Use of aortic pulse pressure and flow in bedside hemodynamic management
AssigneeUniversity of Pittsburgh—Of the Commonwealth System of Higher Education
InventorMichael R. Pinsky
Life of this patent
Estimating the term…
Abstract
A treatment algorithm for managing hemodynamically unstable patients is provided. Specifically, measurements of arterial pressure and stroke volume can be used to calculate pulse pressure variation, stroke volume variation, mean arterial pressure, elastance and cardiac power, the values of which guide treatment decisions and allow optimal management of critically ill patients. In an additional embodiment, a computer system implementing the treatment algorithm is provided.
Claims24
A method of determining a treatment regimen for a hemodynamically unstable patient comprising:
- a) obtaining arterial pressure and stroke volume measurements in said patient;
- b) calculating pulse pressure variation, stroke volume variation, mean arterial pressure, elastance and cardiac power from said measurements;
- and
- c) providing a treatment algorithm based on said calculated values for pulse pressure variation, stroke volume variation, mean arterial pressure, elastance and cardiac power.
A method of electronically determining a treatment regimen for a hemodynamically unstable patient comprising:
- a) providing a computerized data collection and analysis apparatus including
- a first collection apparatus for obtaining arterial pressure measurements in said patient,
- a second collection apparatus for obtaining stroke volume measurements in said patient,
- a microprocessor for storing said measurements and a software program containing said treatment regimen, and for calculating values for pulse pressure variation, stroke volume variation, mean arterial pressure, cardiac power and elastance, based on said measurements, and
- apparatus for displaying information related to at least one of said measurements, said calculated values and said treatment regimen;
- b) using said first collection apparatus, collecting arterial pressure measurements from said patient;
- c) using said second collection apparatus, collecting stroke volume measurements from said patient;
- d) using said microprocessor apparatus, calculating pulse pressure variation, stroke volume variation, mean arterial pressure, elastance and cardiac power values from said measurements;
- e) using said treatment algorithm, selecting a treatment based on said measurements and said calculated values;
- and
- f) providing output displaying said selected treatment regimen.
A treatment algorithm for providing treatment of a hemodynamically unstable patient, said algorithm comprising the following steps:
- a) obtaining arterial pressure and stroke volume measurements in said patient;
- b) calculating pulse pressure variation, stroke volume variation, elastance and cardiac power from said measurements;
- (c) if either pulse pressure variation or stroke volume variation is greater than about 10%-15% then administer an initial fluid infusion and repeat fluid infusions until pulse pressure variation or stroke volume variation becomes less than about 10%;
- and
- (d) if mean arterial pressure remains less than about 55-65 mm Hg, or there is a decrease in mean arterial pressure of greater than about 15-25 mm Hg in a previously hypotensive patient, after said initial fluid infusion then start vasoactive therapy.
A microprocessor programmed to provide a treatment algorithm for treatment of a hemodynamically unstable patient, said treatment algorithm comprising the following steps:
- (a) if either pulse pressure variation or stroke volume variation is greater than about 10%-15% then administer an initial fluid infusion and repeat fluid infusions until pulse pressure variation or stroke volume variation becomes less than about 10%;
- and
- (b) if mean arterial pressure remains less than about 55-65 mm Hg, or there is a decrease in mean arterial pressure of greater than about 15-25 mm Hg in a previously hypotensive patient, after said initial fluid infusion then start vasoactive therapy.
Dependencies are inferred from the claim text.