Patent Grant
11607489
The present disclosure relates, generally, to fluid injector state logic systems and, more particularly, to fluid injector state logic systems with hemodynamic monitoring.
Angiography is a procedure used in the detection and treatment of abnormalities or restrictions in blood vessels. During angiography, a radiographic image of a vascular structure (i.e., blood vessel) is obtained by injecting radiographic contrast material, also referred to as contrast media or simply “contrast,” through a catheter into a vein or artery of the patient. X-rays are passed through the region of the body in which the contrast media is concentrated. The X-rays are absorbed by the contrast material, causing a radiographic outline or image of the blood vessel containing the contrast media. The X-ray images of the blood vessel filled with the contrast media are usually recorded onto film, videotape, and/or digital media and may be displayed on a monitor.
Many angiographic procedures, in particular coronary angiography and especially coronary vascular interventional procedures such as angioplasty, require frequent intermittent injections of contrast media. The contrast media is administered in varying volumes as well as modulated strengths and time durations. The intermittent contrast media injections are critical for optimal positioning of guiding catheters at the targeted blood vessels, positioning of guide wires to and through the targeted areas during catheter interventions (i.e., percutaneous transluminal coronary angioplasty), and for assessment of the results of such interventional procedures.
During angiography, after a physician places the angiographic catheter into a vein or artery, the angiographic catheter is connected to either a manual or automatic contrast medium injection mechanism. A typical manual contrast media injection mechanism includes a syringe and a catheter connection. The user of the manual contrast media injection mechanism adjusts the rate and volume of injection by altering the manual actuation force applied to the plunger of the syringe.
Automatic contrast media injection mechanisms typically involve a syringe connected to an injector having a linear actuator. The liner actuator is connected to a motor that is controlled electronically, for example by a control module. The operator enters into the electronic control module information regarding fixed volumes of contrast media and fixed rates of injection to be used over the course of the angiography procedure. A change in flow rate may be affected by stopping the mechanism and resetting the parameters. Recent improvements in the radiographic imaging field have applied software and hardware interfaces to automatic contrast media injection mechanisms to provide variable flow rate and fixed flow rate modes to the operator. Additionally, the delivery of common flushing agents, such as saline, may also be controlled using the software/hardware interfaces.
While many protective features have been incorporated into the software/hardware interfaces for the automatic contrast media injection systems, unintentional errors by the attending physicians, technicians, or nurses can cause injury to a patient. In particular, one potential issue associated with automatic contrast media injection procedures is unintentional injection of air into arterial vasculature of a patient. Accidental misuse of the automatic contrast media injection system by the operator can initiate injector states or actions, such as purging or priming the fluid lines, while the patient is still connected to the automatic contrast media injection system. The accidental initiation of the priming or purging stage may deliver unwanted volumes of air into the patient's arterial vasculature. Methods and injector systems that may prevent inadvertent errors during injection procedures would be advantageous.
In view of the foregoing, there is a current need for a fluid injector state logic system that notifies a physician or otherwise recognizes when a patient is still fluidly connected to an automatic contrast media injection system. There is a further need for a fluid injector state logic system that prevents activation of an injector state, such as purging or priming, until the physician has verified that the patient is not fluidly connected to the automatic contrast media injection system or the catheter line has already been purged or primed before connection to the patient.
In one example, a fluid injection system may include a graphical user interface, a fluid control module operatively connected to the graphical user interface, at least one monitoring control module operatively connected to at least one of the graphical user interface and the fluid control module, a fluid injector operatively connected to the graphical user interface and the fluid control module, at least one fluid path set in fluid communication with the fluid control module, and a hemodynamic monitoring system operatively connected to the fluid path set and the monitoring control module. The hemodynamic monitoring system may be configured to receive electrical signals indicative of pressure waves formed in a medical fluid injected through the fluid path set using the fluid injector based on a location of the fluid path set in a patient's vasculature, to convert the electrical signals to pressure wave form information, and to send the pressure wave form information to the monitoring control module. Based on the pressure wave form information received from the hemodynamic monitoring system, the monitoring control module may be configured to create a state logic protocol to control the fluid control module to allow an injection procedure or allow a priming or purging sequence based on the pressure wave form information.
In another example, the state logic protocol created by the monitoring control module may include, in the event the pressure wave information is indicative of fluid communication between the fluid path set and the patient's vasculature, instructing the fluid control module to allow the injection procedure, while preventing the purging or priming sequence, and, in the event the pressure wave information is indicative of no fluid communication between the fluid path set and the patient's vasculature, instructing the fluid control module to allow the purging or priming sequence. A transducer may be positioned in-line with the fluid path set and operatively connected to the hemodynamic monitoring system. The transducer may be configured to monitor and convert a fluid flow pressure of the medical fluid within the fluid path set into the electrical signals to be sent to the hemodynamic monitoring system. The transducer may be a pressure transducer. A hemodynamic monitoring mechanism may be positioned in-line between the transducer and the hemodynamic monitoring system. The hemodynamic monitoring mechanism may be configured to send pressure wave form information regarding the medical fluid in the fluid path set to the monitoring control module. The graphical user interface may include a first monitoring control module and the fluid control module may include a second monitoring control module. An automatic pressure isolation valve may be positioned in-line with the fluid path set. The automatic pressure isolation valve may be configured to control the flow of the medical fluid through the fluid path set. The graphical user interface may be configured to display the pressure wave form information to a user to indicate whether there is a fluctuation in the fluid pressure in the fluid path set. In the event the medical fluid is being directed through the fluid path set to the patient's vasculature, the graphical user display may display a first pressure wave, in the event the medical fluid is not being directed through the fluid path set to the patient's vasculature, the graphical user display may display a second pressure wave of substantially zero value, and in the event the medical fluid is being directed through the fluid path set with an amount of air, the graphical user display may display a third pressure wave smaller than the first pressure wave but greater than the second pressure wave. The graphical user interface may be configured to display a visual indicator regarding a status of the system. The visual indicator may be displayed as a warning indicator when a measured fluid pressure in the fluid path set is greater than a possible human intra-coronary pressure range. The visual indicator may be displayed as a caution indicator when the measured fluid pressure in the fluid path set is greater than a normal human intra-coronary pressure range, but within the possible human intra-coronary pressure range. The visual indicator may be displayed as a ready-to-use indicator when the measured fluid pressure in the fluid path set is within the normal human intra-coronary pressure range. An air detector may be positioned in-line with the at least one fluid path set.
