Fluid Responsiveness Assessment Using Dynamic Blood Volume Feedback
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Solution Overview
Problem
Current methods for intravenous fluid administration during anesthesia struggle to balance fluid volume accurately, leading to either fluid overload or underfilling, which can cause complications such as tissue edema, renal dysfunction, and increased infections.
Innovation Solution
A system using a processor to estimate baseline and target blood volumes, calculate fluid loss rates, and adjust infusion rates to maintain optimal circulating blood volume, incorporating haemoglobin data and individual patient characteristics to personalize fluid management.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If traditional intravenous fluid delivery methods are used to maintain blood volume, then blood flow and mean arterial pressure are restored, but fluid overload occurs leading to tissue edema and pulmonary complications
Solution Approach 1:
The system continuously monitors patient blood parameters including haemoglobin concentration, haematocrit, and packed red cell volume, using this feedback to dynamically calculate and adjust the maintenance fluid rate. The processor compares current blood volume against target values and modifies fluid administration accordingly, preventing both fluid overload and underfilling while maintaining adequate blood flow and pressure
Solution Approach 2:
The system changes the parameter of fluid administration from fixed traditional protocols to dynamic, individualized rates based on real-time blood parameter measurements. By continuously adjusting the maintenance fluid rate according to measured haemoglobin, haematocrit, and packed red cell volume, the system optimizes fluid volume to match actual physiological needs
2Quantity of substance
If restrictive fluid administration is used to prevent fluid overload, then fluid balance is improved, but blood pressure drops and organ perfusion deteriorates
Solution Approach 1:
The system uses continuous feedback from blood parameter measurements (haemoglobin, haematocrit, packed red cell volume) to monitor blood volume in real-time, allowing the processor to adjust fluid administration dynamically. This ensures that fluid restriction is applied only when blood volume is adequate, while promptly increasing fluid rates when blood pressure or perfusion deteriorates
Solution Approach 2:
The system transitions from static restrictive fluid protocols to dynamic, real-time adjusted fluid administration. The maintenance fluid rate is continuously modified based on measured blood parameters, allowing the system to adapt to changing physiological conditions and maintain optimal blood pressure and organ perfusion while preventing fluid overload
3Reliability
If fluid administration is based solely on mean arterial pressure, then blood pressure is maintained, but fluid overload or underfilling occurs
Solution Approach 1:
The system introduces blood parameter measurements (haemoglobin concentration, haematocrit, packed red cell volume) as intermediary indicators to assess blood volume status. These parameters serve as more precise mediators than mean arterial pressure alone, allowing the processor to calculate actual blood volume and adjust fluid administration to match real blood volume status, thereby preventing both fluid overload and underfilling
Data Source
AI summary
A system and method for determining a patient's fluid-dependent hemodynamic responsiveness. The system comprises a processor configured to receive one or more of: one or more patient characteristics, one or more surgery characteristics, or one or more measured patient blood parameters. The processor is further configured to receive fluid challenge characteristics for a fluid challenge administered intravenously to the patient, and one or more measurements indicative of the patient heart function before and after the administration of the fluid challenge. The processor determines the patient blood volume (BV) within the patient's central blood compartment, before and after the administration of the fluid challenge, based on the received fluid challenge characteristics and the received one or more of: one or more patient characteristics, one or more surgery characteristics, or one or more measured patient blood parameters. The processor then calculates the relationship between the change in patient blood volume (ABV) and the change in patient heart function.