U.S. patent application number 11/389403 was filed with the patent office on 2006-11-23 for pc-based physiologic monitor and system for resolving apnea episodes during sedation.
This patent application is currently assigned to RIC Investments, LLC.. Invention is credited to Eric W. Starr.
Application Number | 20060264762 11/389403 |
Document ID | / |
Family ID | 37054001 |
Filed Date | 2006-11-23 |
United States Patent
Application |
20060264762 |
Kind Code |
A1 |
Starr; Eric W. |
November 23, 2006 |
PC-based physiologic monitor and system for resolving apnea
episodes during sedation
Abstract
An anesthesia delivery and monitoring system for use during
outpatient surgery performed under sedation level anesthesia that
includes a ventilatory system, a system for supplying sedation
anesthesia, a respiratory sensor adapted to detect a respiration
parameter of such a patient, and a system for supplying a timed
back-up breath to such a patient through the ventilatory system.
The timed back-up breaths are supplied in response to the
respiration parameter falling outside a preset threshold and at a
positive pressure exceeding a base operating pressure of the
respiratory system. The system for supplying sedation anesthesia is
an intravenous supply system for anesthesia, a ventilatory system
coupled to the patient, a needle and syringe, or any combination
thereof. The respiratory system includes a PC-based physiologic
monitor with user modified feedback control signal.
Inventors: |
Starr; Eric W.; (Allison
Park, PA) |
Correspondence
Address: |
MICHAEL W. HAAS, INTELLECTUAL PROPERTY COUNSEL;RESPIRONICS, INC.
1010 MURRY RIDGE LANE
MURRYSVILLE
PA
15668
US
|
Assignee: |
RIC Investments, LLC.
|
Family ID: |
37054001 |
Appl. No.: |
11/389403 |
Filed: |
March 24, 2006 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
60665919 |
Mar 28, 2005 |
|
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|
Current U.S.
Class: |
600/483 ;
128/920; 600/301 |
Current CPC
Class: |
A61M 2230/04 20130101;
A61B 5/4818 20130101; A61M 16/104 20130101; A61M 16/021 20170801;
A61M 16/01 20130101; A61M 2230/40 20130101; A61B 5/087 20130101;
A61M 5/1723 20130101; A61M 2230/63 20130101 |
Class at
Publication: |
600/483 ;
128/920; 600/301 |
International
Class: |
A61B 5/02 20060101
A61B005/02 |
Claims
1. A personal computer based physiologic monitor system comprising:
a personal computer having a display and an input/output port for
attachment to an external device; a physiologic sensor coupled to
the personal computer through the input/output port, wherein a
modified output of the physiologic sensor is graphically displayed
on the display; and a controller for the physiologic sensor,
wherein the controller is adapted to modify the output of the
physiologic sensor, and wherein at least a portion of the
controller is disposed in the personal computer and provides a
feedback control signal for modifying the output of the physiologic
sensor.
2. The physiologic monitor system of claim 1, wherein the portion
of the controller disposed in the personal computer forms a closed
loop feedback control that drives at least one of a drive current,
a drive voltage, a signal gain, a high pass filter point cutoff, a
band pass filter range, or a low pass filter point cutoff for
modifying the output of the physiologic sensor.
3. The physiologic monitor system of claim 2, wherein the portion
of the controller disposed in the personal computer includes a user
input device to allow a user to set and modify the feedback control
signal for controlling the modification of the output of each
physiologic sensor.
4. The physiologic monitor system of claim 1, wherein the
physiologic sensor is selected from the group consisting of a blood
pressure sensor, a blood flow sensor, a blood glucose sensor, a
blood cholesterol sensor, a heart sound sensor, an EMG sensor, an
EEG sensor, an EKG sensor, an EOG sensor, a pulse sensor, an
oxygenation sensor, a blood perfusion sensor, a respiration flow
sensor, a respiration rate sensor, a respiration pressure sensor, a
temperature sensor, a blood gas sensor, a motion sensor, a strain
gauge, a body position sensor, a limb motion sensor, and any
combinations thereof.
5. The physiologic monitor system of claim 1, wherein the personal
computer is a laptop or a notebook computer.
6. The physiologic monitor system of claim 1, wherein a plurality
of physiologic sensors are coupled to the personal computer.