In another example, a fluid injection system may include a fluid control module, a first fluid path set in fluid communication with the fluid control module, a second fluid path set in fluid communication with the fluid control module, a pressure isolation valve in fluid communication with the first and second fluid path sets, a third fluid path set in fluid communication with the fluid control module and a patient's vasculature, and a hemodynamic monitoring system operatively connected to the second fluid path set and the fluid control module. The hemodynamic monitoring system may be configured to receive electrical signals indicative of pressure waves formed in a medical fluid injected through the second fluid path set based on a location of the third fluid path set in a patient's vasculature, to convert the electrical signals to pressure wave form information, and to send the pressure wave form information to the fluid control module. Based on the pressure wave form information received from the hemodynamic monitoring system, the fluid control module may be configured to create a state logic protocol to allow an injection procedure or allow a purging or priming sequence using the fluid control module.
In another example, the state logic protocol created by the fluid control module may include, in the event the pressure wave information is indicative of fluid communication between the third fluid path set and the patient's vasculature, instructing the fluid control module to allow the injection procedure, while preventing the purging or priming sequence, and, in the event the pressure wave information is indicative of no fluid communication between the third fluid path set and the patient's vasculature, instructing the fluid control module to allow the purging or priming sequence. The pressure isolation valve may include an automatic spring-biased spool valve. A transducer may be positioned in-line with the second fluid path set. The transducer may be configured to monitor and convert a fluid flow pressure of the medical fluid within the second fluid path set into the electrical signals to be sent to the hemodynamic monitoring system. A hemodynamic monitoring mechanism may be positioned in-line between the transducer and the hemodynamic monitoring system. An air detector may be positioned in-line with the third fluid path set.
In another example, a method of monitoring fluid pressure within a fluid injection system may include directing a medical fluid through a fluid path set of the fluid injection system; measuring a fluid pressure of the medical fluid using a transducer positioned in-line with the fluid path set; sending fluid pressure information from the transducer to a hemodynamic monitoring system; converting the fluid pressure information into pressure wave form information using the hemodynamic monitoring system; sending the pressure wave form information to a fluid control module of the fluid injection system; and allowing an injection procedure or allowing a priming sequence, and/or a purging sequence using the fluid control module based on the pressure wave form information. The method may further include displaying the pressure wave information on a graphical user interface of the fluid injection system.
The present disclosure is also defined by the following clauses:
Clause 1: A fluid injection system, comprising: a graphical user interface; a fluid control module operatively connected to the graphical user interface; at least one monitoring control module operatively connected to at least one of the graphical user interface and the fluid control module; a fluid injector operatively connected to the graphical user interface and the fluid control module; at least one fluid path set in fluid communication with the fluid control module; and a hemodynamic monitoring system operatively connected to the fluid path set and the monitoring control module, wherein the hemodynamic monitoring system is configured to receive electrical signals indicative of pressure waves formed in a medical fluid injected through the fluid path set using the fluid injector based on a location of the fluid path set in a patient's vasculature, to convert the electrical signals into pressure wave form information, and to send the pressure wave form information to the monitoring control module, and wherein, based on the pressure wave form information received from the hemodynamic monitoring system, the monitoring control module is configured to create a state logic protocol to control the fluid control module to allow an injection procedure or allow a purging or priming sequence based on the pressure wave form information.
Clause 2: The fluid injection system as recited in Clause 1, wherein the state logic protocol created by the monitoring control module comprises: in the event the pressure wave information is indicative of fluid communication between the fluid path set and the patient's vasculature, instructing the fluid control module to allow the injection procedure, while preventing the purging or priming sequence; and in the event the pressure wave information is indicative of no fluid communication between the fluid path set and the patient's vasculature, instructing the fluid control module to allow the purging or priming sequence.
Clause 3: The fluid injection system as recited in Clause 1 or 2, further comprising a transducer positioned in-line with the fluid path set and operatively connected to the hemodynamic monitoring system, wherein the transducer is configured to monitor and convert a fluid flow pressure of the medical fluid within the fluid path set into the electrical signals to be sent to the hemodynamic monitoring system.
Clause 4: The fluid injection system as recited in Clause 3, wherein the transducer comprises a pressure transducer.
Clause 5: The fluid injection system as recited in Clause 3 or 4, further comprising a hemodynamic monitoring mechanism positioned in-line between the transducer and the hemodynamic monitoring system.
Clause 6: The fluid injection system as recited in Clause 5, wherein the hemodynamic monitoring mechanism is configured to send pressure wave form information regarding the medical fluid in the fluid path set to the monitoring control module.
Clause 7: The fluid injection system as recited in any one of Clauses 1-6, wherein the graphical user interface includes a first monitoring control module and the fluid control module includes a second monitoring control module.
Clause 8: The fluid injection system as recited in any of Clauses 1-6, further comprising an automatic pressure isolation valve positioned in-line with the fluid path set, wherein the automatic pressure isolation valve is configured to control the flow of the medical fluid through the fluid path set.
Clause 9: The fluid injection system as recited in any of Clauses 1-8, wherein the graphical user interface is configured to display the pressure wave form information to a user to indicate whether there is a fluctuation in the fluid pressure in the fluid path set.
Clause 10: The fluid injection system as recited in any of Clauses 1-9, wherein: in the event the medical fluid is being directed through the fluid path set to the patient's vasculature, the graphical user display will display a first pressure wave, in the event the medical fluid is not being directed through the fluid path set to the patient's vasculature, the graphical user display will display a second pressure wave of substantially zero value, and in the event the medical fluid is being directed through the fluid path set with an amount of air, the graphical user display will display a third pressure wave smaller than the first pressure wave but greater than the second pressure wave.
Clause 11: The fluid injection system as recited in any of Clauses 1-10, wherein the graphical user interface is configured to display a visual indicator regarding a status of the system, wherein, the visual indicator is displayed as a warning indicator when a measured fluid pressure in the fluid path set is greater than a possible human intra-coronary pressure range, wherein the visual indicator is displayed as a caution indicator when the measured fluid pressure in the fluid path set is greater than a normal human intra-coronary pressure range, but within the possible human intra-coronary pressure range, and wherein the visual indicator is displayed as a ready-to-use indicator when the measured fluid pressure in the fluid path set is within the normal human intra-coronary pressure range.
Clause 12: The fluid injection system as recited in any of Clauses 1-11, further comprising an air detector positioned in-line with the at least one fluid path set.
Clause 13: A fluid injection system, comprising: a fluid control module; a first fluid path set in fluid communication with the fluid control module; a second fluid path set in fluid communication with the fluid control module; a pressure isolation valve in fluid communication with the first and second fluid path sets; a third fluid path set in fluid communication with the pressure isolation valve and a patient's vasculature; and a hemodynamic monitoring system operatively connected to the second fluid path set and the fluid control module, wherein the hemodynamic monitoring system is configured to receive electrical signals indicative of pressure waves formed in a medical fluid injected through the second fluid path set based on a location of the third fluid path set in a patient's vasculature, to convert the electrical signals into pressure wave form information, and to send the pressure wave form information to the fluid control module, and wherein, based on the pressure wave form information received from the hemodynamic monitoring system, the fluid control module is configured to create a state logic protocol to allow an injection procedure or allow a purging or priming sequence using the fluid control module.
