Hemodynamic management systems, devices, and methods

Abstract

A hemodynamic management system, apparatus, and method are disclosed herein. An example hemodynamic management device includes a display interface screen and a processor configured to access a patient medical record using a patient identifier and determine a new infusion start event associated with an infusion pump fluidly connected to a patient from the patient medical record. The processor also causes the display interface screen to display an infusion line mapping interface showing a graphical representation of the human body and potential access points, prompt selection of an access point within the infusion line mapping interface, and associate an infusion pump identifier with the selected access point upon receiving the selection of the access point. The processor also causes the display interface screen to display information from a new infusion start event in conjunction with the selected access point shown within the infusion line mapping interface.

Description

Background Art

[0001] Hemodynamics refers to the fluid dynamics of blood flow in a patient. In a normal circulatory system, the amount of blood returning to the patient's heart is approximately equal to the amount pumped out. Hemodynamic monitoring detects when there is an imbalance between the amount of blood pumped out and the amount of blood returning to the patient's heart. This monitoring is important in diagnosing cardiovascular disease, postoperative trauma, sepsis, respiratory failure, and neurological injury. Hemodynamic health is determined by many patient parameters, including blood pressure or mean arterial pressure ("MAP"), heart rate, arterial oxygen saturation ("SpO2"), body temperature, and / or fluid responsiveness. Other parameters of hemodynamic health that can be monitored or calculated include blood flow velocity, cardiac output ("CO"), arterial pressure, peripheral, systemic or systemic vascular resistance ("SVR"), turbulence, wall tension, stroke volume ("SV"), stroke volume variability ("SVV"), and pulse pressure variation ("PPV").

[0002] In a hemodynamically unstable patient, blood flow into / out of the heart becomes unbalanced. This can cause a dramatic increase or decrease in blood pressure. This can also lead to an increase or decrease in heart rate, sepsis, and even breathing problems. In many cases, hemodynamic instability during treatment can prolong or complicate recovery, lead to more serious health conditions, or even cause death. Therefore, hemodynamic stability is often a key goal for clinicians working in the Intensive Care Unit ("ICU").

[0003] When caring for hemodynamically unstable patients, clinicians face a complex environment that is not conducive to early detection of threats to good clinical outcomes. Clinicians often have difficulty accessing and interpreting relevant data points for clinical decision making. Even when accessed, relevant data includes disparate data points and is only available through fragmented and unintegrated point-of-care (“POC”) systems. This less-than-desirable data access coupled with a shortage of skilled clinicians and a lack of standardization creates challenges for care coordination and delivery. This is especially true for hemodynamic care of patients with acute, high-risk conditions, which requires rapid and accurate responses to resolve hemodynamic instability. Known systems require the use of highly inefficient and manual clinical tasks that must first be completed to make the patient hemodynamically stable. Summary of the invention

[0004] An example system, method, and apparatus for hemodynamic management is disclosed. The example system, method, and apparatus are configured to merge infusion therapy information with physiological and hemodynamic information into a single display device located at the patient's bedside. In some cases, the physiological information may include dialysis information or other information indicating fluid removed from the patient's body. Thus, the system, method, and apparatus provide hemodynamic information about the patient's net fluid balance in real time or near real time.

[0005] The example systems, methods, and apparatus may also be configured to provide a hemodynamic assessment that is integrated with infusion therapy information, physiological information, and hemodynamic information shown on a single display device. The hemodynamic assessment provides an indication of the patient's fluid responsiveness by inducing a reversible increase in cardiac preload. The display of information related to the hemodynamic assessment in conjunction with the infusion therapy information, physiological information, and hemodynamic information provides a better clinician experience by integrating key patient information into a single display device. The incorporation of this information also enables the display device to execute one or more algorithms or protocols to provide automated clinical decision support. Compared to known electronic medical record ("EMR") systems that serve as repositories of patient health information, the systems, methods, and apparatus disclosed herein are configured to provide real-time or near real-time personalized hemodynamic-specific management and corresponding clinical decision support.

[0006] In some embodiments, example systems, methods, and apparatus are configured to manage the mapping of one or more infusion therapies to a patient's intravenous infusion points. The systems, methods, and apparatus use a drug library file that specifies drug-to-drug and / or drug-to-access point type incompatibilities to determine when a planned infusion therapy may be harmful to a patient. The systems, methods, and apparatus may generate a warning indicating which drugs are incompatible and / or which drugs are incompatible with the infusion point. In some embodiments, the systems, methods, and apparatus may recommend one or more alternative infusion points.

[0007] Aspects of the subject matter described herein may be used alone or in combination with one or more other aspects described herein. Without limiting the foregoing description, in a first aspect of the present disclosure, a hemodynamic management device includes a display interface screen, a memory device storing a patient identifier, and a processor communicatively coupled to the display interface screen and the memory device. The processor is configured to access a patient medical record in an electronic medical record database using the patient identifier, and determine from the patient medical record a new infusion start event associated with an infusion pump fluidically connected to a patient corresponding to the patient medical record. The new infusion start event includes information indicating an infusion pump identifier, an infusion fluid name, an infusion rate, an amount to be infused (volume), a dose, a remaining amount (volume remaining), and a time when the new infusion start event is generated by the infusion pump. The processor is also configured to cause the display interface screen to display an infusion line mapping interface, which shows a graphical illustration of a human body and potential access points, and prompts to select an access point in the infusion line mapping interface. The processor is also configured to associate the infusion pump identifier with the selected access point in the memory device after receiving the selection of the access point. Additionally, the processor is configured to cause the display interface screen to display at least some of the information associated with the new infusion start event in conjunction with the selected access point shown within the infusion line mapping interface.

[0008] According to a second aspect of the present disclosure, which can be used in combination with the first aspect, the memory device is configured to store a drug library that specifies incompatibility between a fluid type and an access point type. In addition, the processor is further configured to, after receiving a selection of an access point, perform a check of incompatibility between the selected access point and the infusion fluid name and the access point, and when incompatibility exists, display a warning in the infusion line mapping interface and provide a prompt to change the access point of the infusion fluid name associated with the infusion pump, remove the warning after receiving a selection of a second access point, and display at least some of the information associated with the new infusion start event in conjunction with the selected second access point.

[0009] According to a third aspect of the present invention, which can be used in combination with any one or more of the preceding aspects, the processor is further configured to use the drug library to determine compatible access points based on the infusion fluid name, and to cause the infusion line mapping interface to display a recommendation to fluidically connect the infusion pump to the determined compatible access point.

[0010] According to a fourth aspect of the present invention, which can be used in combination with any one or more of the aforementioned aspects, the processor is further configured to determine from the patient medical record a second new infusion start event associated with a second infusion pump fluidically connected to a patient corresponding to the patient medical record. The second new infusion start event includes second information indicating a second infusion pump identifier, a second infusion fluid name, a second dose, a second infusion rate, a second amount to be infused, a remaining second amount, and a second time when the second new infusion start event is generated by the second infusion pump. The processor is also configured to cause the display interface screen to display an infusion line mapping interface, prompt the user to select a second access point within the infusion line mapping interface, and after receiving the selection of the second access point, cause the display interface screen to display at least some of the second information associated with the second new infusion start event in conjunction with the selected second access point.

[0011] According to a fifth aspect of the present disclosure, which can be used in combination with any one or more of the aforementioned aspects, the memory device is configured to store a drug library of fluid type and fluid type incompatibilities of a specified access point. In addition, the processor is further configured to perform a check of fluid type and fluid type incompatibility between the infusion fluid name and the second infusion fluid name after receiving the selection of the second access point, and when incompatibility exists, display a warning in the infusion line mapping interface and provide a prompt to change the access point of the second infusion fluid name associated with the second infusion pump, remove the warning after receiving the selection of the third access point, and display at least some of the second information associated with the second new infusion start event in conjunction with the selected third access point.

[0012] According to a sixth aspect of the present invention, which can be used in combination with any one or more of the preceding aspects, the processor is further configured to receive hemodynamic information indicating cardiac stroke volume, cardiac output, cardiac index, heart rate, total peripheral resistance index ("TPRI") or fluid responsiveness from at least one sensor, and to cause at least some of the hemodynamic information to be displayed in conjunction with an infusion line mapping interface or in a separate hemodynamic interface.

[0013] According to a seventh aspect of the present invention, which may be used in combination with any one or more of the preceding aspects, the processor is further configured to determine hemodynamic information indicative of cardiac stroke volume, cardiac output, cardiac index, heart rate, total peripheral resistance index ("TPRI") or fluid responsiveness, and to cause at least some of the hemodynamic information to be displayed in conjunction with an infusion line mapping interface or to be displayed within a separate hemodynamic interface.

[0014] According to an eighth aspect of the present invention, which can be used in combination with any one or more of the preceding aspects, the processor is further configured to combine the infusion rate of the infusion fluid name with other infusion rates associated with the patient specified in the patient's medical record, determine a fluid output rate specified in the patient's medical record, the fluid output rate corresponding to at least one of dialysis, urine monitoring, or fluid discharge, determine a fluid balance as the difference between the combined infusion rate and the combined fluid output rate, and display at least the fluid balance within an infusion line mapping interface or an interactive graphical interface shown by a display interface screen.

[0015] According to the ninth aspect of the present invention, which can be used in combination with any one or more of the preceding aspects, the processor is further configured to determine a new infusion event from the patient's medical record, the new infusion event specifying a time when the new infusion event is generated by the infusion pump and indicating at least one of a changed infusion rate, a changed amount to be infused, or a changed remaining amount, and to update the infusion line mapping interface based on information associated with the new infusion event.

[0016] According to a tenth aspect of the present invention, which can be used in combination with any one or more of the preceding aspects, the processor is further configured to receive information indicating an alarm event or determine an alarm event from a patient medical record, and display graphic information indicating the alarm event or at least some of the information indicating the alarm event, wherein the alarm event includes at least one of information indicating penetration detection, pipeline blockage, or that the fluid container is empty or nearly empty.

[0017] According to an eleventh aspect of the present invention, which may be used in combination with any one or more of the preceding aspects, the infusion line mapping interface is configured to display the infusion fluid name and infusion rate, and to display a graphic icon indicating the remaining amount or the time indicating the remaining amount.

[0018] According to the twelfth aspect of the present invention, which can be used in combination with any one or more of the preceding aspects, the processor is further configured to determine that the remaining amount or the time indicating the remaining amount is less than a threshold, display the remaining amount or the time indicating the remaining amount in combination with a graphic icon, and change the color of the selected access point and the graphic icon.

[0019] According to a thirteenth aspect of the present invention, which may be used in combination with any one or more of the preceding aspects, selection of the graphical icon causes the processor to display at least an infusion pump identifier, an amount to be infused, an infusion rate, and an infusion fluid name.

[0020] According to a fourteenth aspect of the present invention, which may be used in combination with any one or more of the preceding aspects, selection of the graphic icon causes the processor to send a message which causes the infusion pump to produce a sound or provide a visual indication.

[0021] According to a fifteenth aspect of the present invention, which may be used in combination with any one or more of the preceding aspects, a patient identifier is entered into the display interface screen and stored in a memory device or determined from the patient medical record.

[0022] According to a sixteenth aspect of the present disclosure, which may be used in combination with any one or more of the preceding aspects, the apparatus further comprises an adapter for connecting to a hub device also connected to the infusion pump.

