JP2009517187A - 呼吸障害指数に基づいて心不全状態を評価する方法及びシステム - Google Patents
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Abstract
Description
DBindex=a1DBNon-REM+a2DBREM+f(a)DBawake [1]
式中、a1及びa2が一定係数である場合、DBNon-REMはノンレム睡眠時に生じる呼吸障害発現に関連した呼吸障害指数を表し、DBREMはレム睡眠時に生じる呼吸障害発現に関連した呼吸障害指数を表し、DBawakeは患者の覚醒時に生成する呼吸障害と関連付けられた呼吸障害指数を表し、f(a)は患者の活性(activity)の関数である。
Claims (34)
- 患者の呼吸を検知し呼吸信号を生成し、
前記呼吸信号に基づいて呼吸障害発現を検出し、
前記検出された呼吸障害発現に基づいて呼吸障害指数を決定し、
一定期間にわたり前記呼吸障害指数の傾向を捕捉し、
前記呼吸障害指数傾向に基づいて心不全状態を評価する、
患者評価を提供すべく医療用具を操作する方法であって、
前記検知すること、検出すること、決定すること、傾向を捕捉すること、評価することのうち少なくとも1つは、少なくとも部分的に植込みで行われる、
医療用具を操作する方法。 - 前記呼吸信号に基づいて前記呼吸障害発現を検出することは、閉塞性呼吸障害発現と中枢性呼吸障害発現とを識別することを含み、
前記呼吸障害指数を決定することは、前記閉塞性呼吸障害発現及び中枢性呼吸障害発現の少なくとも1つに基づいて前記呼吸障害指数を決定することを含む、
請求項1に記載の方法。 - 前記閉塞性呼吸障害発現と前記中枢性呼吸障害発現とを識別することは、周期性呼吸発現時における前記呼吸信号の呼吸亢進部分中の呼吸数に基づいて識別することを含む請求項2に記載の方法。
- 前記呼吸障害指数を決定することは、前記中枢性呼吸障害発現と前記閉塞性呼吸障害発現との比率を決定することを含む請求項2に記載の方法。
- 前記呼吸障害指数を決定することは、前記検出された呼吸障害発現の持続時間に基づいて呼吸障害指数を決定することを含む請求項1に記載の方法。
- 前記呼吸障害指数を決定することは、前記検出された呼吸障害発現の特定部分の長さに基づいて呼吸障害指数を決定することを含む請求項1に記載の方法。
- 前記呼吸障害指数を決定することは、前記検出された呼吸障害発現の頻度に基づいて呼吸障害指数を決定することを含む請求項1に記載の方法。
- 前記呼吸障害発現を検出することは周期性呼吸発現を検出することを含み、
前記呼吸障害指数を決定することは、
前記周期性呼吸発現時において前記呼吸信号を変調する波形を決定し、
前記波形の変調の度合に基づいて呼吸障害指数を決定する、
ことを含む、
請求項1に記載の方法。 - 前記呼吸障害発現を検出することは周期性呼吸発現を検出することを含み、
前記呼吸障害指数を決定することは、
呼吸亢進期間における最大一回呼吸量を検出し、
前記最大一回呼吸量に達するまでの時間を決定する、
ことを含む、
請求項1に記載の方法。 - 前記呼吸障害発現を検出することは急速表在呼吸発現を検出することを含み、
前記呼吸障害指数を決定することは一回呼吸量に対する呼吸速度の割合を決定することを含む、
請求項1に記載の方法。 - 心不全状態に関連する追加情報を取得することを更に含み、
前記心不全状態の評価は前記呼吸障害指数及び前記追加情報に基づいて前記状態を評価することを含む、
請求項1に記載の方法。 - 前記追加情報は患者への質問を利用して取得される請求項11に記載の方法。
- 前記追加情報は検知された情報を含む請求項11に記載の方法。
- 前記追加情報の取得は患者の体位を検出することを含み、
前記呼吸障害指数の決定は患者の体位を呼吸障害発現と相関させることを含む、
請求項11に記載の方法。 - 前記追加情報の取得は患者の活性(activity)を検出することを含み、
前記呼吸障害指数の決定は患者の活性(activity)を呼吸障害発現と相関させることを含む、
請求項11に記載の方法。 - 前記傾向及び前記心不全評価の少なくとも1つを表示することを更に含む請求項1に記載の方法。
- 前記傾向及び前記心不全評価の少なくとも1つに基づいて警報(alert)を生成することを更に含む請求項1に記載の方法。
- 前記傾向及び前記心不全評価の少なくとも1つに基づいて治療を変更することを更に含む請求項1に記載の方法。
- 患者の呼吸に反応する信号を生成すべく構成された呼吸センサを含むデータ取得モジュールと、
前記呼吸センサに連結されると共に呼吸信号に基づいて呼吸障害発現を検知すべく構成された呼吸障害検知器と、
前記呼吸障害検知器に連結されると共に前記検知された呼吸障害発現に基づいて呼吸障害指数を決定すべく構成された指数プロセッサと、
前記指数プロセッサに連結されると共に前記呼吸障害指数の傾向を発展させ格納すべく構成された傾向/保存モジュールと、
前記傾向/保存モジュールに連結されると共に前記呼吸障害指数傾向に基づいて心不全状態を評価すべく構成された診断ユニットと、
を含む、患者評価を提供するためのシステム。 - 前記患者評価システムは少なくとも部分的に植込み型である請求項19に記載のシステム。