Clause 14: The fluid injection system as recited in Clause 13, wherein the state logic protocol created by the fluid control module comprises: in the event the pressure wave information is indicative of fluid communication between the third fluid path set and the patient's vasculature, instructing the fluid control module to allow the injection procedure, while preventing the purging or priming sequence; and in the event the pressure wave information is indicative of no fluid communication between the third fluid path set and the patient's vasculature, instructing the fluid control module to allow the purging or priming sequence.
Clause 15: The fluid injection system as recited in Clause 13 or 14, wherein the pressure isolation valve comprises an automatic spring-biased spool valve.
Clause 16: The fluid injection system as recited in any of Clauses 13-15, further comprising a transducer positioned in-line with the second fluid path set, wherein the transducer is configured to monitor and convert a fluid flow pressure of the medical fluid within the second fluid path set into the electrical signals to be sent to the hemodynamic monitoring system.
Clause 17: The fluid injection system as recited in Clause 16, further comprising a hemodynamic monitoring mechanism positioned in-line between the transducer and the hemodynamic monitoring system.
Clause 18: The fluid injection system as recited in any of Clauses 13-17, further comprising an air detector positioned in-line with the third fluid path set.
Clause 19: A method of monitoring fluid pressure within a fluid injection system, the method comprising: directing a medical fluid through a fluid path set of the fluid injection system; measuring a fluid pressure of the medical fluid using a transducer positioned in-line with the fluid path set; sending fluid pressure information from the transducer to a hemodynamic monitoring system; converting the fluid pressure information into pressure wave form information using the hemodynamic monitoring system; sending the pressure wave form information to a fluid control module of the fluid injection system; and allowing an injection procedure or allowing a priming sequence and a purging sequence using the fluid control module based on the pressure wave form information.
Clause 20: The method as recited in Clause 19, further comprising displaying the pressure wave information on a graphical user interface of the fluid injection system.
These and other features and characteristics of the system, as well as the methods of operation and functions of the related elements of the system, will become more apparent upon consideration of the following description and the appended claims with reference to the accompanying drawings, all of which form a part of this specification, wherein like reference numerals designate corresponding parts in the various figures. It is to be expressly understood, however, that the drawings are for the purpose of illustration and description only, and are not intended as a definition of the limits of the disclosure. As used in the specification and claims, the singular form of “a”, “an”, and “the” include plural referents unless the context clearly dictates otherwise.
For purposes of the description hereinafter, the terms “upper”, “lower”, “right”, “left”, “vertical”, “horizontal”, “top”, “bottom”, “lateral”, “longitudinal”, and derivatives thereof, shall relate to the disclosure as it is oriented in the figures. However, it is to be understood that the disclosure may assume alternative variations and step sequences, except where expressly specified to the contrary. It is also to be understood that the specific systems and processes illustrated in the attached drawings, and described in the following specification, are simply exemplary examples of the disclosure. Hence, specific dimensions and other physical characteristics related to the examples disclosed herein are not to be considered as limiting.
As used herein in the context of communication between two or more units or devices, the terms “communication” and “communicate” refer to the receipt, transmission, or transfer of one or more signals, messages, commands, or other types of data. For one unit or device to be in communication with another unit or device means that the one unit or device is able to receive data from and/or transmit data to the other unit or device. A communication may use a direct or indirect connection, and may be wired and/or wireless in nature. Additionally, two units or devices may be in communication with each other even though the data transmitted may be modified, encrypted, processed, routed, etc., between the first and second unit or device. It will be appreciated that numerous arrangements are possible. Any known electronic communication protocols and/or algorithms may be used such as, for example, UDP, TCP/IP (including HTTP and other protocols), WLAN (including 802.11 and other radio frequency-based protocols and methods), analog transmissions, cellular networks, and/or the like. As used herein to describe a fluid pathway, the term “fluid communication” refers to whether fluid may flow between two described portions of a device. For example, an injector may be in fluid communication with a patient's vasculature when fluid may flow from the injector to the patient's vasculature. Alternatively, an injector may not be in fluid communication with a patient's vasculature when the fluid pathway is blocked, for example, by closing a stopcock, and fluid may not flow from the injector to the patient's vasculature.
As disclosed in
In one example illustrated in
The system 100 and fluid injector 102 are generally used to supply the contrast media under pressure to the fluid path set 206, 210 and, ultimately, the patient through a patient fluid path set 214. In one example, a rotating connection 220 or other fluid control mechanism may be included on a patient connection end of the fluid path set 214 to control flow of medical fluid therethrough. For example, the rotating connection valve 220 may be a three-way stopcock which has at least three positions: a first position that allows fluid communication between the fluid control module 204 and the patient; a second position that allows fluid communication between the fluid control module 204 and a waste port (not shown); and a third closed position where fluid communication between the fluid control module 204 and any component downstream of the valve 220 is blocked. In one example, the injector 102 may be controlled by the hand controller 10 to supply the contrast media at discrete and preselected flow rates based on the physical inputs of the hand controller 10. In another example, a user interface display, such as a graphical user interface (“GUI”) 216 and/or data entry device, may be provided for a user to manually input control parameters for operation of the fluid injector 102 and/or the fluid control module 204. The graphical user interface 216 may include a monitoring control module 218 configured to receive data information from different components of the system, as will be described herein. The monitoring control module 218 may be configured to receive data information either wirelessly or directly from one or more different components in the system, such as, for example, the fluid control module 204, the monitoring control module 212 of the fluid control module 204, a hemodynamic monitoring system 226, and/or a hemodynamic monitoring mechanism or jump box 228. The monitoring control module 218 may include at least one algorithm for evaluation of the signal or data information received from the one or more different components of the system and include decision making criteria for operating the system 100 based on the signal or data information received by the monitoring control module 218. In a further example, input control parameters could be remotely sent to the injector 102 and/or the fluid control module 204, for example by the user through the GUI 216 and corresponding data entry device.
