Method and system for detecting arterial blood pressure damping and performing automated high-speed flushing of a catheter tube.

Abstract

Systems, devices, and methods are provided for determining whether an arterial blood pressure signal damping event is occurring and automatically flushing the catheter tubing in response to determining that an arterial blood pressure signal damping event is occurring. In one example, the determination of whether an arterial blood pressure signal damping event is occurring is based on a distinctive pattern change in the arterial blood pressure signal that exceeds one or more specified threshold values ​​within a specified time window. Additionally or alternatively, a determination as to whether the arterial blood pressure signal damping event has resolved is made in response to automatically flushing the catheter tubing based on the arterial blood pressure signal.

Description

[Technical Field]

[0001]

[0001] The following generally relates to medical technology, medical monitoring technology, physiological monitoring technology, patient safety technology, and related technologies. More specifically, embodiments herein relate to the use of automatic flushing to maintain a stable arterial blood pressure (ABP) signal for patient monitoring. [Background technology]

[0002]

[0002] Invasive arterial (intra-arterial) blood pressure (IABP) monitoring is a technique commonly used in the intensive care unit (ICU). Such arterial blood pressure (ABP) monitoring is also often used in the operating room, for example, when hemodynamic instability is a risk, or when pulse-by-pulse measurement and visualization of pressure waveforms are helpful.

[0003]

[0003] In current clinical practice, ABP signals are typically measured using arterial catheters and external pressure sensors. For example, ABP monitoring usually involves inserting a catheter connected to a piping system into a suitable artery (e.g., the radial artery). However, the piping system is also operably associated with an external pressure sensor.

[0004]

[0004] Such ABP signals can degrade over time. For example, ABP signals can degrade over time due to clot formation and / or other factors. Such degradation of the ABP signal can potentially interfere with / attenuate the transmission of pressure from the artery to the external pressure sensor. Thus, such degradation of the ABP signal can lead to incorrect ABP measurement results, false ABP alarms, and / or misinterpretation of the patient's hemodynamic status.

[0005] As discussed above, such ABP damping is an abnormal measurement state in invasive ABP monitoring. Such ABP damping needs to be timely identified and fixed in order to avoid leading to an incorrect interpretation of the patient's hemodynamic state and / or causing false alarms. Such ABP damping situations are typically observed / identified manually, so such ABP damping situations may be overlooked or mis-identified due to human error and / or delays due to fatigue.

[0006]

[0006] Furthermore, flushing operations in response to ABP damping situations have also typically been performed manually. Therefore, it has an adverse effect on the associated clinical workflow and increases the clinical workload.

[0007]

[0007] The following discloses certain improvements to overcome these and other problems.

Summary of the Invention

Problems to be Solved by the Invention

[0008]

[0008] As discussed above, arterial blood pressure damping identification and high-speed flushing operations are typically performed manually in current clinical practice. Advantageously, some embodiments described herein present methods and systems for automatic detection of arterial blood pressure damping and corresponding automatic flushing.

Means for Solving the Problems

[0009] As will be discussed in more detail below, the embodiments described herein present methods and systems for detecting arterial blood pressure signal damping events and automatically flushing a catheter tube in response thereto. Additionally or alternatively, some implementations herein evaluate the effectiveness of the automatic flushing and transmit a notification when an attenuated arterial blood pressure signal is not resolved after the automatic flushing. Moreover, some implementations herein evaluate the effectiveness of the automatic flushing and initiate another iteration of the automatic flushing and tracking (e.g., re-evaluating) the effectiveness of further flushing. In such an example, if N (e.g., where N is defined by a user, etc.) iterations of the automatic flushing are not effective, a notification will be sent along with an alarm message.

[0010]

[0010] In some implementations herein, methods and systems are provided for determining whether an arterial blood pressure signal damping event is occurring and automatically flushing a catheter tube in response to a determination that an arterial blood pressure signal damping event is occurring. In one example, the determination of whether an arterial blood pressure signal damping event is occurring is based on a characteristic pattern change of the arterial blood pressure signal within a specified time window and exceeding the value of one or more specified thresholds. Additionally or alternatively, the determination as to whether an arterial blood pressure signal damping event has been resolved is made in response to an automatic flushing of the catheter tube based on the arterial blood pressure signal.

[0011]

[0011] In one embodiment, the arterial blood pressure management system includes a pressure sensor receptor and an arterial blood pressure monitor communicatively coupled to the pressure sensor input. The pressure sensor receptor receives an arterial blood pressure signal detected by the pressure sensor. The arterial blood pressure monitor determines, based on the arterial blood pressure signal, whether an arterial blood pressure signal damping event is occurring. The arterial blood pressure monitor transmits a command to an electronically controllable (e.g., automatic) valve to automatically flush the catheter tube in response to the determination that an arterial blood pressure signal damping event is occurring. The arterial blood pressure monitor determines, in response to the automatic flushing of the catheter tube based on the arterial blood pressure signal, whether the arterial blood pressure signal damping event has been resolved. In such an example, the determination that an arterial blood pressure signal damping event is occurring is based on a first criterion, and the determination that the arterial blood pressure signal damping event has been resolved is based on a second criterion different from the first criterion.

[0012]

[0012] In one example, the determination of whether an arterial blood pressure signal damping event has been resolved in response to an automatic flush of the catheter is based on the change between one or more arterial blood pressure characteristics acquired within a specified time window before the automatic flush and one or more arterial blood pressure characteristics acquired within a specified time window after the automatic flush that exceed a specified threshold value. For example, the determination of whether an arterial blood pressure signal damping event is occurring is based on determining whether there is a continuous decrease in systolic arterial blood pressure per heartbeat, based on the value of a first threshold among one or more specified threshold values. Additionally or alternatively, the determination of whether an arterial blood pressure signal damping event is occurring is based on determining whether there is a continuous decrease in the difference between systolic and diastolic arterial blood pressure per heartbeat, based on the value of a second threshold among one or more specified threshold values. Additionally or alternatively, the determination of whether an arterial blood pressure signal damping event is occurring is based on determining whether the mean arterial blood pressure has stabilized over time, based on the value of a third threshold among one or more specified threshold values. Additionally or alternatively, the determination of whether an arterial blood pressure signal damping event is occurring is based on determining whether diastolic arterial blood pressure is stable over time, based on a fourth threshold value among one or more specified threshold values. Additionally or alternatively, the determination of whether an arterial blood pressure signal damping event is occurring is based on determining whether, within a specified time window, the percentage of pulses with signal quality exceeding the signal quality threshold value exceeds a fifth threshold value among one or more specified threshold values.

[0013]

[0013] In another embodiment, the method includes determining whether an arterial blood pressure signal damping event is occurring based on a decrease in the arterial blood pressure signal within a specified time window and exceeding one or more specified threshold values. The method further includes automatically flushing the catheter tube in response to the determination that an arterial blood pressure signal damping event is occurring.

[0014]

[0014] In yet another embodiment, the machine-readable storage includes a machine-readable command, when executed, that includes an operation for determining whether an arterial blood pressure signal damping event is occurring based on a specific pattern change in the arterial blood pressure signal within a specified time window and exceeding one or more specified threshold values. The machine-readable command further includes an operation, when executed, that automatically flushes the catheter tube in response to the determination that an arterial blood pressure signal damping event is occurring.

[0015]

[0015] In yet another embodiment, the device includes means for determining whether an arterial blood pressure signal damping event is occurring based on a specific pattern change in the arterial blood pressure signal within a specified time window and exceeding one or more specified threshold values. The device further includes means for automatically flushing the catheter tube in response to the determination that an arterial blood pressure signal damping event is occurring.