[0023] According to the seventeenth aspect of the present disclosure, which can be used in combination with any one or more of the foregoing aspects, the hemodynamic management method includes: accessing a patient medical record in an electronic medical record database using a patient identifier via a processor, and determining a new infusion start event associated with an infusion pump fluidically connected to a patient corresponding to the patient medical record using the processor from the patient medical record. The new infusion start event includes information indicating an infusion pump identifier, an infusion fluid name, an infusion rate, an amount to be infused, a dose, a remaining amount, and a time when the new infusion start event is generated by the infusion pump. The method also includes: causing a display interface screen to display an infusion line mapping interface via a processor, the infusion line mapping interface showing a graphical illustration of a human body and potential access points; prompting via a processor to select an access point within the infusion line mapping interface; and after receiving the access point selection, associating the infusion pump identifier with the selected access point via the processor. The method additionally includes causing a display interface screen to display at least some of the information associated with the new infusion start event in conjunction with the selected access point shown within the infusion line mapping interface via the processor.

[0024] According to the eighteenth aspect of the present invention, which can be used in combination with any one or more of the preceding aspects, the method further includes, after receiving the selection of an access point, performing a check of fluid type and access point incompatibility between the selected access point and the infusion fluid name via the processor using a drug library that specifies fluid type and access point type incompatibilities, and when incompatibility exists, displaying a warning via the processor in the infusion line mapping interface and providing a prompt to change the access point of the infusion fluid name associated with the infusion pump, removing the warning via the processor after receiving the selection of a second access point, and displaying at least some information associated with a new infusion start event via the processor in conjunction with the selected second access point.

[0025] According to the nineteenth aspect of the present invention, which can be used in combination with any one or more of the preceding aspects, the method further includes determining, via a processor, a compatible access point based on an infusion fluid name using a drug library, and causing, via the processor, an infusion line mapping interface to display a recommendation to fluidically connect the infusion pump to a compatible access point.

[0026] According to the twentieth aspect of the present invention, which can be used in combination with any one or more of the preceding aspects, the method further includes: combining, via a processor, an infusion rate of an infusion fluid name and other infusion rates associated with a patient specified in a patient medical record, determining, via a processor, a fluid output rate specified in the patient medical record, the fluid output rate corresponding to at least one of dialysis, urine monitoring, or fluid discharge, determining, via a processor, a fluid balance as the difference between the combined infusion rate and the combined fluid output rate, and displaying, via the processor, at least the fluid balance in an infusion line mapping interface or an interactive graphical interface shown by a display interface screen.

[0027] According to the twenty-first aspect of the present disclosure, Figures 1 to 24 Any structure and functionality shown and described may be combined with Figures 1 to 24 Any structure and functionality illustrated and described in other figures of the and any structure and functionality illustrated and described in one or more of the preceding aspects may be used in combination.

[0028] In view of the present disclosure and the above aspects, an advantage of the present disclosure is to provide a hemodynamic management device and system that displays real-time hemodynamic parameters for providing hemodynamic assessment.

[0029] Another advantage of the present disclosure is to provide infusion line management by showing current infusion relative to patient access points within a single display interface.

[0030] Another advantage of the present disclosure is to provide a compatibility check of fluid type with fluid type and access point before a new infusion can be performed.

[0031] Another advantage of the present disclosure is that it provides automatic fluid balance monitoring.

[0032] Additional features and advantages are described in the following detailed description and accompanying drawings and will be apparent therefrom. The features and advantages described herein are not exhaustive, and in particular, many additional features and advantages will be apparent to one of ordinary skill in the art upon reference to the accompanying drawings and description. Furthermore, any particular embodiment need not have all of the advantages listed herein, and it is expressly contemplated that each advantageous embodiment is separately claimed. Furthermore, it should be noted that the language used in the specification is selected primarily for readability and instructional purposes, and not for limiting the scope of the subject matter of the present invention. BRIEF DESCRIPTION OF THE DRAWINGS

[0033] Figure 1 is a diagram of a hemodynamic management system including a hemodynamic management device according to an example embodiment of the present disclosure.

[0034] Figure 2 is a diagram showing an example embodiment according to the present disclosure Figure 1Diagram of an example of a hemodynamic management device communicating directly with a sensor.

[0035] Figure 3 According to another exemplary embodiment of the present disclosure Figure 1 Another diagram of the hemodynamic management system.

[0036] Figure 4 is configured to connect to Figures 1 to 3 Diagram of the hub device of the hemodynamic management apparatus.

[0037] Figure 5 A hemodynamic management device having a hemodynamic management device placed near a communication module according to an exemplary embodiment of the present disclosure Figure 4 Another diagram of the hub device, .

[0038] Figure 6 is another diagram of a hub device having a slim version of the hemodynamic management apparatus according to an example embodiment of the present disclosure.

[0039] Figure 7 is a diagram of a hemodynamic management device connected to a pole according to an example embodiment of the present disclosure.

[0040] Figure 8 A diagram showing an example embodiment according to the present disclosure is used to configure Figures 1 to 7 Flowchart of an example process of a hemodynamic management device.

[0041] Fig. 9 According to an exemplary embodiment of the present disclosure, Figures 1 to 7 Illustration of a patient-associated registration interface displayed by a hemodynamic management device.

[0042] Fig.10 A diagram showing an example embodiment according to the present disclosure is used by Figures 1 to 7 A flow chart of an example process for fluid line management performed by a hemodynamic management device.

[0043] Fig.11 According to an exemplary embodiment of the present disclosure, Figures 1 to 7 FIG. 1 is a diagram of an example infusion line mapping interface of a display interface screen of a hemodynamic management device.

[0044] Fig.12 is a diagram illustrating the incompatibility between two infusions connected to the same access point according to an example embodiment of the present disclosure Fig.11 Figure 1 shows the infusion line mapping interface.

[0045] Fig.13 is a diagram showing an example embodiment of the present disclosure according to which input Figures 1 to 7Diagram of different possible physiological data in a hemodynamic management device.

[0046] Fig.14 According to an exemplary embodiment of the present disclosure, by applying Figures 1 to 7 A diagram of a hemodynamic dashboard interface displayed on a display interface screen of a hemodynamic management device.

[0047] Fig.15 It is shown that according to an example embodiment of the present disclosure, Figures 1 to 7 Diagram of a hemodynamic management device showing a fluid responsive interface.

[0048] Fig.16 A hemodynamic dashboard interface is shown after a hemodynamic assessment has been performed according to an example embodiment of the present disclosure.

[0049] Fig.17 is a diagram of an evaluation interface showing a bolus hemodynamic evaluation status according to an example embodiment of the present disclosure.

[0050] Fig.18 is a diagram of a fluid responsiveness interface that may be displayed by applying a hemodynamic management device after a hemodynamic assessment has occurred or is ongoing according to an example embodiment of the present disclosure.

[0051] Fig.19 According to an exemplary embodiment of the present disclosure Fig.14 A diagram of the hemodynamic dashboard interface with the infusion status portion changed to indicate information indicating an alarm or warning.

[0052] Fig. 20 is a diagram showing information indicating an alarm or warning about a bag being nearly empty according to an exemplary embodiment of the present disclosure Fig.11 Figure 1 shows the infusion line mapping interface.

[0053] Fig.21 An example embodiment of the present disclosure is provided for displaying an indication of a warning related to penetration detection. Fig.14 Figure 4. Hemodynamics dashboard interface.

[0054] Fig. 22 is a diagram showing information indicating an alarm or warning regarding penetration detection according to an exemplary embodiment of the present disclosure Fig.11 Figure 1 shows the infusion line mapping interface.

[0055] Fig.23 is a diagram of a fluid balance interface according to an example embodiment of the present disclosure.

[0056] Fig.24is a diagram of a detailed net fluid balance interface according to an example embodiment of the present disclosure. DETAILED DESCRIPTION

[0057] The present disclosure generally relates to a method, system, and apparatus for hemodynamic management. The method, system, and apparatus include a hemodynamic management apparatus configured for use at a patient's bedside. The hemodynamic management apparatus is configured to receive data from a plurality of medical devices. The data is compiled to provide a real-time or near real-time hemodynamic assessment in conjunction with the patient's total fluid balance. The hemodynamic assessment may be performed via a passive leg raise ("PLR"), an infusion bolus, and / or automatic detection of an infusion bolus. The hemodynamic assessment provides an indication of the patient's fluid responsiveness by inducing a reversible increase in cardiac preload.

[0058] As described herein, total fluid balance is the net increase or decrease in patient fluid. The method, system and apparatus are configured to aggregate data from medical devices to determine a cumulative fluid infusion rate and a cumulative fluid output rate. The cumulative fluid infusion rate and output rate are subtracted to determine the net fluid increase / decrease over a period of time (such as one second, one minute, ten minutes, etc.). The net fluid increase / decrease is trended over time to determine how much fluid a patient has lost or gained over a specific period of time (such as one hour, four hours, eight hours, twelve hours, twenty-four hours, forty-eight hours, seventy-two hours, etc.). Total fluid balance and hemodynamic assessment together provide key information that enables automatic or guided identification or prediction of patient hemodynamic instability. This identification enables clinicians to more easily address hemodynamic instability problems detected or predicted at the onset of the disease before the patient's condition worsens.

[0059] The methods, systems, and devices disclosed herein are additionally configured to provide automatic mapping of fluid infusions. Some critically ill patients may have up to fifteen infusions at the same time. Each infusion is connected to a fluid container (such as an intravenous ("IV") bag). The fluid in the fluid container is pumped by a corresponding infusion pump via an IV tube or IV line. Individual IV lines can be connected to the patient at a corresponding access point. However, in order to reduce the number of access points used (reducing patient discomfort), some IV lines can be connected together upstream of the access point location. The method, system, and device do not require clinicians to perform manual compatibility checks and infusion line tracking, but automatically perform compatibility checks to ensure that the infusion fluid is compatible with a specific infusion access point or with one or more other fluids at a specific infusion access point. Automatic mapping also enables the method, system, and device to provide a real-time summary of all infusion status within a single display. This greatly reduces the burden on clinicians to have to check many different infusion pumps individually.

[0060] Reference is made herein to infusion access points, intravenous access points, or more generally access points. As described below, an access point is a location on a patient that receives an infusion fluid. An access point is typically a vein that allows fluid to be infused directly into the patient's bloodstream. For example, humans include many venous access points, including the internal jugular vein, external jugular vein, left subclavian vein, superior vena cava, cephalic vein, base vein, median cubital vein, median cephalic vein, median forearm vein, accessory cephalic vein, dorsal venous arch, metacarpal vein, and finger veins. However, it should be understood that the methods, systems, and devices disclosed herein can provide mapping of any patient access point.

[0061] As disclosed herein, hemodynamic management includes hemodynamic monitoring, vasoactive drug administration / titration, fluid resuscitation, and urine output / fluid balance tracking. Example methods, systems, and apparatus are configured to receive data from medical devices and one or more physiological sensors and use the data for hemodynamic management. The methods, systems, and apparatus include instructions that specify which data is relevant to hemodynamic management for selection or filtering. The instructions may also specify certain calculations to be performed to determine other hemodynamic parameters. The example methods, systems, and apparatus may also include one or more instructions or algorithms for monitoring or analyzing trends or relationships between hemodynamic parameters to identify fluid balance changes, instabilities, and / or physiological changes. In some cases, the methods, systems, and apparatus may also include instructions or algorithms for predicting future hemodynamic instability in a patient by analyzing hemodynamic parameter trends or relationships.

