An adjustable hemodialysis nursing monitoring device

Abstract

This invention relates to the field of nursing devices, specifically to an adjustable hemodialysis nursing monitoring device. The invention includes: a sound wave receiver for fitting against the patient's arm and monitoring sound waves generated at the puncture site during hemodialysis; and a controller for acquiring the sound waves collected by the receiver and determining the dialysis status based on the frequency, amplitude, and wavelength of the sound waves; and issuing an alarm when the sound wave waveform matches the noises caused by arteriovenous fistula failure, needle dislodgement friction noise, or air infiltration noise. Using the technical solution of this invention, the sound wave receiver can judge and differentiate between needle dislodgement at the puncture site, air ingress, and acute arteriovenous fistula failure during hemodialysis, providing timely alarms.

Description

Technical Field

[0001] This invention relates to the field of nursing devices, specifically to an adjustable hemodialysis nursing monitoring device. Background Technology

[0002] Hemodialysis is one of the renal replacement therapies for patients with acute and chronic renal failure. It involves drawing blood from the body and passing it through a dialyzer composed of numerous hollow fibers. The blood exchanges substances with an electrolyte solution containing a concentration similar to that in the body through diffusion, ultrafiltration, adsorption, and convection within and outside the hollow fibers. This process removes metabolic waste, maintains electrolyte and acid-base balance, and removes excess water. The purified blood is then returned to the body. The entire process is called hemodialysis.

[0003] Arteriovenous fistula (AVF) failure refers to the decline (usually less than 200 ml / min) or disappearance of blood flow during dialysis after the AVF has matured, due to various reasons, making dialysis treatment insufficient and leading to inadequate dialysis or even the inability to perform dialysis. Common causes include acute thrombosis, vascular stenosis and occlusion, infection, heart failure, and steal syndrome. The occurrence of acute thrombosis in AVFs is related to the patient's underlying diseases such as diabetes, hyperlipidemia, and hypoproteinemia, as well as factors such as the patient's vascular condition, hypotension, excessive ultrafiltration during dialysis, improper AVF puncture and compression, and the use of erythropoietin.

[0004] Arteriovenous fistula (AVF) failure significantly impacts hemodialysis effectiveness. Existing technologies, such as patent publication CN112545548A, disclose an auscultation device for screening abnormal murmurs in AVFs during hemodialysis. This device uses arteriovenous auscultation to determine if AVF failure has occurred, but relying on manual judgment is unsuitable for continuous monitoring during hemodialysis. Patent publication CN115845171A discloses a flexible AVF monitoring and early warning wristband and method. This wristband, worn on the patient's arm, bypasses the uniqueness of blood flow measurement and monitors the micro-vibrations generated by AVF failure to predict its demise. However, the vibrations of the blood vessels must penetrate the skin to reach the sensor, resulting in poor transmission and numerous interference sources. Besides AVF failure, air entry at the puncture site due to needle dislodgement or loose connection can also occur during hemodialysis. Although most hemodialysis machines integrate the function of monitoring mixed air bubbles, this function is integrated after blood purification is complete, a late point in time, which is not conducive to timely medical response. Summary of the Invention

[0005] To address the aforementioned problems, this invention provides an adjustable hemodialysis nursing detection device, which uses a sound wave receiver to identify and differentiate between needle dislodgement at the puncture site, air ingress, and acute arteriovenous fistula failure during the hemodialysis process, and provides timely alarms.

[0006] To achieve the above objectives, the technical solution of the present invention is as follows: an adjustable hemodialysis nursing monitoring device, comprising:

[0007] Sound wave receiver: used to fit the patient's arm and monitor the sound waves generated at the puncture site during hemodialysis;

[0008] Controller: Used to acquire sound waves collected by the sound wave receiver, and determine the dialysis status based on the frequency, amplitude and wavelength of the sound waves;

[0009] An alarm will be triggered when the sound wave waveform matches the noise, needle dislodgement friction sound, or mixed noise caused by arteriovenous fistula failure.