7. The physiologic monitor system of claim 6, wherein the personal
computer includes a plurality of input/output ports, and wherein
each physiologic sensor is coupled to the personal computer through
a distinct one of the plurality of input/output ports.
8. The physiologic monitor system of claim 7, wherein the modified
output of each physiologic sensor in the plurality of physiologic
sensors is simultaneously displayed in a viewable format on the
display.
9. The physiologic monitor system of claim 6, wherein the portion
of the controller disposed in the personal computer is adapted to
identify each physiologic sensor that is coupled to the personal
computer and to size a respective display area for each modified
output, whereby a size of a display area for a given modified
output associated with a sensor varies depending upon the specific
physiologic sensors coupled to the personal computer.
10. The physiologic monitor system of claim 1, wherein the
physiologic sensor is adapted to be coupled to a patient, the
system further comprising: means for supplying sedation anesthesia
to such a patient; and means for supplying a timed back-up breath
to such a patient, wherein the timed back-up breath is supplied in
response to a respiration parameter falling outside a preset
threshold.
11. The physiologic monitor system of claim 10, wherein the means
for supplying sedation anesthesia includes an intravenous supply
system, a ventilatory system coupled to an airway of such a
patient, or both.
12. A ventilatory system for use during outpatient surgery
performed under sedation level anesthesia comprising: a
pressure/flow generating system adapted to be coupled to a patient;
means for supplying sedation anesthesia to such a patient; a sensor
coupled to such a patient and adapted to detect a respiration
parameter of such a patient; and a controller that receives an
output from the sensor and controls the pressure/flow generating
system so as to provide a timed back-up breath to such a patient
based on the output from the sensor, wherein the timed back-up
breath is supplied in response to the respiration parameter falling
outside a preset threshold, and wherein the timed back-up breath is
supplied at a positive pressure exceeding a base operating pressure
of the pressure/flow generating system.
13. The ventilatory system of claim 12, wherein the means for
supplying sedation anesthesia includes an intravenous supply system
for anesthesia to such a patient.
14. A method of monitoring a subject's physiologic parameters on a
personal computer comprising the steps of: attaching a physiologic
sensor to the personal computer through an input/output port
thereof; graphically displaying a modified output of the
physiologic sensor on the display of the personal computer; and
modifying the output of the physiologic sensor by providing a
feedback control signal from the personal computer that controls
the modification of the output of the physiologic sensor.
15. The monitoring method of claim 14, wherein the step of
modifying the output of the sensor forms a closed loop feedback
control adapted to drive at least one of a drive current, a drive
voltage, a signal gain, a high pass filter point cutoff, a band
pass filter range, or low pass filter point cutoff.
16. The monitoring method of claim 15, further including the step
of inputting by the user on the personal computer to set the
feedback control signal to control the modification of the output
of each physiologic sensor.
17. The monitoring method of claim 14, further including the step
of selecting the sensor from the group consisting of a blood
pressure sensor, a blood flow sensor, a blood glucose sensor, a
blood cholesterol sensor, a heart sound sensor, an EMG sensor, an
EEG sensor, an EKG sensors, an EOG sensor, a pulse sensor, an
oxygenation sensor, a blood perfusion sensor, a respiration flow
sensor, a respiration rate sensor, a respiration pressure sensor, a
temperature sensor, a blood gas sensor, a motion sensor, a strain
gauge, a body position sensor, a limb motion sensor and a
combination thereof.
18. The monitoring method of claim 14, further including the step
of coupling a plurality of physiologic sensors to the personal
computer, wherein each physiologic sensor in the plurality of
physiologic sensors is coupled to the personal computer through a
distinct one of a plurality of input/output ports of the personal
computer.
19. The monitoring method of claim 18, wherein during the graphical
displaying step, the modified output of each physiologic sensor in
the plurality of physiologic sensors is simultaneously displayed in
a viewable format on the display of the personal computer, and
wherein the display area of a given modified output of a sensor on
the display varies depending upon the specific physiologic sensors
coupled to the personal computer.
20. The monitoring method of claim 14, further comprising the steps
of supplying sedation anesthesia to a patient; and supplying a
timed back-up breath to such a patient, wherein the timed back-up
breath is supplied in response to a respiration parameters falling
outside a preset threshold.
21. The monitoring method of claim 20, wherein the step of
supplying sedation anesthesia includes delivering an anesthesia
intravenously, delivering an anesthesia via an airway of such a
patient, or both.
