DE102017004009A1 - Apparatus, method and computer program for determining respiratory effort, patient monitor, method and computer program for determining vital parameters, set of electrodes, method and computer program for recording patient signals, device network - Google Patents

Abstract

Exemplary embodiments provide a device (10), a method and a computer program for determining a respiratory effort, a patient monitor (20), a method and a computer program for determining vital parameters, an electrode set (30), a method and a computer program for acquiring patient signals, and a device network (60) comprising a device (10), a patient monitor (20) and an electrode set (30). The device (10) for determining a respiratory effort of a patient (50) comprises a detection device (12) which is designed to detect patient signals. The device (10) further comprises a network interface (14) adapted to communicate with another network component. The device (10) comprises a control module (16) which is designed to control the detection device (12) and the network interface (14). The control module (16) is further configured to receive the patient signals via the detection device (12) in order to determine information about the respiratory effort of the patient (50) based on the patient signals, and at least partial information about the patient via the network interface (12) Relay patient signals to the other network component.

Description

What is described is a device, a method and a computer program for determining a respiratory effort, a patient monitor, a method and a computer program for determining vital parameters, an electrode set, a method and a computer program for acquiring patient signals, a device network, in particular but not limited to a concept for using an electrode set to determine respiratory effort and vital parameters of a patient.

Surface electromyography for the determination of the respiratory effort (also static and dynamic surface ElectroMyoGraphy (sEMG)) is not yet commercially implemented. Also in perspective, it is more likely to expect that a successful special introduction, a special monitoring with intervention in the therapy reserved for special cases. The decision to use sEMG is typically made by the physician or (e.g., in the US) "Respiratory Therapist" during treatment, e.g. B. in deterioration of the respiratory status. An electrocardiogram (ECG) measurement, on the other hand, is used on virtually every patient within the Intensive Care Unit (ICU) and also at less intensive care settings, and is routinely applied by nurses without consultation.

If a new function like sEMG is to be successful, it should be integrated into the existing processes. Even the patient undergoing sEMG monitoring should continue to be ECG-monitored and the workplace should remain ergonomic.

The document US 2013/0213399 A1 describes a device for simultaneous measurement of sEMG and ECG from the same combined electrode set. On the one hand, the ECG signal is suppressed in order to obtain as undisturbed a signal as possible of the respiratory muscles (sEMG). On the other hand, the ECG signals are rejected prior to suppression and displayed on the respiratory system. A hemodynamic patient monitor, which also displays other vital signs such as invasive and noninvasive blood pressures and SPO2 (blood oxygen levels) in addition to ECG to quickly and appropriately alert, does not have access to the ventilator's ECG measurement in this solution. In addition, the ECG measurement in homogeneous form should be stored continuously for documentation. An sEMG electrode set is therefore attached in addition to the existing ECG electrode set. Not infrequently monitor and ventilator are on different sides of the bed, so that the patient is now less accessible for the care.

A technical object of the present invention may be seen to provide an improved concept for the combined acquisition of patient signals for determining vital parameters and a patient's breathing effort.

The object is solved according to the independent claims.

For example, at least some embodiments can provide, for example, a device network which on the one hand enables normal patients to be provided with an inexpensive and easy-to-install electrode set and to provide it with the hemodynamic monitor (PPM parameter), and on the other hand makes it possible to connect this set of electrodes to the ventilator at a later time by the PPM directly or indirectly via a low-delay point-to-point connection. Some embodiments may avoid alerts - especially due to the short-term not available ECG measurement - in the course of the hanging of the PPM to the ventilator.

The present invention is based on the finding that two sets of electrodes to two different devices on two different sides of the bed (ventilator (ventilator) and monitor) are rather unfavorable. Also, an electrode set with cable connection to two devices would affect the workplace order and the accessibility to the patient. Embodiments are based on the core idea that a device combination on the patient would be better, which allows a rapid upgrade of the sEMG measurement for detecting respiratory effort, if necessary, without replacing the electrode set, attaching a further electrode set or having to provide the existing set with a second cable connection ,

It is a further realization that it would be ergonomically possible to attach the electrode set to the monitor and leave it there. When upgrading with sEMG, the information could be forwarded to the ventilator via a network. Between sEMG measurement and ventilator, however, a very fast data connection with latencies of about 10ms would be necessary to derive a control signal for the ventilator from the sEMG measurement. Conventional network connections are not technically able to guarantee latency times <300ms, which is far too long for ventilation control but sufficient for the requirements of ECG measurement is. Here, the allowable latency between ECG and patient monitor is 500-1000ms.

Another key idea is that the connection between the sEMG measurement and the ventilator is only a point-to-point connection and not a network connection. Some embodiments may therefore allow an electrode set to be initially connected to the patient monitor but later optionally to be reconnected to a respirator without the patient monitor losing access to the heart rate measurement. Also, a corresponding user interaction can be minimized or avoided by hints or requirements with short-term loss of connection to the electrode set.

Therefore, some embodiments provide a network network consisting of at least one ventilator and at least one PPM, which are uniquely associated with a patient via suitable procedures (pairing, oblique encryption certificates). An interface of an electrode set can be connected to both the PPM and the respirator.

Embodiments provide a device for determining respiratory effort of a patient. The device comprises a detection device, which is designed to detect patient signals, and a network interface, which is designed to communicate with another network component. The device further comprises a control module, which is designed to control the detection device and the network interface. The control module is further configured to receive the patient signals via the detection device in order to determine information about the respiratory effort of the patient based on the patient signals, and to forward at least partial information about the patient signals to the other network component via the network interface. Embodiments may therefore provide a sEMG device that provides information for an ECG via a network interface. The other network component may be, for example, a patient monitor.

