JP2022122257A - State management method, program, and dialysis system - Google Patents

Abstract

To provide a technology for managing the condition of a patient during a dialysis treatment in a mode in which burden on the patient is suppressed.SOLUTION: A dialysis system includes a dialyzer and an information processor. The information processor acquires a detection output from a sensor which acquires body information of a patient during a dialysis treatment in a non-contact manner and derives an index related to the patient's condition by using the detection output. The information processor outputs to a display a display instruction on the basis of the derived index and outputs to a blood pressure manometer a measurement instruction.SELECTED DRAWING: Figure 5

Description

FIELD OF THE DISCLOSURE The present disclosure relates to managing a patient's condition during dialysis therapy.

Conventionally, various techniques have been proposed for detecting the patient's condition during dialysis treatment. For example, Japanese Patent Laying-Open No. 2000-000217 (Patent Document 1) discloses a technique of dividing a period of dialysis treatment into a plurality of periods and measuring a patient's blood pressure for each of the plurality of divided periods.

JP-A-2000-000217

Since the patient's condition during dialysis treatment may change suddenly, it is preferable to continuously manage the condition. New dialysis methods such as home dialysis and overnight dialysis, which have been increasing in recent years, are difficult to manage continuously. On the other hand, in blood pressure measurement as disclosed in Patent Literature 1, detection of the patient's condition, such as pressing the patient's arm, is often accompanied by a burden on the patient.

The present disclosure has been devised in view of such circumstances, and its purpose is to provide a technique for managing the state of a patient undergoing dialysis treatment in a manner that reduces the burden on the patient.

According to one aspect of the present disclosure, a computer-implemented method for managing the condition of a patient during dialysis treatment, comprising the steps of: obtaining a detection output from a sensor that non-contactally obtains physical information of the patient during dialysis treatment; and using the detected output to derive an index regarding the patient's condition, the index including the patient's skin temperature, the patient's complexion color information, and the patient's respiratory rate, and providing information based on the index. A state management method is provided further comprising the step of outputting.

The information to be output may include measurement instructions for a device that contacts the patient and measures physical information.

The device may include a sphygmomanometer. Physical information measured in contact with the patient may include blood pressure values.

In the step of outputting information based on the index, if the skin temperature is lower than a given threshold, if the color information changes by more than a given criterion from the start of dialysis treatment, or if the color information is given from the start of dialysis treatment. The output of a measurement indication may be performed when the respiratory rate is at a value corresponding to tachypnea or apnea even if it has not changed beyond the criteria of the skin temperature is below a given threshold , the output of the measurement indication may not be performed when the color information has not changed by more than a given criterion since the start of dialysis treatment and the respiratory rate is normal.

The step of outputting information based on the index performs outputting an indication of the measurement when the color information has changed from the start of dialysis treatment by more than a given criterion and the respiratory rate is at a value corresponding to apnea. may include doing

The step of outputting information based on the index is performed when the color information has not changed by more than a given criterion from the start of dialysis treatment, or even if the color information has changed by more than a given criterion from the start of dialysis treatment. outputting the first information when the respiration rate is a normal value or a value corresponding to tachypnea; and outputting, when the value corresponds to respiration, second information indicating that an event more severe than the event indicated by the first information has occurred.

The step of outputting information based on the index indicates that respiratory rate corresponds to normal or tachypnea if skin temperature is below a given threshold and color information has changed from the start of dialysis treatment by more than a given criterion. and outputting a first information when the respiratory rate is a value corresponding to apnea, indicating that an event more serious than the event represented by the first information has occurred. and outputting the information of 2.

The step of outputting information based on the index may include outputting a measurement indication when the skin temperature is above or below a predetermined range.

According to another aspect of the present disclosure, there is provided a program that, when executed by a processor of a computer, causes the computer to perform the method described above.

According to yet another aspect of the present disclosure, a dialysis system is provided that includes a dialysis machine and an information processing device for managing a patient's condition during dialysis treatment by the dialysis machine. The information processing device includes a memory that stores the program, and one or more processors that execute the program stored in the memory.

The system may further comprise a device that contacts the patient to measure physical information. The device may be configured to output an alarm if it leaves the location where dialysis therapy is delivered.

In the above system, the device may be configured to output an alarm on condition that the device is worn by the patient.

According to the present disclosure, an index based on the patient's physical information is derived without bringing the patient into contact with the sensor, and information based on the index is output. This allows the patient's condition to be managed in a manner that reduces the burden on the patient.

1 is a diagram schematically showing an example of a situation in which a dialysis system is applied; FIG. It is a figure which shows an example of the hardware constitutions of a dialysis system. 4 is a flow chart of an example of processing for outputting information based on the state of the dialysis patient 1 detected in a non-contact manner. 4 is a diagram showing an example of a display screen of display 150. FIG. FIG. 4 is a diagram showing an example of a correspondence relationship between combinations of three types of indices and operations of an information processing device; 4 is a diagram showing a specific example of a notification screen on display 150. FIG. 4 is a diagram showing a specific example of a notification screen on display 150. FIG. 4 is a diagram showing a specific example of a notification screen on display 150. FIG. 4 is a diagram showing a specific example of a notification screen on display 150. FIG. 10 is a flowchart of another example of processing for outputting information based on the state of the dialysis patient 1 detected without contact. 10 is a flowchart of still another example of processing for outputting information based on the state of the dialysis patient 1 detected without contact. 4 is a diagram showing a specific example of a notification screen on display 150. FIG. FIG. 2 is a diagram showing the appearance of an example of a sphygmomanometer 20. FIG. 2 is a diagram showing a hardware configuration of a sphygmomanometer 20; FIG. 4 is a flowchart of an example of processing for outputting an alarm;

A dialysis system according to an embodiment of the present invention will be described below with reference to the drawings. In the following description of the embodiments, the same or corresponding parts in the drawings are denoted by the same reference numerals, and the description thereof will not be repeated.