Referring to
In various embodiments, a transducer 222 may be provided in fluid communication with the pressure isolation valve 202 and may be configured to monitor and convert the fluid flow pressure of the medical fluid within the fluid path set 206, 208, 210 and/or the fluid path set 214 into electrical signals sent to a hemodynamic monitoring system 226 in communication with the transducer 222. When the fluid path set 214 in fluid communication with the patient, the medical fluid flows to the patient's arterial vasculature during an injection procedure. When the patient is fluidly connected with fluid path set 214, i.e., fluid path set 214 is primed with a medical fluid, the patient's heart pumps blood through the vascular system and a fluid pressure fluctuation is created by the variations in the blood pressure due to the heart beat may be measured within the fluid path set 214 based on the beating of the patient's heart. Thus, when a fluid path between the patient and the transducer 222 is in fluid communication, as the patient's heart pumps, the fluctuation of fluid pressure generated within the patient's vasculature is translated through the medical fluid in the fluid path set 214 to transducer 222 and may be converted to an electrical signal by transducer 222. As the fluid flow pressure is monitored by the transducer 222, hemodynamic pressure of the patient may be monitored by the hemodynamic monitoring system 226. Specifically, the fluid flow pressure values read by the transducer 222 may be converted to electrical signals that are sent to the hemodynamic monitoring system 226 to allow the system 100 and/or medical professional to monitor the patient's hemodynamic pressure. Further, a measurement of a patient's hemodynamic pressure by the system is an indication that the patient is in fluid communication with the fluid injection system 100, i.e., that any fluid flow from the system will be transferred to the patient's vasculature system.
In one example, the hemodynamic monitoring system 226 is a system configured to measure the pressure and/or flow of blood within the patient's cardiovascular system and pressure and/or flow of medical fluid within the fluid path sets 206, 208, 210, 214 using the transducer 222. In various embodiments, transducer 222 may be a pressure transducer. Hemodynamic monitoring of the patient is the measurement and interpretation of biological systems within the patient that describes the performance of the patient's cardiovascular system. The hemodynamic monitoring system 226 may be in electrical communication with the transducer 222. The electrical signals generated by the transducer 222, which are correlative to the blood pressure within the patient and fluid flow pressure within the fluid path set 214, are sent to the hemodynamic monitoring system 226, which may generate pressure wave forms 126A, as shown in
When the pressure isolation valve 202 is and the transducer 222 are in fluid communication with the patient's vasculature system, the patient's heart will beat causing fluid flow pressure within the fluid path sets 206, 208, 210, 214, which is monitored and converted into electrical signals by the transducer 222. The electrical signal corresponding to the fluid flow pressure created by the pumping of the patient's heart is sent to the hemodynamic monitoring system 226. As shown in
Based on the pressure wave forms 126A that are generated, the physician may be able to determine whether the fluid path set 214 is properly positioned in the heart and/or vasculature of the patient. Different positions in the patient's heart and vasculature will generate different pressure wave forms such that the physician can interpret the specific pressure wave form to determine the location of the catheter in the patient's vasculature. When the valve 220 is open to the patient, the fluid path set 210 and/or fluid path 214 should not be purged or primed since unwanted air present in the fluid path could be directed into the patient's vasculature. To purge the system, the valve 220 may be moved to the closed position/waste port position. Thereafter, the fluid control module 204 may push fluid through the fluid path sets 206, 208, 210 to prime/purge any air present in the fluid path sets 206, 208, 210, 214 out through the waste port 220. It is possible to purge both fluid path sets 210, 214 when a patient is not connected to the fluid injection system 100 by opening the valve 220 to discharge any air trapped in the fluid path sets 210, 214 from a distal end of the fluid path set 214, for example at the connector at the end of fluid path set 214 for connecting the fluid injection system 100 to the patient. This type of purging should only be conducted when the generated pressure wave forms indicate that the fluid path set 214 is no longer connected to the patient. According to various embodiments, it is possible to determine when a patient is not connected to the fluid injection system 100. By reviewing the hemodynamic monitoring system 226, either by manual or electronic means, before initiating the priming or purging process, the physician may be alerted to the current position of valve 220. In various embodiments, the physician and/or a state logic protocol of the monitoring control module 212 can ensure that the fluid path set 214 is not in fluid communication with the patient before initiating a purging or priming process by reviewing the pressure wave form information from the hemodynamic monitoring system 226, thereby preventing air from being delivered to the patient's vasculature. In certain embodiments, to further assist the physician, the fluid control module 204, and/or the monitoring control module 212 in determining whether air is present in the fluid path set 214, an air detector 230 may be positioned in-line with the fluid path set 210. The air detector 230 may be configured to send signals to the fluid control module 204 to alert the physician when air has been detected in the fluid path set 210, thereby indicating that the fluid path set 210 should be purged or primed. The air detector 230 may be in direct or wireless communication with the fluid control module 204 to send data information regarding the presence and/or amount of air in the fluid path set 210. In the event the air detector 230 detects air in the fluid path set 210, the air detector 230 may send an alert notification to the fluid control module 204 regarding the air detected in the fluid path set 210. Based on this alert notification, the fluid control module 204 may be configured to cease any injection procedure that is currently being completed so as to prevent the air in the fluid path set 210 from being injected into the patient and also notify the user of the air detection event so that the user may take the appropriate action to remove the air and avoid injection of the air into the patient. Once the alert notification is no longer sent form the air detector 230, the fluid control module 204 will identify that no air exists in the fluid path set 210 and an injection procedure can be re-initiated. In one example, the air detector 230 is inoperative during a purging or priming sequence.