[0062] Therefore, the example methods, systems, and devices disclosed herein provide clinicians with an instant and complete picture of the patient's hemodynamic condition within a single display or interface. Displaying all relevant hemodynamic parameters in one interface enables clinicians to make more informed decisions at the point of care by early prediction and detection of hemodynamic problems. The example system disclosed herein also simplifies and streamlines hospital workflows by reducing the number of information sources and interfaces that clinicians must access to make more informed decisions, thereby improving clinician confidence and efficiency. Most importantly, the example system disclosed herein provides more effective hemodynamic management for unstable patients in intensive care, which can lead to better outcomes and shorten hospital stays in the ICU or in a broader sense. It should be understood that the methods, systems, and devices disclosed herein can be applied to other fields, including electrolyte supplementation and renal function monitoring. The example methods, systems, and devices can also be used for antibiotic management, blood glucose management, infection monitoring, and line tracking and / or wound / discharge management.

[0063] Hemodynamic Management System

[0064] Figure 11 is a diagram of a hemodynamic management system 100 according to an example embodiment of the present disclosure. The system 100 includes medical devices that operate in conjunction with a patient. The medical devices include, for example, an infusion pump 102 and a dialysis or renal failure treatment ("RFT") machine 104. The system 100 also includes a hemodynamic management device 106.

[0065] The example infusion pump 102 may include any pump capable of delivering an intravenous therapy to a patient via one or more intravenous line sets. Examples include syringe pumps, linear peristaltic pumps, large volume parenteral pumps, mobile pumps, multi-channel pumps, and the like. The example infusion pump 102 includes a display 108 and an interface 110 for enabling a clinician to specify or program an infusion therapy. In addition to manual programming, the infusion pump 102 may also receive electronic prescriptions from a hospital information system via a network 112 and a gateway server 114. The infusion pump 102 may include one or more drug libraries including specific restrictions based on care area, dosage, rate of change, drug type, concentration, patient age, patient weight, and the like.

[0066] The infusion pump 102 is configured to perform infusion therapy on a patient, which includes infusing one or more fluids, solutions or drugs 111 into the patient. The infusion pump 102 operates according to an infusion prescription entered by a clinician at a user interface 110 of the pump or received via a gateway server 114. The infusion pump 102 can compare the prescription with a drug library and provide any alarms or warnings when the parameters of the prescription violate soft limits or hard limits. The infusion pump 102 is configured to monitor the progress of the treatment and periodically send infusion therapy progress data 116 to the gateway server 114. The infusion therapy progress data 116 may include, for example, infusion rate, dose, total infusion volume, remaining time of treatment, fluid concentration, rate change, remaining amount in a drug container, fluid name, patient identifier, titration information, bolus information, nursing area identifier, timestamp when the data is generated, alarm conditions, warning conditions, events, etc. In some cases, the infusion therapy progress data 116 includes a new infusion start event, which includes information indicating an infusion pump identifier, an infusion fluid name, an infusion rate, an amount to be infused, a dose, a remaining amount, and / or a time when the new infusion start event was generated by the infusion pump. The infusion pump 102 can transmit the data 116 continuously, periodically (e.g., every 30 seconds, 1 minute, etc.), or upon request from the gateway server 114.

[0067] Figure 1An example RFT machine 104 may include any hemodialysis, hemofiltration, hemodiafiltration, continuous renal replacement therapy ("CRRT"), or peritoneal dialysis machine. CRRT is a dialysis modality that is often used to treat critically ill hospitalized patients in intensive care units who develop acute kidney injury ("AKI"). Unlike chronic kidney disease, which occurs slowly over time, AKI typically occurs in hospitalized patients and typically develops within a few hours to a few days. For example, a patient undergoing hemodialysis is connected to an RFT machine 104, where the patient's blood is pumped through the machine. The blood passes through the dialyzer of the machine 104, which removes waste products, toxins, and excess water (e.g., ultrafiltrate) 117 from the blood. The cleaned blood is returned to the patient.

[0068] Hemodialysis is a treatment for kidney failure in which waste products in the blood diffuse across a semipermeable membrane. During hemodialysis, blood is removed from the patient and flows through a semipermeable membrane assembly (dialyser), where the blood typically flows countercurrent to a dialysis solution flowing on the other side of the semipermeable membrane. In the dialyzer, toxins in the blood travel across the semipermeable membrane and out of the dialyzer into the dialysis solution (dialysate) being used. Clean blood that has flowed through the dialyzer is then returned to the patient.

[0069] In the dialyzer, a pressure differential is created across the semipermeable membrane by removing dialysate at a flow rate greater than that used to introduce the dialysis solution into the dialyzer. This pressure differential pulls fluid containing small, medium, and large molecule toxins across the semipermeable membrane. Flow and volume measurements are used to control the amount of fluid removed (ultrafiltration). As shown above, the pump of a hemodialysis machine typically draws blood from the arterial side of the patient, pushes it into and through the dialyzer, and through a drip chamber that separates out the air, and then returns the dialyzed blood to the patient's venous side.

[0070] The RFT machine 104 can alternatively be a hemofiltration machine. Hemofiltration is another renal failure treatment method, similar to hemodialysis. During hemofiltration, the patient's blood also passes through a semipermeable membrane (hemofilter), where fluid (including waste) is pulled through the semipermeable membrane by a pressure difference. This convection carries molecular toxins and electrolytes of a certain size (which are difficult to remove by hemodialysis) across the semipermeable membrane. During hemofiltration, a replacement fluid is added to the blood to replace the amount of fluid and electrolytes removed from the blood by the hemofilter. Hemofiltration in which a replacement fluid is added to the blood before the hemofilter is called pre-dilution hemofiltration. Hemofiltration in which a replacement fluid is added to the blood after the hemofilter is called post-dilution hemofiltration.

[0071] The RFT machine 104 can alternatively be a hemodiafiltration machine. Hemodiafiltration is another renal failure treatment method that combines hemodialysis with hemofiltration. The blood is pumped through the dialyzer again, and unlike the hemofilter, the dialyzer receives fresh dialysis fluid. However, with hemodiafiltration, replacement fluid is delivered to the blood circuit, just as with hemofiltration. Therefore, hemodiafiltration is a neighbor of hemodialysis and hemofiltration.

[0072] The RFT machine 104 can alternatively be a peritoneal dialysis machine. Peritoneal dialysis uses a dialysis solution (also called dialysate) that is infused into the patient's peritoneal cavity via a catheter. The dialysate contacts the peritoneum of the patient's peritoneal cavity. Due to the osmotic gradient created by the solution, waste products, toxins, and excess water pass from the patient's bloodstream through the peritoneum into the dialysate. The spent dialysate is drained from the patient, thereby removing waste products, toxins, and excess water from the patient's body. This cycle is repeated.

[0073] The example peritoneal dialysis machine 104 can perform various types of additional peritoneal dialysis treatments, including continuous cycle peritoneal dialysis ("CCPD"), tidal flow automated peritoneal dialysis ("APD"), and continuous flow peritoneal dialysis ("CFPD"). The APD machine automatically performs drain, fill, and dwell cycles, typically while the patient is sleeping. The APD machine eliminates the need for the patient or clinician to manually perform treatment cycles or to transport supplies during the day. The APD machine is fluidly connected to an implanted catheter, a source or bag of fresh dialysate, and a fluid drain. The APD machine pumps fresh dialysate from a source of dialysate through a catheter into the patient's peritoneal cavity, and allows the dialysate to stay in the cavity, and allows the transfer of waste, toxins, and excess water. The source can be a plurality of sterile dialysate bags. The APD machine pumps used dialysate from the peritoneal cavity through a catheter into the drain. As with the manual process, several drain, fill, and dwell cycles occur during the APD. The "last fill" occurs at the end of CAPD and APD, and it stays in the patient's peritoneal cavity until the next treatment.

[0074] CCPD therapy attempts to completely drain the patient at each drain. CCPD and / or APD can be a batch type system that sends spent dialysate to the drain. Tidal flow systems are modified batch systems. With tidal flow, rather than removing all of the fluid from the patient over a long period of time, a portion of the fluid is removed and replaced after shorter time increments.

[0075] The peritoneal dialysis dialysate may include a solution or mixture containing 0.5% to 10% (preferably 1.5% to 4.25%) dextrose (or more generally glucose). The peritoneal dialysis dialysate may include, for example, Dianeal®, Physioneal®, Nutrineal®, and Extraneal® dialysates. The dialysate may additionally or alternatively include a percentage of icodextrin. It should be understood that in some embodiments of the present disclosure, the dialysate may be infused into the patient via an infusion pump 102 rather than an RFT machine 104.

[0076] Continuous flow dialysis systems (CFPD) clean or regenerate used dialysate instead of discarding it. CFPD systems pump fluid in and out of the patient through a loop. The dialysate flows into the peritoneal cavity through one catheter lumen and then flows out of another catheter lumen. The fluid leaving the patient passes through a reconstitution device that removes waste products from the dialysate, for example, via a urea removal column that employs urease to enzymatically convert urea to ammonia (e.g., ammonium cations). Ammonia is then removed from the dialysate by adsorption before the dialysate is reintroduced into the peritoneal cavity. Additional sensors are employed to monitor the removal of ammonia. CFPD systems are typically more complex than batch systems.

[0077] In hemodialysis and peritoneal dialysis, "sorbent" technology can be used to remove uremic toxins from the waste dialysate, reinfuse therapeutic agents (such as ions and / or glucose) into the treated fluid, and reuse the fluid to continue dialysis for the patient. One commonly used sorbent is made of zirconium phosphate, which is used to remove ammonia produced from the hydrolysis of urea. Typically, large amounts of sorbent are required to remove the ammonia produced during dialysis treatment.

[0078] Similar to the infusion pump 102, the RFT machine 104 can be programmed locally with a dialysis prescription, or receive a dialysis prescription via the gateway server 114. The RFT machine 104 is configured to perform dialysis treatment on a patient, including removing ultrafiltration from the patient. With peritoneal dialysis, the RFT machine 104 infuses dialysate into the patient during a fill cycle. For any dialysis prescription, the RFT machine 104 can compare the parameters of the prescription to one or more limits and provide any warnings or alarms when the parameters of the prescription violate soft limits or hard limits. The RFT machine 104 is configured to monitor the progress of the treatment and periodically send dialysis treatment progress data 119 to the gateway server 114. The dialysis treatment progress data 119 may include, for example, fill rate, dwell time, drain or fluid removal rate, blood flow rate, effluent dose, ultrafiltration removal rate, dialysate removal rate, total dialysate infused, dialysate flow rate, pre-replacement flow rate, post-replacement flow rate, patient weight balance, return pressure, signs of excess patient fluid, filtration fraction, time remaining, dialysate concentration, dialysate name, patient identifier, room identifier, care area identifier, timestamp when data was generated, alarm conditions, warning conditions, events, etc. The RFT machine 104 may send the data continuously, periodically (e.g., every 30 seconds, 1 minute, etc.), or upon request from the gateway server 114.