[0010] The above approach has the following beneficial effects:

[0011] 1. In this protocol, during hemodialysis, the acoustic receiver is placed against the puncture site on the patient's arm. Dialysis can then proceed normally. Various situations may occur during dialysis, such as acute thrombosis leading to arteriovenous fistula failure, needle dislodgement causing bleeding, and air infiltration. Utilizing the commonalities of these situations—abnormal blood flow—resulting in indicative acoustic wave patterns or changes in sound waves, the acoustic receiver detects these issues. Arteriovenous fistula failure produces micro-tremors and micro-murmurs, allowing for timely identification of sudden fistula failure. Needle dislodgement, characterized by a loosened puncture needle, manifests as a friction rub, changes in blood flow velocity, and a mixed sound from air infiltration. The acoustic receiver responds to these various dialysis-related situations, promptly alerting medical staff.

[0012] Existing dialysis machines can determine blood flow rate by detecting dialysis blood flow and detect air infiltration by using bubble detectors, but both require judgment when the blood is drawn into the purification stage, resulting in a delayed response and slow reaction. This solution uses a lightweight detector at the puncture site to determine various situations, including arteriovenous fistula failure, needle dislodgement, and air infiltration. The judgment time point is during the blood extraction process of the dialysis machine, resulting in an earlier response time, allowing medical staff to take immediate action.

[0013] Furthermore, the controller is equipped with a trained convolutional neural network. The convolutional neural network is trained based on the sound waves, patient demographic information, patient vital signs information, and dialysis parameters when the patient experiences arteriovenous fistula failure, needle dislodgement, or air infiltration. The convolutional neural network is used to output the dialysis status by taking into input the patient demographic information, patient vital signs information, dialysis parameters, and sound wave data collected by the sound wave receiver.

[0014] Beneficial effects: Different patients have different physical conditions, blood texture, blood vessel thickness and elasticity, which leads to a wide range of frequencies, amplitudes and wavelengths of sound waves used for judgment. By learning through convolutional neural networks, not only can key judgment frequencies, amplitudes and wavelength ranges be extracted from a large amount of data, but also relevant mapping relationships can be generated based on patient demographic information, patient vital signs, dialysis parameters and other data, thereby accurately and effectively judging the sound wave waveform.

[0015] Furthermore, patient demographic information includes the patient's age, sex, height, weight, dialysis duration, and history of cardiovascular and cerebrovascular diseases.

[0016] Beneficial effects: Patient demographic information can reflect the patient's basic condition, such as statistically significant vascular thickness and elasticity, and the probability of arteriovenous fistula failure, thereby facilitating the refinement of the range of sound wave waveform judgment.

[0017] Furthermore, patient vital signs information includes blood viscosity, blood lipids, blood pressure, plasma protein and white blood cell count, and dialysis parameters include dialysis blood flow rate.

[0018] Beneficial effects: Blood texture also affects the range of sound wave waveform interpretation. Therefore, blood viscosity, blood lipids, blood pressure, plasma proteins, and white blood cell count can be used to assess a patient's blood viscosity and overall health status. Additionally, during dialysis, blood flow is affected by the dialysis machine's settings, making dialysis blood flow another factor influencing the range of sound wave waveform interpretation.

[0019] Furthermore, it also includes a support base, on which a telescopic rod is fixedly connected. A hand rest is provided at the end of the telescopic rod away from the support base, and the hand rest is covered with a flexible layer.

[0020] Beneficial effects: The support provides a stable placement effect, and the telescopic bar can adjust the height of the hand rest according to the patient's body shape and needs. The patient can rest their arm and puncture site on the hand rest, thus providing a more stable and comfortable dialysis posture.

[0021] Furthermore, a gooseneck tube is fixedly connected to the hand rest, and the sound wave receiver is fixedly connected to the gooseneck tube.

[0022] Beneficial effects: The gooseneck tube can be freely molded and positioned, and the acoustic receiver can adjust the fit of the gooseneck tube to the arm, thereby effectively contacting the patient's arm and reducing the impact of excessive pressure on the dialysis process.

