A MEASUREMENT METHOD THAT PERFORMS OBJECTIVE AND DYNAMIC CAPILLARY REFILL TIME (CRT) MEASUREMENT.

Abstract

The invention relates to a measurement and data processing method for determining capillary refill time used in the evaluation of peripheral perfusion. This involves the simultaneous processing of pressure data related to the pressure applied to the tissue and optical data obtained from the tissue; the automatic determination of the measurement start time based on the moment the pressure is released; the mathematical analysis of the tissue's return to its basal state via optical data; and the real-time transmission of the resulting capillary refill time value to the user.

Description

1 TARIFF OBJECTIVE AND DYNAMIC CAPILLARY REFILL TIME (CRT) MEASUREMENT A MEASUREMENT METHOD THAT IS PERFORMED TECHNICAL AREA 5 The invention relates to capillary reprocessing used in the assessment of peripheral perfusion. It relates to a measurement and data processing method for determining filling time. within the scope of pressure data applied to the tissue and data obtained from the tissue Simultaneous processing of optical data, measurement start time, pressure relief. Automatic determination based on the moment it is performed, tissue 10 via optical data mathematical analysis of the return to the basal state and the results obtained The capillary refill time value is instantly transmitted to the user. is provided. PREVIOUS TECHNIQUE 15 Capillary refill time is important in assessing peripheral perfusion. It is one of the clinical indications used. Capillary refilling in known applications. Determining the duration involves healthcare personnel examining the patient's nail bed or soft tissue. applying manual pressure to the tissue for approximately five seconds and the applied The time it takes for the tissue to return to its previous color after the pressure is removed is 20 days. It is based on visual assessment. In this manual procedure, the amount of pressure applied to the tissue and The application time is determined directly by the practitioner. Therefore, it varies. Measurements performed by practitioners showed the same pressure conditions. It is not possible to create it, and the measurement result is based on the 25 performed by the practitioner. This can vary depending on the compression process. In addition, the pressure... The manual measurement starts from the moment the capillary is removed and the capillary refill time begins. It needs to be matched accordingly. The measurement of time with the removal of pressure. The delay between initiation and measurement of capillary refill time is the actual time. This can cause it to differ from the refilling process. 30 Another limitation in known applications is that the texture returns to its normal color. It is the assessment, by the human eye, of whether it has returned. The short time frame of the human eye ambient light with the ability to perceive color changes occurring in these ranges 2 Changes in conditions affect the accuracy and repeatability of the measurement result. It can have an impact. In manual measurement of capillary refill time, pressure, time, and color change as a synchronized data set It is possible that it cannot be recorded. Therefore, especially sepsis, shock and dehydration 5 Changes in peripheral perfusion over time in clinical conditions such as these within it, objective data is used to monitor and the measurement results show a trend. It is becoming difficult to evaluate it in a way that will create a new structure. Therefore, capillaries are being re-evaluated. the pressure applied in determining the filling time can be controlled, and the pressure can be released. the moment it is made and the start of data recording can be automatically synchronized, 10 color changes in the tissue can be optically tracked and the data obtained an objective capillary refill time value is obtained by mathematically processing it. A measurement method is needed that can be established. THE PURPOSE OF THE INVENTION 15 The purpose of the invention is to determine the capillary refill time during the applied pressure is made dependent on a predetermined pressure threshold. a measurement method that reduces pressure differences caused by the operator by introducing to reveal. Another aim of the invention is to capture the moment when pressure on the tissue is relieved via capillaries. 20 the start of the data record used in determining the refill time Matching with millisecond precision to correct measurement discrepancies caused by manual timing. to eliminate. Another aim of the invention is to examine the basal optics of the tissue before pressure is applied. to determine the values, optical 25 that occurs after pressure relief to compare the change with the baseline values ​​and thus regenerate the tissue Mathematical analysis of optical data instead of observational evaluation of the filling process to determine through. Another objective of the invention is the simultaneous monitoring of pressure data and optical data. by enabling the measurement and processing of pressure, time and color throughout the measurement 30 The aim is to enable the evaluation of change as interrelated data. Another objective of the invention is to analyze the obtained capillary refill time values. to provide the user with real-time information, visual and / or auditory feedback if threshold values ​​are exceeded 3 to generate alerts and to track changes in measurement results over time The purpose is to record it digitally. LIST OF FIGURES Figure 1 shows the system 5 of the capillary refill time measurement method, which is the subject of the invention. From initial setup to sensor calibration, sensor data fusion, CRT measurement determining the demand, performing pneumatic compression, target pressure checking the threshold, relieving pressure, synchronizing data logging. initiating in this way, processing optical data, mathematical CRT value from calculation to presentation of the result to the user 10 It shows the workflow of the process being carried out. The equivalents of the references used in the figures are: 100. Central Control Unit 200. Optical Detection Unit 15 300. Pneumatic inflation initiation process. 310. Pressure Monitoring Module 400. Quick Release Valve 410. Data Synchronization Module 500. Signal Processing and Filtering Module 20 510. Mathematical CRT Computing Module 600. Clinical Decision Support and Alert Interface DETAILED DESCRIPTION OF THE INVENTION The invention describes a method used in the assessment of peripheral perfusion. Capillary refill time depends on the pressure applied to the tissue and the amount of fluid obtained from the tissue. Determination by processing optical data within the same measurement process It is based on. Within the scope of the method, monitoring the application of pressure, the pressure Automatic detection of the moment of removal, synchronization of this moment with the optical data recording. processing the obtained optical signals and returning the tissue to its basal optical state 30 The return is being evaluated mathematically. Central control unit in the application of the invention method (100), processing data from sensors and managing the pneumatic system It is used as the main processing unit that performs the operation. Central control unit (100), 4 with the hardware components used in the application of the method at the beginning of the measurement performing calibration of sensor interfaces and subsequent processes data collection, pressure monitoring, pressure relief, data synchronization, signaling It enables the execution of processing, CRT calculation, and result transfer stages. Optical sensing unit (200) to obtain optical data from the tissue being measured 5 It is configured