[0079] The hemodynamic management apparatus 106 includes a processor 120, a memory device 122, and a display interface screen 124. The memory device 122 stores instructions that specify or define operations performed by the application 126. The processor 120 executes the instructions to cause the hemodynamic management apparatus 106 to perform the operations discussed herein via the application 126. The processor 120 may include a controller, a logic device, an application specific integrated circuit ("ASIC"), a microcontroller, etc. The memory device 122 may include a flash drive, a solid state drive, or a hard disk drive.

[0080] The display interface screen 124 of the hemodynamic management device 106 is configured to display information related to hemodynamic monitoring and management. As discussed in further detail below, this includes fluid balance information, hemodynamic assessment information, hemodynamic parameters, and / or warnings related to infiltration, tubing blockage, and / or fluid bag near empty or empty. The display interface screen 124 also displays information related to infusion line management. The display interface screen 124 may include a touch interface configured to receive touch gestures related to available display options or functions.

[0081] The memory device 122 may also be configured to store a data structure or file 127 that associates the infusion pump 102 with a corresponding graphical icon displayed within the infusion line mapping interface 1100, such as Fig.11as shown. The data structure or file 127 may include an index that associates an infusion pump identifier or hardware address with an assigned graphical icon. As discussed in more detail below, the association occurs after a new infusion pump is added and a compatibility check is performed. The data structure or file 127 may also store at least some infusion therapy progress data 116, which includes fluid type / name, infusion rate, amount to be infused, and / or amount of fluid remaining in a fluid container. The application 126 is configured to obtain the infusion therapy progress data 116 from the patient's EMR, the gateway server 114, and / or receive the data 116 directly from the infusion pump 102 when connected to the hub device 400 (discussed in more detail below).

[0082] The hemodynamic management device 106 is communicatively coupled to a gateway server 114 via a network 112. Figure 1 A wireless link is shown, but in other embodiments, the hemodynamic management device 106 is connected to the network 112 via a wired link, such as an Ethernet connection. Figure 3 As discussed in more detail below, the hemodynamic management device 106 communicates with the gateway server 114 to receive information for display.

[0083] In some alternative embodiments (such as Figures 4 to 6 ), the hemodynamic management device 106 is connected to the infusion pump 102 via a hub device. The hemodynamic management device 106 can communicate directly with the infusion pump 102 via the hub device without using the network 112. The communication can be performed via a universal serial bus ("USB") connection or a controller area network ("CAN") connection. Reference is made herein to communication between the hemodynamic management device 106 and other medical devices including the infusion pump 102. It should be understood that the communication can be performed via the network 112 and the gateway server 114. Alternatively, when a hub device is used, the communication can occur locally.

[0084] like Figure 1As shown, the hemodynamic management device 106 is configured to receive physiological data 128 related to the patient from one or more sensors 130. The sensors 130 can non-invasively monitor the patient's physiological data 128, which provides hemodynamic monitoring. The sensors 130 can include, for example, a blood pressure sensor (e.g., a blood pressure cuff), a MAP sensor, a heart rate sensor, an SpO2 sensor, and / or a body temperature sensor. In some embodiments, the sensors 130 and / or the hemodynamic management device 106 are configured to use the physiological data 128 to calculate one or more hemodynamic parameters, including, for example, blood flow velocity, cardiac output ("CO"), arterial pressure, peripheral, total or systemic vascular resistance ("SVR"), turbulence, wall tension, stroke volume ("SV"), stroke volume variability ("SVV"), and / or pulse pressure variation ("PPV"). The sensor 130 and / or the hemodynamic management device 106 may also be configured to use the physiological data 128 to calculate a cardiac index (“CI”), a stroke volume index (“SVI”), and / or a total peripheral resistance index (“TPRI”).

[0085] Although the sensors 130 are shown as being communicatively coupled to the hemodynamic management device 106, in other embodiments, one or more of the sensors 130 are communicatively coupled to the infusion pump 102 and / or the RFT machine 104. Additionally or alternatively, one or more of the sensors 130 are configured to communicate with the gateway server 114 via the network 112. In these other embodiments, the hemodynamic management device 106 is configured to access or receive physiological data 128 from the infusion pump 102, the RFT machine 104, and / or the gateway server 114 via the network 112.

[0086] In one example, the infusion pump 102 may be connected to a pulse oximetry sensor. The infusion pump 102 may be configured to integrate or otherwise include data from the pulse oximetry sensor into the infusion treatment progress data 116, or alternatively, to send the pulse oximetry data separately to the gateway server 114. Similarly, the RFT machine 104 may be communicatively coupled to a blood pressure sensor, a patient weight scale, a glucose sensor, a cardiac monitor, etc. The RFT machine 104 may be configured to integrate or otherwise include data from the sensor into the dialysis treatment progress data 119, or alternatively, to send the sensor data separately to the gateway server 114.

[0087] Figure 2 is a diagram showing that the sensors 130a and 130b according to an example embodiment of the present disclosure are directly connected to Figure 1FIG. 1 is a diagram of an example of a hemodynamic management device 106 communicating with an application 126. In this example, the hemodynamic management device 106 includes a sensor module 202 communicatively coupled to the processor 120. The sensor module 202 is configured to receive physiological data 128a from the cardiac sensor 130a and convert the physiological data into hemodynamic parameters, such as SVI, TPRI, CI, CO, SV, etc. In some cases, the sensor module 202 includes an interactive interface that is integrated with the application 126 to display the hemodynamic parameters. In addition, the sensor module 202 can be configured to receive one or more application commands from the processor 120 for performing a hemodynamic assessment.

[0088] In one example, the sensor module 202 adds fluid responsiveness monitoring to the application 126 of the hemodynamic management device 106. One or more chest patch sensors 130 are plugged into the sensor module 202, which is integrated or otherwise connected to the device 106. The application 126 is configured to display an interface for monitoring stroke volume ("SV") and cardiac output ("CO") and assess whether the patient will respond to additional IV fluids.

[0089] The sensor module 202 may include a Wi-Fi transceiver for enabling wireless data communication with the cardiac sensor 130a. In other embodiments, the sensor module 202 and / or the hemodynamic management device 106 may include a Bluetooth® transceiver. In addition, the sensor module 202 may be capable of operating with a communication interface 204 configured with a USB port, a micro USB port, an HDMI port, or other hard-wired port for the cardiac sensor 130a.

[0090] Figure 2 It is also shown that the hemodynamic management device 106 can communicate with the infiltration sensor 130b via a wired or wireless connection. The infiltration sensor 130b transmits physiological data 128b indicating infiltration of fluid leaking from the vein into the surrounding tissue. The transceiver at the hemodynamic management device 106 is configured to receive the physiological data 128b for use in determining when to activate an alarm or warning indicating that an infiltration was detected. In some embodiments, the hemodynamic management device 106 enables the clinician to specify which IV lines are associated with which infiltration sensors 130b so that the correct lines are highlighted on the display interface screen 124 when an infiltration is detected.

[0091] Back to Figure 1The gateway server 114 includes a controller, a processor, a router, a switch, a computer, etc., which is configured to communicate with the infusion pump 102, the RFT machine 104, and the hemodynamic management device 106 via a network 112 (e.g., a wide area network, a local area network, a wireless local area network, an Ethernet, the Internet, a cellular network, or a combination thereof). The gateway server 114 can be communicatively coupled to more than one infusion pump, RFT machine, and / or hemodynamic management device. In addition, the gateway server 114 can communicate with other medical devices (such as physiological sensors 130). The gateway server 114 is configured to provide two-way communication with the infusion pump 102 for wired / wireless secure transmission of drug libraries, infusion prescriptions, and infusion therapy progress data 116. The gateway server 114 may also be configured to integrate with a hospital information system to send infusion therapy progress data 116 from the infusion pump 102 and / or dialysis therapy progress data 119 from the RFT machine 104 to the hospital electronic medical record (“EMR”) managed by an EMR server 118 .

[0092] The example EMR server 118 is configured to manage the EMRs of patients stored in the EMR database 132. The EMR server 118 receives data 116 and 119 from the medical devices 102 and 104, respectively, and uses the machine identifier and / or patient identifier associated with the data to determine the corresponding patient EMR. The EMR server 118 is configured to write the data 116 and 119 to the appropriate patient EMR within the database 132, thereby providing a record accessible to the hemodynamic management device 106.

[0093] Additionally, the EMR server 118 is configured to store physiological data 128 from one or more sensors 130 to the patient's EMR. The physiological data 128 may be received directly from the sensors 130 and / or from one or more of the infusion pump 102, the RFT machine 104, and / or the hemodynamic management device 106. The EMR server 118 may also store the infusion and / or RFT prescription to the appropriate patient EMR.

[0094] Figure 1Also shown is a clinician device 140 connected to the EMR server 118 and another clinician device 142 communicatively coupled to the network 142. The clinician device 140 may be located behind a firewall or gateway server 114 and may access the EMR server 118 without authentication. The clinician device 142 may be located outside the hospital network 112 and may need to be authenticated to communicate with the EMR server 118, the infusion pump 102, and / or the hemodynamic management device 106. The clinician devices 140 and 142 enable the clinician to enter an infusion prescription and / or a dialysis / RFT prescription, which is transmitted to the EMR server 118 for storage in the patient's EMR. The electronic prescription is also sent by the gateway server 114 to the appropriate medical devices 102, 104.

[0095] In some embodiments, the hemodynamic management device 106 is configured to provide access to the clinician devices 140, 142. During the connection, the hemodynamic management device 106 can cause the clinician device 140, 142 to display the current view shown on the display interface screen 124. Additionally or alternatively, the hemodynamic management device 106 can cause the clinician device 140, 142 to select a desired interface screen, for example, to view trends in hemodynamic parameters over time, perform hemodynamic assessments remotely, and / or view the patient's fluid balance.

[0096] Figure 3 1 is another diagram of a hemodynamic management system 100 according to another example embodiment of the present disclosure. In this example, the RFT machine 104 has been replaced with a fluid output sensor 302, which may include a urine sensor or a sensor that measures other fluid 306 discharged from the patient. The fluid output sensor 302 sends fluid output data 304 to the gateway server 114 for routing to the EMR server 118, which stores the data 304 to the patient's EMR. The fluid output data 304 indicates, for example, the total amount of fluid removed and / or the rate of fluid removal. In other examples, the fluid output sensor 302 is communicatively coupled to the infusion pump 102 and / or the hemodynamic management device 106.

[0097] Figure 3An additional infusion pump is also shown so that both infusion pumps 102a and 102b are fluidly coupled to the patient. Infusion pump 102a is configured to infuse a first fluid 111a to the patient and send first infusion therapy progress data 116a to the gateway server 114 and / or the hemodynamic management device 106. Additionally, infusion pump 102b is configured to infuse a second fluid 111b to the patient and send second infusion therapy progress data 116b to the gateway server 114 and / or the hemodynamic management device 106. The fluid IV lines of infusion pumps 102a and 102b can be connected together so that only one patient access point is required. Alternatively, the fluid IV lines from infusion pumps 102a and 102b can be connected to separate patient access points.

[0098] The first and second fluids 111a and 111b may be different fluids and include drugs or medicines, such as dopamine. The first and second fluids 111a and 111b may also include saline, platelets, lipids, contrast agents, dialysate, and / or parenteral nutrition. It should be understood that the fluids 111a and 111b may include any solution capable of being infused into a patient.