[0023] Furthermore, an ultrasonic transmitter is fixedly connected to the gooseneck tube, and the controller is used to monitor the patient's blood flow rate based on the Doppler effect using the sound wave receiver and the ultrasonic transmitter.

[0024] Beneficial effects: Due to the movement of red blood cells, the frequency of reflected sound waves changes due to the Doppler effect. When red blood cells move towards the probe, the frequency of reflected sound waves increases; when red blood cells move away from the probe, the frequency of reflected sound waves decreases. The blood flow velocity at the puncture site can be calculated using the Doppler effect.

[0025] Furthermore, adhesive tape is detachably attached to both the sound wave receiver and the ultrasonic transmitter, and the adhesive tape is distributed around the sound wave receiver and the ultrasonic transmitter.

[0026] Beneficial effects: The adhesive patch can adhere to the patient's skin, thereby further stabilizing the position of the sound wave receiver and the ultrasound transmitter, reducing the risk of the sound wave receiver falling off due to the patient's arm twitching or other reasons.

[0027] Furthermore, a coupling fluid storage bottle is provided on the hand rest, and a coupling fluid injector is fixedly connected to the gooseneck tube. The injection head of the coupling fluid injector extends into the area surrounding the adhesive patch. The coupling fluid injector and the coupling fluid storage bottle are connected through an extraction tube. The coupling fluid injector is used to inject coupling fluid into the gap between the sound wave receiver and the ultrasound transmitter and the patient's skin after the adhesive patch is attached to the patient's skin.

[0028] Beneficial effects: Coupling fluid is a common auxiliary measure in ultrasound detection. It can enhance the transmission and acquisition of sound waves, while expelling air from gaps and improving monitoring results. The coupling fluid syringe allows for application of the fluid after the adhesive patch is attached to the patient's skin, thus reducing the fluid's impact on the patch's adhesion.

[0029] Furthermore, a camera is fixedly connected to the gooseneck tube. The camera is used to collect images at the puncture point, and the controller is used to acquire the images collected by the camera. Based on image recognition, it determines whether there is bleeding at the puncture point and the amount of bleeding. When the amount of bleeding is greater than a preset value, an alarm is issued.

[0030] Beneficial effects: Bleeding may occur at the puncture site. The camera, fixed to the gooseneck tube, can be aimed at the puncture site during tube adjustment to obtain an image. Through image recognition, it identifies the bleeding and issues an alarm when the bleeding exceeds a preset value, alerting medical personnel to take action.

[0031] Additional aspects and advantages of the invention will be set forth in part in the description which follows, and in part will be obvious from the description, or may be learned by practice of the invention. Attached Figure Description

[0032] Figure 1 This is an isometric schematic diagram of an embodiment of the adjustable hemodialysis nursing monitoring device of the present invention;

[0033] Figure 2This is a side view schematic diagram of an embodiment of the adjustable hemodialysis nursing monitoring device of the present invention;

[0034] Figure 3 This is a schematic diagram of the coupling fluid storage bottle in an embodiment of the adjustable hemodialysis nursing monitoring device of the present invention;

[0035] Figure 4 This is an embodiment of the adjustable hemodialysis nursing monitoring device of the present invention. Figure 3 An enlarged schematic diagram of part A in the middle.

[0036] The reference numerals in the accompanying drawings of the instruction manual include: 1. support base; 2. telescopic rod; 3. hand support; 4. flexible layer; 5. gooseneck tube; 6. ultrasonic transmitter; 7. sound wave receiver; 8. coupling fluid storage bottle; 9. camera; 10. coupling fluid syringe; 11. extraction tube; 12. injection head; 13. adhesive tape. Detailed Implementation

[0037] The technical solution of the present invention will now be clearly and completely described with reference to the accompanying drawings. Obviously, the described embodiments are only some, not all, of the embodiments of the present invention. Based on the embodiments of the present invention, all other embodiments obtained by those skilled in the art without creative effort are within the scope of protection of the present invention.