Embodiments also provide a patient monitor for determining vital parameters of a patient. The patient monitor comprises an electrode interface, which is designed to connect an electrode set for the detection of patient signals. The patient monitor further includes a network interface configured to communicate with at least one other network component. The patient monitor further includes a control module configured to control the electrode interface and the network interface. The control module is further configured to receive the patient signals via the electrode interface in a first mode and to determine information about the patient's vital signs based on the patient signals. The control module is further configured to receive information about the patient signals via the network interface in a second mode, and to determine information about the patient's vital signs based on the information about the patient signals. Embodiments also provide an ECG device that detects vital parameters of a patient by means of patient signals acquired by a directly connected set of electrodes, or by information about patient signals received over a network.

In further exemplary embodiments, the detection device of the apparatus for determining the respiratory effort may be an electrode interface that is designed to connect an electrode set for detecting the patient signals, or an interface for obtaining patient signals acquired with an electrode set. Therefore, some embodiments provide that any ventilator is implemented separately from a sensing device. The network interface can then be present at the detection component and / or during the ventilation component. In this respect, the device for determining the respiratory effort may further comprise a ventilation device for ventilating the patient based on the information about the respiratory effort of the patient. Embodiments may thus provide a ventilator with network interface for relaying the information about the patient signals. In some embodiments, the control module may be configured to pass digitally-converted patient signals to the patient monitor via the network interface. The digitally converted signals can be obtained either already converted digitally, for example, if a corresponding analog-to-digital converter (A / D) in the electrode set or a detection component is present, or a corresponding A / D converter is in the device for conversion provided, so that, for example, analog patient signals can be detected and processed.

In some embodiments, the individual components can also exchange control information via the network, which can serve, for example, for identifying or linking (for example, pairing) the components with one another. For example, the monitoring module of the patient monitor can be designed to determine via the network interface whether there is another device for detecting the patient signals of the same patient. The at least one other network component may, for example, correspond to a device for determining a respiratory effort of a patient or another patient monitor. As such, embodiments may provide a mechanism that allows the components to become aware of each other.

Embodiments furthermore also provide an electrode set for detecting patient signals for determining vital parameters and for determining a respiratory effort of a patient. The set of electrodes is configured to electronically transmit an identifier, the identifier indicating that the set of electrodes is suitable for acquiring patient signals for determining vital parameters and for determining respiratory effort of a patient. This identifier can then be detected, for example, by a sEMG and forwarded via the network to a PPM, which can then identify the patient via the electrode set. By way of example, the control module may be formed on the side of the apparatus for determining the respiratory effort in order to forward information to the patient monitor via the network interface via an identification of an electrode set connected to the electrode interface. On the side of the patient monitor, the control module may then be configured to switch from the first mode to the second mode after a detection of the presence of another device for detecting the patient signals of the same patient.

In some embodiments, the monitor module of the patient monitor may be configured to generate warning information after detection of presence of another device for detecting the patient's signals of the same patient, after completion of detection of the patient signals via the electrode interface and after expiration of a predefined time, that a determination of the vital parameters is interrupted. For example, the predefined time may correspond to one minute. Embodiments may therefore provide that the electrode set is decoupled from an ECG and coupled to a sEMG. The set of electrodes then comprises an electrode interface which can be coupled to a patient monitor and a device for determining a respiratory effort of a patient. In embodiments, the control module may be formed on the side of the patient monitor in order to take into account when determining vital parameters whether the patient signals recorded with the connected electrode set are suitable for determining information about the respiratory effort of the patient. In this respect, the identifier of the electrode set can indicate its suitability in this regard.

As mentioned above, in some embodiments, the electrode set may include an analog-to-digital converter configured to convert analog detected patient signals into digital patient signals. In further exemplary embodiments, the electrode set can continue to record patient signals even during the coupling / reconnecting, so that signals acquired in the meantime can be added after coupling in the documentation or display. In such embodiments, the electrode set includes a power supply, a memory, and a control module. The control module is configured to latch the captured patient signals after disconnecting the electrode set from a patient monitor or apparatus for determining patient respiratory effort in the memory, and the cached signals to a patient monitor or apparatus for determining respiratory effort of a patient after reconnection to transmit a patient monitor or device for determining a respiratory effort of a patient.

Exemplary embodiments also provide a device network with a device for determining the respiratory effort of a patient as described above, a patient monitor as described above and an electrode set as described above.

Embodiments further provide a method for determining respiratory effort of a patient. The method includes acquiring patient signals and communicating with another network component. The method further includes obtaining patient signals to determine information about patient respiratory effort based on the patient signals. The method further includes forwarding at least partial information about the patient signals to the other network component.

Embodiments also provide a method for determining vital parameters of a patient. The method includes detecting patient signals. In a first mode, the method includes obtaining the patient signals via an electrode interface, and determining information about the patient's vital signs based on the patient signals. In a second mode, the method includes obtaining information about the patient signals via a network interface, and determining the information about the vital parameters of the patient based on the information about the patient signals.

Embodiments provide a method for acquiring patient signals for Determination of vital parameters and determination of respiratory effort of a patient with an electrode set. The method comprises electronically transmitting an identifier of the electrode set. The identifier indicates that the electrode set is suitable for acquiring patient signals for determining vital parameters and for determining respiratory effort of a patient.

Embodiments also provide a method for determining vital parameters and respiratory effort of a patient. The method includes detecting patient signals with an electrode set. In a first mode, the method includes coupling the set of electrodes to a patient monitor and determining information about the patient's vital signs based on the patient signals. The method further includes decoupling the electrode set from the patient monitor. In a second mode, the method includes communicating between the patient monitor and a device for sensing patient respiratory effort and coupling the electrode set to the respiratory effort determination device. The method further includes receiving an identifier of the set of electrodes on the apparatus for determining respiratory effort and forwarding information about the identifier to the patient monitor. The method further includes obtaining patient signals at the respiratory effort determination device to determine information about patient respiratory effort based on the patient signals and forwarding at least partial information about the patient signals to the patient monitor. The method further comprises determining information about the vital parameters of the patient based on the at least partial information about the patient signals in the patient monitor.