[0016]

[0016] It should be understood that all combinations of the aforementioned concepts and additional concepts discussed in more detail below (provided that such concepts are not contradictory) are intended to be part of the subject matter disclosed herein. In particular, all combinations of claimed subject matter appearing at the end of this disclosure are intended to be part of the subject matter disclosed herein. Furthermore, it should be understood that any term used expressly herein, incorporated by reference and appearing in any disclosure, should be intended to best correspond to any particular concept disclosed herein.

[0017]

[0017] These and other aspects of various embodiments will become apparent from the embodiments described hereafter and will be explained with reference to those embodiments.

[0018]

[0018] Various advantages of the embodiment will become apparent to those skilled in the art by reading the following specifications and appended claims, and by referring to the following drawings. [Brief explanation of the drawing]

[0019] [Figure 1]

[0019] This figure shows a block diagram of an example arterial blood pressure monitor. [Figure 2]

[0020] This figure shows a graph of the arterial blood pressure signal exhibiting an arterial blood pressure dumping event. [Figure 3]

[0021] This figure shows a block diagram of an exemplary arterial blood pressure management system according to an embodiment. [Figure 4]

[0022] This figure shows a flowchart illustrating an exemplary method for operating an arterial blood pressure management system according to an embodiment. [Figure 5]

[0023] Further diagrams show flowcharts illustrating exemplary methods for operating an arterial blood pressure management system according to an embodiment. [Figure 6]

[0024] This figure shows a graph illustrating the detection of an example of an arterial blood pressure dumping event according to the embodiment, and the resulting evaluation of the recovery of the dumping event after the corresponding flush. [Figure 7]

[0025] This figure further illustrates a graph showing the detection of an example of an arterial blood pressure dumping event according to the embodiment, and the resulting evaluation of the recovery of the dumping event after the corresponding repeated flush. [Figure 8]

[0026] This figure shows a block diagram of a computer program product according to an embodiment. [Figure 9]

[0027] This figure further illustrates an EMR management system according to an embodiment. [Figure 10]

[0028] This figure shows a hardware device including a semiconductor package according to an embodiment. [Modes for carrying out the invention]

[0020]

[0029] As will be described in more detail below, in some implementations discussed herein, once an ABP damping condition is detected, a control signal is issued to initiate an automatic high-speed flushing operation. The ABP signal is subsequently analyzed immediately after the automatic flushing and evaluated to determine whether the damped ABP signal has been resolved (e.g., returned to normal). If the damped ABP signal is resolved after the automatic flushing, the IABP monitoring process continues. If the damped ABP signal is not resolved, the algorithm takes another automatic flushing action and re-evaluates the effectiveness of the flushing. Automatic flushing and evaluation are attempted N times (e.g., where N is a selectable number, e.g., N=3). If N automatic flushing attempts fail, the algorithm issues an alarm / warning to the clinician regarding ABP damping. Note that, in addition to the automatic flushing action, manual flushing operations are also available, allowing the clinician to perform further manual flushing if deemed necessary.

[0021]

[0030] In operation, some of the techniques described herein have the advantage of reducing the burden on clinicians who manually observe and identify ABP dumping conditions. Additionally or alternatively, some of the techniques described herein have the advantage of detecting ABP dumping conditions in a timely manner, thereby avoiding delays related to flushing. Furthermore, some of the techniques described herein have the advantage of reducing false ABP alarms caused by ABP dumping. Additionally, some of the techniques described herein have the advantage of reducing the burden on clinicians to manually flush tubing, thereby improving the relevant clinical workflow. Finally, if some of the techniques described herein detect a false ABP dumping event (e.g., a false positive) and automatic flushing is performed incorrectly, the adverse effects will be limited. This is because automatic flushing occurs for a very short period of time (e.g., 2-3 seconds), so the interruption to IABP monitoring should be very minor.

[0022]

[0031] Figure 1 illustrates a block diagram of an exemplary arterial blood pressure monitor 100. In the illustrated example, the arterial blood pressure monitor 100 includes, associated with a patient 111, a pressure bag 102 (e.g., containing pressurized saline), a flush tube 104, a stopcock 106, a catheter tube (e.g., a pressure tube) 108, an intra-arterial cannula 110, a pressure sensor (e.g., a pressure transducer) 112, a pressure sensor receptor (e.g., a pressure cable) 114, and a pressure signal processing / display unit (monitor) 116. Arterial blood pressure (ABP) is transmitted from the artery to the pressure sensor 112 through a cylinder of incompressible, bubble-free fluid (e.g., 0.9% saline) in the catheter tube 108. The flush tube 104 is connected to the pressure bag 102 (e.g., containing pressurized saline), which is typically pressurized to 300 mmHg, and is attached to the catheter tube 108 via a flush system (e.g., a stopcock 106). The flush system allows for high-pressure flushing of the fluid to keep the catheter tube 108 clean and to verify the system's dynamic characteristics (e.g., damping and natural frequency).

[0023]

[0032] During operation, invasive intra-aortic blood pressure (IABP) monitoring is performed continuously for several hours or even several days, with the piping system remaining in its initial configuration. During such continuous monitoring, if a blood clot forms at the tip of the catheter, it can attenuate the dynamic nature of the pressure transmitted to the sensor, resulting in a damped pressure signal. Several other factors can cause ABP damping problems, namely, the presence of air bubbles in the piping, the possibility of piping twisting, the catheter being moved to a location where fluid movement is hindered, or blood moving into the catheter. A damped ABP signal can lead to incorrect blood pressure (BP) measurements (e.g., particularly systolic and diastolic BP), resulting in false ABP alarms and / or misinterpretation of the hemodynamic status.

[0024]

[0033] Clinicians operating IABP monitoring should pay attention to ABP damping situations by observing the ABP waveform. When suspected ABP damping is present, clinicians often need to take a fast flush action to clear the tubing (which may be obstructed, for example, by a blood clot), allowing pressurized saline solution to flow through the catheter for a short period (e.g., 2-3 seconds). If the attenuated ABP signal is resolved after the fast flush (e.g., returned to a normal dynamic state), IABP monitoring is continued; otherwise, further fast flushes are necessary. If multiple fast flushes do not resolve the attenuated ABP signal, a new set of complete settings for the IABP tubing system is required.

[0025]

[0034] Figure 2 shows a graph of arterial blood pressure signals 200 with an arterial blood pressure dumping event. Figure 2 shows a real case where an attenuated ABP episode was identified and a fast flush was performed. After the flush, ABP was recovered. In the illustrated example, the ABP signal 202 is shown as attenuated ABP 204. A flush 206 is shown as being performed (e.g., a manual flush by the therapist), resulting in recovered ABP 208.

[0026]

[0035] Figure 3 shows a block diagram of an exemplary arterial blood pressure management system 300 according to an embodiment. In the illustrated example, the arterial blood pressure management system 300 is centralized or distributed and includes some or all elements and components of one or more computers or computer systems. For example, the arterial blood pressure management system 300 includes one server computer or multiple server computers (e.g., interconnected to form a server cluster, cloud computing resources, etc., and / or a combination thereof).

[0027]

[0036] In some implementations, the arterial blood pressure management system 300 is used as a control point element of an integrated clinical environment (ICE). As used herein, “Integrated Clinical Environment (ICE)” refers to a platform for creating a medical Internet of Things (IoT) associated with patient care. In such implementations, the arterial blood pressure management system 300 supports many real-time clinical decision support algorithms and closed-loop control algorithms for medical devices in the ICE.

[0028]

[0037] In the illustrated implementation, the arterial blood pressure management system 300 includes a pressure sensor receptor 114 and an arterial blood pressure monitor 302 which is communicatively coupled to the pressure sensor input of the pressure sensor receptor 114. The pressure sensor receptor 114 receives arterial blood pressure signals detected by the pressure sensor 112.