22. A ventilatory method for a patient comprising the steps of:
supplying a flow of gas to an airway of a patient; coupling a
respiratory sensor to such a patient to detect a respiration
parameter of such a patient; and supplying a timed back-up breath
to such a patient through the system used for supplying the flow of
gas, wherein the timed back-up breath is supplied in response to
the detected respiration parameters falling outside a preset
threshold, and wherein the timed back-up breath is supplied at a
positive pressure exceeding a base operating pressure of the system
used for supplying the flow of gas gases.
23. The method of claim 22, wherein the step of supplying a flow of
gas is only operated during the supply of timed back-up
breaths.
24. The method of claim 22, further including the steps of
calculating a total volume for each patient breath, and supplying
the timed back-up breath responsive to the total calculated volume
of at least one breath is outside a preset threshold.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] This application claims priority under 35 U.S.C. .sctn.
119(e) from provisional U.S. patent application No. 60/665,919
filed Mar. 28, 2005 the contents of which are incorporated herein
by reference.
BACKGROUND OF THE INVENTION
[0002] 1. Field of the Invention
[0003] The present invention relates to resolving apnea episodes
during sedentary anesthesia, and, in particular, to the use of a
ventilator system that delivers timed back-up breaths to patients
during sedentary anesthesia, and to a PC-based physiologic monitor
used in such a system.
[0004] 2. Description of the Related Art
[0005] During surgery and other procedures in which the patient
undergoes a light plane of anesthesia, also called sedation level
anesthesia or sedentary anesthesia, the patent is given anesthesia,
but an artificial airway and mechanical ventilation is not
utilized, which is a procedure done during a more major surgery
using a general anesthesia. Because the airway is not protected and
breathing is not assisted, the patient under sedation level
anesthesia can experience obstructive apneas, as well as,
hypoventilation and central apneas. Patients are also known to
accidentally drift from a light plane of anesthesia to a deep
plane. When this occurs, patients are known to experience
obstructive apneas, hypopneas, hypoventilation, and central
apneas.
[0006] It has been previously proposed to apply continuous positive
airway pressure (CPAP) respiratory therapy to certain patients
during certain levels of anesthesia to maintain the patency of the
airway. Furthermore, it has been proposed to apply a bi-level
pressure support therapy, in which the pressure of the flow of gas
delivered to the patient varies with the patient's respiratory
cycle, to certain patients during certain levels of anesthesia to
maintain the patency of the airway and to ensure that the patient
receives a desired tidal volume. These systems represent active
additional respiratory therapies that are applied to certain
patients without regard to whether the patient is actually in need
of the therapy. That is, some patients are being given a CPAP or
bi-level therapy even though that patient may not be experiencing
apneas or hypopneas. There is a need in the art to provide a
ventilatory system that is responsive to sensed patient conditions,
particularly in sedentary anesthesia applications, and to provide
such a system without requiring the use of complicated and costly
anesthesia machines used by hospitals during general
anesthesia.
SUMMARY OF THE INVENTION
[0007] Accordingly, it is an object of the present invention to
provide a monitor system that overcomes the shortcomings of
conventional techniques for monitoring a patient, especially during
sedation level anesthesia. This object is achieved, according to
one embodiment of the present invention, by providing a personal
computer (PC) based physiologic monitor system that includes a
personal computer having a display and an input/output port for
attachment to an external device. The PC based system also includes
a physiologic sensor coupled to the personal computer through the
input/output port so that a modified output of the physiologic
sensor is graphically displayed on the display. A controller, a
portion of which is disposed in the personal computer, modifies the
output of the physiologic sensor and provides a feedback control
signal for modifying the output of the physiologic sensor.
[0008] It is a further object of the present invention to provide a
ventilatory system for use during outpatient surgery performed
under sedation level anesthesia that overcomes the shortcomings of
conventional pressure support systems used in this environment.
This object is achieved, according to one embodiment of the present
invention, by providing a ventilatory system for use during
outpatient surgery performed under sedation level anesthesia that
includes a pressure/flow generating system adapted to be coupled to
a patient, a system for supplying sedation anesthesia to such a
patient, a sensor coupled to such a patient and adapted to detect a
respiration parameter of such a patient, and a controller. The
controller receives the output from the sensor and controls the
pressure/flow generating system so as to provide a timed back-up
breath to such a patient based on the output from the sensor. The
timed back-up breath is supplied in response to the respiration
parameter falling outside a preset threshold, and is supplied at a
positive pressure exceeding a base operating pressure of the
pressure/flow generating system.
