Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B5/00—Measuring for diagnostic purposes; Identification of persons
  • A61B5/0059—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
  • A61B5/0082—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes
  • A61B5/0084—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes for introduction into the body, e.g. by catheters
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B5/00—Measuring for diagnostic purposes; Identification of persons
  • A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
  • A61B5/026—Measuring blood flow
  • A61B5/0261—Measuring blood flow using optical means, e.g. infrared light
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B5/00—Measuring for diagnostic purposes; Identification of persons
  • A61B5/20—Measuring for diagnostic purposes; Identification of persons for measuring urological functions restricted to the evaluation of the urinary system
  • A61B5/202—Assessing bladder functions, e.g. incontinence assessment
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B5/00—Measuring for diagnostic purposes; Identification of persons
  • A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
  • A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
  • A61B5/6885—Monitoring or controlling sensor contact pressure
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B5/00—Measuring for diagnostic purposes; Identification of persons
  • A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
  • A61B5/7203—Signal processing specially adapted for physiological signals or for diagnostic purposes for noise prevention, reduction or removal
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B5/00—Measuring for diagnostic purposes; Identification of persons
  • A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
  • A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
  • A61B5/6847—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive mounted on an invasive device
  • A61B5/6852—Catheters
  • A61B5/6853—Catheters with a balloon