[0099] Figure 3 The system 100 is also shown to include a drug library server 310 and a corresponding database 312. The drug library server 310 is configured to manage a drug library file 314 that specifies, for example, hard and soft limits for infusion of a particular fluid. The drug library file 314 is provided to the infusion pumps 102a and 102b via the drug library server 310 to ensure that the infusion parameters of the infusion prescription (or the infusion parameters entered at the pump) are within clinically acceptable limits. In some embodiments, the drug library file 314 specifies different limits based on patient weight, gender, race, age, nursing area, etc.

[0100] In some embodiments, the drug library file 314 also specifies fluid type to fluid type incompatibilities and / or fluid type to access point incompatibilities. Fluid type to fluid type incompatibilities can specify, for example, fluids that cannot be infused into a patient during the same treatment or within a certain period of time relative to each other. Fluid type to fluid type incompatibilities can also specify which fluids cannot be combined together via an intravenous infusion line upstream of an access point. For example, the drug library file 314 can specify that dopamine and sodium bicarbonate cannot be combined together for a common access point. In another example, fluid type to access point incompatibilities can specify that saline should not be administered to certain veins, such as finger veins. Incompatibilities can be based on critical care intravenous administration guidelines and / or Y-type intravenous infusion compatibility guidelines.

[0101] In the illustrated embodiment, the drug library file 314 may also be sent by the drug library server 310 to the hemodynamic management device 106 via the gateway server 114. Alternatively, the hemodynamic management device 106 may obtain the drug library file 314 using a known address of the drug library server 310. As discussed in more detail below, the hemodynamic management device 106 is configured to use the drug library file 314 to perform fluid type to fluid type incompatibility checks and / or fluid type to access point incompatibility checks as part of infusion line management.

[0102] Hemodynamic Management Device Installation Example

[0103] As above combined Figure 3 As discussed, the hemodynamic management device 106 may be physically connected to a hub device that houses one or more infusion pumps 102 . Figure 4 is configured to connect to Figures 1 to 3 FIG. 4 is a diagram of a hub device 400 for a hemodynamic management device 106 and an infusion pump 102. In the illustrated example, the hub device 400 is a frame for supporting the hemodynamic management device 106 in conjunction with the infusion pumps 102a, 102b, 102c, and 102d. The hub device 400 can be configured to stand on the floor or a tabletop. Alternatively, the hub device 400 can be connected to a patient's bed or pole via at least one clip.

[0104] The hub device 400 includes a communication module 402 that is communicatively coupled to the hemodynamic management device 106 and the infusion pumps 102a, 102b, 102c, and 102d via a CAN connection, a USB connection, and / or a local wireless connection (such as Wi-Fi or Bluetooth®). In the illustrated example, the pumps 102a to 102d are syringe pumps. In other embodiments, the hub device 400 can be connected to a large volume pump, a syringe pump, or a combination of a syringe pump and a large volume pump. Thus, the hub device 400 is configured to be able to connect different combinations of pumps 102 based on an infusion schedule prescribed for a patient. In addition, although Figure 4 Four pumps 102a - 102d are shown, but the hub apparatus 400 can include as few as one pump and as many as twelve pumps.

[0105] The example pumps 102a-102d are connected to the hub device 400 via respective racks. The hemodynamic management device 106 may be connected to the hub device 400 using an adapter placed on one or more of the racks. The adapter is configured to slide over, for example, two racks to provide improved support for the hemodynamic management device 106. The illustrated embodiment enables a hemodynamic management device 106 having a display interface screen 124 of between 8 inches and 12 inches to be placed over or between a stack of infusion pumps 102. The relatively larger size of the display interface screen 124 enables more data to be displayed for infusion line management and hemodynamic management.

[0106] Figure 5 A hemodynamic management device 106 having a hemodynamic management device 106 placed near a communication module 402 according to an exemplary embodiment of the present disclosure Figure 4 4. In this example, the communication module 402 includes an adapter or stage 502 for receiving the hemodynamic management device 106. Placing the hemodynamic management device 106 on top of the hub device 400 enables more pumps 102a-c to be connected to the stack and improves visibility of the display interface screen 124.

[0107] In some embodiments, the communication module 402 is configured to provide local communication between the hemodynamic management device 106 and the infusion pump 102. The hub device 400 may include individually addressed communication ports at each shelf location. When the hemodynamic management device 106 or the infusion pump 102 is connected to the hub device 400, the communication module 402 is configured to associate a pump identifier (e.g., a media access control address (“MAC”)) with the communication port. This association enables the hub device 400 to determine which infusion pump 102 is located in which shelf or module. In addition, the processor 120 of the hemodynamic management device 106 is configured to register or pair with the communication module 402 using the corresponding communication port. Registration of the hemodynamic management device 106 with the communication module 402 enables the communication module 402 to send the infusion therapy progress data 116 (e.g., messages and events) received from the infusion pump 102 to the hemodynamic management device 106. The communicative coupling also enables the processor 120 of the hemodynamic management device 106 to send commands, such as a command to perform a bolus, to the appropriate infusion pump 102 either directly or through the communications module 402 .

[0108] The example communication module 402 is also configured to be communicatively coupled to a gateway server 114 via the network 112. Infusion therapy progress data 116 from the infusion pump 102 is sent to the gateway server 114 for storage in the appropriate patient's medical record within the EMR database 132. In addition, the hemodynamic management device 106 can communicate with the gateway server 114 via the communication module 402 of the hub device 400. As such, the communication module 402 is configured as a network access point and router / switch for the infusion pump 102 and the hemodynamic management device 106.

[0109] Figure 6 is another diagram of a hub device 400 having an elongated version of the hemodynamic management device 106 according to an example embodiment of the present disclosure. In the illustrated example, the hemodynamic management device 106 includes a smaller display interface screen that enables the hemodynamic management device 106 to fit within the housing of the hub device 400 without the need for a special adapter. The hemodynamic management device 106 is configured to occupy approximately the same space as the infusion pump 102.

[0110] In some embodiments, the hemodynamic management device 106 includes a wireless transceiver 602 that communicates with the processor 120. The wireless transceiver 602 may include a Wi-Fi® transceiver, a Bluetooth® transceiver, etc. The wireless transceiver 602 is configured to be communicatively coupled to a clinician device 140, 142, which may have a relatively large screen. The clinician device 140, 142 may communicate directly with the hemodynamic management device 106 or indirectly via the network 112. This configuration enables the clinician device 140, 142 to display one or more interfaces managed by the application 126 of the hemodynamic management device 106. In addition, the clinician device 140, 142 can send commands, such as commands to perform a bolus infusion for hemodynamic assessment and / or commands to remotely cause the hemodynamic management device 106 to instruct the appropriate pump 102 to perform the commanded infusion. The clinician devices 140, 142 may also enable the clinician to remotely change infusion parameters or remotely silence warnings / alarms using the line management interface.

[0111] Figure 7 700 is a diagram of a hemodynamic management device 106 connected to a pole 700 according to an example embodiment of the present disclosure. In this embodiment, the pole 700 is configured to solely support the hemodynamic management device 106. The pole 700 can be floor mounted or set on a table. The hemodynamic management device 106 can be communicatively coupled to the infusion pump 102, the RFT machine 104, and / or the fluid output sensor 302 via the gateway server 114 and / or the network 112.

[0112] Hemodynamic Management Device Configuration Example

[0113] Figure 8 A diagram showing an example embodiment according to the present disclosure is used to configure Figures 1 to 7 Flow chart of an example process 800 of the hemodynamic management device 106. The example process 800 may be performed by, for example, combining Figures 1 to 3 The application 126 and / or processor 120 described herein executes. Although reference Figure 8 The flowchart shown in describes process 800, but it should be understood that many other methods may be used to perform the functions associated with process 800. For example, the order of many blocks may be changed, some blocks may be combined with other blocks, and many of the blocks described are optional.

[0114] The process 800 begins by providing a patient with an entry point for the hemodynamic management device 106 (block 802). This may include attaching the hemodynamic management device 106 to the hub device 400 or otherwise moving the hemodynamic management device 106 to the patient's room. Next, the hemodynamic management device 106 enables the clinician to perform a patient setup routine to associate the patient (block 804). This step can include scanning a patient wristband using a barcode scanner, entering a patient identifier into a registration interface of the hemodynamic management device 106, or searching for the patient within the EMR database 132 using a search interface of the application 126 (block 806).

[0115] For barcode scanning embodiments, a barcode scanner may be connected to the hemodynamic management device 106. In this case, the hemodynamic management device 106 prompts the patient to scan the patient barcode or wristband, which causes the processor 120 to associate the scanned patient identifier with the hemodynamic management device 106. Alternatively, the barcode scanner may be attached to a separate on-board computer or other device. In these embodiments, the hemodynamic management device 106 is configured to display a barcode or quick response ("QR") on the display interface screen 124. The code indicates the identifier of the hemodynamic management device 106. The hemodynamic management device 106 may prompt the clinician to scan a code in addition to the barcode on the patient's wristband. Scanning the code on the display interface screen 124 and the patient's wristband causes the on-wheel computer or other device to write the scanned identifiers of the hemodynamic management device 106 and the patient to the patient's EMR at the EMR database 132. The processor 120 of the hemodynamic management device 106 then reads the EMR at the database 132 to search for its identifier. After the processor 120 locates the identifier of the hemodynamic management device 106, the processor 120 reads the associated patient identifier. At this point, the processor 120 has associated the hemodynamic management device 106 with the patient and has determined the EMR to which the medical devices 102 and 104 are to write the data 116 and / or 119.

[0116] It should be understood that when the hemodynamic management device 106 is connected to the same hub device 400 as the infusion pump 102, patient identification is not necessarily required. In this case, the infusion therapy progress data 116 sent by the infusion pump 102 within the hub device 400 is automatically routed to the hemodynamic management device 106 without relying on a patient identification match. Alternatively, the common connection to the hub device 400 indicates that the hemodynamic management device 106 and the infusion pump 102 are associated with the same patient. However, patient identification may still be required to enable the hemodynamic management device 106 to write the patient's EMR into the database 132.

[0117] In an alternative embodiment, the hemodynamic management device 106 is configured to display a registration interface such as Fig. 9 . As shown, the registration interface 900 is displayed by the application 126 on the display interface screen 124 and prompts the clinician to enter a patient identifier, age, gender, height, weight, and body mass index. The entry of the patient identifier causes the application 126, or more generally the processor 120, to search the EMR database 132 for the corresponding patient EMR. When the patient identifier is unknown, the registration interface 900 may include an option to search the EMR database 132 for the patient identifier using, for example, the patient's name, room number, date of birth, social security number, etc.

[0118] Back to Figure 8 , at which point the hemodynamic management device 106 is associated with the particular patient. The application 126 of the hemodynamic management device 106 next displays a dashboard (block 808) that enables the clinician to set up or configure the sensor 130 for fluid / hemodynamic management and / or add an infusion pump 102 for line management. When the sensor option is selected, the application 126 performs a sensor setup routine (block 810). The routine may include pairing with one or more sensors 130 discussed above. In some embodiments, the sensor module 202 is used to set up or configure the sensor 130.

