This application claims the benefit of Chinese Patent Application No. 201110033470.4, filed Jan. 30, 2010, which is incorporated herein by reference in its entirety.
The following disclosure relates to the field of medical monitoring.
Disclosed herein are embodiments of methods, systems, and devices for managing hemodynamic parameters.
Hemodynamic monitoring is extremely important in clinical anesthesia and intensive care. It is a necessary feature of major operations and critical patient rescue. In general, hemodynamic monitoring includes two types: invasive and non-invasive. Non-invasive hemodynamic monitoring acquires parameters related to cardiovascular function indirectly through the skin or mucous membranes without injuring the patient's body. Invasive hemodynamic monitoring directly measures physiological parameters by inserting catheters or sensors to heart chambers or vascular cavities from the body surface.
There are a wide variety of hemodynamic parameters, such as CCO, CO, CCI, CI, EDV, EDVI, SVR, SVRI, SV, SVI, BT, RVEF, ESV, ESVI, HR, Art, CVP, MAP, ITBV, ITBI, EVLW, EVWI, CFI, PPV, CPO, CPI and dPmx. The clinician may be able to diagnose the patient's condition by one or more of these parameters.
A monitoring device typically displays a number of major hemodynamic parameters on the screen, or provides a menu or a view that lists all the hemodynamic parameters. The clinician has to rely on his clinical experience to select a set of parameters from a large list and estimate the patient's condition using measurements of selected parameters. However, this wastes a great deal of time and effort, and the effect may not be evident. Especially during major operations or critical patient rescue, it is important to discover problems quickly and accurately from monitoring hemodynamic parameters. At present, the accuracy and speed of diagnosis depends mainly on clinician's experience. Clinicians with little experience may be at a loss when facing so many parameters, delaying treatment endangering the patient's life.
The present disclosure is directed to a method, system, and monitoring device for managing hemodynamic parameters, which can handle a large number of hemodynamic parameters according to various diseases, thereby enhancing a clinician's accuracy and speed diagnosis.
According to the present disclosure, different groups of parameters are defined, with each group including certain hemodynamic parameters that are used together to diagnose a disease or a trend of a physiological condition. In this way, the diagnosis doesn't depend as much on the clinician's experience, facilitating greater speed and accuracy of diagnosis.
As noted above, hemodynamic monitoring may involve many parameters. The clinician usually diagnoses a patient's disease or trend according to certain parameters. In one embodiment, monitoring device designers or caregivers select certain hemodynamic parameters and combine them into a group to diagnose a certain disease or reflect a trend. In this disclosure, hemodynamic parameters belonging to a certain functional group are called Selected Hemodynamic Parameters (hereinafter SHPs). A process according to the present disclosure may include finding simultaneously abnormal SHPs belonging to a functional group, comparing the abnormal condition of the SHPs with predefined rule, determining a display mode of the functional group according to the predefined rule, and then displaying a changing map of each functional group on the screen of monitoring device over time based on the determined display mode.
The abnormal situation may be of a variety of types. For example, it could be the number of simultaneously abnormal SHPs in a functional group, that is, the number of SHPs is out of range. Likewise, the abnormal situation could be the abnormal ratio of SHPs in a functional group, that is, the ratio of the abnormal SHPs to the total SHPs in a certain function group. The abnormal situation also could also be the extent to which an SHP is out of range, e.g., slightly out of range, somewhat out of range, and severely out of range. The abnormal situation could be a combination of the above listed types.
The predefined rule is related to the abnormal condition. In one embodiment, the abnormal situation is categorized into levels, each level corresponds to a display mode. For example, the predefined rule can be set as categorizing into levels according to the number of SHPs that are out of range at the same monitoring time. The rule can also be set as categorizing into levels according to the ratio of simultaneously abnormal SHPs in each functional group. The SHPs can also be assigned different weights, which may be based on the extent to which an SHP is out of range. When the SHP is abnormal, the weights may be accumulated and categorized into several levels. It will be understood by those having skill in the art that the predefined rules can also be the combination of the above listed rules or combination of other rules.
The map displays the functional group that contains various hemodynamic parameters combined to indicate a certain disease or physiological symptom. Each functional group represents one type of disease or physiological symptom. One or some of the parameter value changes will have a positive clinical significance. Therefore, even if a caregiver lacks experience, he can know a patient's situation and disease at some time from the map display mode of a functional group. The caregiver does not need to manually select and view parameters and then diagnose patient's situation and/or disease. This will enhance the caregiver's speed and accuracy of diagnosis. In addition, the map can provide information to a caregiver about a patient's condition, which is beneficial to patient treatment.
