Dynamic AKI Risk Index Display for Bypass Surgery Perfusion
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Solution Overview
Problem
Existing predictive models for Acute Kidney Injury (AKI) during cardiac surgery with extracorporeal circulation fail to account for dynamic parameters, lacking real-time monitoring capabilities and effective strategies to mitigate risks, particularly during cardiac surgery.
Innovation Solution
A method and apparatus for monitoring and calculating AKI risk indices during surgery with cardiac surgery, using a dynamic and global AKI risk index, which depends on both the dynamic AKI risk index and on a screen of an apparatus during surgery in such a way that a user, in particular a perfusionist technician or a surgeon or a cardiac anaesthetist, can advantageously understand and/or display the trend of such index(ces).
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If static predictive models are used for AKI risk assessment, then preoperative risk can be evaluated, but real-time monitoring capabilities and dynamic risk adjustment are lost
Solution Approach 1:
The patent transforms the static AKI risk prediction model into a dynamic monitoring system that continuously updates risk assessment during surgery. The system calculates a dynamic AKI risk index by integrating preoperative static risk factors with intraoperative dynamic parameters (oxygen supply, circulation time, hematocrit, blood pressure, lactates) measured in real-time, enabling continuous adaptation of risk evaluation to changing surgical conditions
Solution Approach 2:
The system implements feedback mechanisms by continuously measuring intraoperative parameters and feeding them back into the risk calculation algorithm. The dynamic risk index is updated based on real-time deviations from target values of critical parameters, allowing the system to provide ongoing feedback to the surgical team about accumulating AKI risk and enable timely interventions
2Measurement precision
If multiple intraoperative parameters are monitored in real-time, then dynamic AKI risk can be assessed, but system complexity and data processing requirements increase
Solution Approach 1:
The patent merges multiple separate monitoring functions into a single integrated dynamic risk calculation system. Instead of treating each parameter (oxygen supply, circulation time, hematocrit, blood pressure, lactates) as independent monitoring tasks, the system combines them into a unified AKI risk index calculation that synthesizes all parameters into one comprehensive risk assessment metric
Solution Approach 2:
The monitoring system is designed with multi-functionality to handle diverse parameter types (physiological measurements, time-based metrics, laboratory values) through a single computational framework. The system universally processes all input parameters using standardized normalization and weighting schemes, enabling one system to perform multiple monitoring and assessment functions simultaneously
Data Source
AI summary
The method for monitoring parameters of a patient during surgery with extracorporeal circulation serves to estimate the presence of AKI risk and comprises calculating a dynamic global index of AKI risk as a logistic regression deriving from a static AKI risk index and a dynamic index of AKI risk. The value and/or the time trend of such global index of AKI risk can be advantageously displayed on a monitor during the surgery. The dynamic AKI risk index is calculated at least on the basis of the extracorporeal circulation time, the minimum level of oxygen supply and the exposure time to oxygen supply below a critical threshold which are measured or determined repeatedly during surgery. Preferably, the dynamic AKI risk index is also calculated on the basis of the minimum mean arterial pressure during surgery and/or the maximum concentration of lactate in the blood during surgery and/or the minimum hematocrit during surgery and/or the fact that the patient has been subjected to transfusion(s) during the extracorporeal circulation.