Another embodiment is a program or computer program having program code for performing a method described herein when the program code is executed on a computer, a processor, or a programmable hardware component.

• 1 ein Ausführungsbeispiel einer Vorrichtung zur Bestimmung einer Atemanstrengung eines Patienten, ein Ausführungsbeispiel eines Patientenmonitors und ein Ausführungsbeispiel eines Elektrodensatzes;
• 2 einen ersten Betriebsmodus in einem Ausführungsbeispiel;
• 3 einen zweiten Betriebsmodus in einem Ausführungsbeispiel;
• 4 ein Ausführungsbeispiel einer Erfassungseinrichtung und eines Elektrodensatzes;
• 5 ein Ausführungsbeispiel eines Elektrodensatzes mit integrierter Elektronik;
• 6 Ausführungsbeispiele von Elektrodensätzen mit unterschiedlicher Schirmung;
• 7 ein Blockschaltbild eines Ablaufdiagramms eines Verfahrens für einen Patientenmonitor in einem Ausführungsbeispiel;
• 8 ein Blockschaltbild eines Ablaufdiagramms eines Verfahrens für eine Vorrichtung zur Bestimmung einer Atemanstrengung eines Patienten in einem Ausführungsbeispiel;
• 9 ein Blockschaltbild eines Ablaufdiagramms eines Verfahrens für einen Patientenmonitor in einem Ausführungsbeispiel;
• 10 ein Blockschaltbild eines Ablaufdiagramms eines Verfahrens für einen Elektrodensatz in einem Ausführungsbeispiel; und
• 11 ein Blockschaltbild eines Ablaufdiagramms eines Verfahrens für einen Patientenmonitor in einem Ausführungsbeispiel.

Further advantageous embodiments will be described below with reference to the embodiments illustrated in the drawings, to which embodiments are generally not limited in total. Show it:

• 1 an embodiment of a device for determining a breathing effort of a patient, an embodiment of a patient monitor and an embodiment of an electrode set;
• 2 a first mode of operation in one embodiment;
• 3 a second mode of operation in one embodiment;
• 4 an embodiment of a detection device and an electrode set;
• 5 an embodiment of an electrode set with integrated electronics;
• 6 Embodiments of electrode sets with different shielding;
• 7 a block diagram of a flowchart of a method for a patient monitor in an embodiment;
• 8th a block diagram of a flowchart of a method for a device for determining a breathing effort of a patient in one embodiment;
• 9 a block diagram of a flowchart of a method for a patient monitor in an embodiment;
• 10 a block diagram of a flowchart of a method for a set of electrodes in an embodiment; and
• 11 a block diagram of a flowchart of a method for a patient monitor in an embodiment.

Various embodiments will now be described in more detail with reference to the accompanying drawings, in which some embodiments are illustrated.

In the following description of the attached figures, which show only some exemplary embodiments, like reference characters may designate the same or similar components. Further, summary reference numerals may be used for components and objects that occur multiple times in one embodiment or in a drawing but are described together in terms of one or more features. Components or objects which are described by the same or by the same reference numerals may be identical in terms of individual, several or all features, for example their dimensions, but may also be different if the description does not explicitly or implicitly make reference to the description. Optional components are shown in the figures with dashed lines or arrows.

Although embodiments may be variously modified and changed, embodiments are illustrated in the figures as examples and will be described in detail herein described. It should be understood, however, that it is not intended to limit embodiments to the particular forms disclosed, but that embodiments are intended to cover all functional and / or structural modifications, equivalents and alternatives that are within the scope of the invention. Like reference numerals designate like or similar elements throughout the description of the figures.

Note that an element referred to as being "connected" or "coupled" to another element may be directly connected or coupled to the other element, or intervening elements may be present. Conversely, when an element is referred to as being "directly connected" or "directly coupled" to another element, there are no intervening elements. Other terms used to describe the relationship between elements should be interpreted in a similar manner (e.g., "between" versus "directly in between," "adjacent" versus "directly adjacent," etc.).

The terminology used herein is for the purpose of describing particular embodiments only and is not intended to limit the embodiments. As used herein, the singular forms "a," "an," "an," and "the," are also meant to include the plural forms unless the context clearly indicates otherwise. Furthermore, it should be understood that the terms such as e.g. "Including," "including," "having," "comprising," "comprising," and / or "having," as used herein, indicating the presence of said features, integers, steps, operations, elements, and / or components, but does not preclude the presence or addition of one or more features, integers, steps, operations, elements, components, and / or groups thereof.

Unless otherwise defined, all terms (including technical and scientific terms) used herein have the same meaning as commonly assigned to one of ordinary skill in the art to which the embodiments pertain. Further, it should be understood that terms, e.g. those that are defined in commonly used dictionaries are to be interpreted as having the meaning consistent with their meaning in the context of the relevant art, and not to be interpreted in an idealized or overly formal sense, unless this is so is explicitly defined.

1 shows an embodiment of a device 10 for determining a respiratory effort of a patient 50 , An embodiment of a patient monitor 20 and an embodiment of an electrode set 30 , The device 10 to determine a respiratory effort of the patient 50 comprises a detection device 12 , which is designed to capture patient signals and a network interface 14 which is designed to communicate with another network component. The device 10 further comprises a control module 16 that with the detection device 12 and the network interface 14 is coupled and that to control the detection device 12 and the network interface 14 is trained. The control module 16 is further adapted to over the detection device 12 receive the patient signals to provide information about the patient's respiratory effort based on the patient signals 50 to determine, and to over the network interface 14 to forward at least partial information about the patient signals to the other network component. The partial information can also be complete information, for example, when the raw signals, as from the electrode set 30 be forwarded recorded. For example, digital raw signals, prefiltered or preprocessed signals, etc., can be forwarded, so that they contain only partial information in comparison to the patient signals originally recorded.