Definitions

• the present invention relates to the field of isositive systems and methods for estimating metabolic ameters relating to the infusion of a patient's organ, in particular an organ comprising a mucosa and muscle tissue.
• the invention provides an associated monitoring method.
• Such a system can be used in noisy applications to monitor patients susceptible to hypo-perfusion. These affections must be of various origins: haemorrhagic, infectious or inasasasory,
• the biological parameters relating to the infusion provide the user with information relating to the microcirculation of the organ in order to assist him in the choice of treatments adapted to the patient.
• "good distal perfusion of the organs in patients with ischemia is an important element of their care. The perfusion of the organs can induce major disturbances, even to the point of failure of these organs.
• One of the difficulties of monitoring distal perfusion is that it may be heterogeneous and in some cases may be sufficient at one location and insufficient at another location. In states of alteration of the blood flow, the microcirculation can be pacted.
• the urethral mucosa seems to be particularly sensitive to hepatic alterations. It is therefore particularly interesting to monitor the response of the organization to therapeutic actions. Therapeutic actions are the most comprehensive on the body and will have a resonance on each organ -
• the pho ⁇ ple hysmog aphie technology is a means of evaluating the perfasicsn of a tissue.
• a catheter equipped with a photoplethysmography sensor is used.
• the siasares can be disturbed by variations in the size and consequently of the pressure exerted by the smear on the catheter, altering the density of the urethra.
• capillary network without modifying the blood flow and altering the measurement of the infusion, D® mas, on the other hand, can relax and also alter the measurement.
• the invention provides a tissue perfusion monitoring system, including an infusion sensor, a pressure sensor disposed proximate or at the infusion sensor, said sensors configured to be associated with a processing unit.
• the processing unit comprises at least one mod corrector configured to determine and / or correct perfusion sensor artifacts related to a pressure measured by the pressure sensor.
• the system according to the invention comprises a correction module making it possible to take into account the pressure variations related to the variations in the diameter of the reamer. in the evaluation of the. erfusi n.
• the perfusion reassurance is therefore: it is precise in spite of variations of pressures and rees emen muscular individual-speci ics ⁇
• said corrective modulator is or com ers a module for applying a parameter corrsctear to the signal from the infusion sensor as a function of the signal received by the pressure sensor; and or
• the system preferably comprises a deployment mechanism disposed near or at the base of the infusion sensor, the deployment mechanism being configured to apply tissue pressure, and said corrector module is or includes a module for determining a contraspression at the applying the fabric and function of the signal received by the pressure sensor, and / or applying said expression; and or
• the system comprises a tubular catheter body equipped with the infusion sensor and the pession sensor, and the deployment mechanism comprises a stent internal to the body or an inflatable deployment balloon extending over a portion of the section of the body; and or
• the system comprises said deployment balloon, and the pressure sensor is disposed radially inside the perfusion sensor; and or
• the deployment balloon extends over one half of the section of the body;
• the system comprises said stent, and the perfusion sensor and the pressure sensor are diametrically opposed on the body, ⁇ and / or
• the system includes a holding balloon at one end of the body; and or
• the infusion sensor is a photo plethysmographi TM.
• the invention further relates to a method for monitoring / infusing an average tissue of a host; com ing the e es of:
• the step of correcting includes a step of applying a corrective parameter to the signal from the infusion lacaitorsgs as a function of the applied pressure m itorage.
• the step of correcting comprises a step of detaching against pressure to apply the tissue as a function of the applied pressure monitoring, and / or applying said counterpressure.
• U X 'invention relates u perfusio of mox ⁇ itorage device for f n fabric, particularly a catheter comprising a tubular body equipped with n perf sensor configured to detect sion un® tissue perfusion, and a deployment mechanism near or at the level of the perfusion sensor, the deployment mechanism being provided between a deployment position in which it locally increases the size of the body and a folding position in which it does not locally increase the size of the body, characterized in that the deployment mechanism comprises an internal body stent or an inflatable inflatable balloon extending over a portion of the body section,
• the device according to the invention is of great interest for the urethral tissue, since it includes a specific information associated with a small footprint of the deployment root, while allowing urine to pass through the body of the body.
• the invention will be further described by the description of limiting embodiments, and based on the past figures, in which;
• Figure 1 is a general schematic diagram of a system variant of the invention
• Figure 2 is a diagram of a processing unit of a variant system of the invention.
• Figure 2 is a curve of a coefficient k as a function of pressure.
• FIG. 3 is a detailed diagram of a system according to a variant of the invention.
• FIG. 4 is a detailed diagram of a second variant of an embodiment of the invention.
• the figure SA is n detailed diagram of a mechanism of deployment living a second alternative of the second variant
• FIG. SE is a cross section in the middle of FIG.
• Figure 6 is a detailed diagram of a deployment mechanism according to a first alternative of the second variant.
• the present invention relates to a perfusion monitoring system 1 for a tissue such as ratral® udder.
• the system 1 comprises a catheter-like catheter 2
• the catheter 2 comprises a body 2a, preferably tabular.
• System 1 includes an infusion sensor 3 configured to detect perfusion of the tissue.
• the perfusion sensor 3 is for example a sensor using photopiagnosis technology, namely a hot-plethysmographic sensor.
• This type of sensor 3 associated with such a system 1 and the associated perfusion measurement have been presented in detail, in particular in claims O2013127S19 and O201S ⁇ 44336, concerning measurements in a particular tissue, namely a duodenal mucosa, ⁇ ? u'un our photo plethysmography sensor can Donner indication ef reliable sio in your & ps, it has scaffold, that the path of the photons between i! transmitter and receiver is constant in a given application. In particular, it firstly means that the cape is pressed against the wall, secondly that the interface between the sensor and the wall of the mucosa is always the same, and that the composition of the tissue remains unchanged. .
• the first point is solved by the very nature of the urethra, which is phymexically adapted to block the return of urine. If a S-catheter is placed in the stent, it collapses in the same way on the catheter 2.
• the diameter of the urethra and thus the pressure exerted by the mucosa on the sensor may vary from one indivu to the other. From time to time, during a measurement, there may be a muscle relaxation as a function of the general state of the fabric.
• the invention proposes to integrate a pressure switch 4 into the system 1, in particular onto 1 2, particularly the pressure sensor 4 is disposed at a maximum of 3.
• This arrangement is such that it has a high estimate of the pressure applied to the representative infusion sensor 3 at a tissue loading of the tissue on the infusion sensor 3.
• the pressure sensor 4 is disposed substantially at the level of the infusion sensor 3, in particular with reference to a longitudinal axis of the catheter body 2a, for example,
• the pressure sensor 4 may be arranged radially in within the infusion sensor 3, or in diametrically opposite manner discussed further below.
• the perfusion captear 3 and. the pressure sensor are configured to be associated with the treatment unit 5.
• the treatment unit 5 makes it possible to process the signals ç s by the infusion sensor 3 and the pressure sensor.
• the processing unit. 5 includes for example a computer.
• the catheter 2 is further connected to a urine receptor 2b receiving the urine discharged from it. via the catheter body 2a.
• a "Y" connector may be provided for this purpose at the end of the catheter body 2a,
• the processing unit 5 comprises at least one correction module 6 configured to determine and / or correct the artefacts of the infusion sensor 3 related to a pressure measured by the pressure sensor.
• the processing unit S may be a computer comprising material means and inormal means.
• the processing unit S comprises hardware elements such as a connection module 5a, for example a connection SUS. a control module 5b, for example a CPU, and a memory module 5c.
• the processing unit S comprises S computer modules Sd, Se, ..., S'Z, and at least u module 6a, 6, Se, € d.
• the information modes 5d, 5e, 5 *, are; Known modules make it possible to operate the processing unit 5, for example computerized computer ss.
