Body fluid input / output monitoring system

Abstract

A system for monitoring a patient's fluid balance is disclosed. The system includes a fluid infusion system for delivering infusion fluid to the patient and a UO system for collecting and measuring urine output (UO) from the patient. The UO system is coupled to the fluid infusion system. Fluid input / output (I / O) logic determines fluid I / O data from the fluid infusion data and the UO data while displaying the I / O data on a display and transmitting the I / O data to an electronic medical record. A method for monitoring a patient's fluid balance includes (i) calculating fluid balance from the I / O data, (ii) comparing the fluid balance to a fluid balance limit value stored in a non-transitory computer-readable storage medium, and (iii) generating an alert when the fluid balance exceeds the fluid balance limit value. The method also includes generating modified infusion instructions from the I / O data.

Description

[Background technology]

[0001] Maintenance of proper fluid balance has been shown to be essential for health. Inadequate fluid intake or excessive fluid loss can lead to dehydration, which can affect cardiac and renal function as well as electrolyte management. Inadequate urine production can result in fluid overload, renal failure and electrolyte toxicity. Attention to fluid intake and output is an important component of nursing practice. Poor management of fluid balance has been found to contribute to poor outcomes in acutely ill hospitalized patients.

[0002] The body is in fluid balance when the amount of fluid lost from the body is equal to the amount of fluid taken in. Fluid in the body is found within the body's cells (intracellular), around the cells (interstitial), and within blood vessels (endovascular). It is the body's major chemical component and makes up, on average, 60 percent of body weight.

[0003] Manual recording of fluids in and out has been practiced in the healthcare system for many years. The chart records the patient's fluid in and out over a defined period, typically a 24-hour period. Fluid in / out charting is a critical guide to clinical decisions including medication administration and prescriptions and surgical interventions. Inaccurate or inappropriate charting of fluid balance can be counterproductive and, in some cases, place the patient at significant risk.

[0004] Medical staff, nurses, and dieticians rely on accurate fluid balance totals to plan appropriate care and reduce the risk of complications that may be associated with dehydration, malnutrition, and electrolyte imbalance. Research has shown that manually recording fluid intake and output is often unreliable and inaccurate. Thus, there is a need to automate the monitoring of a patient's fluid balance. Summary of the Invention

[0005] Briefly summarized, disclosed herein is a system for monitoring a patient's fluid balance, the system including a fluid infusion system configured to deliver an infusion fluid to the patient, and a UO system configured to collect and measure urine output (UO) from the patient, the UO system communicatively coupled to the fluid infusion system, the system further including a non-transitory computer readable storage medium (CRM) including infusion input / output (I / O) logic, the I / O logic, when executed by one or more processors of the system, performs operations including (i) receiving infusion data from the infusion system, (ii) receiving UO data from the UO system, (iii) determining I / O data from the infusion data and the UO data, and (iv) displaying the I / O data on a display of the system.

[0006] The I / O logic operations may further include transmitting the I / O data over a network to an external entity, which may include an electronic medical record.

[0007] The fluid infusion system may be coupled to the UO system via a wired connection, and the fluid infusion system and the UO system may be attached together. In some embodiments, the fluid infusion system and the UO system may be secured to a common support structure.

[0008] In some embodiments, the UO system includes a display and / or the I / O logic. The system may further include a housing, the fluid infusion system and the UO system disposed within the housing.

[0009] The operations of the I / O logic may further include (i) calculating a fluid balance from the I / O data, (ii) comparing the fluid balance to a fluid balance limit stored in the CRM, and (iii) generating an alert when the fluid balance exceeds the fluid balance limit. The operations of the I / O logic may further include transmitting the alert to the external entity.

[0010] In some embodiments, the infusion data includes infusion instructions, the action includes generating revised infusion instructions from the I / O data, and the alert includes the revised infusion instructions.

[0011] The modified infusion instructions may include at least one of an increase or decrease in infusion rate, a changed medical dose of the infusion to chemically cause a change in the fluid balance, and a different medication to be administered.

[0012] Also disclosed herein is a method for monitoring fluid balance in a patient, the method including (i) receiving fluid infusion data from a fluid infusion system that provides infusion fluid to a patient, (ii) receiving urine volume (UO) data from a UO system that collects and measures UO from the patient, (iii) determining fluid inflow / outflow (I / O) data from the fluid infusion data and the UO data, and (iv) displaying the I / O data on a display, the UO system being coupled to the fluid infusion system to define an I / O system, and the display being coupled to the I / O system.