[0038] In the description of this invention, it should be noted that the terms "center," "upper," "lower," "left," "right," "vertical," "horizontal," "inner," and "outer," etc., indicate the orientation or positional relationship based on the orientation or positional relationship shown in the accompanying drawings. They are used only for the convenience of describing the invention and for simplifying the description, and do not indicate or imply that the device or element referred to must have a specific orientation, or be constructed and operated in a specific orientation. Therefore, they should not be construed as limitations on the invention. Furthermore, the terms "first," "second," and "third" are used for descriptive purposes only and should not be construed as indicating or implying relative importance.

[0039] In the description of this invention, it should be noted that, unless otherwise explicitly specified and limited, the terms "installation," "connection," and "linking" should be interpreted broadly. For example, they can refer to a fixed connection, a detachable connection, or an integral connection; they can refer to a mechanical connection or an electrical connection; they can refer to a direct connection or an indirect connection through an intermediate medium; and they can refer to the internal connection of two components. Those skilled in the art can understand the specific meaning of the above terms in this invention based on the specific circumstances.

[0040] The following detailed description illustrates the specific implementation method:

[0041] As attached Figures 1-4 As shown: An adjustable hemodialysis nursing monitoring device, comprising:

[0042] Support 1: A telescopic rod 2 is bolted to the support 1. A hand rest 3 is bolted to the end of the telescopic rod 2 away from the support 1. A flexible layer 4 covers the hand rest 3. A gooseneck tube 5 is screwed to the hand rest 3. A sound wave receiver 7 is bonded to the gooseneck tube 5. An ultrasonic transmitter 6 and a sound wave receiver 7 are also bolted to the gooseneck tube 5. A controller is used to monitor the patient's blood flow velocity based on the Doppler effect of the sound wave receiver 7 and the ultrasonic transmitter 6. Adhesive patches 13 are detachably connected to both the sound wave receiver 7 and the ultrasonic transmitter 6, and the adhesive patches 13 are distributed around the sound wave receiver 7 and the ultrasonic transmitter 6.

[0043] A coupling fluid storage bottle 8 is bolted to the hand rest 3, and a coupling fluid injector 10 is bolted to the gooseneck tube 5. The injection head 12 of the coupling fluid injector 10 extends into the area surrounding the adhesive patch 13. The coupling fluid injector 10 and the coupling fluid storage bottle 8 are connected through the extraction tube 11. The coupling fluid injector 10 is used to inject coupling fluid into the gap between the sound wave receiver 7 and the ultrasound transmitter 6 and the patient's skin after the adhesive patch 13 is attached to the patient's skin.

[0044] A camera 9 is fixed to the gooseneck tube 5 with screws. The camera 9 is used to collect images at the puncture point. The controller is used to acquire the images collected by the camera 9, and to determine whether there is bleeding at the puncture point and the amount of bleeding based on image recognition. When the amount of bleeding is greater than a preset value, an alarm is issued.

[0045] Controller: Used to acquire sound waves collected by sound wave receiver 7, and to determine the dialysis status based on the frequency, amplitude and wavelength of the sound waves.

[0046] The controller is equipped with a trained convolutional neural network. The convolutional neural network is trained based on the sound waves, patient demographic information, patient vital signs information, and dialysis parameters when the patient experiences arteriovenous fistula failure, needle dislodgement, or air infiltration. The number of training samples is greater than 800. The convolutional neural network is used to output the dialysis status by taking into input patient demographic information, patient vital signs information, dialysis parameters, and sound wave data collected by the sound wave receiver 7.

[0047] Patient demographic information includes age, sex, height, weight, dialysis duration, and history of cardiovascular and cerebrovascular diseases. Patient vital signs information includes blood viscosity, blood lipids, blood pressure, plasma proteins, and white blood cell count. Dialysis parameters include dialysis blood flow rate.

[0048] An alarm is triggered when the acoustic waveform input to the convolutional neural network matches the noise generated by the failure of the arteriovenous fistula, the friction sound of needle dislodgement, or the mixed noise of air infiltration.