[Configuration of dialysis system]
FIG. 1 is a diagram schematically showing an example of a situation in which a dialysis system is applied. The dialysis system includes a dialysis machine 10 , an information processing device 100 , a sphygmomanometer 20 , a CCD (Charge Coupled Device) camera 30 and an infrared camera 40 . The CCD camera 30 is an example of a sensor that acquires physical information of a patient undergoing dialysis treatment without contact, and the infrared camera 40 is another example. Each of the CCD camera 30 and the infrared camera 40 is arranged so as to photograph the dialysis patient 1 .

The dialysis machine 10 is arranged adjacent to the bed on which the dialysis patient 1 is located in the dialysis room. A shunt is formed in one arm of the dialysis patient 1 . Generally, a shunt is formed in the arm opposite to the dialysis patient's 1 dominant arm. Note that the dialysis patient 1 does not necessarily have to have a shunt.

An arterial blood circuit 12 and a venous blood circuit 13 extend from the dialysis machine 10 toward the dialysis patient 1 . A dialysis needle is inserted into the shunt of a dialysis patient 1 . As a result, the dialysis patient 1 is connected to the arterial blood circuit 12 and the venous blood circuit 13 . Arterial blood circuit 12 and venous blood circuit 13 are each connected to a blood pump provided in dialyzer 10 . A blood pump pumps liquid in a tube connected to a puncture needle.

The information processing apparatus 100 is implemented by, for example, a general-purpose computer or tablet terminal, but may be implemented by any type of device as long as it implements the functions described in this specification.

A sphygmomanometer 20 is attached to the dialysis patient 1 . Each of CCD camera 30 and infrared camera 40 is arranged to photograph dialysis patient 1 during dialysis treatment.

The information processing apparatus 100 derives an index regarding the condition of the dialysis patient 1 using the detection output obtained by the CCD camera 30 and/or the infrared camera 40 in a non-contact manner, and outputs information based on the index. The output of information may be the display of values, the display of messages corresponding to values and/or the output of voices, or the output of measurement instructions to a measuring device such as sphygmomanometer 20. or any other form of output of information.

[Hardware Configuration of Information Processing Device]
FIG. 2 is a diagram showing an example of the hardware configuration of the dialysis system. As shown in FIG. 2, information processing apparatus 100 includes processor 110, interface 120, and memory . Processor 110 controls the operation of information processing apparatus 100 by executing programs stored in memory 130 or another storage device. Information processing device 100 includes a dedicated circuit (application specific integrated circuit (ASIC), field-programmable gate array (FPGA)) for controlling the operation of information processing device 100 instead of processor 110 or in addition to processor 110. etc.) may be included.

The interface 120 may be an interface for wired data communication with other devices such as a USB (Universal Serial Bus), or an interface for wireless data communication with other devices such as a network card. or a combination thereof.

Information processing apparatus 100 is connected to sphygmomanometer 20 , CCD camera 30 , and infrared camera 40 via interface 120 . Information processing apparatus 100 is further connected to input device 140 and display 150 via interface 120 . Input device 140 is, for example, a keyboard, hardware buttons, and/or a touch sensor that constitutes a touch panel. Display 150 is an example of an output device. Information processing apparatus 100 may be connected to other types of output devices such as LEDs (Light Emitting Diodes) and/or speakers in place of or in addition to display 150 as output devices. Input device 140 and/or output device (display 150 ) may be included in information processing device 100 .

The information processing device 100 may be connected to the dialysis machine 10 via an interface 120 . Thereby, the information processing device 100 can refer to the progress of the dialysis treatment by the dialysis device 10 and synchronize the operation of the information processing device 100 with the dialysis treatment by the dialysis device 10 .

[Specific examples of indices derived for dialysis patients]
The information processing device 100 detects the state of the dialysis patient 1 without contact and derives one or more indicators. The derived indices are, for example, skin temperature, complexion color information, and respiratory rate. A specific example of the mode of deriving the index will be described below for each of them. However, the following description is merely an example, and the types and modes of indices derived by the information processing apparatus 100 are not limited to the following.

(skin temperature)
In one implementation, the information processing device 100 identifies the temperature of the face region of the dialysis patient 1 from the detection output (eg, image data) from the infrared camera 40, and treats the identified temperature as an index of skin temperature. The processor 110 may identify the face region of the dialysis patient 1 in the imaging range of the infrared camera 40 by executing an image recognition application, and identify the temperature of the identified region as the temperature of the face region.

The information processing apparatus 100 may specify the temperature of a region other than the face, such as the wrist of the dialysis patient 1, as the skin temperature.

(color information of complexion)
In one implementation example, the information processing device 100 identifies color information (eg, RGB-based color information) of the face region of the dialysis patient 1 from the detection output (eg, image data) from the CCD camera 30, and The luminance value of the R component is treated as an index of color information of the complexion.

The color information of the complexion is the luminance value of the R component in an image taken with the “pupils” of both eyes of the dialysis patient 1 overlapping two reference points, as described in Japanese Patent Application Laid-Open No. 2004-8632, for example. and the luminance value of the R component obtained from the captured image is corrected according to the area of the face region in the captured image and/or the distance between the "pupils" of both eyes may be identified by

In another implementation example, the information processing apparatus 100 identifies color information (RGB-based color information) of the face area from the detection output from the CCD camera 30, as described in Japanese Patent No. 6116375, for example. The color information is converted into information in the L*a*b* color space, and the average value of the coordinate values in each axial direction of the converted information is treated as an index of the color information of the complexion.

When the information processing apparatus 100 calculates the index of the color information of the face area using the detection output from the CCD camera 30, the CCD The detection output from camera 30 may be corrected. More specifically, the information processing apparatus 100 identifies the region of the pupil of the dialysis patient 1 from the captured image included in the detection output, and based on the color information of the pupil portion, determines the color of the other portion of the face region. Information may be corrected.