[0013] The method may further include transmitting the I / O data over a network to an external entity, which may include an electronic medical record. The method may further include (i) calculating a fluid balance from the I / O data, (ii) comparing the fluid balance to a fluid balance limit value stored in a non-transitory computer readable storage medium of the I / O system, and (iii) generating an alert when the fluid balance exceeds the fluid balance limit value. The method may further include transmitting the alert to the external entity.

[0014] In some embodiments, the method includes generating modified infusion instructions from the I / O data and providing a notification of the modified infusion instructions to a user. The modified infusion instructions may include at least one of increasing or decreasing an infusion rate. In further embodiments, the modified infusion instructions may include an altered medical dose of the infusion fluid and / or a different medication to be administered to chemically cause a change in the fluid balance.

[0015] These and other features of the concepts provided herein will become more apparent to those of ordinary skill in the art in view of the accompanying drawings and the following description, which describe in more detail certain embodiments of such concepts.

[0016] A more particular description of the present disclosure will be made by reference to specific embodiments that are illustrated in the accompanying drawings. It should be understood that these drawings depict only typical embodiments of the invention and should not be considered as limiting its scope. Exemplary embodiments of the invention will be described and explained with additional specificity and detail through the use of the accompanying drawings. [Brief description of the drawings]

[0017] [Figure 1A] 1 illustrates a first embodiment of a bodily fluid input / output (I / O) monitoring system according to some embodiments. [Figure 1B] 1B shows an example screenshot that may be displayed on the display of the system of FIG. 1A according to some embodiments. [Figure 1C]1 illustrates an exemplary process for monitoring fluid balance in a patient, according to some embodiments. [Diagram 2] 1 illustrates a second embodiment of a bodily fluid (I / O) monitoring system, according to some embodiments. [Diagram 3] 1 illustrates a third embodiment of a bodily fluid (I / O) monitoring system, according to some embodiments. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0018] Before some specific embodiments are disclosed in more detail, it should be understood that the specific embodiments disclosed herein do not limit the scope of the concepts provided herein. It should also be understood that the specific embodiments disclosed herein can have features that can be easily separated from the specific embodiment and, optionally, combined with or substituted for features of any of the other numerous embodiments disclosed herein.

[0019] With regard to the terms used herein, it should also be understood that the terms are intended to describe some particular embodiments, and that the terms do not limit the scope of the concepts provided herein. Ordinal numbers (e.g., first, second, third, etc.) are generally used to distinguish or identify different features or steps within a group of features or steps, and do not provide sequential or numerical limitations. For example, the "first", "second", and "third" features or steps do not necessarily have to appear in that order, and a particular embodiment including such features or steps is not necessarily limited to three features or steps. Labels such as "left", "right", "upper", "lower", "front", "rear", etc. are used for convenience and do not imply, for example, a particular fixed position, orientation, or direction. Instead, such designations are used to reflect, for example, a relative position, orientation, or direction. The singular forms "one", "one", and "said" also include plural references unless the context clearly dictates otherwise. The words "including," "has," and "having" have the same meaning as the word "comprising" when used herein, including the claims. Furthermore, the terms "or" and "and / or" when used herein shall be construed to mean inclusive or any one or any combination. As an example, "A, B, or C" or "A, B, and / or C" means "any of the following: A only, B only, C only, A and B, A and C, B and C, and A, B, and C." Exceptions to this definition occur only when combinations of elements, components, features, steps, or acts are in some way essentially mutually exclusive.

[0020] The phrases "connected to" and "coupled to" refer to any form of interaction between two or more entities, including mechanical, electrical, magnetic, electromagnetic, fluid, signal, communication (including wireless), and thermal interaction. Two components may be connected or coupled to one another even if they are not in direct contact with one another. For example, two components may be coupled to one another through an intermediate component.

[0021] Any method disclosed herein includes one or more steps or acts of performing the described method. Method steps and / or acts may be interchanged with one another. In other words, the order and / or use of certain steps and / or acts may be changed unless a certain order of steps or acts is required for proper operation of the embodiment. Furthermore, only subroutines or portions of the methods described herein may be separate methods within the scope of the present disclosure. In other words, some methods may include only some of the steps described in a more detailed method.