When the valve 220 is closed, fluid communication between the injector and the patient is broken. The patient's heart beat will continue but the fluid pressure generated by the patient's heart cannot be detected by the transducer 222 since the valve 220 has prevented fluid communication between the patient's vasculature and the transducer 222. Due to the lack of blood pressure fluctuations being detected by the transducer, the resulting electronic signals sent to the hemodynamic monitoring system 226 will produce a second pressure wave form 126B generated by the hemodynamic monitoring system 226 having a zero or low (e.g., fluctuations due to system noise or other phenomena unrelated to a patient's heart beat) value, as shown in
As shown in
In one example, the hemodynamic monitoring system 226 may be configured to send the pressure wave form information received from the transducer 222 to at least one of a first monitoring control module 218 of the graphical user interface 216 and a second monitoring control module 212 of the fluid control module 204. Based on the information received from the hemodynamic monitoring system 226 and/or the transducer 222, the monitoring control module 212 of the fluid control module 204 and/or the monitoring control module 218 of the graphical user interface 216 may be configured to create a state logic protocol, in both a binary form and a quantitative algorithm to determine different states of the system 100, such as, for example, fluid path sets 206, 208, 210, 214. According to various embodiments, based on the state of the fluid path sets 206, 208, 210, 214 as determined by the hemodynamic monitoring system 226 and shown on the graphical user interface 216, the monitoring control module 218 of the graphical user interface 216 may send commands to the monitoring control module 212 of the fluid control module 204 to perform certain procedures and protocols, such as allowing or not allowing specific procedures or protocols based on injector state information. In one example, in the event the pressure wave form information sent to the monitoring control module 218 of the graphical user interface 216 indicates the valve 220 is opened based on the pressure wave pulses detected by the transducer 222, for example as shown in
The monitoring control module 218 of the graphical user interface 216 may include an alert feature that allows the graphical user interface 216 to indicate to the physician that valve 220 is open to the patient and the fluid injection system 100 is in fluid communication with the patient's vasculature and that a priming or purging procedure of the injector should not be initiated or allowed. In one example, the alert feature may be a warning light or audible alert displayed on or generated by the graphical user interface 216, or a tactile sensation in the hand controller 10 indicating that a prime/purge procedure should not be initiated. In certain embodiments, the alert may disable the initiation of a priming or purging procedure until the user has reviewed the system configuration and acknowledged that the event that caused the alert has been addressed. In various examples, as shown in
In another embodiment, in the event that the pressure wave form information sent to the monitoring control module 218 of the graphical user interface 216 indicates the valve 220 is closed based on due to zero or low (due to system noise) pressure wave forms from the hemodynamic monitoring system 226 through patient fluid path set 214, as shown in
In other embodiments of the present disclosure, the graphical user interface 216 may control the fluid control module 204 such that, before the fluid control module 204 can initiate an injection procedure, the graphical user interface 216 must first determine that the fluid path sets 206, 208, 210, 214 have been fully purged/primed so that no unwanted air remains in the fluid path sets 206, 208, 210, 214. For example in certain scenarios, the fluid path sets 206, 208, 210, 214 may have gone through a prime/purge cycle but some air remains in the fluid path sets. According to these embodiments, the system 100 and injector state logic may be configured to detect the remaining air in the system and require the physician to repeat the purge/prime process to remove the detected air. Whether air remains in the fluid lines after a purge/prime cycle may be detected by the shape of the pressure wave form from the hemodynamic monitoring system 226. For example, in the event any air remains in the fluid path set 206, 208, 210, 214, the pressure wave forms 126C generated by the hemodynamic monitoring system 226 may not be as large or strong as when fluid pressure is measured when no air is present in the fluid path sets 206, 208, 210, 214, but may be greater than when the system is substantially filled with air prior to a priming procedure and zero or low fluid pressure fluctuation detected in the fluid path sets 206, 208, 210, 214. This may be due to any pressure signal read by the transducer 222 being muted by the presence of amounts of air in the fluid path sets. According to these embodiments, the muting of the pressure signal may be due to the increased compressibility of air, relative to the liquid in the line. As shown in
In another example of the present disclosure, a hemodynamic monitoring mechanism or jump box 228 may be provided on an electrical line connecting the transducer 222 to the hemodynamic monitoring system 226. As used herein, the term “jump box” means an electronic device that may be inserted in-line for direct connection or wirelessly connected between the transducer and the hemodynamic monitoring system which is capable of receive and duplicate electrical signals from the transducer and sends them to the graphical user interface, and optionally the corresponding monitoring control module, for analysis, monitoring, and/or display to the physician. In one embodiment, in the event the hemodynamic monitoring system 226 cannot be connected in effective communication with the graphical user interface 216, the hemodynamic monitoring mechanism or jump box 228 may be used to intercept the signal from the pressure transducer 222 and send pressure wave form information regarding the fluid pressure in the fluid path sets 206, 208, 210, 214 to the graphical user interface 216. In certain embodiments, the hemodynamic monitoring mechanism or jump box 216 may wrap around the electrical line connecting the transducer 222 or be inserted into the electrical line and the hemodynamic monitoring system 226 to monitor and record the fluid pressure information. In other embodiments similar to the hemodynamic monitoring system 226, the hemodynamic monitoring mechanism or jump box 228 may be configured to convert the fluid pressure information from the transducer 222 into pressure wave forms 126A, B, or C and transmit them to the graphical user interface 216. The pressure wave form information may be sent to the graphical user interface 216 to generate the static logic protocol described herein. The hemodynamic monitoring mechanism or jump box 228 and the graphical user interface 216 may be in direct or wireless communication with one another.
With reference to
In various embodiments, the pressure isolation valves 202 and 304 may be an automatic pressure isolation valve, such as a spring-loaded spool valve, a flow-based valve, or a pressure-based valve. In other embodiments, the pressure isolation valve 202/304 may be a high pressure crack valve. In this example, the pressure isolation valve 202/304 includes a spring-loaded spool that is normally in an open position to permit the fluid communication through the pressure isolation valve from the patient to the pressure transducer 222/316 to allow reading of the pressure wave form due to the patient's heart beat, while preventing high pressures of the contrast media to pass through the pressure isolation valve 202/304 to the pressure transducer 222/316. In the event the fluid control module 302 is instructed to direct contrast media to the patient, the contrast media may be pushed through the pressure isolation valve 304 by the fluid control module 302 into the patient's vasculature. According to certain embodiments, the pressure of the contrast media in the pressure isolation valve 304, for example against the spool of the pressure isolation valve 304 causes the spool to compress the spring therein and block the passage of the saline through the pressure isolation valve 304 to permit the contrast media to be directed to the patient. In one example, when the pressure isolation valve 304 is in the position where there is fluid communication between the contrast line 306, pressure is blocked from reaching the transducer 316 to prevent damage to the transducer 316 due to exposure to the high pressures typically used in contrast injections in angiographic procedures. The pressure isolation valve 304 may be reconfigured to adjust the required amount of pressure from the contrast media necessary to compress the spring to close the saline passage through the pressure isolation valve 304.
A valve 310, such as a stopcock, may be positioned in-line with the fluid path set 311 that extends from the pressure isolation valve 304 to the patient. The stopcock 310 may be rotatable between an open position that permits medical fluid to pass through the fluid path set 312 to the patient and a waste position that blocks the medical fluid from passing therethrough to the patient and instead directs the fluid out of a waste port to direct fluid out of the fluid path set 312 during a purging or priming sequence. An air detector 314 may also be provided in-line between the pressure isolation valve 304 and the patient. The air detector 314 may be configured to detect when any air that is present in the fluid path set 312 or the medical fluid therein. The air detector 314 may be in direct or wireless communication with the fluid control module 302 to send data information regarding the amount of air in the fluid path set 312. In the event the air detector 314 detects air in the fluid path set 312, the air detector 314 may send an alert notification to the fluid control module 302 regarding the air detected in the fluid path set 312. Based on this alert notification, the fluid control module 302 may be configured to alert a physician regarding the detection of air and/or cease any injection procedure that is currently being completed so as to prevent the air in the fluid path set 312 from being injected into the patient. The physician or the fluid injection system may then run a prime/purge cycle to remove the air from the fluid path 312 or system by rotating valve 310 to the waste position and purging/priming the system, before rechecking for the presence of air in the system or fluid pathways. Once air is no longer detected and the alert notification is no longer sent from the air detector 314, the fluid control module 302 will identify that no air exists in the fluid path set 312 and an injection procedure can be allowed to proceed. In one example, the air detector 314 may be inoperative during a purging or priming sequence initiated by the fluid control module 302.