• the models 6, Sfo, 6e, 6d are, respectively, of the corrector module 6 allowing, according to the case of determining the artifacts, to propose a correction of the artifacts,. to correct artifacts.
• a catheter 2 com renan a perfusion sensor 3, an n ec deployment Sik 7f and preferably a pressure sensor 4, close or level one of Another, used to apply internal pressure and to model the tissue plating efforts, in particular to analyze the effects of the pressure measured on the perfusion mask.
• the preferred catheter 2 and deployment mechanism 7 will be further detailed.
• the catheter body 2a is tabular equipped with the infusion sensor 3 and the pressure sensor 4, and the deployment mechanism 7 includes an inflatable inflatable balloon extending over a portion of the body section.
• the deployment balloon extends over one half of the section of the body 2a. It is then a beagle-balloon.
• this configuration makes it possible to limit the size of the catheter 2, which has an incidence in small-scale tissues such as that of urethra.
• the deployment balloon is preferably a high pressure balloon.
• a high pressure balloon by its nature is totally collapsed when the balloon is deflated which allows the insertion of the so in the mea without risk to hang the balloon flaps ..
• the pressure sensor 4 and the perfusion sensor 3 are disposed at the level of the balloon 7, and the pressure sensor 4 is disposed radially within the infusion sensor 3. precise perfusion values and applied pressures at the measurement Kone.
• the catheter body 2a is tubular equipped with perfusion sensor 3 and the pressure sensor, and the deployment mechanism comprises a stan 7fc> internal to the body.
• This variant can be illustrated in FIG. 6.
• the patient realized that this configuration also made it possible to use the cathode ncc connector 2.
• the pressure sensor 4 and the perfusion sensor 3 are disposed at the s tan? F and b are diametrically opposed on the body 2a.
• this configuration also makes it possible to have precise infusion measurements and pressures applied to the air of the airspace.
• the monitoring system i comprises a holding balloon 8 at an end of the body 2a.
• the holding balloon S makes it possible for the catheter body 2a to have a fixed position in the urethra.
• the holding balloon 8 can be positioned in the bladder and inflated there for the first time at the birth of the urethra.
• the holding balloon 8 may be provided at a greater or lesser distance from the sensors 3, 4 because of the difference between the hoj3 ⁇ 4mes and the fses ana omi3 ⁇ 4ua,
• Catheter 2 equipped with the deployment mechanism preferred can be used for modeling, pi quag efforts. ls; Perfusion measured by the infusion sensor 3 may be altered by different plating functions thus creating an eorrespondasiit artifact.
• the air stresses are determined by pressure sensor measurements.
• the measured pressure can be compensated for by the catheter 2 at the time of deployment.
• the pressure of the plating pressure on the measurement of wear can therefore be modeled by applying several pressures on the mechanism of deployment. This makes it possible to determine a correction parameter to be applied to an infusion measurement for a given plating pressure.
• the deployment mechanism is used to effect pressure levels by going from 0, IkPa to 6kPa at a level of 0.2 kPa for a time of 5s. This is preferably achieved at the minimum pressure and at each stage for example for a time of 5 seconds. Re e i at a minimum level makes it possible to avoid an effect of accommodation of the fabric on the pressure.
• the correcting parameter can be a multiplying coefficient.
• a curve of a coefficient k of pulaatility as a function of the measured pressure can be obtained, for example as illustrated in FIG. 2.
• this curve is normalized so that its maximum is. 1.
• this coefficient k can be applied to the pressure values measured by the pressure sensor 4 to correct the corresponding perfusion measurement, preferably by means of ormatic means.
• the infusion measurement is multiplied by 1 / k, with k being equal to. the pressure measurement.
• the corrective parameter thus determined can be applied to systems with on without deployment mechanism 7 to correct the perfusion measurement.
• An alternative system without a deployment mechanism is illustrated in FIG.
• the processing unit 5 has a mod el of the embodiment 6a making it possible to determine the corrector parameter, in particular the coefficient k.
• the system 1 according to this variant makes it possible to minimize, in a given situation with controlled infusion and given pressures applied by a deployment mechanism, what is the calibration of the corresponding coefficient k.
• the calibration can be done with the oxaatiqu.
• the treatment unit S comprises a multiplier modula 6b associated with calibration.
• the calibrator can be pre-filtered to a coefficient k determined by example as described above, recorded in the memory of the university unit. In this case, the calibration being carried out, the module 6a. no longer needed in a calibrated monitoring system,
• the calibration can be carried out by means of a calibration module 6a, for example, before the actual measurement.
• the module 6a is always associated with the module 6b to redo a califoratien,
• Module eh treats the perfusion measurements by correcting them by applying a correction parameter, in particular the multiplier k.
• the artefacts are related to a change in the density of the capillary network, itself related to a variation in tissue diameter which results in a corresponding plating force of the tissue on the catheter.
• tissue pressure on the catheter 2 corresponding to a given effor can be compensated by a catheter 2 confcrepres on the tissue to achieve a target ef ort.
• the pressure measurements on the catheter 2 make it possible to determine a given pressure applied by the tissue to the catheter 2.
• a counterpressure namely "no compensation pressure
• a counterpressure can be applied by the catheter 2 to reach the target pressure.
• a back pressure of 1 may be applied through the catheter 2 to compare the measured pressure and reach the target pressure of 2.
• the processing unit S comprises a stress relief module 6c .
• the strength determination module 6c is configured to determine a pressure to be applied to the fabric, depending on the signal received by the pressure sensor. 4L
• a depressant mechanism such as an inflatable balloon, preferably the hemoglobin, or the stent, can make it possible to apply said expression and to have a target plating effort.
• the isonitoring system 1 comprising the deployment mechanism 7, further comprises a means 2c for applying said expression thus determined.
• a means 2c for applying said expression thus determined.
• an operator informed of the pressure to be applied to the stress determination module 6c can apply said pressure by actuating said means.
• This is for example a stent comma da or inflatable balloon. by an operator.
• the deployment mechanism? is located near or preferably at the infusion sensor 3 so as to have a pressure ap lique at the place where the pressure has been measured.
• the processing unit S may comprise a mod der the force applicator 6d configured to apply the counterpr ssio determined by the modul de disassembly of e fo t Se.
• a mod der the force applicator 6d configured to apply the counterpr ssio determined by the modul de disassembly of e fo t Se.
• this variant® per "to achieve an automatic compensation not requiring, in these cases, action of a oe ateu.
• V ys th 1 comprising both the means 2c for the operator adjustable control and the 6d iodui for automatic compensation, and be provided.
• the invention relates to a process for the sonication of perfusion of a tissue, in particular of tissues of an urethra, by means of a catheter 2, in particular catheter 2 as described above.
• the method according to the invention comprises a step of monitoring a perfusion of the tissue at the catheter 2, as well as a step of measuring a pressure applied by the tissue on the catheter 2.
• the invention provides for the correction of infusion monitoring effects of an applied pressure actuation function.
• the step of correcting comprises a step of applying a correction parameter to the signal issxs of the infusion sensor 3 as a function of the applied pressure gauges.
• the step of correcting comprises a step of determining a counterpressure to be applied to the tissue as a function of the pressure monitoring applied, and / oa applying said counterpressure n,
• the method involves at least one of the modules a ⁇ 6d described above and / or the means 2c for applying pressure.
• the monitoring method is in particular implemented by computer means. Ains.
• Another object of the invention relates to a program product info ma-tica or a computer program loaded in a processing unit, comprising portions of rog amm code for executing the steps of the program. method dec it above, when said progruaaM is performed on said unit trai-tesaent 5,
• each of the modules 6a-Sd is in particular years of a corresponding computer system, eg the electronic monitoring and control system.
• 1 "invention carries out a program product are informat qua or prograxsm ⁇ computer eh & rgeafol® da sie s a very itemen unit, comprising program code portions for puts e in modern a to e mo n one of the Sa ⁇ 6d modules described above, when said program is executed on said processing unit S.

