JP2015519940A - 心拍出量の監視 - Google Patents
心拍出量の監視 Download PDFInfo
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Abstract
Description
CO = MAP/SVR (1)
CO = HR*SV (2)
によって与えられ、ここでSVは1回拍出量であり、また、
CO ∝ HR*C(S-D) (3)
であって、ここでSは収縮期血圧であり、Dは拡張期血圧であり、これらはカフベースの血圧計6を用いて簡単に測定されることができる。しかしながら、Cの信頼できる推定値を提示し、患者固有の校正係数K(ここでKはCO = K*(S-D)によって与えられる)を見つけることは難しい。
C ∝ 1/(S+D) (4)
として推測し、これは、COの基準測定結果を介したKでの校正(すなわち、K = COref/(S-D))の後、COの良好な推定値を与える。
C ∝ PTT2 (7)
を介した関係がある。
PAT = PEP + PTT (8)
なので、PTTは、
PTT = PAT - PEP (9)
から算出されることができる。
CO ∝ HR(S-D)PTT2 (10)
を与える。あるいは、式(3)を式(7)及び(9)とともに用いることは、
CO ∝ HR(S-D)(PAT-PEP)2 (11)
を与える。
SV ∝ C(S-D) (13)
なので、上記の3つの実施形態と同様のコンセプトを用いることができることがわかる。
SVR = MAP/CO (14)
を与え、ここでMAPは平均動脈圧であり、MAPはS及びDと次のように関係する。
MAP = S/3 + 2D/3 (15)
CO = K2HR(S-D)(PAT-PEP)2 (19)
ここでK1及びK2は患者固有の校正係数である。もちろん、COの相対値が決定される場合、K1及びK2の値を知る又は導き出す必要はない。
Claims (15)
- 患者の心拍出量COの測定値を決定する方法であって、前記方法は、
患者の1以上の生理学的特性の測定結果を取得するステップであって、前記生理学的特性は、患者の心拍数HR、患者の収縮期血圧S、及び患者の拡張期血圧Dを少なくとも含むステップと、
患者の心拍出量の測定値を決定するために、前記測定結果を処理するステップと、
を有し、
患者の前記心拍出量の測定値は、
の関係を用いて導き出され、ここでK1及びK2は患者固有の校正係数であり、PATは脈波伝達時間であり、PEPは前駆出期であり、PTTは患者の体の2点間を脈波が伝わるのにかかる時間である脈波伝播時間である、方法。 - K1及び/又はK2は、患者の心拍出量の基準測定結果から決定される、請求項1に記載の方法。
- 患者の前記心拍出量の測定値は、以前の心拍出量の測定結果からの、又は心拍出量に対する基準測定結果からの、心拍出量の変化の測定値であって、前記心拍出量の変化の測定値は、
- 前記測定結果を取得するステップは、心電図信号と、光電式容積脈波信号と、心音及びインピーダンス・カルジオグラム信号のうちの少なくとも1つとを取得するステップを有し、前記処理するステップは、脈波伝達時間を決定するために、前記心電図信号と前記光電式容積脈波信号とを処理するステップと、前駆出期を決定するために、前記心音及び前記インピーダンス・カルジオグラム信号のうちの前記少なくとも1つと、前記心電図信号とを処理するステップと、を有する、請求項1乃至3の何れか一項に記載の方法。
- 患者の前記心拍出量の測定値又は患者の前記心拍出量の変化の測定値を、1つ以上の閾値と比較するステップと、
前記比較するステップの結果を示す出力を提供するステップと、
を更に有する、請求項1乃至4の何れか一項に記載の方法。 - 患者の前記生理学的特性の測定中に、患者に作用する加速度の測定結果を取得するステップと、
患者の姿勢を決定するために、前記加速度の測定結果を処理するステップと、
患者の決定された前記姿勢を、患者に対する所定の姿勢と比較するステップと、
前記決定された姿勢が前記所定の姿勢と同じでない又は十分に近くない場合に、患者に当該患者の姿勢に関するフィードバックを提供するステップと、
を更に有する、請求項1乃至5の何れか一項に記載の方法。 - 前記所定の姿勢は、患者の前記生理学的特性の以前の測定のセット中の、患者の姿勢に対応する、請求項6に記載の方法。
- SVR = MAP/COの関係を用いて、患者の前記心拍出量の測定値から患者の体血管抵抗SVRの測定値を決定するために、前記測定結果を処理するステップを更に有し、ここでMAPは平均動脈圧であり、
MAP = S/3 + 2D/3
によって与えられる、請求項1乃至7の何れか一項に記載の方法。 - 適切なコンピュータ又はプロセッサによって実行されたときに、前記コンピュータ又は前記プロセッサに請求項1乃至8の何れか一項に記載の方法を実行させるコンピュータ可読コードを有する、コンピュータプログラム。
- 患者の心拍出量COを監視するのに用いるための装置であって、前記装置は処理手段を有し、前記処理手段は、
患者の1以上の生理学的特性の測定結果を受け取り、前記生理学的特性は、患者の心拍数HR、患者の収縮期血圧S、及び患者の拡張期血圧Dを少なくとも含み、
患者の心拍出量の測定値を決定するために前記測定結果を処理し、
患者の前記心拍出量の測定値は、
の関係を用いて導き出され、ここでK1及びK2は患者固有の校正係数であり、PATは脈波伝達時間であり、PEPは前駆出期であり、PTTは患者の体の2点間を脈波が伝わるのにかかる時間である脈波伝播時間である、
装置。 - 前記処理手段によって決定される患者の前記心拍出量の測定値は、以前の心拍出量の測定結果からの、又は心拍出量に対する基準測定結果からの、心拍出量の変化の測定値であって、前記処理手段は、前記心拍出量の変化の測定値を、
