Systems and method for identifying the need for measurement of cardiac output

A decision support system (DSS) for providing medical decision support for cardiac output (CO) measurements in connection with an associated patient (P) using one or more physiological models (MOD1) implemented on a computer system, the computer system being arranged for:

• receiving first data (D1) indicative of a relative arterial oxygenation (SaO2, SpO2) in the blood of the patient;
• receiving second data (D2) indicative of a haemoglobin concentration (Hb) in the blood of the patient;
• the decision support system being arranged for:
• applying the physiological model(s) (MOD1) of the patient using said first data (D1) and said second data (D2) for modelling a tissue metabolism in the patient;
• A)
• i. outputting from said physiological model(s) (MOD1), using a preliminary value for a cardiac output (CO_PREL), an estimated measure indicative of haemoglobin oxygen saturation in the mixed venous blood of the patient (SvO2_EST);
• and
• ii. performing a first comparison (COMP1) of said estimated measure indicative of the haemoglobin oxygen saturation in the mixed venous blood of the patient (SvO2_EST) with a reference value for the haemoglobin oxygen saturation in the mixed venous blood of the patient (SvO2_REF);
• and/or
• B)
• iii. outputting from said physiological model(s) (MOD1), using a reference value for the haemoglobin oxygen saturation in the mixed venous blood of the patient (SvO2_REF), an estimated value indicative of the cardiac output (CO_EST) in the patient;
• and
• iv. performing a second comparison (COMP2) of said estimated value indicative for the cardiac output (CO_EST) with a reference value for the cardiac output (CO_REF) in patient;
• and
• based on said first comparison (COMP1, step ii of A) and/or said second comparison (COMP2, step iv of B) generating a measure (NM_CO) indicative of the need for an improved measurement and/or estimation of the cardiac output (CO).

A medical monitoring system capable of providing medical decision support for cardiac output (CO) measurements in connection with an associated patient (P,1) using one or more physiological models (MOD1) implemented on a computer system, the computer system being arranged for:

• providing first data (D1) indicative of a relative arterial oxygenation (SaO2, SpO2) in the blood of the patient, by corresponding first measurement means (M1);
• providing second data (D2) indicative of a haemoglobin concentration (Hb) in the blood of the patient, by corresponding second measurement means (M2);
• the medical monitoring system being arranged for:
• applying the physiological model(s) (MOD1) of the patient using said first data (D1) and said second data (D2) for modelling a tissue metabolism in the patient;
• A)
• i. outputting from said physiological model (MOD1), using a preliminary value for the cardiac output (CO_PREL), an estimated measure indicative of the haemoglobin oxygen saturation in the mixed venous blood of the patient (SvO2_EST);
• and
• ii. performing a first comparison (COMP1) of said estimated measure indicative of the haemoglobin oxygen saturation in the mixed venous blood of the patient (SvO2_EST) with a reference value for the haemoglobin oxygen saturation in the mixed venous blood of the patient (SvO2_REF);
• and/or
• B)
• iii. outputting from said physiological model (MOD1), using a reference value for the haemoglobin oxygen saturation in the mixed venous blood of the patient (SvO2_REF), an estimated value indicative of the cardiac output (CO_EST) in the patient;
• and
• iv. performing a second comparison (COMP2) of said estimated value indicative for the cardiac output (CO_EST) with a reference value for the cardiac output (CO_REF) in patient;
• and
• based on said first comparison (COMP1, step ii of A) and/or said second comparison (COMP2, step iv of B) generating a measure (NM_CO) indicative of the need for an improved measurement and/or estimation of the cardiac output (CO).

A method for providing medical decision support for cardiac output (CO) measurements in connection with a patient (P,1) using one or more physiological models (MOD1) implemented on a computer system, the computer system being arranged for:

• receiving first data (D1) indicative of a relative arterial oxygenation (SaO2, SpO2) in the blood of the patient;
• receiving second data indicative of a haemoglobin concentration (Hb) in the blood of the patient;
• the method comprising the steps of:
• applying the physiological model(s) (MOD1) of the patient using said first data (D1), said second data (D2) for modelling a tissue metabolism in the patient;
• A)
• i. outputting from said physiological model (MOD1), using a preliminary value for the cardiac output (CO_PREL), an estimated measure indicative of the haemoglobin oxygen saturation in the mixed venous blood of the patient (SvO2_EST);
• and
• ii. performing a first comparison (COMP1) of said estimated measure indicative of the haemoglobin oxygen saturation in the mixed venous blood of the patient (SvO2_EST) with a reference value for the haemoglobin oxygen saturation in the mixed venous blood of the patient (SvO2_REF);
• and/or
• B)
• iii. outputting from said physiological model (MOD1), using a reference value for the haemoglobin oxygen saturation in the mixed venous blood of the patient (SvO2_REF), an estimated value indicative of the cardiac output (CO_EST) in the patient;
• and
• iv. performing a second comparison (COMP2) of said estimated value indicative for the cardiac output (CO_EST) with a reference value for the cardiac output (CO_REF) in the patient;
• and
• generating a measure (NM_CO) indicative of the need for an improved measurement and/or estimation of the cardiac output (CO) based on said first comparison (COMP1, step ii of A) and/or said second comparison (COMP2, step iv of B).