[0009] These and other objects, features, and characteristics of
the present invention, as well as the methods of operation and
functions of the related elements of structure and the combination
of parts and economies of manufacture, 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 invention. As used in the
specification and in the claims, the singular form of "a", an and
"the" include plural referents unless the context clearly dictates
otherwise.
BRIEF DESCRIPTION OF THE DRAWINGS
[0010] FIG. 1 is a schematic view of a first embodiment of a
anesthesia delivery and monitoring system for use during outpatient
surgery performed under sedation level anesthesia according to the
principles of the present invention;
[0011] FIG. 2 is a schematic view of a second embodiment of a
anesthesia delivery and monitoring system for use during outpatient
surgery performed under sedation level anesthesia according to the
principles of the present invention;
[0012] FIG. 3 is a schematic representation of the output pressure
of the anesthesia delivery and monitoring system of the present
invention and the patient's tidal volume displayed over a period of
time;
[0013] FIG. 4 is a schematic representation of a control system for
the physiologic sensor according to the principles of the present
invention;
[0014] FIGS. 5A-5E are schematic views of various physiologic
displays for the PC based physiologic sensors according to the
principles of the present invention; and
[0015] FIG. 6 is a flow chart illustrating a method of monitoring a
subject's physiologic parameters on a personal computer according
to the principles of the present invention.
DETAILED DESCRIPTION OF THE EXEMPLARY EMBODIMENTS
[0016] FIG. 1 is a schematic representation of a first embodiment
of a anesthesia delivery and monitoring system 10 for use during
outpatient surgery performed under sedation level anesthesia
according to the principles of the present invention. As noted
above, sedation level anesthesia refers to a level of anesthesia
below general anesthesia, where a patient 12 is intended to be
maintained in what is known as a light plane of anesthesia. This is
common in many outpatient surgeries. The specific types of
anesthesia utilized are well known in the art and are applied in a
number of common techniques. Three common systems for supplying
sedation anesthesia to patient 12 include: (1) an intravenous
supply system for anesthesia, which is such as shown in FIG. 1; (2)
an anesthesia/ventilatory system coupled to the patient, such as
shown in FIG. 2, and (3) a needle and syringe injection (not
shown). In the intravenous supply system of FIG. 1, the sedentary
aesthesia is provided in an appropriate solution in an IV bag 14,
which is mounted on a conventional stand 16. As noted above, a
needle and syringe could also be used to supply intravenous
sedentary anesthesia to patient 12 through simple, periodic
injections.
[0017] Anesthesia delivery and monitoring system 10 of the present
invention includes a ventilatory system coupled to a patient.
Specifically, the ventilatory system includes a controlled
pressure/flow generator 20, which is typically a blower having a
respiratory gas intake and power supply (not shown) and a
respiratory gas output, coupled to the patient 12 through a conduit
22 and a patient interface device 24. Patient interface device 24
is any conventional device that communicates a flow of gas from
conduit 22 to an airway of a patient, such as a nasal mask,
nasal/oral mask, nasal canula, or other respiratory patient
coupling. Because conduit 22 is a single-limb conduit, patient
interface device 24, conduit 22, or both includes an exhaust vent
26 for exhausting gas, such as a patient's exhaled breath, from the
system to the ambient atmosphere, as generally known in the art.
The present invention contemplates that the exhaust vent can be any
suitable type of vent of expelling gas from the system to the
atmosphere, conduit 22 can be any suitable conduit, such as a
flexible hose, and pressure/flow generator 20 is any device capable
of producing a flow of gas.
[0018] Anesthesia delivery and monitoring system 10 includes a
sensor 28 coupled to patient 12 and adapted to detect a respiration
parameter of the patient. In FIG. 1, sensor 28 is attached to
patient 12 through conduit 22. In this configuration, sensor 28 may
be a pressure sensor or flow sensor for detecting the respiration
parameters of the patient. Sensor 28 could be placed on mask 24, at
vent 26, on blower motor 20, or any combination thereof, and obtain
signals indicative of the patient's respiration parameters. Sensor
28 may be placed directly on the patient 12 as well. The specific
type and the location of the sensor can vary, provided that the
sensor provides an output indicative of the patient's respiration
parameters, i.e., at least the time of and preferably an indication
of how much respiratory flow or volume the patient is receiving
with each breath.