[0049] When a patient undergoes hemodialysis, the arm to be punctured is placed on the hand rest 3, and the telescopic rod 2 is adjusted to control the arm position, thus placing the patient in a suitable position. The gooseneck tube 5 is bent to attach the acoustic receiver 7 to the puncture site on the patient's arm, ensuring the adhesive patch 13 is tightly adhered to the skin around the puncture site. The coupling fluid syringe 10 is then used to inject coupling fluid into the gap between the acoustic receiver 7 and the patient's skin. Dialysis can then proceed normally.

[0050] Various situations can occur during dialysis, such as acute thrombosis leading to arteriovenous fistula failure, needle dislodgement causing bleeding, and air infiltration. These situations share a common characteristic: abnormal blood flow, resulting in indicative acoustic wave patterns or changes in sound waves. Arteriovenous fistula failure produces micro-tremors and micro-murmurs, allowing for timely detection of sudden fistula failure by capturing these micro-murmurs. Needle dislodgement, characterized by loosening of the puncture needle, manifests as friction rubs, changes in blood flow velocity, and a mixed sound from air infiltration. The acoustic receiver 7 responds to these various dialysis-related situations, promptly alerting medical staff.

[0051] Different patients have different physical conditions, blood texture, and vascular thickness and elasticity, resulting in a wide range of sound wave frequencies, amplitudes, and wavelengths used for judgment. By using convolutional neural networks for learning, not only can key judgment frequencies, amplitudes, and wavelength ranges be extracted from large amounts of data, but relevant mapping relationships can also be generated based on patient demographic information, vital signs, dialysis parameters, and other data, thereby accurately and effectively judging the sound wave waveform. For example, patients with low vascular elasticity and viscous blood should have a lower alarm trigger threshold, while patients with excellent vascular elasticity and healthy cardiovascular system should have a higher alarm trigger threshold.

[0052] Patient demographic information can reflect the patient's baseline condition, such as statistically significant vascular thickness and elasticity, and the probability of arteriovenous fistula failure, thus facilitating a more refined range for ultrasound waveform interpretation. Blood texture also affects the interpretation range; therefore, blood viscosity, blood lipids, blood pressure, plasma proteins, and white blood cell count are used to assess the patient's blood viscosity and overall condition. Furthermore, during dialysis, blood flow is affected by the dialysis machine's settings, making dialysis blood flow another factor influencing the interpretation range of ultrasound waveforms.

[0053] The patient's age, gender, height, weight, dialysis duration, history of cardiovascular and cerebrovascular diseases, blood viscosity, blood lipids, blood pressure, plasma protein and white blood cell count, dialysis blood flow rate, and other parameters are entered into the controller before the patient's hemodialysis begins.

[0054] The gooseneck tube 5 is flexible and can be positioned. The acoustic receiver 7 can adjust the gooseneck tube 5 to fit the arm, thus effectively contacting the patient's arm and reducing the impact of excessive pressure on the dialysis process. Compared with existing wristband and armband designs, the gooseneck tube 5 is more convenient to use, fits the arm better, and exerts less pressure on the arm, effectively reducing the impact on hemodialysis.

[0055] Because red blood cells are in motion, the frequency of reflected sound waves changes due to the Doppler effect. When red blood cells move towards the probe, the frequency of reflected sound waves increases; when red blood cells move away from the probe, the frequency decreases. The Doppler effect is used to calculate the blood flow velocity at the puncture site. Using this principle, it is possible to determine whether an arteriovenous fistula has failed before hemodialysis by assessing blood flow velocity, ensuring patient safety.

[0056] The adhesive patch 13 can adhere to the patient's skin, thereby further stabilizing the position of the sound wave receiver 7 and the ultrasound transmitter 6, and reducing the risk of the sound wave receiver 7 falling off due to the patient's arm twitching or other reasons.

[0057] Coupling fluid is a common auxiliary measure in ultrasound detection. It can enhance the transmission and acquisition of sound waves, while expelling air from gaps and improving monitoring results. The coupling fluid injector 10 can apply the coupling fluid after the adhesive patch 13 is attached to the patient's skin, thereby reducing the impact of the coupling fluid on the adhesion of the adhesive patch 13.