[0029]

[0038] In the illustrated implementation, the arterial blood pressure monitoring monitor 302 includes a processing module 304, a flashing algorithm 306, and a display 310 (for example, displaying an alarm 312). For example, the processing module 304 amplifies, digitizes, filters, and scales the arterial blood pressure signal received from the pressure sensor 112 via the pressure sensor receptor 114. The processing module 304 further performs pulse detection and feature extraction and provides the scaled arterial blood pressure signal to other connected / coupled components. For example, the arterial blood pressure monitoring monitor 302 is implemented as an invasive blood pressure (IABP) monitor.

[0030]

[0039] As will be discussed in more detail below, the flushing algorithm 306 triggers an alarm and / or automatic flushing in response to an arterial blood pressure signal from the processing module 304. For example, the flushing algorithm 306 performs ABP damping detection by analyzing ABP waveform features in real time. In some implementations, the flushing algorithm 306 performs ABP pulse detection, evaluation of the signal quality of the ABP pulse, extraction of ABP pulse features, detection of ABP damping events by recognizing ABP damping feature patterns, and / or a combination thereof. As will be described in more detail below, the automatic flushing device contains computer-controlled electrofluid values ​​in the flash tube. Upon receiving an activation signal from the ABP damping detection flushing algorithm 306, the automatic flushing device performs a time-determined (e.g., time and duration) high-speed flush. Additionally or alternatively, the flushing algorithm 306 detects ABP recovery by tracking the ABP signal immediately after the automatic flush and determining whether the attenuated ABP signal has been resolved. The return of the ABP signal to an undamped state has identifiable characteristics (for example, the systolic BP value and pulsed BP value are significantly increased, and the maximum ABP waveform slope is significantly increased).

[0031]

[0040] In the illustrated implementation, the arterial blood pressure monitor 302 determines, based on the arterial blood pressure signal, whether an arterial blood pressure signal damping event is occurring. In response to the determination that an arterial blood pressure signal damping event is occurring, the arterial blood pressure monitor 302 transmits a command to the automatic valve 106 (e.g., an electronically controllable valve such as a computer-controlled electrofluid valve) to automatically flush the catheter tube 108. The arterial blood pressure monitor 302 determines whether the arterial blood pressure signal damping event has been resolved in response to the automatic flushing of the catheter tube 108 based on the arterial blood pressure signal. In such an example, the determination that an arterial blood pressure signal damping event is occurring is based on a first criterion, and the determination that the arterial blood pressure signal damping event has been resolved is based on a second criterion different from the first criterion.

[0032]

[0041] In operation, the arterial blood pressure monitor 302 determines, with respect to a first criterion, whether an arterial blood pressure signal damping event has occurred, based on a characteristic pattern change in the arterial blood pressure signal within a specified time window and exceeding one or more specified threshold values. Additionally or alternatively, with respect to a second criterion, the arterial blood pressure monitor 302 determines, with respect to a second criterion, whether the arterial blood pressure signal occurring before a specified pre-flash time window exceeds one or more specified flash effectiveness threshold values, compared with the arterial blood pressure signal occurring after a specified post-flash time window. For example, the values ​​of one or more specified flash effectiveness thresholds include the systolic arterial blood pressure threshold value, the pulsed arterial blood pressure threshold value, the arterial blood pressure waveform slope threshold value, and / or a combination thereof.

[0033]

[0042] In the illustrated example, the arterial blood pressure management system 300 further includes a pressure sensor 112 for sensing the patient's arterial blood pressure and generating a signal, and an automatic valve 106 for automatically flushing the catheter tube 108. In some implementations, the pressure sensor input 114 is implemented as a cable or wireless communication device coupled to communicate with the pressure sensor 112. In some examples, the automatic valve 106 is an electronically controllable fluid valve introduced into the flush tube, which replaces or is used in addition to a manual valve.

[0034]

[0043] Additionally or alternatively, the arterial blood pressure management system 300 further includes therapeutic devices 320, medical management devices 322, a database 324 (e.g., an EMR database), user interfaces 326 (e.g., one or more user interfaces 326 are associated with a user) (e.g., a patient monitor), and / or combinations thereof. For example, the therapeutic devices 320, medical management devices 322, the database 324, and / or user interfaces 326 communicate with each other via internet-based communication, cloud-based communication, wired communication, wireless communication, and / or combinations thereof.

[0035]

[0044] In the example, a patient monitor (not shown) is configured to monitor the patient for vital signs, etc., and the patient monitor transmits such measured patient data to a database 324. In some implementations, such patient monitors include bedside type monitors, transport type monitors, central station type monitors, and / or combinations thereof.

[0036]

[0045] In another example, the therapeutic device 320 is configured to monitor the delivery of a specific treatment (e.g., a non-medication treatment) to a patient and transmit such measured patient data to a database 324. In some implementations, the therapeutic device 320 is coupled to an arterial blood pressure monitor 302. For example, the therapeutic device 320 is a ventilator coupled to an arterial blood pressure monitor 302 as a closed-loop control system.

[0037]

[0046] In a further example, the medical management device 322 is configured to monitor drug delivery to the patient and transmit such measured patient data to a database 324. In some implementations, the medical management device 322 is coupled to an arterial blood pressure monitor 302. For example, the medical management device 322 is a vasoactive drug delivery pump coupled to an arterial blood pressure monitor 302 as a closed-loop control system.

[0038]

[0047] In addition or alternatively, in further examples, the user interface 326 may be implemented by one or more form factor devices (e.g., smartphones, tablets, laptops, workstations, and / or such), interfaces associated with the arterial blood pressure monitor 302, and / or interfaces associated with the patient monitor. In addition or alternatively, the therapist may receive patient data through analog devices, non-networked patient monitors, non-networked therapeutic devices, non-networked medical management devices, and / or combinations thereof.

[0039]

[0048] In the illustrated implementation, database 324 contains one or more types of patient data. For example, database 324 contains patient data including laboratory results data, microbiological data, drug data, vital signs data, treatment sequence data, admission / discharge and transfer data, and / or such data. As used herein, the term “database” refers to a collection of data and information organized to enable the storage, retrieval, updating, and / or manipulation of data and information. As used herein, the term “database” further refers to a database that resides locally or is accessed from a remote location (e.g., via a remote network server).

[0040]

[0049] As used herein, the term “patient data” refers to data or information used to identify an individual. Patient data includes patient data measured from analog medical devices, sensors, patient monitors, therapeutic devices, medical management devices, medical imaging devices, and / or combinations thereof. In addition, patient data includes the patient’s name, age, weight, medical history, hospitalization number, changes in healthcare providers, admission date, medical conditions, medical status, and / or combinations thereof.

[0041]

[0050] Additionally or alternatively, in some implementations, database 324 includes or is associated with a simulated database. In such examples, such a simulated database generates estimated patient data. For example, the simulated database utilizes some measured patient data to generate some other estimated patient data. Such a simulated database utilizes, for example, digital twin technology to perform estimations. In such examples, such estimated patient data is marked to indicate its estimated properties (rather than the measured patient data). Additionally or alternatively, a weight factor is applied to the estimated patient data such that the estimated patient data has a lower weight than the corresponding measured patient data.

[0042]

[0051] As used herein, the term “closed-loop control system” refers to a system that relies on feedback to perform automatic adjustments without user input. For example, a user establishes parameters for a given system (e.g., one or more setpoints, acceptable operating ranges, thresholds, and / or combinations thereof), and at the same time, such a closed-loop control system utilizes blood pressure feedback from the arterial blood pressure monitor 302 to perform automatic adjustments to a given treatment, drug delivery, and / or combinations thereof.

[0043]

[0052] In some implementations, the procedures described herein are performed via one or more of the following: a server, a smart hub, a smart cable, an arterial blood pressure monitor 302, a therapeutic device 320, a medical management device 322, and / or a combination thereof.