1 also shows an embodiment of a patient monitor 20 for determining vital parameters of a patient 50 , The patient monitor 20 includes an electrode interface 22 , for connecting a set of electrodes 30 is designed for detecting patient signals and a network interface 24 , which is designed for communication with at least one other network component. The patient monitor 20 further comprises a control module 26 that with the electrode interface 22 and the network interface 24 is coupled and that to control the electrode interface 22 and the network interface 24 is trained. The control module 26 is further adapted to be in a first mode via the electrode interface 22 receive the patient signals and based on the patient signals information about the vital parameters of the patient 50 to determine. The control module 26 is further configured to provide, in a second mode, information about the patient signals via the network interface 24 and, based on the information about the patient signals, information about the vital parameters (eg heart rate, SPO2, blood pressure, etc.) of the patient 50 to determine.

1 moreover shows an embodiment of an electrode set 30 for recording patient signals for determining vital parameters and for determining respiratory effort of a patient 50 , The electrode set 30 is designed to transmit an identifier electronically, wherein the identifier indicates that the electrode set 30 for recording patient signals for determining vital parameters and for determining respiratory effort of a patient 50 suitable.

In embodiments, a network interface 14 . 24 for example, one or more inputs and / or one or more outputs for receiving and / or transmitting information, such as digital bit values, analog signals, magnetic fields based on code, within a module, between modules, or between modules of different entities. In embodiments, this can be corded or cordless, depending on how a connection to a network is implemented. Some variants of network interfaces 14 . 24 that may occur in embodiments are RJ45, Ethernet, Wireless Local Area Network (WLAN), 802.11, Bluetooth (BT), Mobile, etc.

In embodiments, the detection device 12 be designed as an interface for detecting the patient signals. The patient signals can be present in different embodiments in various forms, eg digital or analog. In some embodiments, between the detection device 12 and an electrode set detecting the patient signal 30 Accordingly, there would be no significant additional signal processing electronics, then would be analog signals from the electrode set 30 detected. The detection device 12 could then correspond to an electrode interface used to connect an electrode set 30 is designed to detect the patient signals. In further embodiments, the detection device 12 also an interface for obtaining with an electrode set 30 correspond to recorded patient signals, these may already be more or less intensively preprocessed, eg A / D-converted, equalized, filtered, scaled, etc.

The electrode interface 22 can also be like an interface 14 . 24 be formed, this with an electrode set 30 can be coupled, which detects the patient signals. As will be explained in detail below, this interface may, for example, have one or more contacts which are designed to couple test leads and possibly their shields (potentially one or more per test lead). This may be, for example, one or more plugs or sockets. In addition, the electrode set can 30 In some embodiments, also have their own electronics, such as an integrated AD converter, power supply, etc. It is also conceivable in such embodiments that the electrode interface 22 is formed digitally, for example as Universal Serial Bus (USB), serial or parallel interface, possibly even wireless, etc.

In embodiments, a control module 16 . 26 correspond to any controller or processor or programmable hardware component. For example, a control module 16 . 26 also be implemented as software that is programmed for a corresponding hardware component. In this respect, a control module 16 . 26 be implemented as programmable hardware with appropriately adapted software. Any processors, such as digital signal processors (DSPs) or processors can be used in general. Embodiments are not limited to a particular type of processor. These are any processors or even multiple processors for implementing a control module 16 . 26 conceivable.

As the 1 indicated by the dashed arrows, the electrode set 30 in embodiments between the device 10 and the patient monitor 20 transposed / switched / coupled. 2 illustrates a first mode of operation in one embodiment. 2 shows a patient 50 in a hospital bed, which has an electrode set 30 from a patient monitor 20 is monitored. This patient 50 should now also to a device 10 for determining the respiratory effort of the patient 50 and be connected to a ventilator coupled thereto. The 2 also shows a network 40 to which both the patient monitor 20 as well as the device 10 with their network interfaces 14 . 24 are coupled. From the point of view of the device 10 is therefore in the present embodiment, the patient monitor 20 the other network component. From the point of view of the patient monitor, the at least one other network component is the device 10 ,

In the embodiment of 2 has the device 10 Furthermore, a ventilation device for ventilating the patient 50 based on the information about the respiratory effort of the patient 50 on. In the present embodiment, the patient 50 now also be ventilated. This is the electrode set 30 from the patient monitor 20 disconnected and to the device 10 coupled / reconnected. This leads to the operation of the patient monitor 20 in the second mode of operation, which is in 3 is shown. 3 shows a second mode of operation in one embodiment. 3 shows the same components as 2 , wherein the electrode set 30 now to the device 10 for determining the respiratory effort of the patient 50 is coupled. The electrode set 30 This may include an electrode interface connected to the patient monitor 20 and the device 10 to Determination of a respiratory effort of a patient 50 can be coupled.

