KR20210023133A - Smart infusion pump - Google Patents

Abstract

Disclosed is a smart infusion pump which automatically adjusts a fluid or drug which controls a patient′s blood pressure according to a result of hemodynamic monitoring. The disclosed smart infusion pump comprises: an information receiving unit for receiving at least one of flow rate information, blood vessel resistance information, cardiac contractility information, and body fluid information from a hemodynamic monitoring device; a monitoring unit for monitoring the flow rate information, vascular resistance information, cardiac contractility information, and body fluid information; an injection amount determining unit configured to determine an infusion amount or a drug injection amount based on at least one of the flow rate information, vascular resistance information, cardiac contractility information, and body fluid information according to the monitoring result; and an injection control unit for controlling the injection of the fluid or drug according to the determined injection amount.

Description

Smart Infusion Pump{SMART INFUSION PUMP}

The present invention relates to an infusion pump, and more particularly, to a smart infusion pump that automatically controls a fluid or drug that controls a patient's blood pressure according to a result of hemodynamic monitoring.

The infusion pump is one of the medical devices widely used in homes and hospitals around the world. The infusion pump is a device that mechanically injects a drug for intravenous injection into a patient according to a given instruction in a fixed amount. It is connected to an IV (Intravenous) set and injects the correct amount into the patient at a certain time. Infusion pumps are sensitive subjects who need to accurately adjust the concentration of drugs or inject drugs that work on the cardiovascular system or respiratory system, such as dopamine, epinephrine, dobutamine, norepinephrine, and steroids. , For example, it can be used to inject drugs into newborns, critically ill patients, and mothers.

In addition, in the case of administration through a catheter over a long period of time and in the case of administration to a patient in an intensive care unit, administration using an infusion pump is advantageous in terms of time and economy rather than administration directly by a nurse or doctor. Do. In particular, in the case of drugs with high risk, such as drugs with a small therapeutic dose range, the utilization of the infusion pump will be greater.

Such an infusion pump may be used for a shock patient exhibiting hemodynamic instability, and a hemodynamic monitoring device for monitoring the hemodynamic state of the shock patient is used. Hemodynamic monitoring refers to continuously checking hemodynamic indicators for the purpose of diagnosis and treatment in severely ill patients with hemodynamic instability. As hemodynamic indicators provided by the hemodynamic monitoring device, there are information on a patient's flow rate, vascular resistance information, cardiac contractility information, and body fluid information.

After checking the hemodynamic index, the medical staff can control the blood pressure of the shock patient by operating the infusion pump by determining the amount of fluid or drug to be injected into the patient. Such manual work by medical staff provides a considerable amount of labor to medical staff, and in particular, since shock patients require 24-hour monitoring, the labor intensity is very high compared to general patients, so that an incorrect shock treatment is performed or the device malfunctions, causing the patient to be treated. It can do harm.

In order to solve this problem, technologies for remotely controlling the infusion pump through a computer or smartphone have been developed, but since medical staff must determine the amount of fluid or drug to be injected into the patient, medical staff still monitor shock patients 24 hours a day. You need to do it.

As related prior documents, there are Korean Patent Application Publication Nos. 2018-0007414 and No. 2018-0012758.

The present invention is to provide a smart infusion pump that automatically controls fluids or drugs that control blood pressure of a patient according to a result of hemodynamic monitoring of a patient.

In addition, the present invention is to provide a smart infusion pump that automatically controls fluids or drugs so that the patient's blood pressure does not drop in order to prevent shock to the patient.

According to an embodiment of the present invention for achieving the above object, from a hemodynamic monitoring device, the information receiving unit for receiving at least one of flow rate information, blood vessel resistance information, cardiac contractility information, and body fluid information of a patient; A monitoring unit that monitors the flow rate information, blood vessel resistance information, cardiac contractility information, and body fluid information; An injection amount determination unit configured to determine an infusion amount or a drug injection amount based on at least one of the flow rate information, blood vessel resistance information, cardiac contractility information, and body fluid information according to the monitoring result; And according to the determined injection amount, there is provided a smart infusion pump including an injection control unit for controlling the infusion of fluids or drugs.