With continued reference to
In one embodiment, the hemodynamic monitoring system 318 may be configured to send the pressure wave form information received from the transducer 316 to a monitoring control module 320 of the fluid control module 302 and/or the monitoring control module of the graphical user interface 303. Based on the information received from the hemodynamic monitoring system 318 and/or the transducer 316, the monitoring control module 320 of the fluid control module 302 may be configured to create a state logic protocol, in a binary form and/or a quantitative algorithm for the different states of the fluid path sets 306, 308, 311, 312. Based on the state of the fluid path sets 306, 308, 311, 312as determined by the hemodynamic monitoring system 318, the monitoring control module 320 of the fluid control module 302 may be configured to perform certain procedures. In one embodiment, in the event the pressure wave form information sent to the monitoring control module 320 of the fluid control module 302 indicates the stopcock 310 is open and fluid path sets 306, 308, 311, 312 are fully primed based on the pressure wave pulses read by the transducer 316, the monitoring control module 320 of the fluid control module 302 may instruct the fluid control module 302 to allow the injection procedure and deliver medical fluid to the patient, while the fluid control module 302 is prevented from allowing a priming or purging procedure that could send unwanted air into the patient's vasculature. It is contemplated that the monitoring control module 320 may provide options to a physician to set limits for the pressure wave forms to notify the fluid control module 302 when an injection procedure is authorized, as described herein. These limits may be set manually by the physician based on the specific condition of the patient. It is also contemplated that the physician may select the limits from a selection of actual patient wave forms that are pre-recorded on the monitoring control module 320 or are read in real-time from the transducer 316. In one embodiment, after the fluid path set 308 has established fluid communication with the patient, the physician may read the fluid pressure measured from the transducer 316 and set this fluid pressure as a baseline for the patient. The physician may then establish upper and lower fluid pressure limits for the pressure wave forms that will determine whether the fluid control module 302 is permitted to initiate an injection procedure. The monitoring control module 320 may also have the ability to record and build a library of pressure wave form history for the patient, so that the physician can monitor and analyze the fluid pressure and adjust the pressure wave limits as needed. In the event the hemodynamic monitoring system 318 sends pressure wave information to the fluid control module 302 indicating that there are zero or low fluctuations in the fluid flow pressure, the fluid control module 302 may recognize that the stopcock 310 has been closed and/or open to the waste port so that fluid communication exists between the injector and the waste port so that the fluid path set 312 is no longer in fluid communication with the patient's vasculature or that the fluid path set 312 has been disconnected from the patient's vasculature. Therefore, in this condition, the fluid control module 302 is permitted to allow a purging or priming sequence through the fluid path sets 306, 308, 311, and 312. Therefore, the transducer 316, the hemodynamic monitoring system 318, the graphical user interface 303, and the monitoring control module 320 of the fluid control module 302 may operate in a similar manner as the transducer 222, the hemodynamic monitoring system 226, the graphical user interface 216, and the monitoring control module 212 of the fluid control module 204 described above in connection with the fluid delivery system 100 (
The fluid delivery system 300 may also include a hemodynamic monitoring mechanism or jump box 322 provided in-line between the transducer 316 and the hemodynamic monitoring system 318 or attached to the communication line therebetween or otherwise in communication with at least one of the transducer 316 and the hemodynamic monitoring system 318. The hemodynamic monitoring mechanism or jump box 322 may be in direct or wireless communication with the fluid control module 302. The hemodynamic monitoring mechanism or jump box 322 may operate in a similar manner as the hemodynamic monitoring mechanism or jump box 228 described herein with reference to
While various examples of the system and methods of operating the system were provided in the foregoing description, those skilled in the art may make modifications and alterations to these examples without departing from the scope and spirit of the disclosure. For example, it is to be understood that this disclosure contemplates that, to the extent possible, one or more features of any example may be combined with one or more features of any other example. Accordingly, the foregoing description is intended to be illustrative rather than restrictive.