[0022] The directional terms "proximal" and "distal" are used herein to refer to opposing locations on a medical device. The proximal end of the device is defined as the end of the device that is closest to the end user when the device is in use by the end user. The distal end is the end along the length of the device opposite the proximal end, or the end that is furthest from the end user.

[0023] Unless otherwise defined, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art. 1A illustrates one embodiment of a system for monitoring the output of bodily fluids from a patient and the input of fluids delivered to the patient, according to some embodiments disclosed herein. The fluid I / O system 100 generally includes a fluid infusion system 110 and a urine volume collection and measurement (UO) system 150. The fluid I / O system 100 is generally configured to automatically record (i) fluids infused to the patient 50 and (ii) fluids output from the patient 50 over a defined period of time to define fluid input / output (I / O) data / information. The fluid I / O system 100 can then display the I / O information on a display.

[0024] The fluid I / O system 100 is further configured to transmit the I / O data to an external entity 40 via a network 30. The network 30 represents a communication path between the fluid I / O system 100 and the external entity 40. In one embodiment, the network 30 is the Internet. The network 30 may also utilize a dedicated or private communication link (e.g., a WAN, MAN, or LAN) that is not necessarily part of the Internet. The network 30 may use standard communication technologies and / or protocols. The external entity 40 may be a person, an institution, or a cloud computing environment (e.g., a cloud computing resource accessible over a network such as the Internet). In some embodiments, the external entity 40 may include an electronic medical record (EMR).

[0025] In the illustrated embodiment, the fluid infusion system 110 includes one or more infusion pumps 111 configured to deliver medical fluid 120 to the patient 50 via one or more infusion lines 112. The fluid infusion system 110 is programmable to facilitate infusion of the medical fluid 120 according to infusion instructions. The infusion instructions may define parameters of the fluid infusion, such as, for example, medication, fluid injection volume, rate of fluid infusion / delivery, and / or start time of the infusion. In some cases, the infusion instructions may include infusion of multiple infusion fluids 120 (including multiple medications) over an extended period of time, e.g., over 24 hours or more, e.g., over multiple days.

[0026] In the illustrated embodiment, the UO system 150 includes a container 160 for collecting UO 52 (i.e., a volume of urine) drained from the patient 50 through a drainage tube 161 coupled to a catheter (not shown) inserted into the patient 50. The container 160 may be sized to accommodate a volume of urine 52 consistent with a total volume of infusion fluid 120 to be infused to the patient 50 pursuant to an infusion order. The UO system 150 is configured to measure and record the volume of urine 52 collected in the container 160. A display module 170 of the UO system measures the weight of the UO 52 in the container 160 over a defined period of time, such as a period of 24 hours or more. The display module 170 includes hardware and software, including one or more processors and non-transitory computer readable storage media, consistent with measuring and recoding the UO 52. The display module 170 includes a display 171 on which UO data / information may be displayed in use.

[0027] Fluid I / O system 100 includes a communication link 105 between fluid infusion system 110 and UO system 150. In the illustrated embodiment, the communication link is a wired connection between fluid infusion system 110 and UO system 150. In other embodiments, communication link 105 may be a wireless connection over the air.

[0028] In the illustrated embodiment, fluid infusion system 110 and UO system 150 are each secured to a support structure 102 (e.g., an IV pole) such that fluid infusion system 110 and UO system 150 can be handled / transported as a single unit. Also, having fluid infusion system 110 and UO system 150 attached to a single support structure 102 takes up less space in a patient room than each of fluid infusion system 110 and UO system 150 having a separate support structure.

[0029] Fluid I / O system 100 includes fluid inlet / outlet (I / O) logic 109. I / O logic 109 is configured to receive infusion data from infusion system 110 and UO data from UO system 150. I / O logic 109 is further configured to generate I / O data / information for patient 50 from the infusion data and UO data. The I / O information may include statistics, tables, charts, graphs, etc. related to the I / O data. I / O logic 109 is configured to display the I / O data / information on display 171.

[0030] The I / O logic 109 is also configured to transmit the I / O data / information to an external entity 40 via the network 30. Thus, a clinician or other medical personnel can remotely monitor the fluid balance of the patient 50 by accessing the I / O data / information of the fluid I / O system 100.