[0019] In anesthesia delivery and monitoring system 10,
pressure/flow generator 20 and sensor 28 are coupled to a central
controller that is in the form of a lap-top computer 30. In the
illustrated exemplary embodiment, sensor 28 is coupled to computer
30 through an amplifier 32 to prove a meaningful signal to computer
30. Of course, amplifier 32 can be built into the sensor or the
computer. The coupling between amplifier 32 and computer 30, shown
as link 34, may be a hardwire connection or a wireless connection.
In a similar fashion, the coupling between blower motor 20 and
computer 30, shown as link 36, may be a hardwire connection or a
wireless connection. Where links 34 are hardwire connections, it is
preferred that they couple to conventional existing ports of laptop
computer 30.
[0020] Anesthesia delivery and monitoring system 10 includes other
physiologic sensors coupled to patient 12. Specifically, a pulse
oximeter sensor 40 is attached to the patient and coupled to the
computer through an amplifier 42 and link 44. The link between
amplifier 42 and computer 30, shown discussed above, may also be a
hardwire connection or a wireless connection. The addition of
physiologic sensors, such as sensors 28 and 40, allows the computer
to be a physiologic monitor graphically displaying the sensed
parameters of the patient, as will be described in detail
hereinafter. The sensors for this physiologic monitor are not
limited to respiratory, pulse and blood oxygenation, as shown in
FIGS. 1 and 2, but may further include a blood pressure sensor, a
blood flow sensor, a blood glucose sensor, a blood cholesterol
sensor, a heart sound sensor, an EMG sensor, an EEG sensor, an EKG
sensor, an EOG sensor, a blood perfusion sensor, a temperature
sensor, a blood gas sensor, a motion sensor, a strain gauge, a body
position sensor, a limb motion sensor, and any combinations
thereof.
[0021] Anesthesia delivery and monitoring system 10' of FIG. 2 is
similar to system 10 of FIG. 1 except that system 10' includes a
system for supplying sedation anesthesia to patient 12. Inhaled
anesthesia agents are used in the embodiment of FIG. 2, which are
supplied to pressure/flow generator 20 through an anesthesia gas
supply 50 and an input conduit 52. When using inhaled agents for
anesthesia, the ventilatory system cannot vent to the room, or it
could adversely affect the caregivers. Therefore, a closed (dual
limb) system is created where vent 26 is replaced with a one way T
or Y coupling 53 and a expiratory limb 54 that carries the gas to a
CO.sub.2/anesthesia scrubber 56 that vents harmless material or
returns the scrubbed respiratory gases to input 52 through tubing
58.
[0022] In the illustrated embodiment, a source of oxygen 60 is
coupled to input conduit 52 through tubing 62 to supply oxygen to
the closed system. An oxygen sensor 64 may be coupled to input
conduit 52 (or elsewhere on the closed system) and coupled to
controller 30 through a link 66. The link between sensor 64 (which
may have an amplifier) and computer 30, may be a hardwire
connection or a wireless connection. As a closed respiratory
system, it is sometimes desirable to track the oxygen level
received by the patient.
[0023] The operation of anesthesia delivery and monitoring systems
10 and 10' are used in the present invention in that the
ventilatory portion of the system provides a system for supplying a
timed back-up breath to the patient. More specifically, the timed
back-up breaths are supplied in response to the respiration
parameter falling outside a preset threshold. As noted above, timed
back-up breaths, within the meaning of this disclosure, refer to
the supplying of positive pressure to the airway of the patient to
assist the patient's breathing. This is done in response to a
sensed failure of the patient's actual breathing over a given
period of time.
[0024] Referring to FIG. 3, line P represents the output pressure
of pressure/flow generator 20 over time, and line Q represents the
measured tidal volume of the patient's respiration over time. The
normal operating pressure of the pressure/flow generator can be
found in time segments 70, 72, 74, and 76, and this may be zero.
Alternatively, the standard operating pressure of pressure/flow
generator 20 may be slightly positive to flush out CO.sub.2 from
the patient circuit, e.g., not enough to assist the patient in
breathing. As can be seen in the figure by referring to line Q,
time periods 70, 72, and 74 demonstrate normal tidal volumes for
the patient's respiration, i.e., the patient is breathing in a
satisfactory manner. Note that line Q is derived from the readings
of sensor 28.