[0044]

[0053] As used herein, the term “smart hub” refers to software, firmware, and / or hardware adapted to monitor and / or control multiple Internet of Things (IoT) devices. Additionally or alternatively, such smart hubs will monitor and / or control the interactions between individual devices within the multiple Internet of Things (IoT) devices.

[0045]

[0054] As used herein, the term “smart cable” refers to a power cable and / or a communications cable including software, firmware and / or hardware adapted to monitor and / or control one or more devices commutably coupled to such a smart cable.

[0046]

[0055] ABP pulse detection and feature extraction

[0047]

[0056] In operation, the ABP pulse detection and feature extraction techniques described herein perform several tasks related to analyzing ABP signals, namely pulse detection, pulse feature extraction, signal quality evaluation, and / or combinations thereof.

[0048]

[0057] For pulse detection, a gradient sum function-based pulse detection algorithm is used, which reliably detects ABP pulses by their onset.

[0049]

[0058] For pulse feature extraction, groups of ABP pulse features, such as pulse intervals between heartbeats, instantaneous ABP values, and short-term averaged ABP values ​​with signal quality control (e.g., including systolic, diastolic, mean, and pulse pressure), instantaneous maximum ABP slope, and short-term averaged maximum ABP slope with signal quality control (e.g., including positive and negative), are extracted for each heartbeat and associated with each pulse.

[0050]

[0059] For signal quality evaluation, ABP signal quality is assessed for each detected pulse by analyzing various ABP waveform characteristics, and a signal quality index (SQI) value ranging from 0 to 1 (for example, 1 represents the best quality, and 0 represents the worst quality) is determined and associated with the pulse.

[0051]

[0060] Detection of ABP dumping events

[0052]

[0061] During operation, the ABP damping detection technique described herein detects ABP damping events by using the following characteristics / features of the detected ABP waveform. In a given time window (e.g., 2 minutes),

[0062] 1) Systolic ABP decreases slowly from pulse to pulse.

[0063] 2) Pulse ABP (i.e., the difference between systolic BP and diastolic BP) decreases slowly from pulse to pulse, reaching a significantly low level (e.g., 65%).

[0064] 3) The mean ABP is kept relatively constant, i.e., maintained at approximately the same level.

[0065] 4) The systolic ABP is kept relatively constant, i.e., maintained at approximately the same level.

[0066] 5) Most (e.g., 90%) of the ABP pulses have sufficient signal quality (e.g., SQI > 0.9).

[0053]

[0067] The output of the ABP damping detection technique described herein is a Flash Necessity Index (FNI) whose binary value is 0 or 1, using 1 if a flash is required when the ABP waveform is attenuated and 0 if the ABP waveform is not attenuated.

[0054]

[0068] For the specific design and implementation form of the ABP damping detection algorithm, as follows, for the currently detected ABP pulse (P i ), assume there are N pulses detected within the time window (T i ) before P w . The ABP characteristics by those N pulses are investigated, and the following variables are defined and calculated. According to one or more exemplary implementations, T w is 2 minutes (120 s).

[0055]

[0069] T w within, the percentage of pulses with good signal quality is

[0070] P good_SQI = M / N (1),

[0071] where N is the total number of pulses within the window (T w ), and M is the number of pulses (within T w ) with good signal quality (i.e., the SQI value is higher than a predefined threshold, e.g., SQI > 0.7).

[0056]

[0072] T wThe percentage of pulses containing a short-term averaged systolic blood pressure (sBPa) that decreases within the pulse is:

[0073] P sBPa_decline =K / N (2),

[0074] Here, K is a pulse (T) where sBPa is lower than the sBPa of the previous pulse. w This is the number of (within).

[0057]

[0075] T w The percentage of pulses containing a short-term averaged pulse BP (pBPa) that decreases within the pulse is:

[0076] P pBPa_decline =L / N; (3)

[0077] Here, L is a pulse (T) where the pBPa is lower than the pBPa of the previous pulse. w This is the number of (within).

[0058]

[0078] T w The difference in average BP (mBPa) averaged over a short period is:

[0079] mBP i_vs_x =mBPa(i) / mBPa(x) (4)

[0080] Here, mBPa(i) is the mBPa value at the current pulse time (i), and mBPa(x) is the value at time x (x=iT). w This is the mBPa value at ).

[0059]

[0081] T w The difference in diastolic blood pressure (dBPa) averaged over a short period is:

[0082] dBP i_vs_x =dBPa(i) / dBPa(x) (5)

[0083] Here, dBPa(i) is the dBPa value at the current pulse time (i), and dBPa(x) is the value at time x (x=iT). w This is the dBPa value at ).

[0060]

[0084] T w The difference in pulse BP (pBPa) averaged over a short period is:

[0085] pBP i_vs_x =pBPa(i) / pBPa(x); (6)

[0086] Here, pBPa(i) is the pBPa value at the current pulse time (i), and pBPa(x) is the value at time x (x=iT). w This is the pBPa value at ).

[0061]

[0087] The ABP Flash Needs Index (FNI) is derived from the following logic.

[0088] IF P good_SQI >thr1 AND

[0089] (P sBPa_decline >thr2 OR P pBPa_decline >thr3) AND

[0090] (mBP i_vs_x >thr4 OR dBP i_vs_x >thr5) AND

[0091] pBP i_vs_x <thr6

[0092] THEN FNI=1;

[0093] ELSE FNI=0; (7)

[0094] Here, thr1, thr2, thr3, thr4, thr5, and thr6 are appropriate thresholds empirically obtained from experimental data. In this embodiment, thr1 is selected as 0.9, thr2 as 0.6, thr3 as 0.6, thr4 as 0.85, thr5 as 0.9, and thr6 as 0.65.

[0062]

[0095] FNI is calculated for each heartbeat.

[0063]

[0096] As will be explained in more detail below, Figure 6 shows exemplary results of ABP damping detection. As illustrated, the ABP raw signal 602 panel is an episode of raw ABP signal recorded from an ICU patient, which contains two ABP damping events followed by a manual flush performed by an ICU nurse (e.g., the manual flush events can be understood as pulses with saturated pressure). The ABP SQI 604 panel shows the ABP signal quality index (SQI) values ​​generated by the automated flush technique described herein. The systolic ABP 606, diastolic ABP 608, and pulsed ABP 610 panels show the short-term averaged (e.g., SQI controlled) systolic, diastolic, and pulsed blood pressure values, respectively, generated by the automated flush technique described herein. The ABP damping (FNI) 612 panel is the FNI (Boolean) value generated by the ABP damping detection algorithm. Referring to the original upper limit ABP signal, the ABP damping detection algorithm is triggered before the desired manual flush event, and the FNI signal remains true until the flush event. Thus, the example in Graph 600 demonstrates that the automated flushing technique described herein can take action before a skilled ICU nurse.

[0064]

[0097] Alternatively or additionally, in response to a determination that an arterial blood pressure signal damping event has occurred, the arterial blood pressure monitor 302 is instructed to alert a medical clinician or specialist to perform IABP monitoring by automatically generating one or more of the following: an audio warning signal, a video warning signal, or a tactile warning signal. This alert for the arterial blood pressure signal damping event is stored in a medical database system and used to prevent related false-positive blood pressure alarms.

[0065]

[0098] Alternatively or additionally, in response to a determination that an arterial blood pressure signal dumping event has occurred, the arterial blood pressure monitor 302 is instructed to automatically start non-invasive arterial blood pressure (NIABP) measurement for subject S. NIABP measurement does not need to be started for events in which one or more recent NIABP measurement results for subject S are available and stored in one or more of the databases 324.

[0066]

[0099] According to one or more exemplary embodiments, the arterial blood pressure management system 300 dynamically monitors a patient's ABP performance by considering one or more identifiable patterns in the IABP waveform associated with damping. The flash effectiveness assessment (FEA) technique described herein is applied to dynamically analyze the IABP waveform in real time to automatically detect one or more identifiable patterns.