[0031] In some embodiments, the I / O logic 109 may be configured to generate alerts (e.g., warnings) in the event of extreme I / O conditions or trends. More specifically, the I / O logic 109 may compare the I / O data and / or statistical parameters to one or more limit values ​​stored in memory. As a result of the comparison, the I / O logic 109 may display one or more alerts on the display 171 and / or send an alert to the external entity 40. In one exemplary embodiment, one of the statistical parameters may be fluid balance, i.e., the difference between the cumulative amount of infusion fluid 120 and the cumulative amount of UO 52 over a defined period of time. A positive fluid balance may indicate that the patient's renal function is unable to keep up with the infusion rate. In one embodiment, the I / O logic 109 may compare the fluid balance to a fluid balance upper limit value and generate an alert when the fluid balance exceeds a fluid balance upper limit value. In another embodiment, the I / O logic 109 can compare the fluid balance to a fluid balance lower limit (ie, a large negative value) and generate an alert when the fluid balance falls below the fluid balance lower limit.

[0032] In some embodiments, I / O logic 109 may be in the form of a software application loaded onto UO system 150 (i.e., stored in a non-transitory computer-readable storage medium of UO system 150) and executable by hardware processing circuitry included in UO system 150. In other embodiments, I / O logic 109, or portions thereof, need not be loaded onto UO system 150, but may instead be executed within a cloud computing environment (which may be represented by reference numeral 30), such that fluid infusion data and UO data are communicated to I / O logic 109 for processing. Thus, any I / O logic 109 represented as part of UO system 150 may include an application programming interface (API) configured to send and receive data communication messages to and from I / O logic 109 operating in the cloud computing environment.

[0033] Those skilled in the art will appreciate that fluid I / O system 100 may include other architectural modules not described herein. Additionally, conventional elements such as firewalls, authentication systems, network management tools, load balancers, etc. are not critical to the present invention and are therefore not shown.

[0034] 1B illustrates an exemplary screenshot 180 showing IO data that may be displayed on the display 171. The screenshot 180 may represent an exemplary infusion graph 181. The infusion graph 181 illustrates a cumulative infusion volume of the infusion fluid 120 delivered by the fluid infusion system 110 over a defined period of time 184. The screenshot 180 may also represent an exemplary UO graph 182. The UO graph 182 illustrates a cumulative UO 52 collected and measured by the UO system 150 over a defined period of time 184. The screenshot 180 may also represent an exemplary fluid balance graph 183. The balance graph 183 illustrates the difference between the cumulative infusion volume of the infusion fluid 120 and the cumulative UO 52. Viewing the balance graph 183 may provide the clinician with an assessment of the fluid balance of the patient 50, e.g., fluid overload versus dehydration.

[0035] 1C illustrates an exemplary process for monitoring fluid balance of a patient 50, according to some embodiments. In use, a clinician 60 may define and input fluid infusion instructions into the fluid infusion system 110 (reference numeral 191). The fluid infusion instructions may include one or more fluid infusion parameters, such as, for example, a total volume of fluid to be infused, a fluid infusion rate, and / or a dosage. The infusion instructions are received by the infusion system 110 (reference numeral 192), which administers the fluid to the patient 50 in accordance with the instructions (reference numeral 193). During the infusion, the UO system 150 collects and measures UO 52 of the patient 50 (reference numeral 194). The I / O logic 109 of the fluid I / O system 100 (i) receives infusion data, which may include fluid infusion command parameters, from the infusion system 110 (reference numeral 195) and (ii) receives UO data from the UO system 150 (reference numeral 196).

[0036] The I / O logic 109 then determines (i.e., calculates) the fluid balance of the patient 50 (reference number 197). Calculating the fluid balance may include subtracting the cumulative amount of UO 52 measured by the UO system 150 from the cumulative amount of infusion fluid 120. A positive fluid balance may indicate that the UO 52 is lagging behind (i.e., less) the fluid infusion, indicating that the patient 50 is retaining fluid and, in extreme cases, indicating fluid overload. A negative fluid balance may indicate that the UO 52 is exceeding (i.e., more) the fluid infusion and, in extreme cases, indicating that the patient 50 is not maintaining a normal / desired amount of fluid and, in extreme cases, indicating dehydration of the patient 50.