Landscapes

• Health & Medical Sciences (AREA)
• Life Sciences & Earth Sciences (AREA)
• Engineering & Computer Science (AREA)
• Surgery (AREA)
• General Health & Medical Sciences (AREA)
• Biophysics (AREA)
• Pathology (AREA)
• Veterinary Medicine (AREA)
• Biomedical Technology (AREA)
• Heart & Thoracic Surgery (AREA)
• Medical Informatics (AREA)
• Molecular Biology (AREA)
• Public Health (AREA)
• Animal Behavior & Ethology (AREA)
• Physics & Mathematics (AREA)
• Physiology (AREA)
• Urology & Nephrology (AREA)
• Signal Processing (AREA)
• Artificial Intelligence (AREA)
• Computer Vision & Pattern Recognition (AREA)
• Psychiatry (AREA)
• Hematology (AREA)
• Cardiology (AREA)
• Infusion, Injection, And Reservoir Apparatuses (AREA)
• Measuring And Recording Apparatus For Diagnosis (AREA)

Applications Claiming Priority (2)

Publications (1)

Family

ID=59699734

Family Applications (1)

Country Status (4)

Family Cites Families (5)

• 2017
  • 2017-06-30 FR FR1700698A patent/FR3068234B1/fr active Active
• 2018
  • 2018-06-28 US US16/647,797 patent/US20230139953A1/en not_active Abandoned
  • 2018-06-28 WO PCT/FR2018/051583 patent/WO2019002769A1/fr unknown
  • 2018-06-28 EP EP18752542.3A patent/EP3817644A1/de active Pending

Also Published As

Similar Documents

Legal Events