[0119] After setting up the sensor 130, the application 126 enables the clinician to start a new hemodynamic assessment (box 812). This option includes selecting an assessment type (box 814), such as a PLR assessment, a bolus assessment, or an automatic bolus assessment (box 816). When a PLR assessment is selected, the application 126 determines a PLR baseline using the physiological data 128 from the sensor 130. The application 126 then prompts the clinician to start a PLR assessment and record the corresponding physiological data 128 from the sensor 130. When a bolus assessment is selected, the application 126 determines a bolus baseline using the physiological data 128 from the sensor 130. The application 126 then prompts the clinician to start a bolus assessment and record the corresponding physiological data 128 from the sensor 130. For an automatic bolus, the application 126 can automatically send a command to the appropriate infusion pump 102 with the instructions and parameters to perform the bolus.

[0120] Returning to block 808, when the clinician selects the infusion management option, the application 126 is configured to display a line management interface that enables the clinician to add a pump. This operation includes displaying one or more line management interfaces (block 820) and associating at least some of the infusion therapy progress data 116 with a designated pump graphic or icon. The process of adding an infusion pump will be combined with Fig.10 After configuring the hemodynamic management device 106, the example process 800 ends.

[0121] In some embodiments, the application is configured to automatically add the infusion pump when the hemodynamic management device 106 and the infusion pump 102 are connected to the hub device 400. In these embodiments, when each infusion pump 102 is programmed, the pump sends the infusion therapy progress data 116 (including the start event) to the hub device 400, which is routed to the processor 120 of the hemodynamic management device 106. The application 126 uses at least some of the information in the infusion therapy progress data 116 to create a graphic or icon for the infusion pump 102 that displays, for example, the fluid name / type, the infusion rate, the dose, and / or information indicating the remaining amount to be infused or the estimated remaining time before the fluid container is empty. In this embodiment, the application 126 only prompts the clinician to specify the patient's access point. Alternatively, when the infusion pump 102 includes access point programming parameters, the application 126 also automatically determines the access point information, which can be included in the infusion therapy progress data 116.

[0122] In some cases of these embodiments, the application 126 is configured to arrange the graphical display of the infusion pumps within the pipeline management interface based on the stacking position within the hub device 400. In these cases, the communication module 402 can indicate the shelf position or stack height of each infusion pump 102 based on the known communication port to which each pump is connected. Such a configuration provides a graphical layout of the infusion pumps 102 that matches the actual position within the hub device 400, which makes it easier for clinicians to quickly identify a certain infusion pump 102, such as an infusion pump associated with an alarm or warning. In these examples, the display interface screen 124 can show the infusion pump (or container) icons relative to the graphics of the hub device 400, or relative to each other based on the position within the hub device 400.

[0123] Fig.10 A diagram showing an example embodiment according to the present disclosure is used by Figures 1 to 7 Flow chart of an example process 1000 for fluid line management performed by the hemodynamic management device 106 of FIG. The example process 1000 may be performed by, for example, combining Figures 1 to 3 The application 126 and / or processor 120 described herein executes. Although reference Fig.10 The flowchart illustrated in describes process 1000, but it should be understood that many other methods may be used to perform the functions associated with process 1000. For example, the order of many blocks may be changed, some blocks may be combined with other blocks, and many of the blocks described are optional.

[0124] The example process 1000 begins when the hemodynamic management device 106 is associated with a patient, such as in conjunction with Figure 8The process 800 described in . At this point, the clinician can set up the infusion pump 102 to perform the infusion therapy. The setup includes ordering fluids via the patient's EMR in the database 132, fulfilling the order, and hanging the fluid container associated with the order near the infusion pump 102 in the patient's room. The setup also includes connecting the IV tubing or IV line set to the fluid container and starting the IV tubing or IV line set. Next, the IV line set or IV tubing is loaded into the infusion pump 102 and connected to the patient's access point. Then, the clinician programs the infusion pump 102 to administer the treatment. Programming can include manually entering infusion parameters (such as fluid name, dosage, amount to be infused, and / or infusion rate) into the interface 108, 110 at the infusion pump 102. Programming can also include scanning a label or barcode on a fluid container, which includes programming parameters that are automatically programmed into the infusion pump. Programming can also include scanning a pump barcode and / or a patient barcode, so that the electronic prescription in the patient's EMR is sent to the infusion pump 102. After programming, the infusion pump 102 compares the programmed parameters to the limits in the drug library file 314 and generates a warning / alarm when at least one limit is exceeded. In some embodiments, after programming, the infusion pump 102 sends the infusion therapy progress data 116 including a new infusion start event to the EMR server 118 for storage in the patient's EMR. The new infusion start event can include information indicating the infusion pump identifier, the infusion fluid name, the infusion rate, the amount to be infused, the dose, the amount remaining, and / or the time when the new infusion start event was generated by the infusion pump 102.

[0125] The process 1000 continues with the hemodynamic management device 106 next using the patient association to access the patient's EMR to determine that a new infusion start event has occurred (block 1002). The hemodynamic management device 106 may additionally be configured to scan the patient's EMR or listen for new start events via the hub device 400. The hemodynamic management device 106 may use the timestamp of the event to determine that the event is new and that the infusion pump 102 is ready to start (or has started) an infusion. Alternatively, the new infusion start event may be sent to the hemodynamic management device 106 via the hub device 400.

[0126] The hemodynamic management device 106 next displays the infusion line mapping interface (block 1004 ). Fig.111 is a diagram of an example infusion line mapping interface 1100 that may be displayed by the display interface screen 124 of the hemodynamic management device 106. The infusion line mapping interface 1100 displays a graphical representation of a human body in conjunction with graphical representations or icons 1102 of fluids infused into a patient via a line set. Each icon 1102 indicates the amount of fluid remaining in a fluid container or the estimated time remaining before a fluid container, as reported by the corresponding infusion pump 102 via the infusion therapy progress data 116. Each icon 1102 also includes a fluid name, an infusion rate, and a dose. Each icon 1102 may be associated with a corresponding infusion pump identifier.

[0127] In the illustrated example, after the hemodynamic management device 106 detects a new infusion start event, an icon 1102 is created for display. Fig.10 As noted, the infusion line mapping interface 1100 prompts the clinician to specify an access point for the infusion (block 1006). This may include displaying a drop-down list of possible access points or displaying possible access points on a graphical representation of a person within the interface 1100 for selection.

[0128] After receiving the selection of the access point, the hemodynamic management device 106 is configured to perform an infusion point compatibility check (block 1008). This may include using the fluid type-access point list within the drug library file 314 to determine whether the specified fluid type is allowed to be infused into the patient at the selected access point. In some embodiments, the hemodynamic management device 106 actively performs a compatibility assessment by using the fluid type-access point compatibility check within the drug library file 314 to filter possible access points for selection based on known fluid types.

[0129] like Fig.10 As shown, when there is a compatibility issue, the hemodynamic management device 106 displays a warning and prompts the clinician to select an alternative access point in the infusion line mapping interface 1100 (block 1010). The hemodynamic management device 106 then receives a selection of a second different access point (block 1012). The hemodynamic management device 106 may perform another compatibility check on the second access point.

[0130] The hemodynamic management device 106 also determines when more than one fluid is to be injected into an access point (block 1014). Fig.11As shown, furosemide, lipids, platelets, dexmedetomedine, and midazolam are fluidly connected to the same access point. To make the fluid connections, the clinician can use a series of Y-connectors or T-connectors. If more than one fluid is injected into the access point, the hemodynamic management device 106 is configured to perform a fluid type and fluid type incompatibility check (box 1016). It should be understood that the incompatibility check determines whether certain fluid types can be mixed before injection into the patient. The drug library file 314 also provides a general fluid type incompatibility list that specifies which fluid types cannot be injected into the patient at the same time or within a certain duration, regardless of the use of different access points. It should be understood that the hemodynamic management device 106 is configured to perform access point-specific compatibility checks and general fluid checks.

[0131] To check the compatibility of multiple fluids for an access point, the hemodynamic management device 106 is configured to determine other fluid types associated with a given access point. The hemodynamic management device 106 then determines whether the other determined fluid types are listed in the incompatibility section for the given fluid type within the drug library file 314. When there is an access point-specific compatibility issue, the hemodynamic management device 106 displays a warning and prompts the clinician to select an alternative access point within the infusion line mapping interface 1100 (block 1010). The warning may include displaying the incompatible infusion with a red or yellow icon 1102, such as Fig.12 as shown. The hemodynamic management device 106 then receives a selection of a second, different access point (block 1012). In some embodiments, the hemodynamic management device 106 may proactively determine access points that are compatible with the new fluid type and provide a recommendation via the infusion line mapping interface 1100. In some embodiments, the hemodynamic management device 106 is configured to first search for access points that already have infusion connections. When a compatible currently in-use access point is not found, the hemodynamic management device 106 is configured to identify an access point that requires a new needle access. When other fluid types are being infused into the second access point, the hemodynamic management device 106 may perform another compatibility check on the second access point selected by the user.

[0132] To perform a general fluid compatibility specific check, the hemodynamic management device 106 is configured to determine other fluid types specified within the infusion line mapping interface 1100. The hemodynamic management device 106 may also check the patient's EMR for past infusions. The hemodynamic management device 106 then determines whether the other determined fluid types are listed in the incompatibility section for a given fluid type within the drug library file 314. When there is a general fluid type compatibility issue, the hemodynamic management device 106 is configured to display a warning indicating that the selected fluid type cannot be administered because other fluids are being administered. The warning may indicate the specific fluid that caused the patient's incompatibility. The hemodynamic management device 106 may also specify the reason for the incompatibility. In some cases, the hemodynamic management device 106 sends a warning or alarm to the corresponding infusion pump 102, thereby preventing the infusion pump 102 from performing the treatment. In addition, the hemodynamic management device 106 may send a warning or alarm to the clinician devices 140, 142.

[0133] like Fig.10 As shown, when the compatibility check indicates that there are no incompatibility issues, the hemodynamic management device 106 is configured to associate the selected access point within a given infusion pump (block 1018). The hemodynamic management device 106 may update a table or other data structure (e.g., data structure 127) that associates the access point with the icon 1102 and the infusion pump. The table or data structure 127 may be stored in the memory device 122 of the hemodynamic management device 106 and provides a correspondence between infusions, fluid types, and access points. After association, the hemodynamic management device 106 displays information associated with the new infusion start event at the selected access point in the infusion line mapping interface 1100 (block 1020). Fig.11 As shown, this includes displaying an icon 1102 with information indicating the amount of fluid remaining in the fluid container, a graphic showing the connection between the icon 1102 and the access point, the fluid type name, and the infusion rate and dose. In some embodiments, an identifier for the infusion pump may also be displayed. When a given fluid type is connected to other fluid types of the access point, the infusion line mapping interface 1100 shows the infusion lines connected together before connecting to a single line to the access point. The clinician can then press a "Start" button on the newly added infusion pump to begin therapy. Alternatively, the hemodynamic management device 106 can transmit a message to the newly added infusion pump 102 indicating that it is able to begin infusion therapy. Return Fig.10 The example process 1000 continues when the hemodynamic management device 106 detects or otherwise receives another infusion start event.