[0037] As discussed above, the I / O logic 109 may define one or more limits related to the fluid balance of the patient 50. In the illustrated process, the I / O logic 109 may include a high fluid balance limit and a low fluid balance limit, and the I / O logic 109 may compare the determined fluid balance to the fluid balance limit. In response to the comparison, the I / O logic 109 may generate an alert (reference number 198) when the fluid balance exceeds either limit. Generating the alert (reference number 198) may also include directly notifying the clinician via the display 171 and / or sending the alert to the external entity 40. In some embodiments, generating the alert includes informing the clinician if a nephrotoxic medication is being administered. For example, if there is a fluid imbalance, such as low urine output, the type of medication administered may be changed.

[0038] The I / O logic 109 may also generate modified fluid infusion instructions (reference number 199) according to the determined fluid balance. As an example, if the positive fluid balance exceeds a high limit value, the I / O logic 109 may generate modified fluid infusion instructions to reduce the rate of fluid infusion, thereby returning the fluid balance to the desired value within a defined period of time. In another case, if the negative fluid balance exceeds a low limit value, the I / O logic 109 may generate modified fluid infusion instructions to increase the rate of fluid infusion, thereby returning the fluid balance to the desired value within a defined period of time. It should be noted that the desired value of fluid balance may deviate from a zero value. In other words, the desired value of fluid balance may be positive or negative. In some examples, the modified infusion instructions may include initiating the infusion of a dose of a drug (e.g., sodium) or changing the infusion rate to chemically cause a change in the fluid balance of the patient 50.

[0039] FIG. 2 illustrates a second embodiment of a body fluid (I / O) monitoring system 200, which may be similar in certain respects to the components of the fluid I / O system 100 described in connection with FIGS. 1A-1C. It will be understood that all illustrated embodiments may have similar features. Accordingly, the relevant disclosures set forth above with respect to similar features may not be repeated below. Additionally, certain features of the fluid I / O system 200 and related components illustrated in FIG. 2 may not be indicated or identified by reference numbers in the drawings or specifically described in the description set forth below. However, such features may be clearly the same or substantially the same as features shown in and / or described in connection with other embodiments. Accordingly, the relevant description of such features applies equally to the features of the system of FIG. 2. Any suitable combination of features and variations thereof described with respect to the fluid I / O system 100 and components illustrated in FIGS. 1A-1C may be employed with the system and components of FIG. 2, and vice versa. This pattern of disclosure applies equally to the alternative embodiments shown in subsequent figures and described below.

[0040] Fluid I / O system 200 includes fluid infusion system 110 and UO system 150. UO system 150 is configured to measure and record UO 52 collected in container 160, and display module 170 of UO system 150 displays UO data on display 171. Fluid I / O system 200 includes a separate display module 270 that includes display 271. In some embodiments, display module 270 may be a computing device, such as, for example, a tablet computer. Display module 270 is wirelessly connected to infusion system 110 and UO system 150.

[0041] Fluid I / O system 200 includes fluid input / output (I / O) logic 209 configured to (i) receive fluid infusion data from fluid infusion system 110, (ii) receive UO data from UO system 150, (iii) display the I / O data on display 271, and (iv) transmit the I / O data to external entity 40 via network 30. In some embodiments, I / O logic 209 may be in the form of a software application loaded onto display module 270 and executable by hardware processing circuitry included in display module 270. In other embodiments, I / O logic 209, or portions thereof, need not be loaded onto display module 270 but may instead be executed within a cloud computing environment (which may be represented by reference numeral 30), such that fluid infusion data and UO data are communicated to I / O logic 209 for processing. Thus, any I / O logic 209 represented as part of display module 270 may include an application programming interface (API) configured to send and receive data communication messages to and from I / O logic 209 operating in the cloud computing environment.

[0042] As shown, in some embodiments, fluid infusion system 110 may include support structure 202A and UO system 150 may include a separate support structure 202B. In other embodiments, fluid infusion system 110 and UO system 150 may be mounted to a single support structure, such as support structure 202A.

[0043] 3 illustrates a third embodiment of a bodily fluid (I / O) monitoring system 300. The fluid I / O system 300 includes a fluid infusion system 110 and a UO system 150 disposed within a common housing 310 that is attached to a support structure 302. The fluid I / O system 300 further includes a display 371 integrated into the housing 310, the display 371 being configured to display I / O data / information thereon.