This application is a 371 national phase application of PCT International Application No. PCT/US2018/034613, filed May 25, 2018, and claims the priority to U.S. Provisional Patent Application No. 62/511,471, filed on May 26, 2017, the disclosures of which are incorporated herein by reference in their entirety.
| Filing Document | Filing Date | Country | Kind |
|---|---|---|---|
| PCT/US2018/034613 | 5/25/2018 | WO |
| Publishing Document | Publishing Date | Country | Kind |
|---|---|---|---|
| WO2018/218132 | 11/29/2018 | WO | A |
| Number | Name | Date | Kind |
|---|---|---|---|
| 1832266 | Thomas | Nov 1931 | A |
| 2191990 | Jordan | Feb 1940 | A |
| 2202123 | Strode | May 1940 | A |
| 2223944 | Roy | Dec 1940 | A |
| 2415258 | Parker et al. | Feb 1947 | A |
| 2702547 | Glass | Feb 1955 | A |
| 2729228 | Stevenson | Jan 1956 | A |
| 3207179 | Klagues | Sep 1965 | A |
| 3565056 | Louis | Feb 1971 | A |
| 3633605 | Larry | Jan 1972 | A |
| 3645139 | John | Feb 1972 | A |
| 3675891 | Gordon et al. | Jul 1972 | A |
| 3713341 | Madsen et al. | Jan 1973 | A |
| 3831629 | Mackal et al. | Aug 1974 | A |
| 3859985 | Eckhart | Jan 1975 | A |
| 3863504 | Borsanyi | Feb 1975 | A |
| 3865100 | Kanai et al. | Feb 1975 | A |
| 4005219 | Buckle et al. | Jan 1977 | A |
| 4005710 | Zeddies et al. | Feb 1977 | A |
| 4077882 | Gangemi | Mar 1978 | A |
| 4080967 | O″Leary | Mar 1978 | A |
| 4094318 | Burke et al. | Jun 1978 | A |
| 4109535 | Reed et al. | Aug 1978 | A |
| 4226124 | Kersten | Oct 1980 | A |
| 4243031 | Genese | Jan 1981 | A |
| 4314480 | Becker | Feb 1982 | A |
| 4331262 | Snyder et al. | May 1982 | A |
| 4335729 | Reynolds et al. | Jun 1982 | A |
| 4337770 | Young et al. | Jul 1982 | A |
| 4341224 | Stevens | Jul 1982 | A |
| 4342218 | Fox | Aug 1982 | A |
| 4351332 | Whitney et al. | Sep 1982 | A |
| 4384470 | Fiore | May 1983 | A |
| 4392847 | Whitney et al. | Jul 1983 | A |
| 4414999 | Basta | Nov 1983 | A |
| 4415003 | Paradis et al. | Nov 1983 | A |
| 4428383 | Devroom | Jan 1984 | A |
| 4431009 | Marino, Jr. et al. | Feb 1984 | A |
| 4444198 | Petre | Apr 1984 | A |
| 4444219 | Hollenstein | Apr 1984 | A |
| 4464172 | Lichtenstein | Aug 1984 | A |
| 4509946 | McFarlane | Apr 1985 | A |
| 4516595 | Acomb | May 1985 | A |
| 4517844 | Powell | May 1985 | A |
| 4610256 | Wallace | Sep 1986 | A |
| 4624662 | Le | Nov 1986 | A |
| 4677980 | Reilly et al. | Jul 1987 | A |
| 4683916 | Raines | Aug 1987 | A |
| 4697617 | Bourke et al. | Oct 1987 | A |
| 4712583 | Pelmulder et al. | Dec 1987 | A |
| 4779625 | Cole | Oct 1988 | A |
| 4815313 | Beard | Mar 1989 | A |
| 4838856 | Mulreany et al. | Jun 1989 | A |
| 4858127 | Kron et al. | Aug 1989 | A |
| 4890640 | King, Sr. | Jan 1990 | A |
| 4960127 | Noce et al. | Oct 1990 | A |
| 5002528 | Palestrant | Mar 1991 | A |
| 5004079 | Ivers et al. | Apr 1991 | A |
| 5007904 | Densmore et al. | Apr 1991 | A |
| 5057081 | Sunderland et al. | Oct 1991 | A |
| 5076280 | Moriuchi et al. | Dec 1991 | A |
| 5106379 | Leap | Apr 1992 | A |
| 5120313 | Elftman | Jun 1992 | A |
| 5140862 | Pappalardo | Aug 1992 | A |
| 5148811 | Messinger | Sep 1992 | A |
| 5174038 | Neyens et al. | Dec 1992 | A |
| 5237999 | Von Berg | Aug 1993 | A |
| 5241986 | Yie | Sep 1993 | A |
| 5263367 | Pippert | Nov 1993 | A |
| 5273047 | Tripp et al. | Dec 1993 | A |
| 5300031 | Neer et al. | Apr 1994 | A |
| 5336051 | Tamari | Aug 1994 | A |
| 5383858 | Reilly et al. | Jan 1995 | A |
| 5423751 | Harrison et al. | Jun 1995 | A |
| 5429611 | Rait | Jul 1995 | A |
| 5433712 | Stiles et al. | Jul 1995 | A |
| 5460609 | O'Donnell | Oct 1995 | A |
| 5515851 | Goldstein | May 1996 | A |
| 5535785 | Werge et al. | Jul 1996 | A |
| 5540668 | Wilson, Jr. et al. | Jul 1996 | A |
| 5551301 | Cowan | Sep 1996 | A |
| 5554113 | Novak et al. | Sep 1996 | A |
| 5569208 | Woelpper et al. | Oct 1996 | A |
| 5573515 | Wilson et al. | Nov 1996 | A |
| 5575767 | Stevens | Nov 1996 | A |
| 5584671 | Schweitzer, Jr. et al. | Dec 1996 | A |
| 5593385 | Harrison et al. | Jan 1997 | A |
| 5630935 | Treu | May 1997 | A |
| 5631552 | Ogawa et al. | May 1997 | A |
| 5684246 | Korpi | Nov 1997 | A |
| 5692539 | Pickl, Jr. | Dec 1997 | A |
| 5727594 | Choksi | Mar 1998 | A |
| 5770675 | Kim et al. | Jun 1998 | A |
| 5775671 | Cote, Sr. | Jul 1998 | A |
| 5779675 | Reilly et al. | Jul 1998 | A |
| 5800397 | Wilson et al. | Sep 1998 | A |
| 5808203 | Nolan, Jr. et al. | Sep 1998 | A |
| 5840026 | Uber, III et al. | Nov 1998 | A |
| 5873861 | Hitchins et al. | Feb 1999 | A |
| 5916165 | Duchon et al. | Jun 1999 | A |
| 5938639 | Reilly et al. | Aug 1999 | A |
| 5947935 | Kazousky et al. | Sep 1999 | A |
| 5967176 | Blann et al. | Oct 1999 | A |
| 5992462 | Atkinson et al. | Nov 1999 | A |
| 6029076 | Fiddian-Greene et al. | Feb 2000 | A |
| 6089272 | Brand et al. | Jul 2000 | A |
| 6096011 | Trombley, III et al. | Aug 2000 | A |
| 6099502 | Duchon et al. | Aug 2000 | A |
| 6099511 | Devos et al. | Aug 2000 | A |
| 6171253 | Bullister et al. | Jan 2001 | B1 |
| 6221045 | Duchon et al. | Apr 2001 | B1 |
| 6336913 | Spohn et al. | Jan 2002 | B1 |
| 6344030 | Duchon et al. | Feb 2002 | B1 |
| 6346084 | Schnell et al. | Feb 2002 | B1 |
| 6390120 | Guala | May 2002 | B1 |
| 6390130 | Guala | May 2002 | B1 |
| 6422057 | Anderson | Jul 2002 | B1 |
| 6471674 | Emig et al. | Oct 2002 | B1 |