(breathing rate)
In one implementation example, the information processing apparatus 100 is described in Non-Patent Document (Hanawa Dai, et al., "A study on automation of nose breathing detection using far-infrared image", [online], 2010 (Heisei 22) , Information Processing Society of Japan, [searched on September 28, 2020], Internet <URL: https://www.ieice.org/publications/conference-FIT-DVDs/FIT2010/pdf/K/K_033 pdf>), the history of temperature in the nasal region of the dialysis patient 1 is identified in the detected output from the infrared camera 40 and used to derive an index of respiration rate.

More specifically, in the temperature history, the information processing apparatus 100 changes the reference value after a temperature rise that crosses a predetermined reference value occurs, and after a temperature drop that crosses the reference value occurs. The time until a crossover temperature rise occurs, that is, the time from the generation of certain temperature information to the generation of the next temperature information is specified as the time required for one breath. Then, the information processing apparatus 100 obtains the number of breaths that occur within a predetermined time (for example, one minute) from the time required for one breath, and uses the number of breaths that occur within the predetermined time as an index of the number of breaths. deal.

The information processing apparatus 100 may specify the nose region of the dialysis patient 1 from the image captured by the CCD camera 30 and/or the infrared camera 40 by executing an application for image recognition.

In another implementation, the dialysis system further comprises an infrared laser, and the information processing device 100 is described in Non-Patent Document (Isao Sato, et al., "Development of a Two-Camera FG Respiratory Monitoring System", [online], 2009). (2009), Institute of Image Electronics Engineers of Japan, [searched on September 28, 2020], Internet <URL: https://www.jstage.jst.go.jp/article/iieej/38/ 4/38_4_385/_pdf>) to determine the respiratory rate, and derive the index of the respiratory rate using the respiratory rate.

More specifically, the infrared laser of the dialysis system irradiates the chest and/or abdomen of the dialysis patient 1 with a plurality of laser beams in a grid pattern. The information processing device 100 identifies the positions of a plurality of bright spots from the detection output from the CCD camera 30, and identifies the volume history of the chest and/or abdomen of the dialysis patient 1 from the identified positions of the plurality of bright spots. Then, the number of breaths in a predetermined time specified from the history is treated as an index of the number of breaths.

[Process flow (1)]
A first example of the flow of processing executed by the information processing apparatus 100 will be described with reference to FIGS. 3 and 4. FIG. FIG. 3 is a flowchart of an example of processing for outputting information based on the state of the dialysis patient 1 detected without contact. The information processing apparatus 100 may perform the processing shown in FIG. 3 by causing the processor 110 to execute a given program. The process of FIG. 3 may be initiated in response to inputting an instruction to input device 140 and/or receiving notification from dialysis machine 10 to initiate dialysis therapy.

In this example, when the index of the condition of the dialysis patient 1 derived based on the non-contact detection includes an abnormal value, the information processing device 100 outputs information to that effect. A specific example of the processing will be described below with reference to FIG.

In step S100, information processing apparatus 100 determines whether or not a certain period of time (for example, 10 seconds) has passed since step S106 was executed last time, and stops control at step S100 until it is determined that it has passed (step If NO in S100) and it is determined that the period has elapsed (YES in step S100), control proceeds to step S102. The information processing apparatus 100 advances the control to step S102 even when step S106 has not yet been executed.

In step S102, the information processing apparatus 100 acquires the detection output from the CCD camera 30 in the most recent fixed time period (for example, 10 seconds).

In step S104, information processing apparatus 100 acquires the detection output from infrared camera 40 in the most recent fixed time period (for example, 10 seconds).

In step S106, the information processing apparatus 100 uses the detection output obtained in step S102 and/or step S104 to derive indices of skin temperature, complexion color information, and respiratory rate for the dialysis patient 1. do.

At step S108, the information processing apparatus 100 determines whether the index derived at step S106 includes an abnormal value. When information processing apparatus 100 determines that an abnormal value is included (YES at step S108), control proceeds to step S110, otherwise (NO at step S108), control returns to step S100.

In step S<b>110 , information processing apparatus 100 outputs to display 150 an instruction to display information related to the index determined to include an abnormal value. After that, the information processing apparatus 100 returns the control to step S100.

(Derivation of index in step S106 and judgment in step S108)
Here, the derivation of the index in step S106 and the determination in step S108 are specifically described as follows.

(About skin temperature index)
Information processing apparatus 100 may specify, as a skin temperature index, the average value of each skin temperature specified from the images of each frame (for example, the image captured by infrared camera 40) during the predetermined period of time.

Information processing apparatus 100 determines that the skin temperature index does not include an abnormal value when the skin temperature is within a predetermined temperature range (for example, 35.5° C. to 37.0° C.), and determines that the temperature range If lower or higher, it may be determined that the skin temperature indicator contains an outlier.

If the skin temperature has not changed by a predetermined temperature or more since the start of dialysis treatment, the information processing apparatus 100 determines that the skin temperature index does not include an abnormal value, and if the skin temperature has changed by a predetermined temperature or more. Alternatively, it may be determined that the skin temperature index contains an outlier.

(Regarding indicators of color information of complexion)
The information processing apparatus 100 specifies the average value of the color information (luminance value) of the R component specified from the image of each frame (for example, the image captured by the CCD camera 30) during the predetermined time period as an index of the color information of the complexion. You may

The memory 130 of the information processing apparatus 100 may store standard values for indices of color information of complexion. The standard value may be color information of the R component specified from the face image of the dialysis patient 1 at the start of dialysis treatment, or may be predetermined color information.