For example, the patient monitor determines 20 Whether there is another ECG-enabled device (eg, a respirator with sEMG option, such as the device 10 hereinafter also referred to) the same patient 50 assigned. In other words, the control module 16 be trained to over the network interface 14 Information about an identification of a to the detection device 12 connected electrode set 30 to the patient monitor 20 forward, for example, the identifier of the electrode set 30 , The control module 26 can be trained to over the network interface 24 to determine if another device to capture the patient's signals from the same patient 50 is present, for example, by receiving the identifier over the network 40 ,

In one embodiment, if this is the case, the patient monitor expects 20 for a reasonable time - z. For one minute - the ECG signal from the ECG-enabled device 10 over the network. The control module 26 is then adapted, after detection of a presence of another device for detecting the patient signals of the same patient 50 switch from the first mode to the second mode. The control module 26 may then be further configured, after a detection of the presence of the further device for detecting the patient signals of the same patient 50 upon completion of detection of the patient signals via the electrode interface 22 and to generate after the expiration of a predefined time a warning information indicating that a determination of the vital parameters is interrupted. For example, the predefined time may be one minute.

For example, during the appropriate time possible messages or alarms - due to the interruption of the ECG measurement - suppressed. The ECG signal received via the network is then used as a substitute for the previously directly received ECG signal. For example, the A / D converted signal becomes the patient monitor without further digital filtering or modification 20 sent, so in the patient monitor 20 the same algorithms used for the directly used signal can be used. In some embodiments, the control module 16 be configured to digitally converted patient signals via the network interface 14 to the patient monitor 20 forward.

In further embodiments, the patient monitor 20 Determine if the set of electrodes is an sEMG-capable set of electrodes (because they are connected to specific positions of the electrodes). This information is preferably included in the ECG evaluation, z. B. to avoid errors in the interpretation of the ECG signal. The control module 26 can therefore be designed to take into account in the determination of vital parameters, whether with the connected electrode set 30 recorded patient signals to determine information about the respiratory effort of the patient 50 suitable.

In some embodiments, a digital electrode interface (DEI) becomes fixed to the electrode set 30 coupled. 4 shows an embodiment of a detection device 12 and / or an electrode set 30 , As already mentioned above, in embodiments more or less electronics for signal processing can be used for the electrode set 30 or the detection device 12 be assigned. In this case, extremes are also conceivable, for example, a purely analog electrode set, wherein the electronics for signal processing of the detection device 12 or more or less complete digital conversion and processing in the electrode set 30 , The 4 shows right below the electrode set 30 the on a patient 50 is attached and recorded there corresponding signals. In addition, the shows 4 a detection device 12 with a microprocessor, μP, n A / D converters, which can detect n measuring channels and 1..n screen driver circuits, which can generate a potential between the respective measuring line and its shield for better measured value acquisition. In the embodiment of 4 For this purpose, five amplifiers are indicated, which hold five shields of five test leads to possibly different potential. Optionally, the detection device 12 make a separation of the signals for ECG and sEMG evaluation and a digital identification (ID) of the electrode set 30 make.

Between the electrode set 30 and the detection device 12 Depending on the implementation, a digital point-to-point connection can be established (also point-to-point), for example via USB or BT. Then the electrode set includes 30 corresponding components. This may include the analogue electronics for individually driven shielding lines as well as the A / D conversion of the voltage differences between the measuring electrodes and the reference electrode. In some embodiments, the DIE contains a digital ID. The electrode set 30 can then first via the digital point-to-point connection with the patient monitor 20 get connected.

Accordingly, the electrode set comprises 30 in some embodiments, an analog-to-digital converter configured to detect analog Convert patient signals into digital patient signals. In addition, the electrode set 30 a power supply and a memory and a control module, μC. The control module is designed to after uncoupling the electrode set 30 from the patient monitor 20 (or a device 10 for determining a respiratory effort of a patient 50 ) in the memory to latch the detected patient signals, and the cached signals to a patient monitor 20 or a device 10 for determining a respiratory effort of a patient 50 after a reconnection to the patient monitor 20 or the device 30 for determining a respiratory effort of a patient 50 transferred to. In addition, the electrode set 30 comprise one or more shield lines with sense electrodes coupled to electronics, the electronics being configured to adjust a potential difference between a shield and a line of a shield line.

For example, the DEI 12 . 30 from the patient monitor 20 away and with another ECG enabled device 10 connected to the network, the ECG signal will be sent to the patient monitor along with the digital ID 20 forwarded. The patient monitor 20 uses the ID to determine that they are the same patient 50 (same electrode set 30 ). To delay messages or alarms due to the disconnected ECG, the patient monitor is sufficient 20 in a further variant, the information already prefers that it is a sEMG-compatible electrode set 30 and that it is a sEMG enabled device on the network 10 gives. The identity of the patient 50 will not be detected until after re-coupling using the electrode set ID (identifier). There are analyzes of the ECG signal that use information that may change depending on the position of individual electrodes. Electrode positions can also be corrected by simulation if the default position is not available. The patient monitor 20 recognizes in some embodiments that after the changeover, it is still the same set of electrodes 30 trades and uses the known electrode position-dependent information. Otherwise, new information is determined or a message is issued. In addition or alternatively, the monitor can detect after re-plugging that this is the old cable, then the positions do not have to be re-entered. A recognition of the patient can be done in some embodiments, for. Eg via manual input, detection of an ID on the patient or characteristic features in the ECG signal.

The DEI 12 . 30 can optionally be equipped with an energy storage capacitor, a battery or rechargeable battery. The ECG measurement can continue during the conversion process and the measured values are subsequently saved after reconnection. The DEI 12 . 30 optionally contains the preprocessing of the EMG and delivers as output signal z. Eg the respiratory effort in real time or the trigger signal for the ventilation control. In some embodiments, the DIE is equipped with a rechargeable battery or capacitor to further decouple ECG measurement and storage.

5 illustrates an embodiment of an electrode set 30 with integrated electronics. In the embodiment shown, monolead cables (ML) are used towards the actual electrodes. One in the electrode set 30 Integrated μC is implemented in an ECG sEMG μC box together with an A / D converter. There, a separation of the signal components relevant for ECG-sEMG and a calculation of EMG triggers can take place. Furthermore, an asynchrony calculation, a respiratory effort calculation, and a pressure assist calculation may be performed. Based on these calculations, a respirator can then be controlled.