In addition, according to another embodiment of the present invention for achieving the above object, from a hemodynamic monitoring device, the information receiving unit for receiving at least one of flow rate information, vascular resistance information, cardiac contractility information, and body fluid information of a target patient; A monitoring unit that monitors the flow rate information, blood vessel resistance information, cardiac contractility information, and body fluid information; An injection amount determination unit configured to determine an infusion amount or a drug injection amount by inputting at least one of the flow rate information, blood vessel resistance information, cardiac contractility information, and body fluid information into a pre-learned artificial neural network according to the monitoring result; And according to the determined injection amount, there is provided a smart infusion pump including an injection control unit for controlling the infusion of fluids or drugs.

According to an embodiment of the present invention, since the infusion amount or the amount of drug infusion is automatically determined according to the patient's hemodynamic index, it is possible to reduce mistakes of medical staff and fatigue of medical staff, as well as in developing countries and underdeveloped regions where medical staff are insufficient. It can be provided so that the disparity in the provision of medical services can be eliminated.

In addition, according to an embodiment of the present invention, it is possible to provide high-quality medical services without supplementing manpower in a hospital treated by a medical staff with low skill level, and can be applied in a non-hospital environment such as long-distance patient transfer or a disaster situation. Therefore, the patient's survival rate may increase.

According to an embodiment of the present invention, unlike a method in which a medical staff comprehensively and subjectively determines various hemodynamic indicators to directly determine the infusion amount or drug infusion amount, the infusion amount or drug infusion amount is automatically determined according to a preset algorithm. By doing so, mistakes by the medical staff can be prevented.

1 is a view for explaining a shock treatment system according to an embodiment of the present invention.
2 is a view for explaining a smart infusion pump according to an embodiment of the present invention.
3 is a view for explaining a method of controlling a smart infusion pump according to an embodiment of the present invention.
4 is a view for explaining a method of controlling a smart infusion pump according to another embodiment of the present invention.

In the present invention, various modifications may be made and various embodiments may be provided, and specific embodiments will be illustrated in the drawings and described in detail in the detailed description. However, this is not intended to limit the present invention to a specific embodiment, it should be understood to include all changes, equivalents, and substitutes included in the spirit and scope of the present invention. In describing each drawing, similar reference numerals have been used for similar elements.

Hereinafter, embodiments of the present invention will be described in detail with reference to the accompanying drawings.

1 is a view for explaining a shock treatment system according to an embodiment of the present invention.

Referring to FIG. 1, a shock treatment system according to an embodiment of the present invention includes a smart infusion pump 110 and a hemodynamic monitoring device 120.

The smart infusion pump 110 according to an embodiment of the present invention receives a hemodynamic index for a patient from the hemodynamic monitoring device 120 and injects fluid or a drug so that the patient's blood pressure can be maintained at the target blood pressure. . Since shock may occur when the patient's blood pressure is lowered, the smart infusion pump 110 controls the infusion amount of fluid or drug to increase the blood pressure and injects it into the patient when the patient's blood pressure is in a low blood pressure state.

Whether the patient's blood pressure is in a hypotensive state can be confirmed from the hemodynamic index. Hemodynamic indicators include flow information, vascular resistance information, cardiac contractility information, and body fluid information.

The flow information includes stroke volume, stroke volume index, cardiac output, and cardiac index. The stroke volume index is a value obtained by dividing the stroke volume value by the patient's body surface area, and represents the value obtained by correcting the stroke volume by the patient's age, sex, and height. The cardiac output index is a value obtained by dividing the cardiac output value by the body surface area of the patient, and indicates a value obtained by correcting the cardiac output value by age, sex, and height.

The vascular resistance information includes systemic vascular resistance and systemic vascular resistance index. The systemic vascular resistance value represents the force estimated by the posterior load that the ventricle must overcome in order for blood to erupt into the aorta, and the systemic vascular resistance index is a value obtained by dividing the body surface area of the patient's systemic vascular resistance Represents the value corrected by age, sex, and height.

