty nurses or physicians at any time. Once infusion leakage is detected, warning signals, such as flashing LED and buzzer alarm on the device are activated. In the meantime, message of leakage with warning signal is also sent to the smart phone/tablet and the computer of the nurse station simultaneously, and the infusion interruption device is activated too.
The present application has composite features, in addition to the functions of infusion-leakage detection and alarm, it also includes the sensing part of the infusion-leakage detection device for aligning the sensing region of the device to the IV catheter in order to obtain a better sensitivity, small size, convenience for use, immunity of the actual leakage/no-leakage signal from body movement, remote monitoring patient's current status of leakage/no-leakage with smart phone/tablet at a remote site by on-duty nurses or physicians, and computer at the nurse station.
The present application provides an infusion-leakage detection device including: a substrate; a circuit and infusion-leakage detection region formed on the substrate at can hemi-surround the hub at the proximal end of an IV catheter and be aligned to the IV catheter which has been inserted into a blood vessel of a patient, and the region includes at least a light-emitting element and at least a light detector, wherein the light-emitting element emits a light with wavelength range within or covering the second optical window of biological organization to a target organization of a human body, and the light detector receives the light reflected, transmitted, diffused or scattered from the target organization to generate an electrical signal; and a circuit and battery region formed on the substrate, comprising a control and calculation unit and an acceleration detector wired to the control and calculation unit; wherein the control and calculation unit connects to the light-emitting element to control the light intensity of the light-emitting element; wherein the acceleration detector senses body movement of a patient and provides a three dimensional acceleration signal of the movement to the control and calculation unit, and the control and calculation unit judges whether the body movement influences the actual infusion-leakage signal.
The present application also provides an infusion-leakage detection device, including: the infusion-leakage detection device; a server; and an infusion-leakage interruption device: wherein the infusion-leakage detection device transfers the detected data and alarm signal to the server and infusion interruption device via a wireless technique or network; wherein the server connects to an intranet network system of a hospital so that the detected infusion-leakage data and warning signal can be delivered to the smart phones of on-duty nurses/physicians and a computer of the hospital; wherein the infusion-leakage interruption device is activated when receiving the signal from the infusion-leakage detection device to block the infusion flow of the infusion conduit to cease the leakage not to get worse.
The infusion-leakage detection/interruption devices can further include a signal processing circuit and a battery with power management circuit on the substrate, wherein the signal processing circuit contains an amplifier for amplifying the infusion leakage/no-leakage signal coming from the light detectors. The control and calculation unit is for converting the analog signal output from the amplifier to digital signal and making leakage/no-leakage decision by an embedded algorithm. A communication unit receives an alarm signal from the control and calculation unit and sends patient's ID code and the alarm signal to the remote monitoring equipment and the leakage-interruption device if leakage occurs, and receives the acknowledgement signal from the leakage-interruption device as a confirmation of activation. The battery with power management circuit contains a button battery and related circuit which distributes corresponding regulated voltage to targeted electrical components and circuits.
The present application also provides a remote monitoring system, including wireless gateway, server and mobile equipment (smart phone/tablet) and the computer at the nurse station. The status signals of leakage/no-leakage in patients are sent to the mobile equipment and the computer at the nurse station by the infusion-leakage detection device periodically through the wireless network. When leakage occurs, the mobile equipment and the computer at the nurse station alarm, also the patient's bed is also highlighted shown on the screen. The advantage of this design is that the nurse needs not to check the patients periodically and can do the other work at the saved time.
To make the aforesaid and other objects, features and advantages of the present invention can be more apparent and easier to be understood, some embodiments are introduced in the following quotes, and in together with the accompanying drawings to make a detailed description below (embodiments).
According to an embodiment of the present application, a system including infusion-leakage detection device, infusion interruption device and wireless remote monitoring network is disclosed. The present application can be applied to every peripheral intravenous (PIV) infusion process of medical treatment, therefore patients can obtain the benefits from this technique including real time monitoring PIV infusion-leakage with any kind of situation, errors-prevention resulted from body movement, infusion interruption when leakage occurs, and wirelessly remote monitoring the status of leakage/no-leakage during IV therapy.