6 shows embodiments of electrode sets with different shielding. 6 illustrates above a shield in which all shield conductors are at the same potential and below the variant already described with different potential for each measuring line. In the upper exemplary embodiment, the active shielding is at a common reference potential, whereas in the lower exemplary embodiment the shielding can be operated at individual potentials. For example, in embodiments, the contacts for coaxial shield conductors on the connector plug can be individually controlled and led out, for example monolead cables. In some embodiments, two coaxial shielding conductors per line (triaxial cable) can be used. Thereby, a further improvement of the noise decoupling can be achieved.

In further embodiments, various aspects may be used to drive the connected umbrella contacts to a common potential. ECG electrode sets may typically have a coupling capacity with the patient's skin 50 can be connected and the alternating parts of the skin tensions can be measured. Against external interference fields, the cables can be shielded with a coaxial conductor. A small potential difference between the shield and the measuring signal can be advantageous because it minimizes or reduces the influence of capacitance changes due to cable bending. The screens of the cables are in some Embodiments driven with an operational amplifier circuit to the low-pass filtered average potential of all measuring cables. The average potential differences between the cables can optionally be limited by high-impedance coupling resistors.

The EMG signal may be about 100 times less than the ECG signal in embodiments and also superimposed by this. The need for Störentkoppelung can then be significantly higher than in a pure ECG measurement. For this reason, the screens are typically driven to the respective low-pass filtered single signal, so that the potential difference between the screen and the measurement signal is reduced even further compared to a common reference potential. In some embodiments, a combination with triaxial cables can be used.

In some embodiments, an analog interface 22 be used, which leads two contacts for each measuring electrode: the measuring contact and the shield contact. The control of the screens is carried out either by driving the connected screen contacts to a common potential or in individual control of the screen contacts, as described above.

Another embodiment is a device network 60 with a device 10 for determining the respiratory effort of a patient 50 as described above, a patient monitor 20 as described above and an electrode set 30 as described above. A device composite of respirator 10 , Patient monitor 20 and patient part 30 can also network 40 include, cf. 2 and 3 , The devices that a patient 50 are assigned over the network 40 connected. The assignment to a patient 50 is ensured for example via a pairing process. The patient part or the electrode set 30 is set up either directly with the ventilator 10 or directly with the patient monitor 20 to be connected.

In further embodiments, the electrode set 30 or the DIE and the ventilator 10 have a private and public key certificate. The source of the ECG signal is clearly the DIE through the use of the public key 12 . 30 or respirator 10 assigned. The signal becomes a bundle of waveforms to the patient monitor 20 transferred. The patient monitor 20 Uses the signal analogous to the previously received signal via the ECG input. Embodiments provide a device network with secure ECG measurement when moving the electrode set 30 from patient monitor 20 after ventilator / sEMG 10. The patient monitor 20 recognizes over the network 40 that the patient 50 associated with a bioelectrical device that is sEMG and ECG enabled. If the bio-electrical device after a predetermined time over the network 40 If no ECG signal is sent, a message is generated.

In some embodiments, the electrode set becomes 30 analogous to the patient monitor 20 or the ventilator 10 connected. The bioelectrical analog interface of the ventilator 10 allows individual control of the shield contacts. The asymmetric certificate identifies the ventilator 10 as sEMG and ECG-capable. For example, by the ventilator 45 seconds after disconnection of the electrode set 30 from the PPM 20 no ECG signal delivered, gives the patient monitor 20 an optical or acoustic message.

The 7 shows a block diagram of a flowchart ( 60 ) a method for a patient monitor 20 in one embodiment. First, in one step 62 determined if the electrode set 30 or the patient part of patients 50 was decoupled. In one step 64 then it is checked if the patient part sEMG is suitable, if not so in step 66 a corresponding message is issued. Unless the ventilator 10 is not sEMG-capable, is also in step 66 the corresponding message is issued. If the waiting time has expired and the ECG signal for the patient is not available in the network, will also step with 66 and the output of the message continued. If none of the queries is positive becomes the step 62 declined. Additionally or alternatively, for example, even upon detection of unsuitability of an electrode set 30 a warning message can be generated directly.

8th shows a block diagram of a flowchart of a method for a device 10 for determining a respiratory effort of a patient 50 in one embodiment. The method includes detection 72 of patient signals and communicating 74 with another network component, such as a patient monitor 20 , The method further includes obtaining 76 of patient signals to provide information about the patient's respiratory effort based on the patient signals 50 to determine and forwarding 78 at least partial information about the patient signals to the other network component.

9 shows a block diagram of a flowchart 60 a method for a patient monitor in one embodiment. The method includes detection 82 of patient signals. In a first mode, the method includes obtaining 82a the patient signals over a Electrode interface, and determining 82b information about the vital parameters of the patient 50 based on the patient signals. In a second mode, the method includes obtaining 84a information about the patient signals via a network interface, and determining 84b the information about the vital parameters of the patient 50 based on the information about the patient signals.

10 11 illustrates a block diagram of a flowchart of a method for an electrode set in one embodiment. The method for acquiring patient signals for determining vital parameters and determining respiratory effort of a patient 50 with the electrode set 30 includes an electronic transmission 92 an identifier of the electrode set 30 , The identifier indicates that the electrode set 30 for recording patient signals for determining vital parameters and for determining respiratory effort of a patient 50 suitable.