The cardiac contractility information includes a heart velocity value (velocity index) and a heart acceleration index (acceleration index). The heart velocity value represents the maximum velocity of blood flow in the aorta during systole, and the cardiac acceleration index represents the maximum acceleration of blood flow in the aorta during systole divided by the body surface area of the patient.

The fluid information includes the rate of change in ejection volume, chest fluid status, chest fluid status index, and preloading value. The stroke volume variation represents the rate of change in stroke volume according to the breathing cycle (exhalation, inspiration), and the thoracic fluid content represents the volume of fluid in the rib cage. In addition, the thoracic fluid content index represents the value obtained by dividing the value of the chest fluid state by the body surface area of the patient, and the preload is the volume of blood returned to the heart, that is, the volume of blood immediately before ejection from the heart to the aorta. Represents.

The smart infusion pump 110 monitors at least one of these hemodynamic indicators, determines whether the patient's blood pressure is in a low blood pressure state, determines the infusion amount or the drug infusion amount so that the patient's blood pressure becomes the target blood pressure, Control the infusion of drugs. As an example, the target blood pressure may be set to a systolic blood pressure of 90 mmHg, an average arterial pressure of 65 mmHg, or higher.

The smart infusion pump 110 may use a pre-set injection amount or a pre-learned artificial neural network according to a patient's hemodynamic index in order to determine an infusion amount or drug infusion amount. It is described in more detail in 2-4.

The smart infusion pump 110 may include a wired/wireless communication module, and the determined injection amount may be transmitted to a terminal such as a smart phone of a medical staff. In addition, the smart infusion pump 110 may receive an infusion amount or a drug infusion amount from a terminal of a medical staff, and inject the infusion or drug into a patient.

According to an embodiment of the present invention, since the infusion amount or the amount of drug infusion is automatically determined according to the patient's hemodynamic index, it is possible to reduce mistakes of medical staff and fatigue of medical staff, as well as in developing countries and underdeveloped regions where medical staff are insufficient. It can be provided so that the disparity in the provision of medical services can be eliminated.

In addition, according to an embodiment of the present invention, it is possible to provide high-quality medical services without supplementing manpower in a hospital treated by a medical staff with low skill level, and can be applied in a non-hospital environment such as long-distance patient transfer or a disaster situation. Therefore, the patient's survival rate may increase.

2 is a view for explaining a smart infusion pump according to an embodiment of the present invention.

Referring to FIG. 2, a smart infusion pump according to an embodiment of the present invention includes an information receiving unit 210, a monitoring unit 220, an injection amount determining unit 230, and an injection control unit 240.

The information receiving unit 210 receives at least one of a patient's flow rate information, blood vessel resistance information, cardiac contractility information, and body fluid information from the hemodynamic monitoring device. According to an embodiment, the information receiving unit 210 may further receive information on a patient's systolic blood pressure and average arterial pressure from the hemodynamic monitoring device. The hemodynamic indicator may be received through a wired or wireless communication network, and may be received directly from a hemodynamic monitoring device or through a separate computing device.

The monitoring unit 220 monitors at least one of flow rate information, blood vessel resistance information, cardiac contractility information, and body fluid information to determine whether the patient is in a hypotensive state.

According to the monitoring result, the injection amount determining unit 230 determines the injection of one of an infusion solution or a drug, and determines an infusion amount or a drug injection amount based on at least one of flow rate information, vascular resistance information, cardiac contractility information, and body fluid information. The injection amount determination unit 230 may determine the infusion amount or drug injection amount so that the patient's blood pressure becomes the target blood pressure, according to the rate of change of the stroke volume or the cardiac acceleration index when the single stroke volume index decreases as a result of monitoring by the monitoring unit 220. have.

In addition, the injection amount control unit 240 controls the injection of an infusion solution or a drug according to the injection amount determined by the injection amount determination unit 230.