[0058] Bleeding may occur at the puncture site. Camera 9, fixed to the gooseneck tube 5, can be aligned with the puncture site during the adjustment of the gooseneck tube 5, thereby acquiring an image of the puncture site. Through image recognition, the camera identifies the bleeding and issues an alarm when the bleeding exceeds a preset value, alerting medical personnel to take action.

[0059] Obviously, the above embodiments are merely illustrative examples for clear explanation and are not intended to limit the implementation. Those skilled in the art will recognize that other variations or modifications can be made based on the above description. It is neither necessary nor possible to exhaustively list all possible implementations here. However, obvious variations or modifications derived therefrom are still within the scope of protection of this invention.

Claims

1. An adjustable hemodialysis nursing monitoring device, characterized in that, include: Sound wave receiver (7): used to fit the patient's arm and monitor the sound waves generated at the puncture point during hemodialysis; Controller: Used to acquire sound waves collected by the sound wave receiver (7) and determine the dialysis status based on the frequency, amplitude and wavelength of the sound waves; An alarm is triggered when the sound wave waveform matches the noise, needle dislodgement friction sound, or mixed noise caused by arteriovenous fistula failure; The controller is equipped with a trained convolutional neural network. The convolutional neural network is trained based on the sound waves, patient demographic information, patient vital signs information, and dialysis parameters when the patient experiences arteriovenous fistula failure, needle dislodgement, or air infiltration. The convolutional neural network is used to input patient demographic information, patient vital signs information, dialysis parameters, and sound wave data collected by the sound wave receiver (7) to output the dialysis status. Patient demographic information includes the patient's age, sex, height, weight, dialysis duration, and history of cardiovascular and cerebrovascular diseases; Patient vital signs include blood viscosity, blood lipids, blood pressure, plasma proteins, and white blood cell count. Dialysis parameters include dialysis blood flow rate.

2. The adjustable hemodialysis nursing monitoring device according to claim 1, characterized in that, It also includes a support base (1), on which a telescopic rod (2) is fixedly connected. A hand rest (3) is provided at the end of the telescopic rod (2) away from the support base (1), and a flexible layer (4) covers the hand rest (3).

3. The adjustable hemodialysis nursing monitoring device according to claim 2, characterized in that, A gooseneck tube (5) is fixedly connected to the hand support (3), and a sound wave receiver (7) is fixedly connected to the gooseneck tube (5).

4. The adjustable hemodialysis nursing monitoring device according to claim 3, characterized in that, An ultrasonic transmitter (6) is also fixedly connected to the gooseneck tube (5), and the controller is used to monitor the patient's blood flow rate through the Doppler effect based on the sound wave receiver (7) and the ultrasonic transmitter (6).

5. The adjustable hemodialysis nursing monitoring device according to claim 4, characterized in that, Adhesive stickers (13) are detachably attached to both the sound wave receiver (7) and the ultrasonic transmitter (6), and the adhesive stickers (13) are distributed around the sound wave receiver (7) and the ultrasonic transmitter (6).

6. The adjustable hemodialysis nursing monitoring device according to claim 5, characterized in that, The hand rest (3) is equipped with a coupling fluid storage bottle (8), and the gooseneck tube (5) is fixedly connected to a coupling fluid injector (10). The injection head of the coupling fluid injector (10) extends into the area surrounded by the adhesive patch (13). The coupling fluid injector (10) and the coupling fluid storage bottle (8) are connected through the extraction tube (11). The coupling fluid injector (10) is used to inject coupling fluid into the gap between the sound wave receiver (7) and the ultrasonic transmitter (6) and the patient's skin after the adhesive patch (13) is attached to the patient's skin.

7. The adjustable hemodialysis nursing monitoring device according to claim 6, characterized in that, A camera (9) is fixedly connected to the gooseneck tube (5). The camera (9) is used to collect images at the puncture point. The controller is used to acquire images collected by the camera (9), and to determine whether there is bleeding at the puncture point and the amount of bleeding based on image recognition. When the amount of bleeding is greater than the preset value, an alarm is issued.

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