to collect RGB and PPG data. Optical sensing Color data and pulse data relating to light reflection of the tissue by unit (200). is obtained. Before the measurement is started, via the Optical detection unit (200) The tissue is continuously monitored, and the basal optical values ​​of the tissue prior to measurement are recorded. These baseline values ​​are determined 10 minutes after the end of pressure application. then a reference in evaluating the tissue's return to its initial state. It is used as follows: Pressure data and optical sensing unit within the scope of the invention. RGB and PPG data provided by (200) are interrupted independently of each other. It is processed without being disrupted. The thread distribution structure used for this purpose, data It ensures that collection and inspection processes are carried out in parallel and 15 pressure-time-color change information simultaneously within the same measurement process. This allows for monitoring. Controlled compression on the tissue is applied upon initiation of the measurement. Pneumatic inflation process (300) is carried out in order to create it. This process pressure created by a pneumatic system causes whitening on the tissue. 20 It is applied in such a way as to create and control the applied pressure. This is performed by the control module (310). Pressure control module (310), the applied pressure value with the predetermined target pressure threshold It compares. The pneumatic system will not work unless the pressure value reaches the target pressure threshold. Pressure application is continued and the pressure value is rechecked. 25 The compression phase begins when the applied pressure reaches the target pressure threshold. It is determined that it is complete and the method enters the automatic pressure relief phase. This allows the compression portion of the measurement to be processed by the practitioner. instead of a subjective pressure assessment, a predetermined pressure is used. It is carried out based on the threshold. Upon reaching the target pressure threshold, 30 The signal that the target pressure has been reached is transmitted to the central control unit (100) and the central The quick relief valve (400) is activated by the control unit (100). Quick relief valve (400) releases the pressure created on the tissue in milliseconds. It is an electromechanical element that provides rapid pressure relief in the tissue. Capillary refilling process is initiated by the central control unit (100). Simultaneously with the pressure relief process, the Data synchronization module (410) It is being put into operation. Data synchronization module (410), measurement with pressure relief moment. software that matches the moment data recording begins with millisecond precision It is a trigger. 5 along with identifying the drop in pressure data corresponding to the discharge. The moment in question is defined as the time reference moment T0 of the measurement, and the optical Recording data for CRT analysis purposes is based on the same time reference. This is accomplished by removing the pressure and measuring time. to prevent user-caused delays between initiation It is being passed. 10 Obtained by the optical sensing unit (200) after the pressure is relieved The raw optical data obtained is transferred to the signal processing and filtering module (500). Signal processing and filtering module (500), filtering on raw optical data by removing noise from the signal to be used in the analysis. It provides. The module in question extracts 15 from the green channel within the RGB data. The obtained optical data is isolated and used to determine the change in peripheral perfusion. The dataset to be used is being created. Data set prepared by signal processing and filtering module (500) It is transferred to the mathematical CRT calculation module (510). Mathematical CRT calculation module (510), optical 20 of the tissue after pressure relief It represents the return of the values ​​to the baseline values ​​determined before the measurement. It processes the change curve of the tissue from its basal state. On this curve, the tissue's change curve is shown. The transition zone between 10% and 90%, representing the return rate, is being analyzed, and The objective capillary refill time value as a result of this transition analysis. is created. Thus, determining the CRT value relates to the color of the tissue. 25 Dynamic range obtained after pressure relief, regardless of observational decision. This is done via optical data. Capillary generated by the mathematical CRT calculation module (510) refill time value clinical decision support and alert interface (600) is transmitted. Clinical decision support and alert interface (600), 30 of the measured values This enables the transfer of data to the user. This transfer is done via a wired USB connection. and / or via ETH or wirelessly via WiFi and / or BT technologies. It can be accomplished. 6 Clinical decision support and alert interface (600), the obtained measurement result It generates a visual and / or auditory alarm if the set threshold value is exceeded. The obtained CRT values ​​are also digitally recorded, thus allowing for sequential analysis. Tracking the change in the values ​​obtained from the measurements over time as a trend. This ensures that it can be done. 5 The working flow of the invention method is primarily the central control unit (100) System and sensor calibration is performed by [Name / Title]. Calibration... then RGB, PPG and pressure data are matched via the optical sensing unit (200). Sensor data fusion is performed, which is monitored in real time. At this stage... The basal optical values ​​of the tissue are determined. The initiation of CRT measurement is 10 days. then pneumatic inflation process (300) is carried out and pressure is applied on the tissue is created. The current pressure value is generated by the pressure monitoring module (310). It is continuously compared with the target pressure threshold. To the target pressure threshold If this is not reached, pressure application continues until the target pressure threshold is reached. If this occurs, the quick release valve (400) is activated to quickly reduce the pressure on the tissue. The pressure is being discharged in this way. Data synchronization occurs along with the pressure relief process. The moment T0 is determined by module (410) and optical data is used for CRT analysis. The recording process is initiated synchronously with the T0 time. The recorded data... Optical data is filtered by the signal processing and filtering module (500), RGB The green channel of the data is isolated and dynamic optical data suitable for analysis is obtained. 20 The dynamic optical data obtained is processed by a mathematical CRT calculation module. (510) via the return curve to the basal optical value of the tissue The transition region of the return curve between 10% and 90% is being evaluated. The CRT value is calculated by performing this procedure. The calculated CRT value provides clinical decision support and... The warning is conveyed to the user via the warning interface (600), exceeding the threshold value 25 In this case, a visual and / or auditory warning is generated and the measurement result is subsequently They are recorded digitally so that they can be compared with measurements. Thanks to this structure, the pressure application depends on the target threshold value. It was checked that the pressure relief and the start of the measurement coincided with the reference time. connected, color change in tissue is monitored via optical data and capillary 30 integrated and where the refill time is determined by mathematical transition analysis. A dynamic measurement process is being carried out.