[0067]

[0100] Automatic flushing start

[0068]

[0101] During operation, when an ABP damping event is detected, a single pulse or a square wave-like flushing control signal is issued to initiate automatic flushing control. Thus, the automatic valve 106 is opened for an appropriate duration (e.g., 2 seconds) and then closed to complete the automatic flushing operation control. The square wave-like flushing control signal allows for multiple automatic flushing operations when multiple such operations are required.

[0069]

[0102] For example, when damping is detected, the arterial blood pressure monitor 302 automatically transmits a first control signal to initiate a rapid flushing sequence. The flash effectiveness evaluation (FEA) technique described herein continues to analyze the IABP waveform after the rapid flushing sequence to evaluate whether the detected attenuated IABP waveform has been resolved (e.g., returned to normal). If the attenuated IABP waveform has been resolved after the rapid flushing sequence, the IABP monitoring process continues.

[0070]

[0103] According to one or more exemplary embodiments, an automated high-speed flushing sequence is performed by a flushing device that includes an automated valve 106 (e.g., a computer-controlled electrofluid valve) in a flush tube 104. Upon receiving an activation signal from the arterial blood pressure monitor 302, the arterial blood pressure management system 300 causes a time-allocated (e.g., with respect to time and duration) high-speed flushing to be performed.

[0071]

[0104] ABP recovery detection (after flash)

[0072]

[0105] In operation, the arterial blood pressure monitor 302 is configured to track the ABP waveform immediately following an automatic flushing sequence, and then determine whether the attenuated ABP waveform has recovered, for example, whether the flushing operation is effective. Recovery of the ABP waveform is indicated by one or more identifiable features, for example, a significant increase in systolic BP and pulsed BP values, and a significant increase in the maximum ABP waveform slope.

[0073]

[0106] According to one or more embodiments, detection of ABP recovery by the arterial blood pressure monitor 302 after the execution of an automated flushing sequence is performed by the arterial blood pressure monitor 302 initiating a flush effectiveness assessment (FEA) algorithm. The FEA algorithm tracks certain ABP waveform features immediately after the automated flushing sequence and then compares them to the same features taken immediately before the automated flushing sequence to determine whether the ABP waveform has recovered.

[0074]

[0107] The specific design and implementation of the FEA algorithm are performed as follows: The automatic flushing sequence start time is F on Assume that the following ABP features prior to the flash sequence are F on The T before b1 T located at (for example, 2s) b2 It is calculated from ABP pulses over a period of time (e.g., 10 seconds).

[0108] T b2 sBPa before flushing, which is the averaged systolic ABP;

[0109] T b2 The pulse ABP averaged to the pre-flash pBP;

[0110] T b2 The maximum ABP waveform slope averaged to mxSLPa before flash, provided that good signal quality (e.g., SQI > 0.9), T b2 Only the ABP pulse of T is taken into consideration. In this embodiment, T b2 It was selected as 10s, T b1 The time interval is set to 2s, and the SQI threshold is set to 0.9.

[0075]

[0111] The end time of the automatic flushing sequence is F off Let's assume that the following ABP features after the flash are F off T after e1 T located at (for example, 3s) e2 It is calculated from ABP pulses over a period of time (e.g., 10 seconds).

[0112] T e2 sBPa after flushing, which is the averaged systolic ABP;

[0113] T e2 pBPa after flash is the averaged pulse ABP;

[0114] T e2 The maximum ABP waveform slope averaged to mxSLPa after flash, provided that good signal quality (e.g., SQI > 0.9), T e2 Only the ABP pulse is taken into consideration. According to one or more exemplary embodiments, T e2 It was selected as 10s, T e1 The time interval is set to 3s, and the SQI threshold is set to 0.9.

[0076]

[0115] The Flash Effectiveness Index (FEI) is derived from the following logic.

[0116] FEI=0;

[0117] IF pABPa_after_flush / pABPa_before_flush >r1 AND

[0118] sABPa_after_flush / sABPa_before_flush >r2 AND

[0119] mxSLPa_after_flush / mxSLPa_before_flush >r3 AND

[0120] THEN FEI=1; (for 2 seconds)

[0121] ELSE FEI=-1; (for 2s) (8)

[0122] Here, r1, r2, and r3 are appropriate (ratio) thresholds empirically obtained from experimental data. According to one or more exemplary embodiments, r1 is selected as 1.5, r2 as 1.2, and r3 as 2.0.

[0077]

[0123] The FEI value is initialized to 0. If the automatic flushing sequence is effective (i.e., the ABP signal is recovered), the FEI receives a value of "1" (for 2 seconds, then returns to a value of 0 to visually indicate the result). On the other hand, if the automatic flushing sequence is unsuccessful, the FEI receives a value of "-1" (for 2 seconds, and then returns to a value of 0 to visually indicate the result). off The time after (T e1 +T e2 A decision is made at this point. This short delay is necessary because a reasonable time period is required to ensure that ABP features are acquired after the automatic flushing sequence. Skip window T b1 and T e1 However, it is introduced to eliminate ABP waveforms that are very close to (and therefore could be disrupted by) the automatic flashing sequence.

[0078]

[0124] The FEI is calculated immediately after the completion of each automatic flushing sequence. Further details regarding the FEI results are described below with reference to Figures 6 and 7.

[0079]

[0125] To illustrate the FEI results, the flushing signal is generated according to a manual flushing operation on the ABP record for a skilled ICU medical clinician or specialist, as illustrated in the illustrated example of Figure 6, as described below. The flushing signal includes a single pulse or square wave function, including its non-zero value, corresponding to the manual flushing operation for the medical clinician or specialist (identified, for example, by the saturated ABP signal shown in the ABP Raw Signals panel 602). The proposed FEA algorithm performed by the arterial blood pressure monitor 302 takes the start and stop times of each flushing operation and calculates the (T) after the flush stop time for this flush, as shown in the Flash Effectiveness (FEI) panel 616. e1 +T e2The FEI value is generated at ). The FEI value lasts for a duration of 2 seconds and resets to zero to visually observe the result of the flash effectiveness evaluation. Flash Effectiveness (FEI) 616 As seen in the panel, both flashes are evaluated as properly effective.

[0080]

[0126] As illustrated in Figure 7 and described in more detail below, multiple flashes were performed for IABP dumping detection and flash effectiveness evaluation. The first IABP dumping event is appropriately detected by the arterial blood pressure monitor 302, as indicated by the FNI value in the ABP Dumping (FNI) 712 panel, and prior to visual observation by a medical clinician or specialist. The flash sequence includes four manual flashes performed by a medical clinician or specialist (as shown in the Flash Operation 714 panel). The first three flashes corresponded to the first dumping event. Of the first three flashes, the first two were ineffective, and the third flash was successful (e.g., effective). The proposed FEA algorithm performed by the arterial blood pressure monitor 302 appropriately evaluated the flashing effectiveness by producing an FEI using a value of -1 for the first two flashes and a value of 1 for the third flash (as shown in the Flash Effectiveness (FEI) 716 panel). The fourth flash corresponds to the second ABP dumping event. The second IABP dumping event is appropriately detected by the arterial blood pressure monitor 302 prior to manual identification by a medical clinician or specialist. The (4th) manual flushing operation (around 07:17:00) is appropriately evaluated as effective (FEI has a value of 1).

[0081]

[0127] According to one or more exemplary embodiments, the arterial blood pressure management system 300 is configured to label detected IABP data streams associated with ABP dumping events as "suspicious," thereby preventing the generation of alarms based on false-positive physiological alarms according to its logic.

