# US 2014/0155818 A1 · Burn Patient Resuscitation System

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- Number: US 2014/0155818 A1
- Document ID: US20140155818A1
- Status: Published application
- Kind: A1
- Application number: 14/094,436
- Filed: 2013-12-02
- Published: 2014-06-05
- Earliest claimed: 2007-03-19
- Assignees: Board of Regents, The University of Texas System; United States Government as represented by the Secretary of the Army
- Applicants: Board of Regents of the University of Texas System; United States Government, as represented by the Secretary of the Army
- Inventors: Jose Salinas; George C. Kramer; Guy A. Drew
- Web page: https://patentgrep.com/patent/US20140155818A1

## CPC

- A61M 5/1723: {using feedback of body parameters, e.g. blood sugar or pressure}
- A61B 5/412: {Detecting or monitoring sepsis}
- G16H 10/60: for patient-specific data, e.g. for electronic patient records
- G16H 20/17: delivered via infusion or injection
- G16H 50/20: for computer-aided diagnosis, e.g. based on medical expert systems
- A61B 5/20: for measuring urological functions {restricted to the evaluation of the urinary system (A61B5/4375 takes precedence)}
- A61M 2202/0496: Urine
- A61M: DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY (introducing media into or onto the bodies of animals A61D7/00; means for inserting tampons A61F13/26; devices for administering food or medicines orally A61J; containers for collecting, storing or administering blood or medical fluids A61J1/05); DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY (surgery A61B; chemical aspects of surgical articles A61L); DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR {(Electrotherapy, e.g. producing anaesthesia by the use of alternating or intermittent currents A61N1/36021)}
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- G16H: HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA

## Abstract

A system for operating a semi-closed loop and/or a closed loop resuscitation of a burn patient in view of patient information and other physiological data gathered by the system. The system in at least one embodiment includes an urine sensor, an infusion pump and a processor that controls the operation of the infusion pump at least in part from a signal received from the urine sensor.

## Claims

### Claim 1

A system for use in resuscitating a patient comprising:
a urine sensor;
an infusion pump;
an electronic medical records interface; and
a processor connected to said urine sensor and said infusion pump, said processor having
means for calculating an infusion rate using an infusion rate model based on at least a current infusion rate received from at least one of said infusion pump and said electronic medical records interface, a current urinary output, and infusion rate model based constants, the new infusion rate is calculated using the following equation
I
t
=
I
t
-
1
+


(
t
)
×
IRC
t
UOC
t
where It is the new infusion rate, It-1 is the last infusion rate, e(t) is the urinary output error between the current urinary output and a target urinary output, IRCt is the infusion rate constant at time t based on the hours post burn, and UOCt is the urinary constant.

### Claim 2 (depends on 1)

The system according to claim 1, wherein the infusion rate constant decreases based on hours post-burn in at least two steps with a first step at 14 hours post burn and a second step at 34 hours post burn.

### Claim 3 (depends on 1)

The system according to claim 1,
wherein the urinary output error is further multiplied by at least one of a modifier based on a patient's weight, a modifier based on a percentage of a total body surface area burned, and a Gaussian function calculated using an end point of a target urinary output range furthest from the current urinary output; and
at least one of the patient's weight and the percentage of the total body surface area burned are obtained from said electronic records system.

### Claim 4 (depends on 1)

The system according to claim 1, wherein the urinary output error is further multiplied by a Gaussian function calculated using a mid-point of a target urinary output range, where the Gaussian function is calculated using
G=1−Ae−(X-B)2/C2
where A is set to 1; X is set to the current urinary output; B is set to the mid-point of the target urinary output range; and C is set to 5.

### Claim 5 (depends on 1)

The system according to claim 1, further comprising a timer connected to said processor, said calculating means calculates a new infusion rate when said timer expires after running for a predetermined time.

### Claim 6 (depends on 5)

The system according to claim 5, wherein the predetermined time is based on hours post burn.