As shown in
In another embodiment, hemodynamic parameter management system includes a map analysis unit (not shown) and a map segment display unit (not shown). The map analysis unit analyzes the map of functional groups and determines a Most Typical Time (MTT), which refers to the time when there are N abnormal SHPs in a functional group, and the time when there are N abnormal SHPs that recover to normal. In one embodiment, N is an integer greater or equal to 1. The map segment display unit displays the map segment at the above-defined MTT. The map segment contains the SHPs value in the functional group at that time.
With increased research into various diseases, there may be a requirement to change SHPs in functional groups. Therefore, the hemodynamic system may also include a functional group setup unit (not shown). The user can set hemodynamic parameters and/or functional group names through the functional group setup unit.
In one embodiment, as shown in
Step S11, Create functional group templates. The functional group templates can be created in the design phase by designers or they can be subsequently created according to user requirements. Each functional group contains one or more hemodynamic parameters to define a certain disease or physiological symptom. A functional group can be defined to include several hemodynamic parameters. Also, a hemodynamic parameter can be listed in multiple functional groups. Each functional group represents one type of disease or physiological criterion. Users can edit functional groups according to their requirements, including what and how many parameters need to be configured, renaming functional groups according to clinical customs and terminology, deleting unnecessary functional groups, and so on. Users can also set up multiple functional groups according to their requirement to evaluate the overall physiological state of patients. In addition, the trend of each functional group can be used for correlation research among functional groups, which will provide more clinical evidence. Users can adopt a disease name as the name of functional group, example, e.g., pulmonary edema, heart failure, respiratory failure, etc. From the functional group name, users can diagnose the disease and physiological trend changes of the patients.
Step S12, Load functional group templates. One or multiple predefined functional group templates may be loaded and the hemodynamic parameters (SHPs) obtained from each functional group template. For default functional group templates, the system may have already acquired the hemodynamic parameters from functional groups. In this case, it is also regarded as loading functional group templates.
Step S13, Read the information of SHPs. Information from real-time monitored hemodynamic parameters may be saved in a database in advance in various storage devices. SHP information may be read from the storage device(s). The parameter information can be the value and the monitoring time of the hemodynamic parameter, or a mark showing whether each hemodynamic parameter is abnormal.
Step S14, Count abnormal situations. Statistics may be calculated for the abnormal situations of the simultaneously selected SHPs in a functional group based on parameter information. The statistics of the abnormal situation can be calculated by following predefined rules set by users, e.g., count the number of simultaneously abnormal SHPs in each functional group, compute the ratio of simultaneously abnormal SHPs in each functional group, or count the number of SHPs beyond the normal range. If the parameter information is the value associated with monitoring time, the method may compare each SPH value with a predefined normal range to determine if the SHP is normal.
According to parameter properties, the normal range of a hemodynamic parameter can be values of a bilateral closed area or values of a unilateral closed area. If the normal range is values of a bilateral closed area, the method may compare SHP values with the normal range. There may be three results: (i) in the range, (ii) higher than the upper limit, and (iii) lower than the lower limit. If the hemodynamic parameter value is in the range, it is regarded as normal; if the value is higher than the upper limit, or lower than the lower limit, it is regarded as abnormal. The abnormal situations can be counted respectively or counted together.
If the normal range is values of a unilateral closed area, the method may compare SHP values with the normal range. There may be two results: (i) in the range or (ii) anomaly (higher than the upper limit or lower than the lower limit). The method may calculate the statistics of the anomaly. If the parameter information is the mark that indicates whether the value is in the range, the method may compare each hemodynamic parameter value with the predefined range. The mark for an abnormal situation could be of two types (above the upper limit and below the lower limit) or one type (above the upper limit or below the lower limit). If it is required to calculate the statistics of the extent of SHPs beyond the normal range, the method may compute the value.
Step S15, Determine the display mode. The method may compare the abnormal situations of the simultaneously abnormal SHPs in each functional group with predefined rules and determine the display mode of each functional group at that the time of monitoring. In one embodiment, the predefined rule is to categorize abnormal situations of SHPs into levels according to the number of abnormal SHPs, each level corresponding to a display mode. In another embodiment, the predefined rule is to categorize into levels according to the ratio of the abnormal SHPs, each level corresponding to a display mode. The latter mode requires dividing the number of total SHPs by the number of abnormal SHPs in each functional group to determine the ratio and then comparing the ratio with the predefined rules.