[0082]

[0128] As will be discussed in more detail below with reference to Figure 5, if the ABP waveform is recovered after the automated flushing sequence, IABP monitoring continues. In the event that IABP is not recovered, a subsequent automated flushing sequence is performed. If the number of flashes in the sequence exceeds a predetermined or predetermined value M (e.g., M=3), but the IABP waveform has not yet recovered, the arterial blood pressure management system 300 triggers the generation of an alarm (e.g., an audio warning signal, a video warning signal, a tactile notification signal, and / or a combination thereof) to alert a medical clinician or specialist, indicating that the catheter tube 108 has an overdumping problem and requires manual intervention to resolve the dumping issue.

[0083]

[0129] Figure 4 shows an exemplary method 400 for operating an arterial blood pressure management system according to an embodiment. Method 400 is generally implemented within an arterial blood pressure management system, such as the arterial blood pressure management system 300 (Figure 3) discussed earlier.

[0084]

[0130] In embodiments, Method 400 (and Method 500 (Figure 5)) is implemented in logical commands (e.g., software), configurable logic, fixed-function hardware logic, or any combination thereof. Certain parts of the operation of the EMR management system 300 (Figure 3) are illustrated within Method 400 (and Method 500 (Figure 5)), while other parts of the operation of the EMR management system 300 (Figure 3) are intentionally omitted to simplify the explanation of the Method.

[0085]

[0131] The illustrated processing block 402 enables the determination of whether an arterial blood pressure signal damping event is occurring. For example, such determination is based on a specific pattern change in the arterial blood pressure signal within a specified time window and exceeding one or more specified threshold values.

[0086]

[0132] The illustrated processing block 404 enables the automatic flushing of the catheter tube. For example, the catheter tube is automatically flushed in response to a determination that an arterial blood pressure signal damping event has occurred.

[0087]

[0133] Additional and / or alternative operations for Method 400 are described in detail below in the description in Figure 5.

[0088]

[0134] Figure 5 is a flowchart of an example of another method 500 for operating an arterial blood pressure management system according to an embodiment. Method 500 is generally implemented within an arterial blood pressure management system, such as the arterial blood pressure management system 300 (Figure 3) already discussed.

[0089]

[0135] The illustrated processing block 504 enables pulse detection and feature extraction from the signal 502. For example, pulse detection is performed on the arterial blood pressure signal. Additionally, pulse features are extracted from the arterial blood pressure signal.

[0090]

[0136] In some implementations, signal quality is determined for each pulse and associated heartbeat. For example, pulse features are extracted for each pulse and associated heartbeat, but the pulse features include one or more of the following: pulse interval between heartbeats, instantaneous arterial blood pressure value, averaged arterial blood pressure value, instantaneous maximum arterial blood pressure slope, averaged maximum arterial blood pressure slope, and / or a combination thereof.

[0091]

[0137] The illustrated processing block 506 enables the detection of arterial blood pressure damping. For example, the determination of whether such an arterial blood pressure signal damping event is occurring is further based on one or more of the following: determining whether there is a continuous decrease in systolic arterial blood pressure per heartbeat based on a first threshold value from one or more specified threshold values; determining whether there is a continuous decrease in the difference between systolic and diastolic arterial blood pressure per heartbeat based on a second threshold value from one or more specified threshold values; determining whether the mean arterial blood pressure is stable over time based on a third threshold value from one or more specified threshold values; determining whether the diastolic arterial blood pressure is stable over time based on a fourth threshold value from one or more specified threshold values; determining whether, within a specified time window, the percentage of pulses having a signal quality exceeding a signal quality threshold value exceeds a fifth threshold value from one or more specified threshold values; and / or one or more combinations thereof.

[0092]

[0138] In some implementations, the determination that an arterial blood pressure signal damping event has occurred is based on a first criterion, while the determination that the arterial blood pressure signal damping event has resolved is based on a second criterion that differs from the first criterion.

[0093]

[0139] The illustrated processing block 508 provides a determination block regarding whether arterial blood pressure is being attenuated. If it is determined that no arterial blood pressure signal damping event has occurred, method 500 returns to processing block 504. If it is determined that an arterial blood pressure signal damping event has occurred, method 500 proceeds to processing block 510.

[0094]

[0140] The illustrated processing block 510 enables the triggering of an arbitrarily selected alarm for an arterial blood pressure signal damping event.

[0095]

[0141] Additionally, the blood pressure limit alarm is blocked in response to the transmission of a dumping event notification to the user interface.

[0096]

[0142] If an optional alarm for an arterial blood pressure signal damping event is triggered, method 500 proceeds to processing block 512; otherwise, method 500 proceeds to processing block 514.

[0097]

[0143] The illustrated processing block 512 enables the delivery of an optional alarm for an arterial blood pressure signal damping event. For example, a damping event notification is transmitted to a user interface 326 associated with a healthcare provider and / or other devices (e.g., an arterial blood pressure monitor 302, a therapeutic device 320, a medical management device 322, etc., and / or a combination thereof) in response to a determination that an arterial blood pressure signal damping event has occurred.

[0098]

[0144] The illustrated processing block 514 implements the initialization of a counter.

[0099]

[0145] The illustrated processing block 516 enables the initiation of an automatic flushing operation.

[0100]

[0146] The illustrated processing block 517 realizes the use of an electric flushing valve to perform an automatic flushing operation.

[0101]

[0147] The illustrated processing block 518 enables the detection of arterial blood pressure recovery. For example, a determination of whether an arterial blood pressure signal damping event has resolved is made in response to automatic flushing of the catheter based on the arterial blood pressure signal. Such a determination that an arterial blood pressure signal damping event has resolved includes determining whether an arterial blood pressure signal that occurred before a specified pre-flash time window exceeded one or more specified flush effectiveness threshold values, compared with an arterial blood pressure signal that occurred after a specified post-flash time window.

[0102]

[0148] In some implementations, one or more specified flash effectiveness threshold values ​​include the systolic arterial blood pressure threshold value, the threshold value for the difference between systolic and diastolic arterial blood pressure (e.g., "pulse ABP"), the threshold value for the maximum arterial blood pressure waveform slope, and / or combinations thereof.

[0103]

[0149] The illustrated processing block 520 provides a determination block for determining whether arterial blood pressure recovery has occurred. If arterial blood pressure recovery has occurred, method 500 returns to processing block 504. If arterial blood pressure recovery has not occurred, method 500 proceeds to processing block 522.

[0104]

[0150] The illustrated processing block 522 provides a determination block for determining whether the counter exceeds a pre-set maximum iteration value. If the counter exceeds the pre-set maximum iteration value, method 500 proceeds to processing block 524. If the counter does not exceed the pre-set maximum iteration value, method 500 proceeds to processing block 526.

[0105]

[0151] The illustrated processing block 524 implements the generation of an alarm indicating that arterial blood pressure recovery has not occurred. For example, such an alarm is generated after a limit of automatic flushes has occurred but the arterial blood pressure damping could not be resolved. In some implementations, the unresolved flush notification is forwarded to a user interface 326 associated with the healthcare provider and / or other devices (e.g., arterial blood pressure monitor 302, therapeutic device 320, medical management device 322, etc., and / or a combination thereof) in response to the determination that the arterial blood pressure signal damping event has not been resolved.

[0106]

[0152] Additionally, the blood pressure limit alarm is blocked in response to the transfer of unresolved flash notifications to the user interface.

[0107]

[0153] The illustrated processing block 526 implements the incrementing of a counter and returning to processing block 516.

[0108]

[0154] In operation, method 500 is performed via one or more of the following: a server, a smart hub, a smart cable, an arterial blood pressure monitor 302, a therapeutic device 320, a medical management device 322, and / or a combination thereof.

[0109]

[0155] It will be understood that some or all of the operations in Method 500 described above that are described using a “pull” architecture (e.g., polling for new information and the corresponding response thereafter) are instead performed using a “push” architecture (e.g., sending information when there is new information to report), and vice versa.