[0134] In some embodiments, the infusion line mapping interface 1100 enables clinicians to quickly identify which infusion pump is associated with each infusion represented by a corresponding graphical icon. For example, selecting the graphical icon 1102 may cause the application 126 to display additional information about the infusion pump 102 and / or the infusion. The additional information can include an infusion pump identifier, the amount to be infused, the infusion rate, and / or the name of the infusion fluid. The additional information may also include an option to ping the infusion pump 102. Selecting the ping option causes the application 126 to send a message to the infusion pump 102, which causes the infusion pump 102 to emit a sound, flash the display screen 108, or otherwise display a graphical / visual indication of the selected pump. The message can be sent directly to the infusion pump via the hub device 400, or sent to the infusion pump 102 via the gateway server 114.

[0135] Fig.11 It is also shown that the application 126 can be configured to calculate a cumulative infusion rate. The application 126 adds each infusion rate displayed in the interface 1100. The cumulative infusion rate is then displayed, and the cumulative infusion rate can indicate the patient's total fluid intake. The interface 1100 also includes hemodynamic parameters, including SVI, CO, and heart rate. These parameters can be determined based on physiological data 128 sent by one or more sensors 130 coupled to the hemodynamic management device 106. Therefore, in addition to displaying information indicating fluid balance or intake and hemodynamic information, the infusion line mapping interface 1100 also provides infusion line management.

[0136] Example Hemodynamic Patterns

[0137] Fig.13 is a diagram showing an example embodiment of the present disclosure according to which input Figures 1 to 7 1 and 2. The physiological data 128 corresponds to hemodynamic parameters displayed by the hemodynamic management device 106. In some embodiments, the physiological data 128 is processed by the hemodynamic management device 106 to determine other hemodynamic parameters, such as CI, SVI, and / or TPRI.

[0138] Physiological data 128 may be received from one or more sensors 130. As shown, the physiological data 128 may include cardiac output, stroke volume, blood pressure cuff measurements, SpO2 values, heart rate, heart rate variability, patient temperature, arterial line measurements (including MAP, SVV, and / or PPV), ECG 2-lead measurements, ECG 3-lead measurements, respiratory rate, EtCO2 measurements, tidal volume, infiltration detection signals, pleural fluid content measurements, PVP and / or bioimpedance fluid status, urine output measurements, intra-abdominal pressure values, continuous non-invasive blood pressure, continuous glucose and / or lactate measurements, continuous electrolyte measurements, continuous hematocrit measurements, central venous pressure measurements, blood gas measurements, ejection fraction measurements, ultrafiltration measurements or estimates, and / or fluid output measurements.

[0139] The example hemodynamic management device 106 is configured to use the physiological data 128 within one or more hemodynamic modes provided by the application 126. Fig.12 As shown, the modes can include hemodynamic assessment, including PLR, bolus, and / or auto-bolus. The modes also include hemodynamic parameter display and trending, overall fluid balance management, and / or guided hemodynamic therapy associated with vasopressors, inotropes, and / or CRRT fluid removal. The modes also include providing early detection of sepsis, acute kidney injury ("AKI"), and hemodynamic instability. With respect to fluid management, the modes include infiltration detection, patient association, IV line management, relay control, medication timer management, and fluid story management.

[0140] Fig.14 According to an exemplary embodiment of the present disclosure, Figures 1 to 7The application 126 of the hemodynamic management device 106 displays a diagram of a hemodynamic dashboard interface 1400 on the display interface screen 124. The hemodynamic dashboard interface 1400 includes sections for fluid responsiveness / assessment, infusion status, and fluid balance. The fluid responsiveness section indicates that the last hemodynamic bolus assessment was performed 4 hours and 15 minutes ago, where the ASYI has increased by 12.3% since the assessment. The infusion status indicates the total fluid infusion rate in addition to indicating that a new infusion line has been detected. The fluid balance section indicates that the 12-hour fluid balance is +120 milliliters ("mL"), with the most recent change in the past hour being +60 mL. As discussed in more detail below, selecting a section causes the application 126 to open another interface. The hemodynamic dashboard interface 1400 also includes a hemodynamic parameter section, including heart rate, CO, SVI, and TPRI. The SVI and TPRI parameter values ​​can be determined by one or more calculations or comparisons of the physiological data 128. It should be appreciated that in other embodiments, additional or fewer hemodynamic parameters may be displayed in the dashboard interface 1400. The hemodynamic dashboard interface 1400, and the hemodynamic management device 106 more generally, thus integrates hemodynamic monitoring and therapy monitoring to provide safer, more effective, personalized therapy to hospital patients during the patient's hospital stay.

[0141] Fluid Responsiveness Examples

[0142] Fig.15 A diagram of fluid responsive interfaces 1502, 1504, 1506, and 1508 that may be displayed by the application 126 of the hemodynamic management device 106 according to an example embodiment of the present disclosure is shown. The fluid responsive interfaces 1502, 1504, 1506, and 1508 are configured to provide hemodynamic assessment in conjunction with displaying hemodynamic parameters including, for example, SVI, CI, and heart rate.

[0143] In clinician choice Fig.14 1404 . After selecting the fluid responsiveness portion of the dashboard interface 1400 and then selecting to perform a PLR assessment, a first fluid responsiveness interface 1502 may be displayed. The fluid responsiveness interface 1502 includes a prompt to perform a PLR. After the patient is positioned, selecting the "Next" option causes the application 126 to start a timer while the PLR ​​assessment is ongoing, as shown in fluid responsiveness interface 1504. Prior to the PLR ​​assessment, the application 126 may store baseline hemodynamic parameter values, and then after the assessment begins, the application 126 summarizes or tracks new hemodynamic parameter values. The application 126 continues the assessment, as shown in fluid responsiveness interface 1506, until the timer expires. The application 126 then displays a fluid responsiveness interface 1508 showing information indicative of fluid responsiveness, as determined based on measured or calculated hemodynamic parameters.

[0144] This includes, for example, percent change in SVI, fluid rate, and type of fluid used for the assessment. In this manner, the application 126 of the hemodynamic management device 106 provides real-time clinical decision support regarding patient fluid responsiveness. Fig.16 The hemodynamic dashboard interface 1400 is shown after a hemodynamic assessment has been performed. The fluid responsiveness section indicates the time since the last assessment and the option to perform a new assessment via PLR or bolus.

[0145] It should be understood that, for example, when the bolus option is selected in the hemodynamic dashboard interface 1400, the application performs similar operations for the bolus hemodynamic assessment. In some cases, the application 126 includes a prompt that enables the clinician to indicate when the bolus begins. Alternatively, the application 126 is configured to detect a bolus start event via the infusion line mapping interface 1100 and the corresponding data structure, which triggers the display of the assessment interface and the hemodynamic assessment tracking. In another alternative embodiment, the application 126 can send an instruction via the hub device 400 or the gateway server 114 to cause the designated infusion pump 102 to administer the bolus. The instruction can identify the infusion pump, the start bolus instruction, and the bolus duration. In this way, the application 126 itself initiates the fluid-responsive hemodynamic assessment.

[0146] Fig.17 1 is a diagram of an assessment interface 1700 showing the status of a bolus hemodynamic assessment according to an example embodiment of the present disclosure. The assessment interface 1700 includes a bolus duration, a completion percentage, a fluid type, and a fluid rate. The application 126 can receive information indicating a completion percentage, a fluid type, and / or a rate from the infusion therapy progress data 116 generated by the corresponding infusion pump 102.

[0147] Fig.18is a diagram of a fluid responsive interface 1800 that may be displayed by the application 126 of the hemodynamic management device 106 after a hemodynamic assessment has occurred or is ongoing according to an example embodiment of the present disclosure. The fluid responsive interface 1800 shows trends of SVI, CI, and heart rate over time, including a baseline prior to the hemodynamic assessment. It should be understood that the fluid responsive interface 1800 may include additional or fewer hemodynamic parameters. The fluid responsive interface 1800 also highlights a portion of the trend data corresponding to the hemodynamic assessment, which highlights how the hemodynamic parameters respond to the assessment. The fluid responsive interface 1800 also includes features that allow the clinician to change the time scale of the trend data between fifteen minutes, one hour, four hours, twelve hours, twenty-four hours, forty-eight hours, etc. The fluid responsive interface 1800 can provide real-time, continuous information about heart rate, cardiac index, cardiac output, stroke volume index, stroke volume, and / or total peripheral resistance accordingly.

[0148] In addition, although Fig.18 Hemodynamic parameters are shown, but it should be understood that the application 126 is configured to provide an interface that displays values ​​of other physiological data 128 and / or physiological trends, which can be displayed in conjunction with infusion or fluid balance trends. For example, heart rate, SVI, and blood pressure can be displayed in conjunction with a specific infusion rate or infusion amount, cumulative infusion rate / infusion amount, and / or net fluid balance rate / amount.

[0149] Infusion state embodiment

[0150] Fig.14 The illustrated hemodynamic dashboard interface 1400 also includes an infusion status section. The application 126 is configured to detect alarms and / or warnings within the infusion therapy progress data 116 or the physiological data 128. The alarms or warnings may indicate an infiltration, a line blockage, a pump or IV line leak, an empty or nearly empty bag, or that the physiological data 128 exceeds one or more physiological limits (e.g., a heart rate exceeding 125 beats per minute). When the application 126 detects an alarm and / or warning, the application 126 is configured to update the hemodynamic dashboard interface 1400. Fig.19 is a diagram of a hemodynamic dashboard interface 1400 in which an infusion status portion is changed to indicate an indication or an alarm or warning according to an example embodiment of the present disclosure.

[0151] Specifically, in this embodiment, the infusion status portion indicates that at least one bag or fluid container is nearly empty. The clinician can select the infusion status portion of the hemodynamic dashboard interface 1400, which causes the application 126 to display the infusion line mapping interface 1100, such as Fig. 20As shown. The application 126 highlights the IV line and graphic icon 2002 associated with the bag near empty warning. In some embodiments, the application 126 provides the highlight by changing the color from blue / gray to yellow. The bag empty can be displayed in red. The graphic icon 2002 is also changed to display an estimated amount of fluid remaining in the fluid container or an estimated time until the fluid container is empty. The application 126 can also display a value indicating the remaining time. Selecting the graphic icon 2002 can cause the application 126 to send a command to the corresponding infusion pump 202 to make it sound or flash a light or screen, or display other indications indicating which infusion pump 202 corresponds to the warning / alarm. In other cases, the display 108 of the infusion pump 102 may already display information indicating the warning / alarm. The alarm / warning can be eliminated by changing the bag and having the barcode scanner scan the new bag or entering the infusion pump 102 to which the new bag has been added. Thus, the application 126 detects the change of the bag in the corresponding event data of the infusion therapy progress data 116 stored in the patient's EMR within the database 132 or sent to the hemodynamic management device 106 via the hub device 400 .

[0152] Fig.21 is a diagram of a hemodynamic dashboard interface 1400 displaying a warning indication associated with the detection of an infiltration. The application 126 can be based on Figure 2 The alert may identify the access point associated with the corresponding one or more infusions. In this example, the alert within the hemodynamic dashboard interface 1400 indicates that an infiltration was detected at the right antecubital access point. Selecting the infusion status portion of the hemodynamic dashboard interface 1400 causes the application 126 to display the infusion line mapping interface 1100, such as Fig. 22 Here, the application highlights the IV line connected to the problematic access point and indicates an infiltration warning. The clinician can eliminate the warning by fixing the access point connection or clearing the warning after determining that no infiltration has occurred.