[0044] Fluid I / O system 300 includes fluid input / output (I / O) logic 309 configured to (i) receive fluid infusion data from fluid infusion system 110 and receive UO data from UO system 150, (ii) display the I / O data on display 371, and (iii) transmit the I / O data to external entity 40 via network 30. In some embodiments, I / O logic 309 may be in the form of a software application stored on a non-transitory computer-readable storage medium 308 of fluid I / O system 300 and executable by one or more processors of fluid I / O system 300. In further embodiments, I / O logic 309 may be loaded into fluid infusion system 110 or UO system 150 and executable by hardware processing circuitry included within the respective systems. In other embodiments, the fluid I / O system 300 may include an optional display module 370 disposed within the housing 310, and the I / O logic 309 may be loaded into the display module 370 or may be executable by hardware processing circuitry contained within the display module 370.

[0045] In yet another embodiment, the I / O logic 309, or portions thereof, may be executed within a cloud computing environment (which may be represented by reference numeral 30), such that fluid injection data and UO data are communicated to the I / O logic 309 for processing. Accordingly, any I / O logic 309 represented as part of the fluid I / O system 300 may include an application programming interface (API) configured to send and receive data communication messages to and from the I / O logic 309 operating in the cloud computing environment.

[0046] It is believed that those skilled in the art can utilize the present invention to its fullest extent using the preceding description without further elaboration. The claims and embodiments disclosed herein are merely illustrative and exemplary and should not be construed as limiting the scope of the present disclosure in any way. It will be apparent to those skilled in the art that, with the aid of the present disclosure, changes can be made to the details of the above embodiments without departing from the basic principles of the disclosure herein. In other words, various modifications and improvements of the embodiments specifically disclosed in the above description are within the scope of the appended claims. Furthermore, the order of steps or operations of the methods disclosed herein may be changed by those skilled in the art without departing from the scope of the present disclosure. In other words, unless a specific order of steps or operations is necessary for the proper operation of the embodiment, the order or use of specific steps or operations may be changed. The scope of the present invention is therefore defined by the following claims and their equivalents.

Claims

1. A system for monitoring a patient's fluid balance, comprising: A fluid infusion system configured to deliver an infusion fluid to the patient; A urine output (UO) system configured to collect and measure the urine output (UO) excreted from the patient and communicatively coupled to the fluid infusion system; A non-transitory computer-readable memory medium (CRM) including infusion input / output (I / O) logic; And comprising: When the I / O logic is executed by one or more processors of the system, Receiving infusion data from the infusion system; Receiving UO data from the UO system; Determining I / O data from the infusion data and the UO data; And displaying the I / O data on a display of the system. A system that performs operations including these.

2. The system according to claim 1, wherein the operations further include transmitting the I / O data to an external entity via a network.

3. The system according to claim 2, wherein the external entity includes an electronic medical record.

4. The system according to any one of claims 1 to 3, wherein the fluid infusion system is coupled to the UO system via a wired connection.

5. The system according to any one of claims 1 to 3, wherein the fluid infusion system and the UO system are attached together.

6. The system according to any one of claims 1 to 3, wherein the fluid infusion system and the UO system are fixed to a common support structure.

7. The system according to any one of claims 1 to 3, wherein the UO system includes the display.

8. The system according to any one of claims 1 to 3, wherein the UO system includes the I / O logic.

9. The system according to any one of claims 1 to 3 further includes a housing, and the fluid infusion system and the UO system are disposed within the housing.

10. The system according to any one of claims 1 to 3, wherein the operations include: Calculating a fluid balance from the I / O data; Comparing the fluid balance with a fluid balance limit value stored in the CRM; And generating an alert when the fluid balance exceeds the fluid balance limit value. A system further including these.

11. The system according to claim 10, wherein the operation further includes sending the alert to an external entity. **Claim 12** A system according to claim 10, wherein the infusion data includes an infusion order, the operation includes generating a modified infusion order from the I / O data, and the alert includes the modified infusion order. **Claim 13** The system according to claim 12, wherein the modified infusion order includes at least one of an increase or a decrease in infusion rate. **Claim 14** The system according to claim 12, wherein the modified infusion order includes an altered medical dosage of the infusion fluid for chemically causing a change in the body fluid balance. **Claim 15** The system according to claim 12, wherein the modified infusion order includes a different drug to be administered.

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