[0110]

[0156] Figure 6 shows a graph 600 illustrating the detection of an example of an arterial blood pressure dumping event according to an embodiment, and the resulting evaluation of recovery regarding the dumping event after the corresponding flush. In the illustrated example, the raw ABP signal 602, ABP SQI 604, systolic ABP 606, diastolic ABP 608, pulsed ABP 610, ABP dumping (FNI) 612, flush operation 614 (e.g., manual flush by the therapist), and flush effectiveness (FEI) 616.

[0111]

[0157] Graph 600 shows an example of an ABP dumping event due to blood clot formation, along with the corresponding flush and return to normal pressure. The ABP dumping event is appropriately detected by the techniques described herein (e.g., earlier than observation by a skilled nurse) (e.g., as indicated by ABP Dumping (FNI) 612). Both flushes are appropriately assessed as effective by the techniques described herein (as indicated by Flush Effectiveness (FEI) 616).

[0112]

[0158] Figure 7 shows a further illustration of Graph 700 illustrating the detection of an example of an arterial blood pressure dumping event according to an embodiment, and the resulting evaluation of the recovery of the dumping event after the corresponding repeated flush. In the illustrated example, the raw ABP signal 702, ABP SQI 704, systolic ABP 706, diastolic ABP 708, pulsed ABP 710, ABP dumping (FNI) 712, flush operation 714 (e.g., manual flush by the therapist), and flush effectiveness (FEI) 716.

[0113]

[0159] Graph 700 shows another example of an ABP dumping event due to blood clot formation, along with the corresponding flash. The two ABP dumping events are appropriately detected (e.g., earlier than nurse observation) by the techniques described herein (as indicated by ABP Dumping (FNI) 712). The effectiveness of the flash (including effective and ineffective flashes) is appropriately assessed by the techniques described herein (as indicated by Flash Effectiveness (FEI) 716).

[0114]

[0160] Figure 8 shows a block diagram of an exemplary computer program product 800. As shown in Figure 8, in some examples, the computer program product 800 further includes machine-readable storage 802, which includes logic 804. In some implementations, machine-readable storage 802 is implemented as non-temporary machine-readable storage. In some implementations, logic 804 is implemented as machine-readable instructions, such as software. In some embodiments, as already discussed, when executed, logic 804 implements one or more aspects of method 400 (Figure 4), method 500 (Figure 5), and / or realizes the arterial blood pressure management system 300 (Figure 3).

[0115]

[0161] Figure 9 shows an illustrative example of the arterial blood pressure management system 300. In the illustrated example, the arterial blood pressure management system 300 includes a processor 902 and a memory 904 communicatively coupled to the processor 902. The memory 904 includes a logic 906 as a set of instructions. In some implementations, the logic 906 is implemented as software. In embodiments, as already discussed, when executed, the logic 906 implements one or more aspects of method 400 (Figure 4), method 500 (Figure 5), and / or realizes the arterial blood pressure management system 300 (Figure 3).

[0116]

[0162] In some implementations, the processor 902 includes a general-purpose controller, a dedicated controller, a storage controller, a storage manager, a memory controller, a microcontroller, a general-purpose processor, a dedicated processor, a central processing unit (CPU), and / or a combination thereof.

[0117]

[0163] Furthermore, implementation forms include distributed processing, component / target distributed processing, parallel processing, and / or combinations thereof. For example, virtual computer system processing implements one or more methods or functions as described herein, and the processor 902 described herein is used to support such virtual processing.

[0118]

[0164] In some examples, memory 904 is an example of computer-readable storage medium. For example, memory 904 is any memory accessible to processor 902, including, but not limited to, RAM memory, registers, register files, and / or combinations thereof. References to “computer memory” or “memory” should, in some cases, be interpreted as referring to multiple memories. Memory is, for example, multiple memories within the same computer system. Memory is further, multiple memories distributed among multiple computer systems or coding devices.

[0119]

[0165] Figure 10 shows an exemplary semiconductor device 1000 (e.g., a chip and / or package). The exemplary device 1000 includes one or more substrates 1002 (e.g., silicon, sapphire, or gallium arsenide) and logic 1004 (e.g., configurable logic and / or fixed-function hardware logic) coupled to the substrate(s) 1002. In embodiments, as already discussed, the logic 1004 implements one or more aspects of method 400 (Figure 4), method 500 (Figure 5), and / or implements the arterial blood pressure management system 300 (Figure 3).

[0120]

[0166] In some implementations, logic 1004 includes transistor arrays and / or other integrated circuit / IC components. For example, implementations of configurable logic and / or fixed-function hardware logic of logic 1004 include configurable logic such as programmable logic arrays (PLAs), field-programmable gate arrays (FPGAs), composite programmable logic devices (CPLDs), or fixed-function logic hardware, using circuit technologies such as application-specific integrated circuits (ASICs), complementary metal-oxide-semiconductor (CMOS), or transistor-transistor logic (TTL) technology, and / or combinations thereof.

[0121]

[0167] All provisions set forth and used herein should be understood to govern dictionary definitions, documentary definitions incorporated by reference, and / or the ordinary meanings of the terms provided.

[0122]

[0168] The subject matter described herein sometimes refers to different components contained within or connected to other different components. It should be understood that such expressed architectures are merely illustrative, and that in fact many other architectures can be implemented to achieve the same function. In a conceptual sense, any constructs of components for achieving the same function are effectively “associated” in such a way that the desired function is achieved. Thus, any two components in this specification that are combined to achieve a particular function, whether architectural or intermediate components, can be understood as “associated” with each other in such a way that the desired function is achieved. The term “connected” in this specification is used to refer to any type of direct or indirect relationship between the components in question, and applies to electrical, mechanical, fluid, optical, electromagnetic, electromechanical, or other connections. Similarly, any two components thus associated can also be considered “operably connected” or “operably coupled” with each other in such a way that they achieve the desired function, and any two components that can be associated in such a way can also be considered “operably coupled” with each other in such a way that they achieve the desired function. Specific examples of components that can be operably coupled include, but are not limited to, components that can physically interlock and / or interact with each other.

[0123]

[0169] In the claims and the above specifications, terms such as “first,” “second,” etc., are used herein solely for the purpose of facilitating discussion and, unless otherwise indicated, do not carry any particular temporal or chronological significance.

[0124]

[0170] In the claims and in the above specifications, all transitional phrases such as “equipped with,” “include,” “carry,” “have,” “contain,” “accompany,” “hold,” and “composed of” should be understood to be open-ended, that is, not limited to those that include. Only the transitional phrases “consist of” and “essentially consist of” shall be closed or semi-closed transitional phrases, respectively.

[0125]

[0171] In the specifications and claims, singular elements as used herein should be understood to mean “at least one” unless explicitly stated otherwise.

[0126]

[0172] As used herein, the terms “or” or “and / or” are inclusive and non-exclusive unless explicitly otherwise indicated or otherwise indicated by context. Thus, as used herein, “A or B” means “A, B, or both” unless explicitly otherwise indicated or otherwise indicated by context. Furthermore, as used herein, “and” means both jointly and separately unless explicitly otherwise indicated or otherwise indicated by context. Thus, as used herein, “A and B” means “A and B, jointly or separately” unless explicitly otherwise indicated or otherwise indicated by context.

[0127]

[0173] In the specifications and claims, the phrase “at least one” as used herein in relation to a list of one or more elements should be understood to mean at least one element selected from any one or more elements in the list of elements, but not necessarily including at least one of each and all of the elements specifically enumerated in the list of elements, and not excluding any combination of elements in the list of elements. This provision also allows for elements to exist separately from the elements specifically identified in the list of elements to which “at least one” refers, whether or not they are related to the specifically identified elements, at their discretion.