[0153] Fluid Balance Example

[0154] Fig.14 The hemodynamic dashboard interface 1400 also includes a fluid balance section. Selecting this section causes the application 126 to display the fluid balance interface 2300, such as Fig.23As shown. The fluid balance interface 2300 provides a summary of the fluid injected and the fluid removed detected within a specified time period (such as one hour, four hours, eight hours, twelve hours, twenty-four hours, forty-eight hours, seventy-two hours, etc.). The injected fluid is determined by summing or combining the individual infusion rates displayed in the infusion line mapping interface 1100. The removed fluid can be determined from the RFT machine 104, the fluid output sensor 302 and / or any other sensor 130 configured to measure the fluid removed from the patient. The application 126 is also configured to determine output data from the fluid of the patient EMR within the database 132. In some embodiments, the fluid balance interface 2300 can enable a clinician to manually enter a fluid input amount or a fluid output amount. In addition, in the embodiment shown, the fluid balance interface 2300 provides an indication of the fluid assessment relative to the fluid balance.

[0155] Fig.24 is a diagram of a detailed net fluid balance interface 2400 according to an example embodiment of the present disclosure. The net fluid balance interface 2400 provides a fine-grained list of each fluid input to the patient, as determined from the infusion line mapping interface 1100 and / or manually entered by the clinician. In addition, the net fluid balance interface 2400 provides a list of fluids removed, as detected by different sources including the RFT machine 104, the fluid output sensor 302, and the drain sensor. In addition, the clinician can manually enter information indicating the drained fluid. The net fluid balance interface 2400 is capable of monitoring the total input fluid and the total output fluid as well as the current infusion information. In addition, the net fluid balance interface 2400 integrates the infusion therapy information to provide a comprehensive view on one screen, thereby improving the clinician experience.

[0156] in conclusion

[0157] It will be understood that all disclosed methods and processes described herein can be implemented using one or more computer programs or components. These components can be provided as a series of computer instructions on any conventional computer-readable medium, including RAM, ROM, flash memory, magnetic or optical disks, optical storage or other storage media. These instructions can be configured to be executed by a processor, and when the processor executes the series of computer instructions, the processor performs or facilitates the execution of all or part of the disclosed methods and procedures.

[0158] It should be understood that various changes and modifications of the example embodiments described herein will be apparent to those skilled in the art. Such changes and modifications can be made without departing from the spirit and scope of the present subject matter and without impairing its intended advantages. Therefore, such changes and modifications should be covered by the appended claims.

[0159] It should be understood that 35 USC 112(f) or former AIA 35 USC 112, paragraph 6 is not intended to be invoked unless the term "means" or "step" is explicitly mentioned in a claim. Thus, the claims are not intended to be limited to the corresponding structures, materials, or acts described in the specification or their equivalents.

Claims

1. A hemodynamic management device, comprising: Display interface screen; a memory device storing a patient identifier; as well as a processor communicatively coupled to the display interface screen and the memory device, the processor configured to: accessing the patient's medical record in an electronic medical record database using the patient identifier, determining, based on the patient medical record, a new infusion start event associated with an infusion pump fluidly connected to a patient corresponding to the patient medical record, the new infusion start event comprising information indicating an infusion pump identifier, an infusion fluid name, an infusion rate, an amount to be infused, a dose, an amount remaining, and a time when the new infusion start event was generated by the infusion pump, causing the display interface screen to display an infusion line mapping interface showing a graphical representation of a human body and potential access points, Prompt to select an access point in the infusion line mapping interface, upon receiving a selection of an access point, associating within the memory device the infusion pump identifier and the selected access point, and The display interface screen is caused to display at least some of the information associated with the new infusion start event in conjunction with the selected access point shown within the infusion line mapping interface.

2. The hemodynamic management device according to claim 1, wherein: The memory device is configured to store a library of drugs specifying incompatibilities of a fluid type with an access point type, and the processor is further configured to: After receiving the selection of the access point, performing a fluid type and access point incompatibility check between the selected access point and the infusion fluid name; and When an incompatibility exists: displaying a warning within the infusion line mapping interface and providing a prompt to change the access point of the infusion fluid name associated with the infusion pump, removing the warning after receiving a selection of a second access point, and The at least some of the information associated with the new infusion start event is displayed in conjunction with the selected second access point.

3. The hemodynamic management device according to claim 2, wherein: The processor is further configured to: using the drug library to determine a compatible access point based on the infusion fluid name; as well as The infusion line mapping interface is caused to display a recommendation to fluidly connect the infusion pump to the determined compatible access point.

4. The hemodynamic management device according to claim 1, wherein: The processor is further configured to: determining, based on the patient medical record, a second new infusion start event associated with a second infusion pump fluidly connected to the patient corresponding to the patient medical record, the second new infusion start event comprising second information indicating a second infusion pump identifier, a second infusion fluid name, a second dose, a second infusion rate, a second amount to be infused, a second amount remaining, and a second time at which the second new infusion start event was generated by the second infusion pump; causing the display interface screen to display the infusion line mapping interface; Prompting to select a second access point in the infusion line mapping interface; as well as After receiving a selection of the second access point, causing the display interface screen to display at least some of the second information associated with the second new infusion start event in conjunction with the selected second access point.

5. The hemodynamic management device according to claim 4, wherein: The memory device is configured to store a library of drugs that specify fluid types of access points and fluid type incompatibilities, and the processor is further configured to: After receiving the selection of the second access point, performing a fluid type to fluid type incompatibility check between the infusion fluid name and the second infusion fluid name; and When an incompatibility exists: displaying a warning in the infusion line mapping interface and providing a prompt to change the access point of the second infusion fluid name associated with the second infusion pump, removing the warning after receiving a selection of a third access point, and At least some of the second information associated with the second new infusion start event is displayed in conjunction with the selected third access point.

6. The hemodynamic management device according to claim 1, 3 or 5, wherein: The processor is further configured to: receiving, from at least one sensor, hemodynamic information indicative of stroke volume, cardiac output, cardiac index, heart rate, total peripheral resistance index ("TPRI"), or fluid responsiveness; as well as At least some of the hemodynamic information is caused to be displayed in conjunction with the infusion line mapping interface or in a separate hemodynamic interface.

7. The hemodynamic management device according to claim 1, 3 or 5, wherein: The processor is further configured to: determining hemodynamic information indicative of stroke volume, cardiac output, cardiac index, heart rate, total peripheral resistance index ("TPRI"), or fluid responsiveness; as well as At least some of the hemodynamic information is caused to be displayed in conjunction with the infusion line mapping interface or in a separate hemodynamic interface.

8. The hemodynamic management device according to claim 1, 3 or 5, wherein: The processor is further configured to: combining the infusion rate for the infusion fluid name with other infusion rates associated with the patient specified in the patient medical record; determining a fluid output rate specified in a medical record of the patient, the fluid output rate corresponding to at least one of dialysis, urine monitoring, or fluid removal; determining a fluid balance as a difference between the combined infusion rates and the combined fluid output rates; and At least the fluid balance is displayed within the infusion line mapping interface or interactive graphical interface displayed by the display interface screen.

9. The hemodynamic management device according to claim 1, 3 or 5, wherein: The processor is further configured to: determining, based on the patient medical record, a new infusion event, the new infusion event specifying a time when the new infusion event was generated by the infusion pump and indicating at least one of a changed infusion rate, a changed amount to be infused, or a changed amount remaining; as well as The infusion line mapping interface is updated based on information associated with the new infusion event.

10. The hemodynamic management device according to claim 1, 3 or 5, wherein: The processor is further configured to: receiving information indicative of an alarm event or determining an alarm event based on said patient medical record; as well as displaying a graphic indicative of said alarm event or at least some of said information, The alarm event includes at least one of information indicating penetration detection, pipeline blockage, or that the fluid container is empty or nearly empty.

11. The hemodynamic management device according to claim 1, 3 or 5, wherein: The infusion line mapping interface is configured as follows: displaying the infusion fluid name and the infusion rate; and A graphic icon indicating the remaining amount or a time indicating the remaining amount is displayed.

12. The hemodynamic management device according to claim 11, wherein: The processor is further configured to: Determining that the remaining amount or the time indicating the remaining amount is less than a threshold; displaying the remaining amount or indicating the time of the remaining amount in conjunction with the graphic icon; and Change the color of the selected access point and the graphical icon.

13. The hemodynamic management device according to claim 11, wherein: The selection of the graphical icon causes the processor to display at least the infusion pump identifier, the amount to be infused, the infusion rate, and the infusion fluid name.

14. The hemodynamic management device according to claim 11, wherein: The selection of the graphical icon causes the processor to send a message that causes the infusion pump to generate a sound or provide a visual indication.

15. The hemodynamic management device according to claim 1, 3 or 5, wherein: The patient identifier is entered into the display interface screen and stored to the memory device or determined from the patient medical record.

16. The hemodynamic management apparatus of claim 1, 3 or 5, further comprising an adapter for connecting to a hub device also connected to the infusion pump.

17. A method for hemodynamic management, comprising: accessing, via the processor, a medical record of the patient in an electronic medical record database using the patient identifier; determining, using the processor, based on the patient medical record, a new infusion start event associated with an infusion pump fluidly connected to a patient corresponding to the patient medical record, the new infusion start event including information indicating an infusion pump identifier, an infusion fluid name, an infusion rate, an amount to be infused, a dose, an amount remaining, and a time when the new infusion start event was generated by the infusion pump; causing, via the processor, a display interface screen to display an infusion line mapping interface showing a graphical representation of a human body and potential access points; prompting, via the processor, to select an access point within the infusion line mapping interface; upon receiving a selection of an access point, associating, via the processor, the infusion pump identifier with the selected access point; as well as The display interface screen is caused, via the processor, to display at least some of the information associated with the new infusion start event in conjunction with the selected access point shown within the infusion line mapping interface.

18. The hemodynamic management method according to claim 17, further comprising: upon receiving the selection of the access point, performing, via the processor, a check for fluid type to access point incompatibility between the selected access point and the infusion fluid name using a library of drugs specifying fluid type to access point type incompatibilities; as well as When an incompatibility exists: displaying, via the processor, a warning within the infusion line mapping interface and providing a prompt to change an access point for the infusion fluid name associated with the infusion pump, After receiving a selection of a second access point, removing, via the processor, the alert, and The at least some of the information associated with the new infusion start event is displayed, via the processor, in conjunction with the selected second access point.

19. The hemodynamic management method according to claim 18, further comprising: determining, via the processor, a compatible access point based on the infusion fluid name using the drug library; as well as The infusion line mapping interface is caused, via the processor, to display a recommendation to fluidly connect the infusion pump to the compatible access point.

20. The hemodynamic management method according to claim 17, further comprising: combining, via the processor, the infusion rate for the infusion fluid name with other infusion rates associated with the patient specified in the patient medical record; determining, via the processor, a fluid output rate specified in the patient medical record, the fluid output rate corresponding to at least one of dialysis, urine monitoring, or fluid removal; determining, via the processor, a fluid balance as a difference between a combined infusion rate and a combined fluid output rate; as well as At least the fluid balance is displayed, via the processor, within the infusion line mapping interface or interactive graphical interface shown by the display interface screen.

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