[0025] Time period 76, however, illustrates a situation in which
satisfactory breath has not been taken by the patient. During this
time interval, the patient is considered to be experiencing an
apnea or hypopnea. In response to the event occurring in period 76,
a back-up breath is supplied to the patient in period 78 by the
pressure/flow generator. Specifically, in delivering the timed
back-up breath, pressure/flow generator 20 supplies respiratory
gases to the patient at a positive pressure (as shown at line P in
period 78) exceeding the normal operating pressure of pressure/flow
generator 20 of the respiratory system at all other times. This can
be done using any conventional pressure/flow control techniques,
such by changing the operating speed of the blower in the
pressure/flow generator or by manipulating a pressure/flow control
valve in the pressure/flow generator. The preset limit that
triggers the back-up breath, need not be "time without a breath",
the limit could be an indication of tidal volume, or a combination
of any respiratory parameter set points, as desired. Further, it is
expected that this limit may be varied by the operator using
computer 30. The system may provide only one timed back-up breath
then return to monitoring the patient's respiratory parameters, or
may provide multiple breaths, as desired by the operator.
[0026] Pressure/flow generator 20 is effectively off (or at a low
pressure) before any episode or event. In an exemplary embodiment,
pressure/flow generator 20 returns to this standard operating
pressure after an event (with one, two, or other preset number of
back-up breaths having been supplied to the patient). Consequently,
the ventilator portion of the anesthesia delivery and monitoring
system is a passive, back up ventilatory system that assists the
patient's respiration only as required.
[0027] Computer 30 in the present invention serves as an
inexpensive, user controlled, physiologic monitor that graphically
displays the sensed parameters of patient 12. In an exemplary
embodiment of the present invention, each desired physiologic
sensor, such as the sensors 28, 40, and 64 discussed above, are
coupled to a standard input/output port of computer 30 (including
wireless inputs). As shown in FIG. 4, each sensor (generically
shown as 80) is coupled through an external amplifier (generically
shown as 82) through a link that allows an input signal 84 from the
sensor to the computer and a feedback control signal 86 from a
controller 90 within computer 30 to amplifier 82. The feedback
control signal controls the modification of the output of the
physiologic sensor. A user input device 92, such as a keyboard
and/or mouse, allows the user to set and modify feedback control
signal 86 to control the modification of the output of physiologic
sensor 80, such as respiratory sensor 28.
[0028] Closed loop feedback control signal 86 controls or drives at
least one of a drive current, a drive voltage, a signal gain, a
high pass filter point cutoff, a band pass filter range, or a low
pass filter point cutoff for modifying the output of sensor 80.
Closed loop feedback control signal 86 set by the user gives the
user great flexibility in using the desired sensors 80. In clinical
use, the sensors 80 will likely have automatic or default settings.
In research applications, the desired setting may vary greatly and
the present physiologic monitoring system provides a simple,
inexpensive tool to the researcher for adjusting these
settings.
[0029] The physiologic monitoring portion of anesthesia delivery
and monitoring system 10 and 10' includes a display 94 on computer
30 to display the output or the modified output of sensors 80.
Controller 90 identifies each of the sensors that are coupled to
the personal computer and sizes a respective display area for each
modified output. As shown in FIGS. 5A-5E, a display area of a given
modified output associated with one sensor 80 will vary depending
upon the specific sensors coupled to the personal computer 30.
Specifically, FIG. 5A illustrates an exemplary display area for the
output of a sensor 80 when one sensor 80 is attached to computer
30. FIG. 5B illustrates exemplary display areas for the output of
two sensors 80 when two sensors 80 are attached to the computer 30.
FIG. 5C shows exemplary display areas of three sensors 80. FIG. 5D
shows exemplary display areas when four sensors 80 are attached to
the computer, and FIG. 5E shows exemplary display areas for six
sensors 80.
[0030] The display areas in FIGS. 5A-5E are described above as
exemplary display areas for several reasons. First, the present
invention contemplates providing the user the ability to adjust the
size of any window displayed (even electing to eliminate a given
display) in a manner familiar to the Windows.RTM. operating system.