Claims

7 REQUESTS 1. Capillary refill time in the assessment of peripheral perfusion It is a measurement method for determining, and its characteristic feature is; - System components and sensor 5 by a central control unit (100) calibrating interfaces, - RGB and PPG data from tissue by an optical sensing unit (200) obtaining and measuring the tissue using the optical data in question Determining the prior basal optical values, - Applying pressure to the tissue by a pneumatic inflation process (300) and 10 The applied pressure value is controlled by a pressure monitoring module (310). comparison with a predetermined target pressure threshold, - Central control upon reaching the target pressure threshold of the applied pressure. a signal is sent to the unit (100) that the target pressure has been reached and to the central By activating a quick relief valve (400) by the control unit (100) 15 relieving pressure on the tissue, - Data synchronization simultaneously with the pressure relief process. Commissioning of module (410) corresponds to relief in pressure data. Determining the incoming drop, measuring the moment of that drop. The reference point is determined as T0 and the optical data is recorded 20 synchronization to the aforementioned T0 moment, - after pressure relief by the optical sensing unit (200) a signal processing and filtering module (500) of the raw optical data obtained by filtering and removing noise from the RGB data. Isolation of optical data obtained from the green channel, 25 - a mathematical CRT calculation module of isolated optical data (510) by, the optical values ​​of the tissue after pressure relief the change curve representing the return to the basal optical values ​​in question processing through and the change curve in question between 10% and 90% By analyzing the transition zone between them, the capillary refill time is 30. It is characterized by including the steps involved in calculating its value.

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