The information processing apparatus 100 obtains a difference between the color information of the complexion specified during dialysis treatment and the standard value, and if the difference is within a predetermined value range, the index of the complexion color information is abnormal. It may be determined that it does not contain a value, and that it contains an abnormal value if the difference is outside the range. In this example, during dialysis treatment, when the redness in the complexion increases or decreases from the state corresponding to the standard value (for example, at the start of dialysis treatment), it is assumed that the indicator of the color information of the complexion includes an abnormal value. be judged.

When the color information of the complexion specified during dialysis treatment is equal to or greater than the standard value, or the difference from the standard value is equal to or smaller than a predetermined value, the information processing apparatus 100 determines that the indicator of the color information of the complexion is It may be determined that no outliers are included. The information processing apparatus 100 may determine that the color information of the specified complexion during dialysis treatment includes an abnormal value when it has decreased by exceeding a predetermined value with respect to the standard value. In this example, it is determined that the indicator of the color information of the complexion includes an abnormal value when the redness in the complexion becomes lower than the state corresponding to the standard value (for example, at the start of dialysis therapy) during dialysis treatment.

The information processing apparatus 100 does not use the standard value, does not include an abnormal value when the index of the color information of the complexion obtained during dialysis treatment is within a predetermined value, and does not include an abnormal value. It may be determined that an outlier is included if it is high or low.

(Regarding respiratory rate index)
The information processing apparatus 100 uses the time required for one breath specified in the given period of time as an index of the number of breaths predicted to occur within a given period of time (for example, one minute). may be specified.

The information processing apparatus 100 determines that the respiratory rate index does not include an abnormal value when the respiratory rate index is within a predetermined range, and determines that the respiratory rate index is outside the predetermined range. It may be determined that the indicator contains outliers. The information processing apparatus 100 further determines that the state is “apnea” when the respiratory rate index is below the above range, and determines that the state is “tachypnea” when the respiratory rate index is above the above range. You can judge that there is. In one implementation, 25 or more breaths per minute is considered a "tachypnea" condition, and 0 breaths per minute is considered an "apnea" condition. If the number of breaths is 9 or less, it may be judged as "brady breathing", and if the number of breaths per minute is 10 to 24, it may be judged as normal.

(Step S110)
The display on the display 150 under the control of step S110 will be specifically described with reference to FIG. FIG. 4 is a diagram showing an example of a display screen of display 150. As shown in FIG.

Screen 400 in FIG. 4 includes elements 401 , 402 and 403 . Element 401 contains the message "Skin temperature change detected." Element 401 is displayed when it is determined that the skin temperature index includes an abnormal value in step S108, and the display of element 401 is omitted when it is determined that the skin temperature index does not include an abnormal value. be. The information processing apparatus 100 may change the message displayed as the element 401 according to the value of the skin temperature index. is displayed, and if the skin temperature is lower than a predetermined temperature range, the message "The skin temperature is low."

Element 402 contains the message "Change in complexion detected." Element 402 is displayed when it is determined in step S108 that the index of complexion color information includes an abnormal value, and element 402 is displayed when it is determined that the index of complexion color information does not include an abnormal value. display is omitted. The information processing apparatus 100 may change the message displayed as the element 402 according to the value of the color information of the complexion.

Element 403 contains the message "Abnormal breathing rate detected." Element 403 is displayed when it is determined in step S108 that the respiratory rate index includes an abnormal value, and the display of element 403 is omitted when it is determined that the respiratory rate index does not include an abnormal value. be. The information processing apparatus 100 may change the message displayed as the element 403 according to the value of the respiratory rate index. tachypnea detected.", and if the value of the respiratory rate index corresponds to the "bradypnea" state, display the message "bradypnea detected." If the value of the indicator corresponds to an "apnea" condition, the message "apnea detected." may be displayed.

Visual display of information using display 150 described herein is an example of how information is output. Information may be output in other ways, such as audio, instead of or in addition to visual output. In addition, the information processing device 100 transfers information (such as the display screen of the display 150) notified in the dialysis system to a terminal that manages the dialysis system and/or a mobile terminal possessed by a medical worker, You may make it display.

In the processing described with reference to FIGS. 3 and 4, the information processing device 100 acquires detection outputs from sensors (CCD camera 30, infrared camera 40) that acquire physical information of a patient undergoing dialysis treatment without contact. and the detected output is used to derive an index of the patient's condition. Then, information processing apparatus 100 outputs a display instruction to display 150 and outputs a measurement instruction to sphygmomanometer 20 based on the derived index. Although three types of indicators are used as indicators of the dialysis patient 1 to be detected without contact, the number of types of indicators to be used is not limited to "3". As long as one or more types are included, the indices used need not include all three types illustrated, and may include types of indices other than the illustrated types.

[Process flow (2)]
A second example of the flow of processing executed by the information processing apparatus 100 will be described with reference to FIGS. 5 to 10. FIG.

(Premise)
In this example, the information processing device 100 determines the operation of the information processing device 100 based on a combination of three types of indices derived based on non-contact detection.

FIG. 5 is a diagram showing an example of a correspondence relationship between combinations of three types of indices and operations of the information processing apparatus. Information identifying the relationships illustrated in FIG. 5 may be stored in memory 130 . The table shown in FIG. 5 includes four items ("skin temperature", "complexion", "breathing rate", and "operation of information processing apparatus").

"Skin temperature" represents an index of skin temperature. In FIG. 5, three types of characteristics (“normal”, “decreased”, and “increased”) are shown for “skin temperature”. "Normal" means that the index of skin temperature does not contain abnormal values, and "decreased" and "increased" means that it contains abnormal values. In particular, "decrease" indicates that the skin temperature is below the predetermined temperature range, and "increase" indicates that the skin temperature is above the predetermined temperature range.