Once the user sets a given display arrangement for a given set of
sensors, that display will be the designated display format for
those collections of sensors (unless the operator elects to go back
to the default settings or the change the display again). Further,
the present invention contemplates providing the user with the
ability to select an alternative series of displays using any
conventional selecting technique, such as via a pull down menu. For
example, where there are six sensors attached to the system, the
user may elect to display the output of two of the sensors on a
first screen (FIG. 5B), the output of three of the sensors on a
second screen (FIG. 5C), and the final sensor output on a third
screen (FIG. 5A), with the user clicking to toggle or cycle between
the given screens. This user defined set up would then become the
display setting for this collection of sensors.
[0031] As shown in FIG. 6, in using computer 30 as a physiologic
monitor, the first step 100 is attaching physiologic sensors 80 to
the patient and to the computer, as noted above. Then, in step 102,
the user inputs the parameters for the feedback control signals 86
for each sensor 80 (or uses the defaults). At step 104, the output
of each of the physiologic sensors 80 is modified by the respective
feedback control signal 86. With all of the sensors attached,
controller 90 identifies, at step 106, the sensors that are
actually attached to the computer to thereby size the output
display areas on the display. Finally, computer 30, in step 108,
graphically displays a modified output each of the physiologic
sensors on the respective display area of display 94.
[0032] Although the invention has been described in detail for the
purpose of illustration based on what is currently considered to be
the most practical and preferred embodiments, it is to be
understood that such detail is solely for that purpose and that the
invention is not limited to the disclosed embodiments, but, on the
contrary, is intended to cover modifications and equivalent
arrangements that are within the spirit and scope of the appended
claims.
Definition of Terms Used in the Specification
[0033] The following is a listing of the terms used in the above
specification. This listing is intended to supplement and not
replace the definition of the terms given above, as understood by
those skilled in the art based on the context in which they are
presented, but may serve to help clarify the intended meaning of
each.
[0034] A personal computer within the meaning of this specification
is a computer with its own operating system and of software
intended for a variety of operations by the user. Examples of
personal computers include those commonly referred to as a desk-top
computer, a laptop computer, a workstation, or a notebook computer.
A personal computer does not include a processor or CPU imbedded
within a dedicated piece of equipment.
[0035] A physiologic sensor within the meaning of this
specification is a sensor that measures a parameter related to a
physical characteristic of a living subject, such as a human. The
types of physiologic sensors include, for example, blood pressure
sensors, blood flow sensors, blood glucose sensors, blood
cholesterol sensors, heart sound sensors, EMG sensors, EEG sensors,
EKG sensors, EOG sensors, pulse sensors, oxygenation sensors, blood
perfusion sensors, respiration sensors (both pressure, flow and
rate), temperature sensors, additional blood gas sensors (such as
nitrogen partial pressure, carbon dioxide partial pressure, carbon
monoxide partial pressure, oxygen partial pressure, and pH level),
motion sensors, strain gauges, body position sensors, limb motion
sensors and the like. The term respiratory sensors is a subset of
physiologic sensors and refers to those sensors measuring physical
parameters of a subject indicative of respiration of the
subject.
[0036] The input/output ports of a personal computer refer to the
communications links through which the personal computers send and
receive information, which generally include serial ports, parallel
ports, wireless links or connectors (such as WI-FL and Bluetooth),
and universal serial bus (UBS) ports. In addition, some laptops
have expansion slots for PCMCIA standard adaptor cards (Type I and
Type II) that also form input/output ports.
[0037] The terms sedation anesthesia or sedation level anesthesia
within the meaning of this specification refers to a level of a
anesthesia below general anesthesia in which a patient is intended
to be able to respond to physical stimulus and maintain an airway,
also known as a light plane of anesthesia. General anesthesia
corresponds to a level of sedation in which a patient does not
respond to physical stimulus and, as a result, cannot maintain an
airway and breath on their own, also known as a deep plane of
anesthesia. These definitions follow the American Society of
Anesthesiologists (ASA) definitions.
[0038] The term timed back-up breaths within the meaning of this
specification refers to the supplying of, through a ventilatory
system coupled to the patient, positive pressure assist to a
patients breathing in response to a sensed failure of the patient's
actual breathing over time or a reduction of the patient's
respiratory flow or volume below a given threshold.
[0039] The term respiratory gases, within the meaning of this
specification, are gases to be breathed by the patient. This
includes untreated air, air supplemented with increased oxygen or
treated with other medicaments, oxygen, and other gases and
combination of gases used for conventional respiratory treatment
and care.
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