[0128]

[0174] In this application and in the claims, the list of items joined by the term "one or more of the listed terms" means any combination of the listed terms. For example, the phrase "one or more of A, B, or C" means A; B; C; A and B; A and C; B and C; or A, B and C.

[0129]

[0175] As described in more detail above, one or more processors, other units, and / or combinations thereof realize the functions of some of the items described in the claims.

[0130]

[0176] As described in more detail above, computer programs are stored / distributed on suitable media such as optical storage media or solid-state media supplied together with or as part of other hardware, but are also distributed in other forms, such as via the Internet or other wired or wireless communication systems.

[0131]

[0177] Unless explicitly stated otherwise, it should also be understood that in any method discussed herein involving multiple steps or actions, the order of the steps or actions of the method is not necessarily limited to the order in which the steps or actions of the method are described. Furthermore, such methods may have additional or alternative steps or actions.

[0132]

[0178] When used in patent claims, the mere fact that certain means are described in different dependent claims does not indicate that a combination of these means cannot be used advantageously.

[0133]

[0179] It should be further noted that the claims include reference numerals / digits in accordance with PCT Rule 6.2(b). However, these claims should not be considered limited to exemplary implementations corresponding to those reference numerals / digits.

[0134]

[0180] Those skilled in the art will understand from the foregoing description that the broad techniques of the embodiments of the present invention can be implemented in various forms. Therefore, although embodiments of the present invention have been described in relation to specific examples, the true scope of embodiments of the present invention should not be limited in this way, for other modifications will become apparent to those skilled in the art through study of the drawings, specifications, and the following claims.

Claims

1. A pressure sensor receptor for receiving arterial blood pressure signals detected by a pressure sensor, An arterial blood pressure monitor is communicably coupled to the pressure sensor receiver. An arterial blood pressure management system comprising, The aforementioned arterial blood pressure monitor is Based on the arterial blood pressure signal, it is determined whether an arterial blood pressure signal damping event has occurred. A command is transmitted to the electronically controllable valve to control the valve to automatically flush the catheter tube in response to the determination that the arterial blood pressure signal damping event has occurred. The determination of whether the arterial blood pressure signal damping event has been resolved in response to the automatic flushing of the catheter tube based on the arterial blood pressure signal is made, wherein the determination that the arterial blood pressure signal damping event has occurred is based on a first criterion, and the determination that the arterial blood pressure signal damping event has been resolved is made based on a second criterion different from the first criterion. With respect to the first criterion, it is determined whether multiple features of the arterial blood pressure signal within a specified time window exceed the values ​​of multiple specified thresholds, and if multiple features of the arterial blood pressure signal exceed the values ​​of the multiple specified thresholds, it is determined that an arterial blood pressure signal damping event has occurred, wherein the values ​​of the multiple specified thresholds have threshold values ​​for the percentage of pulses containing decreasing systolic arterial blood pressure within the specified time window. With respect to the second criterion, it is determined whether each ratio of the same characteristics of the arterial blood pressure signal occurring after a specified post-flash time window to the characteristics of the arterial blood pressure signal occurring before a specified pre-flash time window exceeds a corresponding value of a plurality of specified flash effectiveness thresholds, and if each ratio exceeds the corresponding value of the specified flash effectiveness threshold, it is determined that the arterial blood pressure signal damping event has been resolved, wherein the values ​​of the plurality of specified flash effectiveness thresholds include a threshold value for the ratio of systolic arterial blood pressure, a threshold value for the ratio of pulsed arterial blood pressure, and a threshold value for the ratio of arterial blood pressure waveform slope. An arterial blood pressure management system that performs this function.

2. The arterial blood pressure management system according to claim 1, further comprising the pressure sensor for sensing the patient's arterial blood pressure signal and the electronically controllable valve for automatically flushing the catheter tube.

3. The method for operating an arterial blood pressure monitor, A step of determining whether an arterial blood pressure signal damping event is occurring based on the arterial blood pressure signal detected by a pressure sensor, The steps include transmitting a command to the electronically controllable valve to control the electronically controllable valve to automatically flush the catheter tube in response to the determination that the arterial blood pressure signal damping event has occurred, A step of determining whether the arterial blood pressure signal damping event has been resolved in response to the automatic flushing of the catheter tube based on the arterial blood pressure signal, wherein the determination that the arterial blood pressure signal damping event has occurred is based on a first criterion, and the determination that the arterial blood pressure signal damping event has been resolved is based on a second criterion different from the first criterion. With respect to the first criterion, the step of determining whether a plurality of features of the arterial blood pressure signal within a specified time window exceed a plurality of specified threshold values, and determining that an arterial blood pressure signal damping event has occurred if the plurality of features of the arterial blood pressure signal exceed the plurality of specified threshold values, wherein the plurality of specified threshold values ​​have threshold values ​​for the percentage of pulses containing a decrease in systolic arterial blood pressure within the specified time window. With respect to the second criterion, the step of determining whether each ratio of the same characteristics of the arterial blood pressure signal occurring after a specified post-flash time window to the characteristics of the arterial blood pressure signal occurring before a specified pre-flash time window exceeds a corresponding value of a plurality of specified flash effectiveness thresholds, and determining that the arterial blood pressure signal damping event has been resolved if each ratio exceeds the corresponding value of the specified flash effectiveness threshold, wherein the values ​​of the plurality of specified flash effectiveness thresholds include a threshold value for the ratio of systolic arterial blood pressure, a threshold value for the ratio of pulsed arterial blood pressure, and a threshold value for the ratio of arterial blood pressure waveform slope. A method for operating an arterial blood pressure monitor, comprising the following:

4. The steps include: performing pulse detection to generate the arterial blood pressure signal; The steps include extracting pulse features from the arterial blood pressure signal, The method according to claim 3, further comprising the step of determining the signal quality for each pulse and associated heartbeat.

5. The method according to claim 4, wherein the pulse features are extracted for each pulse and associated heartbeat, and the pulse features include one or more of the pulse interval between heartbeats, instantaneous arterial blood pressure value, averaged arterial blood pressure value, instantaneous maximum arterial blood pressure slope, and averaged maximum arterial blood pressure slope.

6. The determination of whether the aforementioned arterial blood pressure signal damping event is occurring is further performed. A step of determining whether there is a continuous decrease in the difference between systolic and diastolic arterial blood pressure with each heartbeat, based on the value of a second threshold among the plurality of specified threshold values, A step of determining whether the mean arterial blood pressure has stabilized over time based on the value of a third threshold among the multiple specified threshold values, A step of determining whether the diastolic arterial blood pressure has stabilized over time based on the value of a fourth threshold among the plurality of specified threshold values, The step of determining whether the proportion of pulses having a signal quality exceeding the value of the signal quality threshold within the specified time window exceeds the value of a fifth threshold among the plurality of specified threshold values. The method according to claim 3, based on one or more of the above.

7. The method according to claim 3, further comprising the step of forwarding a dumping event notification to a user interface associated with a healthcare provider in response to the determination that the arterial blood pressure signal dumping event is occurring, wherein a blood pressure limit alarm is blocked in response to the forwarding of the dumping event notification to the user interface.

8. The method according to claim 3, further comprising the step of forwarding an unresolved flash notification to a user interface associated with the therapist in response to the determination that the arterial blood pressure signal damping event has not been resolved, and the blood pressure limit alarm is blocked in response to the forwarding of the unresolved flash notification to the user interface.

9. The method according to claim 3, which is performed via one or more of the following: a server, a smart hub, a smart cable, an arterial blood pressure monitor, a therapeutic device, and a medical management device.

10. A machine-readable storage comprising machine-readable instructions that, when executed, realize the system described in claim 1 or 2, or the method described in any one of claims 3 to 8.

11. An apparatus comprising means for performing the method described in any one of claims 3 to 8.

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