"Face color" represents an index of color information of the complexion. FIG. 5 shows two types of features (“no change” and “change”) for “complexion”. "No change" indicates that the index of the color information of complexion does not include an abnormal value, and "Changed" indicates that the index of the color information of complexion includes an abnormal value.

"Respiratory rate" represents an index of respiratory rate. In FIG. 5, three types of characteristics (“normal”, “apnea”, “bradypnea”, and “tachypnea”) are shown for “respiratory rate”. "Normal" indicates that the respiratory rate index does not include an abnormal value, and "apnea", "bradypnea", and "tachypnea" each indicate that the respiratory rate index includes an abnormal value. In particular, "apnea" and "bradypnea" refer to respiration rates below a given range, and "tachypnea" refer to respiration rates above a given range.

“Operation of information processing device” represents the content of the operation performed by the information processing device 100 . The content of the operation is a combination of one or more types of control selected from four types of control (“vital measurement instruction,” “notification (A),” “notification (B),” and “notification (C)”).

“Vital measurement instruction” represents output of a blood pressure measurement instruction to the sphygmomanometer 20 .

The output of the blood pressure measurement instruction to the sphygmomanometer 20 is an example of the output of the physical information measurement (vital measurement) instruction of the dialysis patient 1 to the device. The information processing apparatus 100 may output a blood glucose level measurement instruction to the blood glucose level meter attached to the dialysis patient 1 instead of outputting the blood pressure measurement instruction, or in addition to outputting the blood pressure measurement instruction. Alternatively, an electrocardiogram measurement instruction may be output to the electrocardiograph attached to the dialysis patient 1 . The sphygmomanometer 20 is an example of a device that comes into contact with a patient and measures physical information. A blood glucose meter is another example, and an electrocardiograph is yet another example.

"Notification (A)", "Notification (B)", and "Notification (C)" represent notifications having different degrees of importance. 6 to 9 are diagrams showing specific examples of notification screens on display 150. FIG.

A screen 700 in FIG. 7 is an example of a "notification (A)" screen. The screen 700 includes the title "notification" and the message "a drop in skin temperature has been detected." This message indicates that only the "skin temperature" index among the three types of indices contains an abnormal value.

A screen 800 in FIG. 8 is an example of a "notification (B)" screen. Screen 800 includes the title "Caution" and the message "Low skin temperature and tachypnea detected. Check vitals." This message indicates that the "skin temperature" and "respiratory rate" indices of the three types of indices include abnormal values, and prompts the user to confirm the vital signs of the dialysis patient 1. When the control for "notification (B)" is executed in a state where the respiratory rate corresponds to "bradypnea", the character string "tachypnea" in the screen 800 is changed to the character string "bradypnea". The content displayed on the screen, such as, can be changed as appropriate according to the state that has occurred (detected).

"Notification (B)" may be a notification that an event more serious than "Notification (A)" has occurred. In this case, screen 800 may be displayed in a manner that attracts the user's attention more than screen 700 . Screen 800 may be displayed in a darker color than screen 700 . Screen 800 may be accompanied by sound when screen 700 is not accompanied by sound, or may be accompanied by a louder volume of sound than screen 700 is accompanied by.

A screen 900 in FIG. 9 is an example of a "notification (C)" screen. Screen 900 includes the title "Warning" and the message "Emergency! Prepare ambulance cart! Check vitals!". This message indicates the occurrence of an emergency and also indicates the action to be taken by the user.

"Notification (C)" may notify that an event more serious than "Notification (B)" has occurred. In other words, "notification (C)" may notify that the most serious event has occurred among the three kinds of notifications. In this case, the screen 900 may be displayed in a manner that attracts the user's attention more than the screen 800 does. Screen 900 may be displayed in a darker color than screen 800 . Screen 900 may be accompanied by sound when screen 800 is not accompanied by sound, or may be accompanied by a louder volume of sound than screen 800 is accompanied by. When the screen 900 is displayed on the display 150, the information processing apparatus 100 further notifies the contact information (e-mail address, telephone number, etc.) associated with the attending doctor and/or the attending nurse of the dialysis patient 1. (eg, what is displayed on screen 900).

In the table of FIG. 5, numbers from 1 to 16 are assigned to each combination of three types of index features, as shown in the leftmost column.

For example, the number '1' corresponds to the combination of the feature 'decreased' for the indicator 'skin temperature', the feature 'no change' for the indicator 'complexion' and the feature 'normal' for the indicator 'respiration rate'. . "Notice (A)" is defined as "operation of information processing apparatus" for the combination of number "1". As a result, when the combination of indicators identified for dialysis patient 1 matches the number "1", information processing apparatus 100 causes display 150 to display the "notice (A)" screen (screen 700 in FIG. 7). output a display instruction for

The number "15" corresponds to the combination of the feature "normal" for the index "skin temperature", the feature "changed" for the index "complexion", and the feature "apnea" for the index "breathing rate". For the combination of number "15", "instruction to measure vital signs" and "notification (C)" are defined as "operation of information processing apparatus". As a result, information processing apparatus 100 outputs a blood pressure measurement instruction to sphygmomanometer 20 when the combination of indicators specified for dialysis patient 1 matches the number "15", and displays on display 150: An instruction to display the "notification (C)" screen (screen 900 in FIG. 9) is output.

(Processing flow)
FIG. 10 is a flowchart of another example of processing for outputting information based on the state of the dialysis patient 1 detected without contact. The information processing apparatus 100 may perform the processing shown in FIG. 10 by causing the processor 110 to execute a given program. The process of FIG. 10 may be initiated in response to inputting an instruction to input device 140 and/or receiving notification from dialysis machine 10 to start dialysis therapy.

Compared to the process shown in FIG. 3, the process shown in FIG. 10 includes steps S120 to S126 instead of steps S108 and S110.

More specifically, information processing apparatus 100 advances the control to step S120 after deriving indices of skin temperature, facial color information, and respiratory rate in step S106.