The display mode can be represented in many ways. For example, different colors, symbols, pictures, images, or codes may be used. When codes are used, each monitoring time of the functional groups may have the corresponding code. Different codes correspond to different states of parameters in the function group and therefore the display mode is varied. For example, suppose color coding is used. When all the parameters are within range, the display mode is green at that time. When one parameter is out of range, the display mode is yellow at that time. When more than two parameters are out of range, the display mode is red at that time. Similarly, when one parameter is higher than an upper limit, the display mode may be yellow. When one parameter is lower than the lower limit, the display mode may be red. The importance of the parameter can be through weights, with the most important parameter having higher weights, and less important parameters having lower weights. If a problem occurs, the radar diagram will indicate a state according to the variation per unit time of the parameter with a different weight.
Step S16, Display the map. The method may display a changing map of each functional group according to the specified display mode. As shown in
In another embodiment, the parameter information is an indication of whether the parameter is normal. During collection and generation of the parameter information, the method may compare the collected physiological parameter data with the normal range in advance, and obtain the parameter information (normal or abnormal). The method may set a marker bit for each collected parameter during storage. For example, the marker for a normal parameter may be “0”, while the marker for abnormal parameter may be “1”. When reading the parameter information, reading the value in the marker bit and counting the marker bit with “1” in each functional group will obtain the number of simultaneously abnormal SHPs.
The example embodiment includes maps of three functional groups. A skilled artisan will understand that more or fewer function groups may be included.
The above functional group template creation steps can be intiated by users. If a user needs to edit the templates, he can activate the functional setup unit at any step and set the hemodynamic parameters and/or functional group names.
In another embodiment, detailed information may be displayed in the form of map segments, such as the map segments 50, 51, 52 shown in
In one embodiment, the process of displaying map segments is as follows. The user locates the cursor 47, 48, 49 in the map. The system detects the cursor selected position at a certain functional group map, and then displays the map segment of the time according to the cursor selected position. When there are multiple cursor selected locations at the map, multiple map segments will be displayed.
In another embodiment, the process of displaying map segments is as follows. The method may determine the Most Typical Time (MTT) in the map by analyzing the map of a functional group and then display all map segments at the MTT. The MTT refers to the time when there are N abnormal SHPs in a functional group and the time when N abnormal SHPs recover to normality. N is an integer that is greater than or equal to 1.
The map segments can be displayed in a newly created window or in the designated area. The SHP values at that time can be displayed in the form of graph or numeric value in the map segment, such as spider vision diagram, datasheet, or histogram. As shown in
As shown in
In various embodiments, the system can analyze multiple map segments. The analysis method can include one of the following:
1. Arrange multiple map segments of functional groups on MTT automatically or by user's configuration. The arrangement rules may include, but are not limited to, by time, by time of one or more parameters, or by alarm priority and time.
2. Superimpose multiple map segments. The system may also include a map superimposing unit that is used to superimpose map segments in a functional group on different times and then show them in one graph. For example, there may be loop connection diagrams on two or more different times in one spider vision diagram. The superimposing time can be determined by users. The superimposing display mode for map segments is more convenient to accurately analyze a patient's physiological trend.
Rules for superimposing graphical segments may include 1) superimpose graphical segments in the same functional group; 2) superimpose graphs according to the same parameter; 3) superimpose map segments by time sequence; and 4) the position of each parameter stays the same after being superimposed.
Rules for superimposing numerical segments may include 1) superimpose numeric segments in the same functional group; 2) superimpose segments with the same parameter name; 3) parameter values at the same time are combined to a corresponding parameter set.
The above embodiment provides an effective tool for medical monitors to manage patient physiological parameters according to physical sign trending in diagnosing diseases and symptoms. This management tool supports the creation of functional groups for managing diseases. The tool can provide a period of a patients' physiological trend change; it also can provide real-time diagnosis for a decision maker. This tool can efficiently manage physiological parameters, simplify the user of monitors, save medical resources, save time, and enhance diagnostic efficiency.