- 前記患者評価システムの少なくとも1つの構成要素は心臓律動管理装置のハウジング内に配置される請求項19に記載のシステム。
- 前記指数プロセッサは、閉塞性呼吸障害発現と中枢性呼吸障害発現を区別すると共に、閉塞性呼吸障害発現及び中枢性呼吸障害発現の少なくとも1つに基づいて呼吸障害指数を決定すべく構成される請求項19に記載のシステム。
- 前記指数プロセッサは周期性呼吸発現の呼吸亢進部分中に呼吸速度に基づいて閉塞性呼吸障害発現と中枢性呼吸障害発現とを区別すべく構成される請求項22に記載のシステム。
- 胸郭圧、心臓圧、血管圧の少なくとも1つを測定すべく構成された圧力センサを更に含み、前記指数プロセッサは圧力センサによって生成された出力に基づいて閉塞性呼吸障害発現と中枢性呼吸障害発現を区別すべく構成される請求項22に記載のシステム。
- 前記指数プロセッサは呼吸障害発現の持続時間に基づいて呼吸障害指数を決定すべく構成される請求項19に記載のシステム。
- 前記指数プロセッサは呼吸障害発現の頻度に基づいて呼吸障害指数を決定すべく構成される請求項19に記載のシステム。
- 前記指数プロセッサは呼吸障害発現のパターンに基づいて前記呼吸障害指数を決定すべく構成される請求項19に記載のシステム。
- 前記指数プロセッサに連結されると共に睡眠段階を検出すべく構成された睡眠段階センサを更に含み、
前記指数プロセッサは、
呼吸障害発現を睡眠段階と相関させると共に睡眠段階及び呼吸障害発現に基づいて呼吸障害指数を決定すべく構成された、
請求項19に記載のシステム。 - 前記指数プロセッサに連結されると共に患者の活性(activity)を検知すべく構成された活性(activity)センサを更に含み、
前記指数プロセッサは呼吸障害発現を患者の活性(activity)と相関させると共に患者の活性(activity)及び呼吸障害発現に基づいた呼吸障害指数を決定すべく構成される、
請求項19に記載のシステム。 - 前記指数プロセッサに連結されると共に患者の体位を測定すべく構成された体位センサを更に含み、
前記指数プロセッサは呼吸障害発現を患者の体位と相関させると共に患者の体位及び呼吸障害発現に基づいて変更呼吸障害指数を決定すべく構成される、
請求項19に記載のシステム。 - 患者の呼吸を検知すると共に、呼吸信号を生成すべく構成された検知システムと、
前記呼吸信号に基づいて呼吸障害発現を検知すべく構成された呼吸障害検知器と、
前記検知された呼吸障害発現に基づいて呼吸障害指数を決定する手段と、
一定期間にわたる呼吸障害指数の傾向を捕捉する手段と、
少なくとも呼吸障害指数傾向に基づいて心不全状態を評価する手段と、
を含み、
前記検知システム、前記呼吸障害検知器、前記決定する手段、前記傾向を捕捉する手段及び前記評価する手段の少なくとも1つは、植込み型構成要素を含む、
医療システム。 - 患者の体位を検知する手段と、
前記患者の体位を呼吸障害発現と相関させる手段と、
を更に含む請求項31に記載のシステム。 - 患者の活性(activity)を検知する手段と、
前記患者の活性(activity)を呼吸障害発現と相関させる手段と、
を更に含む請求項31に記載のシステム。 - 心不全評価に基づいて治療を変更する手段を更に含む請求項31に記載のシステム。
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US11/291,525 US7766840B2 (en) | 2005-12-01 | 2005-12-01 | Method and system for heart failure status evaluation based on a disordered breathing index |
US11/291,525 | 2005-12-01 | ||
PCT/US2006/045646 WO2007064682A1 (en) | 2005-12-01 | 2006-11-29 | Method and system for heart failure status evaluation based on a disordered breathing index |
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Also Published As
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US20070129643A1 (en) | 2007-06-07 |
US20140194705A1 (en) | 2014-07-10 |
US7766840B2 (en) | 2010-08-03 |
US20100298733A1 (en) | 2010-11-25 |
WO2007064682A1 (en) | 2007-06-07 |
EP1960044B1 (en) | 2019-05-22 |
US8696589B2 (en) | 2014-04-15 |
JP5236485B2 (ja) | 2013-07-17 |
EP1960044A1 (en) | 2008-08-27 |
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