In step S120, information processing apparatus 100 identifies which number from 1 to 16 in the table shown in FIG. 5 corresponds to the combination of indices derived in step S106. Then, information processing apparatus 100 instructs display 150 to display (one of screens 600, 700, 800, and 900) included in "operation of information processing apparatus" corresponding to the specified number.

In step S122, information processing apparatus 100 determines whether or not the "operation of information processing apparatus" corresponding to the number identified in step S120 includes a vital measurement instruction. If YES), the control proceeds to step S124, and if it is determined not to be included (NO in step S122), the control returns to step S100.

In step S<b>124 , information processing apparatus 100 outputs a blood pressure measurement instruction to sphygmomanometer 20 .

In step S126, information processing apparatus 100 acquires the measurement result from sphygmomanometer 20, stores the measurement result in memory 130, and returns control to step S100.

In the examples described above with reference to FIGS. 5 to 10, the measurement instruction to the sphygmomanometer 20 is output based on the result of the non-contact detection of the state of the dialysis patient 1. FIG. Thereby, the information of the dialysis patient 1 is observed without contact, and the blood pressure measurement by the sphygmomanometer 20 is performed only when necessary.

In the blood pressure measurement by the sphygmomanometer 20, the arm of the dialysis patient 1 is compressed by the cuff. Therefore, it is preferable to avoid blood pressure measurement as much as possible, especially during dialysis treatment. On the other hand, if the condition of the dialysis patient 1 changes during dialysis treatment, blood pressure measurements are required to reliably identify the manner of change. That is, while blood pressure measurements are preferably avoided during dialysis treatment, they may be required.

In the processing described with reference to FIGS. 5 to 10, vital measurements such as blood pressure measurement of the dialysis patient 1 are automatically performed only when it is determined to be necessary based on the result of non-contact state detection of the dialysis patient 1. is carried out. That is, the minimum required blood pressure measurement is automatically performed.

(Examples of processing features)
In the processing described with reference to FIGS. 5-9, control is performed according to the derived indices and the relationships shown in FIG.

As a certain aspect, attention is focused on the case where the "skin temperature" is "drop" (numbers "1" to "8"). When the "complexion" is "changed" (numbers "5" to "8"), or even if the "complexion" is "no change", the "respiration rate" is "tachypnea" or "bradypnea" Or when it is "apnea" (numbers "2", "3", "4"), the information processing apparatus 100 outputs a vital measurement instruction. On the other hand, when the "complexion" is "no change" and the "respiratory rate" is "normal" (number "1"), the information processing apparatus 100 does not output a vital measurement instruction.

As a certain aspect, attention is focused on the case where the "complexion" is "changed" and the "respiratory rate" is "apnea" (numbers "8", "15", and "22"). In these cases, the information processing apparatus 100 outputs a vital measurement instruction regardless of the "skin temperature" feature.

As one aspect, when "complexion" is "changed" and "respiratory rate" is "apnea" (numbers "8", "15", "22"), and in other cases (number "1 ” to “7”, “9” to “14”, “16” to “21”). In the former case, the information processing apparatus 100 outputs an instruction to display "notification (C)" regardless of the characteristics of "skin temperature". (“Notification (A)” or “Notification (B)”) instruction is output.

As a certain aspect, attention is focused on the case where the "skin temperature" is "decreased" and the "color information" is "changed" (numbers "5" to "8"). In this case, when the "respiratory rate" is "normal", "tachypnea" or "bradypnea" (numbers "5", "6", "7"), the information processing apparatus 100 "notifies (B )” is output, whereas when the “respiratory rate” is “apnea” (number “8”), the display instruction “notification (C)” is output. That is, the latter directs the indication of the occurrence of more serious events than the former.

When the skin temperature of a patient undergoing dialysis treatment decreases and the complexion changes, if there is no abnormality in breathing or tachypnea, it is assumed that a mild shock state due to hypoglycemia has occurred. When it is breathing, it is assumed that a lethal state of shock has occurred. In the above situation, information processing apparatus 100 can instruct display 150 to display in a manner that is easier to attract the user's attention when a fatal shock state is assumed than when a light shock state is assumed. Furthermore, the information processing apparatus 100 does not notify the contacts of the attending physician and/or the attending nurse when a mild shock state is assumed, but does not notify the contacts when a fatal shock state is assumed. make a notification to

[Process flow (3)]
A third example of the flow of processing executed by the information processing apparatus 100 will be described with reference to FIGS. 11 and 12. FIG. In a third example, the information processing apparatus 100 performs non-contact detection of the condition of the dialysis patient 1 using only the skin temperature index.

FIG. 11 is a flow chart of still another example of processing for outputting information based on the contactless detected state of the dialysis patient 1 . The information processing apparatus 100 may perform the processing shown in FIG. 11 by causing the processor 110 to execute a given program. The process of FIG. 11 may be initiated in response to inputting an instruction to input device 140 and/or receiving notification from dialysis machine 10 to start dialysis therapy.

In the process of FIG. 11, the information processing device 100 executes the determination in step S100, similarly to the information processing device of FIG. In the process of FIG. 11, the information processing apparatus 100 advances the control to step S104 instead of advancing the control to step S102.

In step S107, the information processing apparatus 100 derives an index only for the skin temperature.

In step S109, the information processing apparatus 100 determines whether the index derived in step S107 includes an abnormal value. When information processing apparatus 100 determines that an abnormal value is included (YES at step S109), control proceeds to step S111, and otherwise (NO at step S109), control returns to step S100.

In step S<b>111 , information processing apparatus 100 outputs a display instruction regarding skin temperature abnormality to display 150 . An example of the displayed screen is shown in FIG.