### Claim 7 (depends on 1)

The system according to claim 1, further comprising a display, and
said processor further includes
means for driving said display and receiving information from said display of information entered by a user including an infusion rate different than the infusion rate calculated, and
means for controlling operation of said infusion pump at one of the calculated infusion rate and the different infusion rate received from the user until a new infusion rate is received or calculated.

### Claim 8 (depends on 7)

The system according to claim 7, wherein said calculating means sets an initial infusion rate for the patient based on a predetermined formula.

### Claim 9 (depends on 1)

The system according to claim 1, further comprising means for notifying medical staff when a problem has arisen with at least one of the patient and the system.

### Claim 10 (depends on 1)

The system according to claim 1, wherein the current urinary output is based on a running average of recent urinary outputs.

### Claim 11 (depends on 1)

The system according to claim 1, wherein said urine sensor includes a drop rate sensor.

### Claim 12

A system for use in resuscitating a patient comprising:
a urine sensor;
an infusion pump;
an electronic medical records system;
a timer; and
a processor connected to said urine sensor, said infusion pump, and said timer, said processor having program code embodied therewith, the program code executable by said processor to
calculate an infusion rate in response to a signal from said timer and based on at least the current infusion rate received from at least one of said infusion pump and said electronic medical records system, the current urinary output received from at least one of said urine sensor and said electronic medical records system, infusion rate model based constants, a patient's weight received from said electronic medical records system, a percentage of total body surface area received from said electronic medical records system, and a Gaussian function centered on a target urinary output.

### Claim 13 (depends on 12)

The system according to claim 12, wherein the infusion rate model based constants include an infusion rate constant and a urinary output constant.

### Claim 14 (depends on 12)

The system according to claim 12, further comprising a display, and
said processor further having program code embodied therewith, the program code executable by the processor to
drive said display and receiving information from said display of information entered by a user including an infusion rate different than the infusion rate calculated, and
control operation of said infusion pump at one of the calculated infusion rate and the different infusion rate received from the user until a new infusion rate is received or calculated.

### Claim 15 (depends on 12)

The system according to claim 12, wherein the current urinary output is based on a running average of recent urinary outputs.

### Claim 16 (depends on 12)

The system according to claim 12, wherein calculating the infusion rate uses the following equation
I
t
=
I
t
-
1
+


(
t
)
×
IRC
t
UOC
t
×
Y
weight
×
Y
tbsa
×
G
UO
where It is the new infusion rate, It-1 is the last infusion rate, e(t) is the urinary output error, IRCt is the infusion rate constant at time t based on the hours post burn, UOCt is the urinary constant, Yweight is a modifier based on the patient's weight, Ytbsa is a modifier based on the percentage of the total body surface area, and GUO is the Gaussian function based on the target urinary output.

### Claim 17 (depends on 16)

The system according to claim 16, wherein the Gaussian function is calculated using a mid-point of a target urinary output range, where the Gaussian function is calculated using
G=1−Ae−(X-B)2/C2
where A is set to 1; X is set to the current urinary output; B is set to the mid-point of the target urinary output range; and C is set to 5.

### Claim 18 (depends on 12)

The system according to claim 12, wherein calculating the infusion rate sets an initial infusion rate for the patient based on a predetermined formula.

### Claim 19

A system for use in resuscitating a patient comprising:
a urine sensor;
an infusion pump;
a display;
an electronic medical records system;
receiving means for receiving patient data including percentage of total body surface area burned and time since the patient was burned from said electronic medical records system;
first means for calculating an initial infusion rate based on at least the received patient data based on a predetermined formula;
second means for calculating an urinary output error based on a difference between a target urinary output and a current urinary output provided by at least one of said urine sensor and said electronic medical records system;
third means for calculating a new infusion rate based on at least the calculated urinary output error multiplied by a constant calculated in part based on an exponential function with the input of hours post burn for the patient with the result being added to the current infusion rate;
outputting means for outputting the new infusion rate to at least one of said display, said electronic medical records system, and said infusion pump; and
a timer for controlling the operation of said second means, said third means and said outputting means.

### Claim 20 (depends on 19)

The system according to claim 19, further comprising a processor having said receiving means, said first means, said second means, said third means, and said outputting means.