Pairing is a wireless network technique to connect two devices each other by a standard procedure. Pairing for patient and the infusion-leakage detection system can be pre-processed before the infusion-leakage detection device being put on patient's body. This process can be done at the patient's bedside with dedicated smart phone/tablet or at the remote computer site at the nurse station.
After pairing is done, the infusion-leakage detection device is then put on the patient's body where the infusion takes place. The entire system is activated after the IV catheter being inserted into the blood vessel and a “function” button being pressed on the device. At this time the device starts to do auto-calibration, and the LED of the device flashes yellow light for several second when the calibration is done. Then the status of the device such as battery power, and the information of leakage/no-leakage is transmitted to the remote nurse station and the smart phone/tablet of the on-duty nurses and physicians. If leakage occurs, the LED and the buzzer on the device will flash light and tweet as alarm signals. Meanwhile this warning message is also passed to the nurse station and the on-duty nurse's/physician's smart phone/tablet too.
The wavelength range of the light source applied to the present application can be between 1000 nm and 1350 nm or little wider, which is within or covers the second optical window of biological organization. Thus the light chosen within this window that absorbed by melanin,
HbO2 and Hb shall much less than most of lights having wavelengths within the first optical window of biological organization but highly absorbed by water, therefore the wavelengths chosen within the second optical window shall fully meet the demand of infusion-leakage detection of the present application and has better sensitivity than those outside this optical window.
When interruption is activated, the interruption device 40 will immediately responds an acknowledgment signal to the mobile equipment/nurse station 20 and the detection device 10 by way of wireless gateway 50 and sever 30.
The light intensity of the light-emitting element 15 can be controlled by the control and calculation unit 11. The light received by the light detector 16 is converted to an electrical signal and amplified by the amplifier 14 (for example, multiple stages of amplifying and filtering), and then converted to a digital signal via an analog to digital converter (ADC) of the control and calculation unit 11. This digital signal is then processed and judged by an algorism, which is embedded in this unit 11. The judged signal is transmitted to the mobile equipment/nurse station 20 through the communication unit 13, or to the wireless gateway in
Wherein the communication unit 13 bridges the control and calculation unit 11 and the external equipment. The external equipment can be the mobile equipment/nurse station 20, server 30 or the infusion interruption device 40 in
Wherein the acceleration detector 17 wired to the control and calculation unit 11 is to sense body movement. The acceleration detector 17 is applied in a situation: no matter whether the movement occurred or not of the patient's body, it provides a 3D acceleration signals to the control and calculation unit at any time. If there is any movement that influences the stability of the infusion-leakage detection device at the infusion site, this movement signal will be removed from the received infusion-leakage signal by signal processing of an algorithm in this unit 11. The sensitivity of the acceleration detector is adjustable through the control and calculation unit 11. Therefore, a judging mechanism of an algorithm is added to the present application. When the acceleration signal generated by the acceleration detector 17 and detected by the control and calculation unit 11 is over a threshold value of the acceleration, and causes the received leakage signal over the leakage threshold value, however, after removing the body movement signal and resulting in “no-leakage” by the judgement of the algorithm, the alarm signal will not be generated in the time duration of the body movement. Otherwise, if both infusion leakage and body movement occur in the meantime, “leakage” is announced and alarm command is sent out by the control and calculation unit 13.
As shown in the embodiment of
In addition, the substrate can be formed by a flexible printed circuit (FPC) or a printed circuit board (PCB).
In the embodiment of
The light-emitting element 15A emit a light to a target organization of a human body, and the light detectors 16A and 16B receive the light transmitted, reflected or scattered from the target organization, or the light penetrating through the target organization, and an electrical signal is generated and amplified by an amplifier, and then delivered to the control and calculation unit 11. In the embodiment, the light emitted from the light-emitting elements 15A can be absorbed in various level that results from how serious of the leakage occurred since the reduction of light being received by the light detector is proportional to the amount of the leaking liquid within the tissue. The form of the light emitted from the light-emitting element 15A can be DC or any form of AC (such as sinusoidal or pulsed). The light emitting elements 15A can be either LED or laser diode.