FIG. 12 is a diagram showing a specific example of a notification screen on display 150. As shown in FIG. Screen 1200 of FIG. 12 includes the title "Notification" and the message "A rise in skin temperature has been detected. Check your vitals." The displayed message may be changed according to the skin temperature value indicated by the derived index. That is, when the skin temperature value is low, the part of the message "increase in skin temperature" may be changed to "decrease in skin temperature".

Returning to FIG. 11, after step S111, information processing apparatus 100 outputs a blood pressure measurement instruction to sphygmomanometer 20 in step S124. Then, in step S126, information processing apparatus 100 stores the measurement result obtained from sphygmomanometer 20 in memory 130, and returns control to step S100.

In the process described with reference to FIGS. 11 and 12, information processing apparatus 100 outputs display instructions and blood pressure measurement instructions regardless of whether the skin temperature is high or low. These instructions may be output only when the skin temperature is low, and these instructions may not be output when the skin temperature is high.

[Equipment alarm function]
A dialysis system is configured to output an alarm when a patient attempts to leave the place where dialysis treatment is performed (e.g., a dialysis room) while wearing a device that touches the patient and measures physical information. may An example of such an alarm output will be described with reference to FIGS. 13 to 15. FIG.

FIG. 13 is a diagram showing the appearance of an example of sphygmomanometer 20. As shown in FIG. The sphygmomanometer 20 is an example of a device that comes into contact with a patient and measures physical information.

The sphygmomanometer 20 includes a belt 20A wrapped around the patient's arm. A housing including a display 26 and a pressure sensor 22 are attached to the belt 20A. The pressure sensor 22 detects the value of pressure applied to the pressure sensor 22 . As a result, the pressure sensor 22 outputs different signals depending on whether or not the belt 20A is attached to the patient's body (for example, wrist). That is, based on the signal output from the pressure sensor 22, the state in which the sphygmomanometer 20 is worn by the patient can be determined. In this sense, instead of the pressure sensor 22, the sphygmomanometer 20 is equipped with any type of sensor that outputs a signal that enables determination of whether the sphygmomanometer 20 is being worn by a patient. may be Whether or not the sphygmomanometer 20 is attached to the patient may be determined based on a signal output from a sensor mounted on a device other than the sphygmomanometer 20 or an image of the patient.

FIG. 14 is a diagram showing the hardware configuration of the sphygmomanometer 20. As shown in FIG. As shown in FIG. 14, sphygmomanometer 20 includes controller 21 . Controller 21 is connected to pressure sensor 22, pressure motor 23, pressure sensor 24, deaeration valve 25, display 26, speaker 27, memory 28, input device 29, and communication interface 20X.

Sphygmomanometer 20 includes a cuff. A pressurization motor 23 is driven to deliver air to the air bladder of the cuff. A pressure sensor 24 detects the pressure applied to the cuff. A degassing valve 25 is an electromagnetic valve that opens and closes the air bag. In the sphygmomanometer 20 , the controller 21 drives the pressure motor 23 to introduce an appropriate amount of air into the air bag, and derives the measurement result of the patient's blood pressure from the detection output of the pressure sensor 24 . The method of measuring blood pressure in the sphygmomanometer 20 is not limited to using a cuff, and may be based on pulse waves using an optical sensor. After deriving the measurement result, the controller 21 may cause the deaeration valve 25 to open the air bag, thereby returning the pressure inside the air bag to the atmospheric pressure.

The input device 29 includes operation buttons that are operated to give instructions to the controller 21 .

The controller 21 may start the blood pressure measurement when the input device 29 is operated, when a predetermined timing arrives, and/or in response to an instruction from the information processing device 100 . After starting the blood pressure measurement, the controller 21 may continuously measure the blood pressure multiple times at given intervals. The length of the interval can be set as appropriate. The number of consecutive blood pressure measurements can be set as appropriate. Once blood measurements are initiated, controller 21 may continue continuous blood measurements at the intervals described above until a given event (eg, manipulation of input device 29) occurs.

Controller 21 may include a processor, which processor 110 controls operation of sphygmomanometer 20 by executing programs stored in memory 28 or other storage device. The controller 21 may include a dedicated circuit (ASIC, FPGA, etc.) for controlling the operation of the sphygmomanometer 20 instead of or in addition to the processor.

The communication interface 20X wirelessly transmits and receives data to and from another device (for example, the interface 120 of the information processing apparatus 100). Data transmission/reception by the communication interface 20X may be realized according to the Bluetooth (registered trademark) standard, for example, but the method for data transmission/reception is not limited to this.

FIG. 15 is a flowchart of an example of processing for outputting an alarm in the dialysis system. In one implementation, blood pressure monitor 20 implements the process of FIG. 15 by having the processor of controller 21 execute a given program.

Referring to FIG. 15, in step S200, sphygmomanometer 20 determines whether or not sphygmomanometer 20 is being worn by a patient. Sphygmomanometer 20 repeats the determination in step S200 until it determines that sphygmomanometer 20 is being worn by the patient (NO in step S200). YES at step S200), control proceeds to step S202.

In step S<b>202 , sphygmomanometer 20 determines whether or not it is communicating with information processing apparatus 100 . When sphygmomanometer 20 determines that it is communicating with information processing apparatus 100 (YES at step S202), control returns to step S202, otherwise (NO at step S202), control proceeds to step S204. .

In one implementation, blood pressure monitor 20 determines that blood pressure monitor 20 is communicating with information processing apparatus 100 when communication interface 20X is receiving a signal from information processing apparatus 100 . The communication interface 20X communicates with Bluetooth. In this sense, in step S202, it is determined whether or not blood pressure monitor 20 is located within a range where Bluetooth communication with information processing apparatus 100 is possible.

In step S204, sphygmomanometer 20 outputs an alarm. The output of the alarm may be audio output from the speaker 27 (for example, the audio of the message "The sphygmomanometer is still attached."), or the display of a message on the display 26. Other modes (generation of vibration) may be used, or a combination thereof may be used. The alarm output may be stopped by operating the input device 29 . Thereafter, sphygmomanometer 20 returns control to step S200.