In another embodiment, the monitoring device designer or caregiver selects some hemodynamic parameters that can be combined to diagnose a disease and sets those parameters with the same properties, e.g., they may have the same mark. The specified hemodynamic parameter management system is shown in
Based on the above system, a hemodynamic parameter management method may include the following steps, as shown in
Step S21, set up the hemodynamics parameter properties in advance. The parameters used to represent the same disease are of same properties. Different diseases will have the parameters of different properties.
Step S22, read the information of SHPs. The method may acquire the parameter information of the SHPs with properties from the real-time hemodynamic parameter values related to time.
Step S23, count abnormal situations. The method may calculate the statistics of abnormal situations of the simultaneously abnormal SHPs with the same properties. The detailed statistical method is same as previously described.
Step S24, determine the display mode. The method may compare the abnormal situations of the simultaneously abnormal SHPs with same properties with predefined rules and determine the display mode of the parameter with those properties at that monitoring time. The method for determining the display mode may be the same as described previously.
Step S25, display maps. The method may take the SHPs with the same properties as a functional group and display the functional group map changing over time according to the determined display mode.
The above mentioned hemodynamic parameter management system can be applied to monitors, such as patient monitors or central monitoring systems. The structure of such monitors is shown in
This disclosure has been made with reference to various exemplary embodiments including the best mode. However, those skilled in the art will recognize that changes and modifications may be made to the exemplary embodiments without departing from the scope of the present disclosure. For example, various operational steps, as well as components for carrying out operational steps, may be implemented in alternate ways depending upon the particular application or in consideration of any number of cost functions associated with the operation of the system, e.g., one or more of the steps may be deleted, modified, or combined with other steps.
Additionally, as will be appreciated by one of ordinary skill in the art, principles of the present disclosure may be reflected in a computer program product on a computer-readable storage medium having computer-readable program code means embodied in the storage medium. Any tangible, non-transitory computer-readable storage medium may be utilized, including magnetic storage devices (hard disks, floppy disks, and the like), optical storage devices (CD-ROMs, DVDs, Blu-Ray discs, and the like), flash memory, and/or the like. These computer program instructions may be loaded onto a general purpose computer, special purpose computer, or other programmable data processing apparatus to produce a machine, such that the instructions that execute on the computer or other programmable data processing apparatus create means for implementing the functions specified. These computer program instructions may also be stored in a computer-readable memory that can direct a computer or other programmable data processing apparatus to function in a particular manner, such that the instructions stored in the computer-readable memory produce an article of manufacture, including implementing means that implement the function specified. The computer program instructions may also be loaded onto a computer or other programmable data processing apparatus to cause a series of operational steps to be performed on the computer or other programmable apparatus to produce a computer-implemented process, such that the instructions that execute on the computer or other programmable apparatus provide steps for implementing the functions specified.
While the principles of this disclosure have been shown in various embodiments, many modifications of structure, arrangements, proportions, elements, materials, and components, which are particularly adapted for a specific environment and operating requirements, may be used without departing from the principles and scope of this disclosure. These and other changes or modifications are intended to be included within the scope of the present disclosure.
The foregoing specification has been described with reference to various embodiments. However, one of ordinary skill in the art will appreciate that various modifications and changes can be made without departing from the scope of the present disclosure. Accordingly, this disclosure is to be regarded in an illustrative rather than a restrictive sense, and all such modifications are intended to be included within the scope thereof. Likewise, benefits, other advantages, and solutions to problems have been described above with regard to various embodiments. However, benefits, advantages, solutions to problems, and any element(s) that may cause any benefit, advantage, or solution to occur or become more pronounced are not to be construed as a critical, a required, or an essential feature or element. As used herein, the terms “comprises,” “comprising,” and any other variation thereof, are intended to cover a non-exclusive inclusion, such that a process, a method, an article, or an apparatus that comprises a list of elements does not include only those elements but may include other elements not expressly listed or inherent to such process, method, system, article, or apparatus. Also, as used herein, the terms “coupled,” “coupling,” and any other variation thereof are intended to cover a physical connection, an electrical connection, a magnetic connection, an optical connection, a communicative connection, a functional connection, and/or any other connection.
Those having skill in the art will appreciate that many changes may be made to the details of the above-described embodiments without departing from the underlying principles of the invention. The scope of the present invention should, therefore, be determined only by the following claims.
Number | Date | Country | Kind |
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CN201110033470.4 | Jan 2011 | CN | national |