11 shows a block diagram of a flowchart of another method for a patient monitor 20 in one embodiment. The procedure for the determination of vital parameters and a respiratory effort of the patient 50 includes an acquisition 102 of patient signals with an electrode set 30 , In a first mode, the method includes coupling 102 of the electrode set 30 to a patient monitor 20 , a determination 102b information about the vital parameters of the patient 50 based on the patient signals and uncoupling 102c of the electrode set 30 from the patient monitor 20 , In a second mode, the method includes communicating 104a between the patient monitor 20 and a device 10 to record the respiratory effort of the patient 50 , In the second method mode, coupling takes place 104b of the electrode set 30 to the device 10 for determining the respiratory effort and a
Receive 104c an identifier of the electrode set 30 at the device 10 to determine the respiratory effort. Furthermore, in the second mode, the method comprises a forwarding 104d information about the identifier to the patient monitor 20 and a get 104e of patient signals (from the electrode set 30 ) on the device 10 for determining respiratory effort to provide information about the patient's respiratory effort based on the patient signals 50 to determine. In the second mode, forwarding then takes place 104f at least partial information about the patient signals to the patient monitor 20 and determining 104g the information about the vital parameters of the patient 50 based on the at least partial information about the patient signals in the patient monitor 20 ,

Another embodiment is a program having program code for performing one of the methods described herein when the program code is executed on a computer, a processor, or a programmable hardware component.

The features disclosed in the above description, the claims and the drawings may be important both individually and in any combination for the realization of embodiments in their various embodiments and - unless otherwise stated in the description - are combined with each other as desired.

Although some aspects have been described in the context of a device, it will be understood that these aspects also constitute a description of the corresponding method, so that a block or a component of a device is also to be understood as a corresponding method step or as a feature of a method step. Similarly, aspects described in connection with or as a method step also represent a description of a corresponding block or detail or feature of a corresponding device.

Depending on particular implementation requirements, embodiments of the invention may be implemented in hardware or in software. The implementation may be performed using a digital storage medium, such as a floppy disk, a DVD, a Blu-Ray Disc, a CD, a ROM, a PROM, an EPROM, an EEPROM or FLASH memory, a hard disk, or other magnetic disk or optical memory are stored on the electronically readable control signals, which can cooperate with a programmable hardware component or cooperate such that the respective method is performed.

A programmable hardware component may be integrated by a processor, a central processing unit (CPU), a graphics processing unit (GPU), a computer, a computer system, an application-specific integrated circuit (ASIC) Circuit (IC = Integrated Circuit), a system on chip (SOC) system, a programmable logic element or a field programmable gate array with a microprocessor (FPGA = Field Programmable Gate Array) may be formed.

The digital storage medium may therefore be machine or computer readable. Some embodiments thus include a A data carrier having electronically readable control signals capable of interacting with a programmable computer system or a programmable hardware component to perform one of the methods described herein. One embodiment is thus a data carrier (or a digital storage medium or a computer readable medium) on which the program is recorded for performing any of the methods described herein.

In general, embodiments of the present invention may be implemented as a program, firmware, computer program, or computer program product having program code or data, the program code or data operative to perform one of the methods when the program resides on a processor or a computer programmable hardware component expires. The program code or the data can also be stored, for example, on a machine-readable carrier or data carrier. The program code or the data may be present, inter alia, as source code, machine code or bytecode as well as other intermediate code.

Yet another embodiment is a data stream, signal sequence, or sequence of signals that represents the program for performing any of the methods described herein. The data stream, the signal sequence or the sequence of signals can be configured, for example, to be transferred via a data communication connection, for example via the Internet or another network. Embodiments are also data representing signal sequences that are suitable for transmission over a network or a data communication connection, the data representing the program.

A program according to an embodiment may implement one of the methods during its execution, for example, by reading out of or writing into these data or data, thereby optionally switching operations or other operations in transistor structures, in amplifier structures or in other electrical, optical, magnetic or caused by another operating principle working components. Accordingly, by reading a memory location, data, values, sensor values or other information can be detected, determined or measured by a program. A program can therefore acquire, determine or measure quantities, values, measured variables and other information by reading from one or more storage locations, as well as effecting, initiating or executing an action by writing to one or more storage locations and controlling other devices, machines and components.

The embodiments described above are merely illustrative of the principles of the present invention. It will be understood that modifications and variations of the arrangements and details described herein will be apparent to others of ordinary skill in the art. Therefore, it is intended that the invention be limited only by the scope of the appended claims and not by the specific details presented in the description and explanation of the embodiments herein.

LIST OF REFERENCE NUMBERS

10

contraption

12, 22

detector

14, 24

Network Interface

16, 26

control module

20

patient monitor

30

electrode set

40

network

50

patient

60

unit network

62, 64, 66

step

72

Capture patient signals

74

Communicate

76

Obtaining patient signals

78

Hand off

82

Capture the patient signals

82a

Receiving the patient signals

82b

Determine information

84a

Receive

84b

Determine

92

Transmitting an identifier of the electrode set

102

Capture patient signals

102

Couple

102b

Determine

102c

uncouple

104a

Communicate

104b

link up

104c

Receive

104d

Hand off

104e

Receive

104f

Forward partial information

104g

Determine

QUOTES INCLUDE IN THE DESCRIPTION

This list of the documents listed by the applicant has been generated automatically and is included solely for the better information of the reader. The list is not part of the German patent or utility model application. The DPMA assumes no liability for any errors or omissions.