In the process described with reference to FIG. 15 , step S202 is provided to output an alarm on condition that blood pressure monitor 20 cannot communicate with information processing apparatus 100 . When communication with the information processing apparatus 100 is limited to the dialysis room, an alarm is output when the sphygmomanometer 20 is taken out of the dialysis room in step S202.

Note that the method for detecting that the sphygmomanometer 20 has been taken out of the dialysis room is not limited to determining whether communication with the information processing apparatus 100 is possible. For example, sphygmomanometer 20 may include a GPS signal receiver, and controller 21 may be configured to output an alarm when location information identified from the GPS signal indicates outside the dialysis room. .

In addition, the alarm output is not after the sphygmomanometer 20 is actually taken out of the dialysis room, but when the sphygmomanometer 20 is about to be taken out of the dialysis room (when the sphygmomanometer 20 is close to the exit of the dialysis room). ) occurs, the controller 21 may be configured to output an alarm.

Further, an alarm output may be instructed from the information processing device 100 instead of the controller 21 or in addition to the controller 21 . For example, the information processing apparatus 100 acquires the position information of the sphygmomanometer 20 at regular time intervals, and when the position information indicates that the sphygmomanometer 20 has been taken out of the dialysis room (or when the exit is approached), the sphygmomanometer 20 may be instructed to output an alarm. Sphygmomanometer 20 may be configured to output an alarm in response to an instruction from information processing apparatus 100 .

In the process described with reference to FIG. 15, step S200 is provided for outputting an alarm on condition that sphygmomanometer 20 is attached to the patient. Note that the output of the alarm may be performed only on the condition that the sphygmomanometer 20 is taken out of the dialysis room. That is, step S200 may be omitted. In this case, an alarm can also be output when the sphygmomanometer 20 is taken out of the dialysis room without being worn by the patient, for example, when the sphygmomanometer 20 is taken out for maintenance by a medical worker. If an alarm is output when the sphygmomanometer 20 is taken out by a medical staff, the medical staff may perform an operation to stop outputting the alarm.

Each embodiment disclosed this time should be considered as an illustration and not restrictive in all respects. The scope of the present invention is indicated by the scope of the claims rather than the above description, and is intended to include all modifications within the scope and meaning equivalent to the scope of the claims.

1 dialysis patient, 10 dialysis machine, 12 arterial blood circuit, 13 venous blood circuit, 20 sphygmomanometer, 20A belt, 20X communication interface, 21 controller, 22, 24 pressure sensor, 30 camera, 40 infrared camera, 100 information processing Device, 110 processor, 120 interface, 130 memory, 140 input device, 150 display.

Claims (12)

A computer-implemented method of patient condition management during dialysis treatment, comprising:
obtaining a detection output from a sensor that obtains contactless physical information of a patient undergoing dialysis treatment;
using the detected output to derive an indication of the patient's condition;
the indicators include the patient's skin temperature, the patient's complexion color information, and the patient's respiratory rate;
A state management method, further comprising the step of outputting information based on the indicator. 2. The condition management method according to claim 1, wherein said information to be output includes a measurement instruction to equipment for measuring physical information in contact with a patient. the device comprises a sphygmomanometer;
3. The condition management method according to claim 2, wherein the physical information measured by contacting the patient includes a blood pressure value. In the step of outputting information based on the index,
when the skin temperature is lower than a given threshold, when the color information has changed by more than a given criterion from the start of dialysis treatment, or when the color information has changed by more than a given criterion from the start of dialysis treatment. Outputting an indication of the measurement is performed when the respiratory rate is at a value corresponding to tachypnea or apnea even if not
if the skin temperature is below a given threshold, the color information has not changed by more than a given criterion since the start of dialysis treatment, and the respiratory rate is normal; 4. The state management method according to claim 2 or 3, wherein the output of is not implemented. The step of outputting information based on the index includes:
performing the output of the indication of measurement when the color information changes by more than a given criterion from the start of dialysis therapy and the respiration rate is a value corresponding to apnea. The state management method according to claim 2 or 3. The step of outputting information based on the index includes:
when the color information has not changed by more than a given standard since the start of dialysis treatment, or when the respiration rate is normal or frequent even if the color information has changed by more than a given standard after the start of dialysis treatment; outputting the first information when the value corresponds to respiration;
An event more severe than the event represented by the first information occurs when the color information changes by more than a given criterion from the start of dialysis treatment and the respiratory rate is at a value corresponding to apnea. 6. The state management method of claim 5, comprising outputting second information indicating that the state has occurred. The step of outputting information based on the index includes:
When the skin temperature is below a given threshold and the color information has changed by more than a given criterion since the start of dialysis treatment, when the respiratory rate is normal or a value corresponding to tachypnea, outputting first information; and outputting second information indicating that an event more severe than the event represented by the first information occurred when the respiratory rate was at a value corresponding to apnea. The state management method according to any one of claims 1 to 3, comprising: The condition management according to claim 2 or 3, wherein the step of outputting information based on the index includes outputting the measurement instruction when the skin temperature is higher or lower than a predetermined range. Method. A program that, when executed by a processor of a computer, causes the computer to perform the method according to any one of claims 1 to 8. a dialysis machine;
A dialysis system comprising an information processing device for managing a patient's condition during dialysis treatment by the dialysis device,
The information processing device is
a memory for storing the program according to claim 9;
and one or more processors executing programs stored in the memory. Further comprising a device for measuring physical information in contact with the patient,
11. The dialysis system of Claim 10, wherein the device is configured to output an alarm when away from the location where dialysis therapy is performed. 12. The dialysis system according to claim 11, wherein the device is configured to output the alarm on condition that the device is worn by the patient.

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