As an embodiment, the monitoring unit 220 is in a state in which the systolic blood pressure or average arterial pressure is reduced, the stroke volume index decreases, the stroke volume change rate is greater than the threshold value or the stroke volume index decreases, and the cardiac acceleration index is If it decreases, or if the ejection amount index falls within the normal range, but the systemic vascular resistance index decreases, it may be determined that the amount of infusion of fluid or drug should be adjusted.

The injection amount determination unit 230 may determine the amount of infusion infusion amount when the one-time stroke amount index decreases and the rate of change in the amount of one stroke amount is greater than a threshold value, and as an example, the amount of infusion solution of the crystalline solution may be determined as 500 ml. Under the control of the injection amount control unit 240, 500 ml of a crystalline fluid may be rapidly injected into the patient.

Alternatively, the injection amount determining unit 230 may determine the infusion amount of the crystalline fluid as 500ml even when the stroke volume index and the cardiac acceleration index decrease, and the rate of change in the stroke volume is greater than the threshold value.

Alternatively, the injection amount determination unit 230 may determine the amount of drug injection when the stroke volume index and the cardiac acceleration index decrease, and the rate of change of the stroke volume is less than the threshold value, and as an example, the injection amount of dobutamine is 0.5 ug/kg/min. You can decide.

Alternatively, the injection amount determination unit 230 may determine the amount of drug injection when the one-time ejection amount index is included in the normal range and the systemic vascular resistance index decreases, and as an example, the norepinephrine may be determined as 0.04 ug/kg/min. . In this way, the injection amount determination unit 230 may determine the injection amount of different drugs, such as dobutamine and norepinephrine, according to whether the single stroke volume index is decreased, that is, whether the single stroke volume index is included in the normal range.

On the other hand, unlike the above-described embodiment, the injection amount determining unit 230 may determine an infusion amount or a drug injection amount by using a pre-learned artificial neural network. The injection amount determination unit 230 may determine an infusion amount or a drug injection amount by inputting at least one of flow rate information, blood vessel resistance information, cardiac contractility information, and body fluid information into a pre-learned artificial neural network according to a monitoring result.

Here, the artificial neural network may be an artificial neural network learned based on a prescribed amount of infusion or drug infusion according to flow rate information, blood vessel resistance information, cardiac contractility information, and body fluid information obtained in a hypotensive state of a sample patient. In other words, as training data for the artificial neural network, flow rate information, blood vessel resistance information, cardiac contractility information, and body fluid information acquired in the hypotensive state of the sample patient are used, and the amount of infusion or drug infusion prescribed in the hypotension state of the sample patient is also used. It is used as training data.

In the learning stage, flow information, blood vessel resistance information, cardiac contractility information, and body fluid information acquired in the hypotensive state of the sample patient are input to the input node of the artificial neural network, and the amount of infusion or drug infusion prescribed in the hypotension state of the sample patient is labeled. It is used as (label).

And in the prediction step, the injection amount determination unit 230 inputs the flow rate information, blood vessel resistance information, cardiac contractility information, and body fluid information received from the information receiving unit 210 as an input node of the artificial neural network, and the artificial neural network is an infusion amount or drug. The injection volume can be predicted.

According to an embodiment of the present invention, unlike a method in which a medical staff comprehensively and subjectively determines various hemodynamic indicators to directly determine the infusion amount or drug infusion amount, the infusion amount or drug infusion amount is automatically determined according to a preset algorithm. By doing so, mistakes by the medical staff can be prevented.

3 is a view for explaining a method of controlling a smart infusion pump according to an embodiment of the present invention.

The smart infusion pump according to an embodiment of the present invention monitors the one-time stroke amount index and determines whether the one-time stroke amount index decreases (S310). The smart infusion pump may determine that the stroke amount index decreases when the stroke amount index is smaller than a preset first threshold value, or the stroke amount index indicates a pattern of decreasing for a preset time.