Cited patent literature

• US 2013/0213399 A1 [0004]

Claims (20)

Apparatus (10) for determining respiratory effort of a patient (50), comprising detection means (12) adapted to detect patient signals; a network interface (14) adapted to communicate with another network component; and a control module (16) which is designed to control the detection device (12) and the network interface (14) and which is further configured to receive the patient signals via the detection device (12) in order to obtain information about the patient based on the patient signals To determine respiratory effort of the patient (50), and to forward via the network interface (12) at least partial information about the patient signals to the other network component. Device (10) according to Claim 1 wherein the other network component is a patient monitor (20), and / or wherein the detection means (12) of an electrode interface, which is designed for connection of an electrode set (30) for detecting the patient signals, or an interface for obtaining with an electrode set (30 ) corresponds to recorded patient signals. Device (10) according to one of Claims 1 or 2 further comprising respiration means for ventilating the patient (50) based on the respiratory effort information of the patient (50), and / or wherein the control module (16) is adapted to send digitally converted patient signals to the patient via the network interface (14) Patient monitor (20) forward. Device (10) according to one of Claims 1 to 3 in that the control module (16) is designed to forward information about an identification of an electrode set (30) connected to the detection device (12) to the patient monitor (20) via the network interface (14). Patient monitor (20) for determining vital parameters of a patient (50), with an electrode interface (22) adapted to connect an electrode set (30) for detecting patient signals; a network interface (24) adapted to communicate with at least one other network component; a control module (26) configured to control the electrode interface (22) and the network interface (24) and further configured to in a first mode via the electrode interface (22) to receive the patient signals and to determine based on the patient signals information about the vital parameters of the patient (50), and in a second mode, obtaining information about the patient signals via the network interface (24), and determining information about the patient's vital signs (50) based on the information about the patient signals. Patient monitor (20) according to Claim 5 wherein the control module (26) is designed to determine, via the network interface (24), whether there is another device for detecting the patient signals of the same patient (50), and / or the at least one other network component of a device (10). to determine a respiratory effort of a patient (50) or another patient monitor. Patient monitor (20) according to one of Claims 5 or 6 wherein the control module (26) is adapted to switch from the first mode to the second mode upon detection of a presence of another device for detecting the patient signals of the same patient (50). Patient monitor (20) according to one of Claims 5 to 7 wherein the control module (26) is adapted to provide warning information upon detection of the presence of another device for sensing the patient signals of the same patient (50), upon completion of detection of the patient signals via the electrode interface (22), and after expiration of a predefined time generate, indicating that a determination of the vital parameters is interrupted. Patient monitor (20) according to Claim 8 where the predefined time is one minute. Patient monitor (20) according to one of Claims 5 to 9 wherein the control module (26) is designed to take into account in the determination of vital parameters whether the patient signals detected with the connected electrode set (30) are suitable for determining information about the respiratory effort of the patient (50). An electrode set (30) for acquiring patient signals for determining vital parameters and determining respiratory effort of a patient (50), the electrode set (30) being adapted to electronically transmit an identifier, the identifier indicating that the set of electrodes (30 ) is suitable for acquiring patient signals for determining vital parameters and for determining respiratory effort of a patient (50). Electrode set (30) according to Claim 11 , further comprising an electrode interface, which with a patient monitor (20) and a device (10) for determining a respiratory effort of a patient (50) can be coupled. Electrode set (30) according to one of Claims 11 or 12 further comprising an analog-to-digital converter configured to convert analog detected patient signals to digital patient signals. Electrode set (30) according to Claim 13 further comprising a power supply, a memory and a control module, wherein the control module is adapted to disconnect the electrode set (30) from a patient monitor (20) or apparatus (10) for determining respiratory effort of a patient (50) in the memory to buffer the acquired patient signals, and the cached signals to a patient monitor (20) or a device (10) for determining respiratory effort of a patient after reconnection to the patient monitor (20) or device (30) for determining respiratory effort of a patient (50 ) transferred to. A device network (60) with a device (10) according to one of Claims 1 to 4 , a patient monitor (20) according to one of Claims 5 to 10 and an electrode set (30) according to any one of Claims 11 to 14 , A method of determining respiratory effort of a patient (50), comprising detecting (72) patient signals; Communicating (74) with another network component; and obtaining (76) patient signals to determine information about the patient's respiratory effort (50) based on the patient signals; and forwarding (78) at least partial information about the patient signals to the other network component. A method for determining vital parameters of a patient (50), comprising detecting (82) patient signals; in a first mode Obtaining (82a) the patient signals via an electrode interface, and determining (82b) information about the vital parameters of the patient (50) based on the patient signals; and in a second mode Obtaining (84a) information about the patient signals via a network interface, and Determining (84b) the information about the vital parameters of the patient (50) based on the information about the patient signals. A method for acquiring patient signals for determining vital parameters and determining respiratory effort of a patient (50) with an electrode set (30) comprising electronically transmitting (92) an identifier of the electrode set (30), the identifier indicating that the electrode set ( 30) is suitable for acquiring patient signals for determining vital parameters and for determining respiratory effort of a patient (50). Method for determining vital parameters and respiratory effort of a patient (50), with Detecting (102) patient signals with an electrode set (30); in a first mode Coupling (102a) the electrode set (30) to a patient monitor (20); Determining (102b) information about the vital parameters of the patient (50) based on the patient signals; Decoupling (102c) the electrode set (30) from the patient monitor (20); in a second mode Communicating (104a) between the patient monitor (20) and a patient breathing apparatus (10) (10); Coupling (104b) the electrode set (30) to the apparatus (10) for determining the respiratory effort; Receiving (104c) an identifier of the set of electrodes (30) on the apparatus (10) for determining respiratory effort; Forwarding (104d) information about the identifier to the patient monitor (20); Obtaining (104e) patient signals on the respiratory effort determination device (10) to determine information about patient respiratory effort (50) based on the patient signals; Forwarding (104f) at least partial information about the patient signals to the patient monitor (20); Determining (104g) the information about the vital parameters of the patient (50) based on the at least partial information about the patient signals in the patient monitor (20). Computer program with a program code for carrying out one of the methods according to one of Claims 16 to 19 if the program code is executed on a computer, a processor or a programmable hardware component.

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