- 前記処理手段は更に、
患者の前記心拍出量の測定値又は患者の前記心拍出量の変化の測定値を、1つ以上の閾値と比較し、
比較の結果を示す出力を提供する、
請求項10又は11に記載の装置。 - 血圧計、心拍センサ、心電センサ、光電式容積脈波センサ、インピーダンス・カルジオグラムセンサ、及び1以上のマイクロホンのうちの任意の1以上の生理学的特性センサを更に有する、請求項10乃至12の何れか一項に記載の装置。
- 前記1以上の生理学的特性センサは、患者によって着られる衣類の品目に組み込まれる、請求項13に記載の装置。
- 前記処理手段は更に、患者に作用する加速度の測定結果を受け取り、患者の姿勢を決定するために前記加速度の測定結果を処理する、請求項10乃至14の何れか一項に記載の装置。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US201261646941P | 2012-05-15 | 2012-05-15 | |
US61/646,941 | 2012-05-15 | ||
PCT/IB2013/053198 WO2013171599A1 (en) | 2012-05-15 | 2013-04-23 | Monitoring of cardiac output |
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JP2015519940A true JP2015519940A (ja) | 2015-07-16 |
JP5779299B2 JP5779299B2 (ja) | 2015-09-16 |
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JP2015512150A Expired - Fee Related JP5779299B2 (ja) | 2012-05-15 | 2013-04-23 | 心拍出量の監視 |
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US (1) | US9326735B2 (ja) |
EP (1) | EP2849639B1 (ja) |
JP (1) | JP5779299B2 (ja) |
CN (1) | CN104244814B (ja) |
BR (1) | BR112014028318A2 (ja) |
WO (1) | WO2013171599A1 (ja) |
Cited By (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JP2018061826A (ja) * | 2016-10-12 | 2018-04-19 | 三星電子株式会社Samsung Electronics Co.,Ltd. | 生体情報推定装置及び方法並びに血圧情報推定装置 |
JP2019503824A (ja) * | 2015-12-07 | 2019-02-14 | メディシ テクノロジーズ,エルエルシー | 観察的心不全モニタリングシステム |
JP2019523678A (ja) * | 2016-06-06 | 2019-08-29 | トゥーセンス,インコーポレイテッド | 血液透析を受けている患者を監視するための生理学的監視装置 |
JP2019170709A (ja) * | 2018-03-28 | 2019-10-10 | 日本光電工業株式会社 | 生体情報処理装置、生体情報処理方法、プログラム及び記憶媒体 |
WO2020050067A1 (en) | 2018-09-06 | 2020-03-12 | Nihon Kohden Corporation | Physiological information processing apparatus, physiological information processing method, program and storage medium |
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- 2013-04-23 WO PCT/IB2013/053198 patent/WO2013171599A1/en active Application Filing
- 2013-04-23 BR BR112014028318A patent/BR112014028318A2/pt not_active Application Discontinuation
- 2013-04-23 EP EP13726031.1A patent/EP2849639B1/en not_active Not-in-force
- 2013-04-23 JP JP2015512150A patent/JP5779299B2/ja not_active Expired - Fee Related
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EP2849639A1 (en) | 2015-03-25 |
CN104244814A (zh) | 2014-12-24 |
CN104244814B (zh) | 2017-08-11 |
BR112014028318A2 (pt) | 2017-06-27 |
WO2013171599A1 (en) | 2013-11-21 |
EP2849639B1 (en) | 2015-09-23 |
US20150126820A1 (en) | 2015-05-07 |
JP5779299B2 (ja) | 2015-09-16 |
US9326735B2 (en) | 2016-05-03 |
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