When the single stroke amount index decreases, the smart infusion pump determines whether the rate of change of the stroke amount is greater than the second threshold (S320). Here, the second threshold may be determined to be 15%, and the rate of change in stroke volume is the rate of change according to the patient's breathing cycle. The smart infusion pump rapidly injects 500ml of a crystalline fluid, which is a preset infusion amount, into the patient when the rate of change in the ejection amount is greater than 15% (S330).

The smart infusion pump determines whether or not the patient's blood pressure reaches the target blood pressure within a preset time after the infusion of the fluid (S340), and if the blood pressure does not rise, 500 ml of the crystalline fluid is rapidly injected back to the patient (S330). )do. At this time, the patient's blood pressure may be calculated by the product of the cardiac output value and the systemic vascular resistance value, or may be provided from a hemodynamic monitoring device. Fluid can be injected.

Returning to step S310, the smart infusion pump determines whether or not the systemic vascular resistance index decreases when the ejection amount index is not decreased (S350). The smart infusion pump may determine that the systemic vascular resistance index decreases when the systemic vascular resistance index is smaller than a preset third threshold value or when the systemic vascular resistance index exhibits a pattern of decreasing for a preset time.

When the systemic vascular resistance index decreases, the smart infusion pump injects norepinephrine at a preset drug injection amount of 0.04 ug/kg/min (S360). The smart infusion pump determines whether or not the blood pressure of the patient has reached the target blood pressure within a preset time, such as within 5 minutes, after the drug injection has improved (S370), and if the blood pressure does not rise, a preset ratio By increasing the dose of norepinephrine, for example, by increasing the dose by twice, the injection is performed (S360). Steps S360 and S370 may be repeated until the dose of norepinephrine reaches a maximum of 0.3ug/kg/min.

4 is a view for explaining a method of controlling a smart infusion pump according to another embodiment of the present invention.

The smart infusion pump according to an embodiment of the present invention monitors the one-time stroke amount index and determines (410) whether the one-time stroke amount index decreases. The smart infusion pump may determine that the stroke amount index decreases when the stroke amount index is smaller than a preset first threshold value, or the stroke amount index indicates a pattern of decreasing for a preset time.

When the stroke volume index decreases, the smart infusion pump determines whether the cardiac acceleration index decreases (S420). The smart infusion pump may determine that the cardiac acceleration index decreases when the cardiac acceleration index is smaller than the preset fourth threshold value or the cardiac acceleration index decreases for a preset time.

When the single stroke amount index decreases, the smart infusion pump determines whether the rate of change of the stroke amount is greater than the second threshold (S430). The smart infusion pump rapidly injects 500ml of a crystalline fluid into the patient when the rate of change in one stroke volume decreases by more than 15% (S440).

The smart infusion pump determines whether the patient's blood pressure has reached the target blood pressure within a preset time after the infusion of the fluid (S450), and if the blood pressure does not rise, 500 ml of the crystalline fluid is rapidly injected back to the patient (S440). )do.

Returning to step S410 again, the smart infusion pump performs step S350 if the one-time stroke amount index has not decreased.

And in step S430, when it is determined that the rate of change of the ejection amount is equal to or less than the second threshold, the smart infusion pump injects dobutamine at a preset drug injection amount of 0.5 ug/kg/min (S460).

The smart infusion pump determines whether or not the patient's blood pressure has reached the target blood pressure within a preset time, for example, within 5 minutes after drug injection, and the patient's blood pressure has improved (S470). The dose is increased by a preset ratio, for example, by increasing the dose by twice, and injection is performed (S460). Steps S460 and S470 may be repeated until the dose of dobutamine reaches a maximum of 20 ug/kg/min.

The above-described technical contents may be implemented in the form of program instructions that can be executed through various computer means and recorded in a computer-readable medium. The computer-readable medium may include program instructions, data files, data structures, and the like alone or in combination. The program instructions recorded on the medium may be specially designed and configured for the embodiments, or may be known and usable to those skilled in computer software. Examples of computer-readable recording media include magnetic media such as hard disks, floppy disks, and magnetic tapes, optical media such as CD-ROMs and DVDs, and magnetic media such as floptical disks. -A hardware device specially configured to store and execute program instructions such as magneto-optical media, and ROM, RAM, flash memory, and the like. Examples of program instructions include not only machine language codes such as those produced by a compiler, but also high-level language codes that can be executed by a computer using an interpreter or the like. The hardware device may be configured to operate as one or more software modules to perform the operations of the embodiments, and vice versa.