| 6475192 | Reilly et al. | Nov 2002 | B1 |
| 6536278 | Scagliarini | Mar 2003 | B1 |
| 6595957 | Griffiths et al. | Jul 2003 | B1 |
| 6622752 | Kushida et al. | Sep 2003 | B2 |
| 6626862 | Duchon et al. | Sep 2003 | B1 |
| 6649046 | Chevallet | Nov 2003 | B2 |
| 6650929 | Nemoto et al. | Nov 2003 | B1 |
| 6656157 | Duchon et al. | Dec 2003 | B1 |
| 6811139 | Hishikawa | Nov 2004 | B2 |
| 6866039 | Wright et al. | Mar 2005 | B1 |
| 6866654 | Callan et al. | Mar 2005 | B2 |
| 6896002 | Hart et al. | May 2005 | B2 |
| 6929619 | Fago et al. | Aug 2005 | B2 |
| 6945959 | Duchon et al. | Sep 2005 | B2 |
| 6986753 | Bui | Jan 2006 | B2 |
| 6988510 | Enerson | Jan 2006 | B2 |
| 7014624 | Meythaler et al. | Mar 2006 | B2 |
| 7017418 | Thakre et al. | Mar 2006 | B1 |
| 7094216 | Trombley, III et al. | Aug 2006 | B2 |
| 7153288 | Duchon et al. | Dec 2006 | B2 |
| 7192416 | Lazzaro et al. | Mar 2007 | B1 |
| 7267667 | Hou et al. | Sep 2007 | B2 |
| 7291131 | Call | Nov 2007 | B2 |
| 7302960 | Patzer | Dec 2007 | B2 |
| 7326186 | Trombley et al. | Feb 2008 | B2 |
| 7389788 | Wilson et al. | Jun 2008 | B2 |
| 7549977 | Schriver et al. | Jun 2009 | B2 |
| 7556619 | Spohn et al. | Jul 2009 | B2 |
| 7563249 | Schriver et al. | Jul 2009 | B2 |
| 7610936 | Spohn et al. | Nov 2009 | B2 |
| 7611503 | Spohn et al. | Nov 2009 | B2 |
| 7704236 | Denolly | Apr 2010 | B2 |
| 7713239 | Uber et al. | May 2010 | B2 |
| 8147464 | Spohn et al. | Apr 2012 | B2 |
| 8251092 | Spohn et al. | Aug 2012 | B2 |
| 8337456 | Schriver et al. | Dec 2012 | B2 |
| 8361040 | Spohn et al. | Jan 2013 | B2 |
| 8540698 | Spohn et al. | Sep 2013 | B2 |
| 9433730 | Schriver et al. | Sep 2016 | B2 |
| 9808571 | Riley et al. | Nov 2017 | B2 |
| 9895527 | Spohn et al. | Feb 2018 | B2 |
| 20020016569 | Critchlow et al. | Feb 2002 | A1 |
| 20020143294 | Duchon et al. | Oct 2002 | A1 |
| 20030004463 | Reilly et al. | Jan 2003 | A1 |
| 20030011135 | Meacham | Jan 2003 | A1 |
| 20030011136 | Ramirez et al. | Jan 2003 | A1 |
| 20030040723 | Hart et al. | Feb 2003 | A1 |
| 20030139706 | Gray | Jul 2003 | A1 |
| 20030171712 | Critchlow et al. | Sep 2003 | A1 |
| 20040064041 | Lazzaro et al. | Apr 2004 | A1 |
| 20040122370 | Joyce et al. | Jun 2004 | A1 |
| 20040138641 | Patzer | Jul 2004 | A1 |
| 20040143212 | Trombley et al. | Jul 2004 | A1 |
| 20040143225 | Callan et al. | Jul 2004 | A1 |
| 20040158205 | Savage et al. | Aug 2004 | A1 |
| 20040168530 | Adolfs et al. | Sep 2004 | A1 |
| 20040217315 | Doyle | Nov 2004 | A1 |
| 20040221904 | Usher et al. | Nov 2004 | A1 |
| 20040254533 | Schriver et al. | Dec 2004 | A1 |
| 20050077225 | Usher et al. | Apr 2005 | A1 |
| 20050104444 | Callan et al. | May 2005 | A1 |
| 20050113754 | Cowan | May 2005 | A1 |
| 20050148867 | Neer | Jul 2005 | A1 |
| 20050194047 | Bausmith et al. | Sep 2005 | A1 |
| 20050230575 | Zelenski et al. | Oct 2005 | A1 |
| 20050234407 | Spohn et al. | Oct 2005 | A1 |
| 20050234428 | Spohn et al. | Oct 2005 | A1 |
| 20060009699 | Roteliuk et al. | Jan 2006 | A1 |
| 20060065873 | Doyle | Mar 2006 | A1 |
| 20060079765 | Neer et al. | Apr 2006 | A1 |
| 20060108555 | Kiehne | May 2006 | A1 |
| 20060149189 | Diamond et al. | Jul 2006 | A1 |
| 20060155248 | Hashimoto et al. | Jul 2006 | A1 |
| 20060178632 | Trombley et al. | Aug 2006 | A1 |
| 20060180202 | Wilson et al. | Aug 2006 | A1 |
| 20070106208 | Uber et al. | May 2007 | A1 |
| 20070161970 | Spohn et al. | Jul 2007 | A1 |
| 20080045919 | Jakob et al. | Feb 2008 | A1 |
| 20080086087 | Spohn et al. | Apr 2008 | A1 |
| 20080154214 | Spohn et al. | Jun 2008 | A1 |
| 20090216192 | Schriver et al. | Aug 2009 | A1 |
| 20110190710 | Miyoshi et al. | Aug 2011 | A1 |
| 20120123257 | Stokes, Jr. et al. | May 2012 | A1 |
| 20120130236 | Nystrom | May 2012 | A1 |
| 20130123619 | Griggs | May 2013 | A1 |
| 20130197883 | Grow et al. | Aug 2013 | A1 |
| 20130255390 | Riley | Oct 2013 | A1 |
| 20140034169 | Harton et al. | Feb 2014 | A1 |
| Number | Date | Country |
|---|---|---|
| 202005015741 | Dec 2005 | DE |
| 1090650 | Apr 2001 | EP |
| 1602388 | Dec 2005 | EP |
| 1602388 | Nov 2009 | EP |
| 2848859 | Jun 2004 | FR |
| 2274148 | Jul 1994 | GB |
| H01147841 | Jun 1989 | JP |
| H0630905 | Feb 1994 | JP |
| H07100212 | Apr 1995 | JP |
| 2004357985 | Dec 2004 | JP |
| 2010538761 | Dec 2010 | JP |
| 9308454 | Apr 1993 | WO |
| 9422686 | Oct 1994 | WO |
| 9522280 | Aug 1995 | WO |
| 9707841 | Mar 1997 | WO |
| 0010629 | Mar 2000 | WO |
| 0065984 | Nov 2000 | WO |
| 0204049 | Jan 2002 | WO |
| 2005110007 | Nov 2005 | WO |
| 2007146586 | Dec 2007 | WO |
| 2011041290 | Apr 2011 | WO |
| 2012155035 | Nov 2012 | WO |
| 2015061723 | Apr 2015 | WO |
| Entry |
|---|
| Hemodynamic Monitoring: Principles to Practice—M. L. Cheatham, MD, FACS, FCCM, Revised on Jan. 13, 2009. |
| “International Preliminary Report on Patentability in PCT Application No. PCT/US2018/034613”, dated Dec. 5, 2019. |
| Omron. 7 Series Blook Pressure Monitor with ComFit Cuff. Instruction Manual. 2010. |
| OMRON Instruction Manual, 7 series, Blood Pressure Monitor with ComFit Cuff, 2010. |
| Number | Date | Country | |
|---|---|---|---|
| 20200330682 A1 | Oct 2020 | US |
| Number | Date | Country | |
|---|---|---|---|
| 62511471 | May 2017 | US |