In the embodiment of
Wherein the light-emitting elements 15A and 15B emit lights to a target organization of a human body, and the light detectors 16A and 16B receive the light transmitted, reflected or scattered from the target organization, or the light penetrating through the target organization, and an electrical signal is generated and amplified by an amplifier, and then delivered to the control and calculation unit 11. In the embodiment, the light emitted from the light-emitting elements 15A and 15B can be absorbed in various level that results from how serious of the leakage occurred since the reduction of light being received by the light detector is proportional to the amount of the leaking liquid within the tissue. The form of the light emitted from the light-emitting elements 15A and 15B can be DC or any form of AC (such as sinusoidal or pulsatile). The light emitting elements 15A and 15B can be either LED or laser diode.
In the embodiment of
In the embodiment of
In the present application, because of the organization of tissue does not change during the period of the infusion therapy, the signal from the light-emitting element to the light detector is assumed to be a constant value (without body movement) since the distance between the light-emitting element and the light detector is fixed. Thus, the model of the present application can be simplified and explained by Beer-Lambert Law (Beer's Law). In a single biological structure, a light emitted from light-emitting element S through the organization having a thickness I, absorption coefficient α and medium concentration (or density) c to the light detector D. In accordance with Beer's Law: the relation is A=α1c. Wherein α is absorptivity, absorption coefficient or extinction coefficient.
The transmittance T of light is defined by a formula:
wherein I0 is the light intensity of the light emitting into the organization, Ie is the light intensity after the light passing through the organization. The relation of the transmittance of light with the absorptivity is defined by a formula
If a light transmits a plurality of organizations having different thicknesses (I1, I2 . . . In) and the corresponding absorptivity and density of each organization is (α1, α2 . . . αn) and (c1, c2 . . . cn), respectively, and the total absorptivity At and the total transmittance Tt can be presented as equations (1) and (2), respectively.
A
t=α1l1c1+α2l2c2 + . . . + αnlncn=A1+A2 + . . . + An (1)
T
t
=T
1
*T
2
* . . . * T
n (2)
In above equations (1) and (2), it is assumed that the intrinsic tissue thickness of In (n=1, 2 . . . n) does not change when leakage occurs. If an infusion liquid such as water leaks, the total absorptivity A t of the intrinsic tissue (At) and the leaked liquid (A*t) can be added together and shown as equation (3).
A′
t
=A
t
+A
t
* (3)
wherein At*=αH2O* lH2O*cH2O (4)
After considering the leaking liquid, the transmittance become: T′t=*Tt*Tt* (5)
Thus, when a situation of infusion-leakage is considered, the total transmittance Tt drops to Tt', and resulting in lowering the signal received by the light detector. The difference of the transmittance AT can be shown as equation (6)
ΔT=T′
t-Tt=10−A′
wherein k represents the light signal detected by the detector before thaleakage occurs.
If simply considering the light signal received by the light detector, the signal value Sλ(function of wavelength) can be shown as equation (7)
S
λ=ελT′t=ελTt*Tt*=ελk*10−α
Where ελrepresents the sensitivity of the light detector and is a function of wavelength. K=Tt, is the transmittance of light in the biological organization before that infusion-leakage occurs. αλ(H2O) is the absorptivity of water when the wavelength of light is λ. When infusion-leakage continues, the lH2O(t) increases with time (a function of time), and the total S drops, and cH2O may also increase too.
Please referring to
In summary, the invention declares a method, a device and a system in the application of infusion leakage detection, infusion interruption and remote monitoring for IV therapy. The second optical window applied on biological tissue allows that the wavelengths of the light source within it can be minimally absorbed by melanin of skin, oxygenized and deoxygenized hemoglobin in blood, also it can be absorbed greatly by the infusion liquid (water is the majority of the liquid) (see
Although the present application has been explained above, it is not the limitation of the range, the sequence in practice, the material in practice, or the method in practice. Any modification or decoration for the present application is not detached from the spirit and the range of such.
Number | Date | Country | Kind |
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106106220 | Feb 2017 | TW | national |