In addition, as described above, in the present invention, specific matters such as specific components, etc., and limited embodiments and drawings have been described, but this is only provided to help a more general understanding of the present invention, and the present invention is limited to the above embodiments. It is not, and a person having ordinary knowledge in the field to which the present invention pertains can make various modifications and variations from this description. Therefore, the spirit of the present invention is limited to the described embodiments and should not be defined, and all things that are equivalent or equivalent to the claims as well as the claims to be described later fall within the scope of the spirit of the present invention. .

Claims (10)

An information receiver configured to receive at least one of a patient's flow rate information, blood vessel resistance information, cardiac contractility information, and body fluid information from the hemodynamic monitoring device;
A monitoring unit that monitors the flow rate information, blood vessel resistance information, cardiac contractility information, and body fluid information;
An injection amount determining unit configured to determine an infusion amount or a drug injection amount based on at least one of the flow rate information, blood vessel resistance information, cardiac contractility information, and body fluid information according to the monitoring result; And
An injection control unit that controls the injection of fluids or drugs according to the determined injection amount
Smart infusion pump comprising a.
The method of claim 1,
The flow rate information includes a single stroke amount index,
The cardiac contractile force information includes a cardiac acceleration index,
The bodily fluid information includes a rate of change in one stroke volume,
The injection amount determination unit
As a result of the monitoring, when the single stroke volume index decreases, the infusion amount or the drug injection amount is determined according to the single stroke volume change rate or the cardiac acceleration index.
Smart Infusion Pump.
The method of claim 2,
The injection amount determination unit
When the rate of change in the single stroke amount is greater than the threshold value, determining the amount of infusion infusion
Smart Infusion Pump.
The method of claim 2,
The injection amount determination unit
When the cardiac acceleration index decreases and the rate of change in the stroke volume is greater than a threshold value, determining the infusion amount
Smart Infusion Pump.
The method of claim 2,
The injection amount determination unit
When the cardiac acceleration index decreases and the rate of change in the ejection amount is less than or equal to a threshold value, determining the amount of drug injection
Smart Infusion Pump.
The method of claim 2,
The flow rate information includes a one-time stroke amount index,
The vascular resistance information includes a systemic vascular resistance index,
The injection amount determination unit
As a result of the monitoring, when the single stroke volume index is included in the normal range, and the systemic vascular resistance index decreases, the drug injection amount is determined.
Smart Infusion Pump.
The method of claim 6,
The injection amount determining unit
According to whether or not the single stroke volume index contains the normal range, to determine the injection amount of different drugs
Smart Infusion Pump.
The method of claim 1,
The injection amount determination unit
To determine the infusion amount or the drug infusion amount so that the blood pressure of the patient becomes the target blood pressure
Smart Infusion Pump.
An information receiving unit configured to receive at least one of flow rate information, blood vessel resistance information, cardiac contractility information, and body fluid information of a target patient from the hemodynamic monitoring device;
A monitoring unit that monitors the flow rate information, blood vessel resistance information, cardiac contractility information, and body fluid information;
An injection amount determination unit configured to determine an infusion amount or a drug injection amount by inputting at least one of the flow rate information, blood vessel resistance information, cardiac contractility information, and body fluid information into a pre-learned artificial neural network according to the monitoring result; And
An injection control unit that controls the injection of fluids or drugs according to the determined injection amount
Smart infusion pump comprising a.
The method of claim 9,
The artificial neural network is
An artificial neural network learned based on the amount of infusion or drug infusion prescribed according to the flow information, vascular resistance information, cardiac contractility information, and body fluid information acquired in the hypotensive state of the sample patient.
Smart Infusion Pump.

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