WO2011070422A1 - Medical device system - Google Patents

Medical device system Download PDF

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Publication number
WO2011070422A1
WO2011070422A1 PCT/IB2010/003114 IB2010003114W WO2011070422A1 WO 2011070422 A1 WO2011070422 A1 WO 2011070422A1 IB 2010003114 W IB2010003114 W IB 2010003114W WO 2011070422 A1 WO2011070422 A1 WO 2011070422A1
Authority
WO
WIPO (PCT)
Prior art keywords
homeostasis
software
medical device
bioimpedance
score
Prior art date
Application number
PCT/IB2010/003114
Other languages
English (en)
French (fr)
Inventor
Albert Maarek
Original Assignee
Ld Technology Llc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority to EP10814724A priority Critical patent/EP2509493A1/en
Application filed by Ld Technology Llc filed Critical Ld Technology Llc
Priority to US13/514,353 priority patent/US20130204103A1/en
Priority to BR112012013294A priority patent/BR112012013294A2/pt
Priority to JP2012542630A priority patent/JP2013524860A/ja
Priority to CN201080054967.8A priority patent/CN102781314B/zh
Priority to CA2782858A priority patent/CA2782858A1/en
Priority to AU2010329611A priority patent/AU2010329611A1/en
Publication of WO2011070422A1 publication Critical patent/WO2011070422A1/en
Priority to PCT/IB2011/002935 priority patent/WO2012076957A1/en
Priority to US13/991,694 priority patent/US20130324814A1/en
Priority to US14/681,297 priority patent/US20150313477A1/en
Priority to US15/082,823 priority patent/US9629559B2/en
Priority to US15/497,170 priority patent/US20170224232A1/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/145—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue
    • A61B5/1455—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue using optical sensors, e.g. spectral photometrical oximeters
    • A61B5/14551—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue using optical sensors, e.g. spectral photometrical oximeters for measuring blood gases
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
    • A61B5/024—Detecting, measuring or recording pulse rate or heart rate
    • A61B5/0245—Detecting, measuring or recording pulse rate or heart rate by using sensing means generating electric signals, i.e. ECG signals
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/05—Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves 
    • A61B5/053—Measuring electrical impedance or conductance of a portion of the body
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/05—Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves 
    • A61B5/053—Measuring electrical impedance or conductance of a portion of the body
    • A61B5/0531—Measuring skin impedance
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/08—Detecting, measuring or recording devices for evaluating the respiratory organs
    • A61B5/091—Measuring volume of inspired or expired gases, e.g. to determine lung capacity
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/145—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue
    • A61B5/14532—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue for measuring glucose, e.g. by tissue impedance measurement
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
    • A61B5/021—Measuring pressure in heart or blood vessels
    • A61B5/022—Measuring pressure in heart or blood vessels by applying pressure to close blood vessels, e.g. against the skin; Ophthalmodynamometers
    • A61B5/02225—Measuring pressure in heart or blood vessels by applying pressure to close blood vessels, e.g. against the skin; Ophthalmodynamometers using the oscillometric method
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
    • A61B5/024—Detecting, measuring or recording pulse rate or heart rate
    • A61B5/02405—Determining heart rate variability
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
    • A61B5/024—Detecting, measuring or recording pulse rate or heart rate
    • A61B5/02416—Detecting, measuring or recording pulse rate or heart rate using photoplethysmograph signals, e.g. generated by infrared radiation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/48—Other medical applications
    • A61B5/4869—Determining body composition
    • A61B5/4872—Body fat

Definitions

  • the present invention relates to a medical device system utilising a combination of technologies and software to establish an evaluation. More particularly the device comprises technologies including spectrophotometry and impedance monitoring to establish a measure of homeostasis for a practitioner to determine and monitor treatment.
  • the homeostasis score provides a fast overview of a patient's homeostasis processes and responses with the key indicators, to understand the patient's potential adaptation to lifestyle, disorders, diseases or current treatment.
  • the healthy subject is not identified as such simply because he does not have any disease, but because his homeostasis score is acceptable and therefore his body can adapt and remain healthy when challenged.
  • the homeostasis score cannot be used as diagnosis.
  • the proposed technology and its analysis aims to provide low cost therapeutic follow up.
  • a doctor should be able to test how the planned treatment would affect a patient, save time and as the possibilities of treating diseases improve, it is important to choose the right treatment for each individual patient.
  • a device wherein at least one technology is based on bio-impedance measuring and/or at least one technology is based on spectrophotometry measurements and software cross analyses the results to assess the homeostasis of an individual.
  • Medical device monitoring systems tend to measure one parameter or set of parameters in isolation. This has disadvantages for the patient in that other conditions or aggravating issues could be overlooked.
  • the present invention provides a medical device and or a series of medical devices measuring a variety of parameters using different technologies and software to provide a homeostasis score.
  • a medical device comprising at least a pulse oximeter which provides a vascular waveform.in combination with other biosensors and software.
  • the devices combined in one or more devices comprising a system may include EKG, blood glucose meter, spirometer and a variety of other known and new technologies.
  • the system is a combination of 4 biosensor technologies with 6 features and signal processing analysis managed by software.
  • Preferred technologies include a) bioimpedance in bipolar mode (EIS sensor), b) bioimpedance in tetrapolar mode (ES-BC sensor), c) the spectrophotometry (ESO sensor) and d) oscillometric measurements. (NIBP sensor)
  • Preferred bio impedance biosensor features are:
  • the bio impedance in bipolar mode sensor (such as the EIS (electro interstitial scan) sensor) feature evaluates the segmental and general conductivity of the human body with low frequencies via at least 4 to 8 tactile electrodes.
  • the signal processing analysis of the measurement provides estimated parameters related to living tissue : interstitial fluid sodium ion related to the Na+/K+ATPase pump activity (NAKA), interstitial fluid negative ions ( chloride ions and bicarbonate) and morphology of the interstitial fluid space.
  • the bio impedance in tetra polar mode (ES-BC (electro scan body composition) sensor) feature evaluates the resistance and the reactance of the human body using a mono frequency (50 KHz) via 4 tactile electrodes, to estimate body composition parameters (total body water (TWB), fat free mass, fat mass) according to predictive equations as commonly seen in peer reviews.
  • body composition parameters total body water (TWB), fat free mass, fat mass
  • the pulse oximeter displays Sp02%, pulse rate value and vertical bar graph pulse amplitude.
  • the photoelectrical plethysmograph or digital pulse analysis (DP A) feature is the signal processing analysis of the pulse waveform provided by the oximeter.
  • the mathematical analyses provide indicators to estimate the artery stiffness, associated with the heart rate detection the cardiac output and associated with the NIBP sensor, the systemic vascular resistance and means arterial pressure.
  • the Heart Rate Variability feature both in the time domain and in the frequency domain (spectral analysis).
  • HRV Heart Rate Variability feature
  • NN normal-to-normal
  • RR Rate-to-Rate
  • the non invasive blood pressure device (NIBP sensor) feature is the measurement of the systolic and diastolic pressure.
  • FIG 1 shows the EIS process
  • Figure 2 shows a graph of conductivity against time for an individual EIS measurement
  • Figure 3 shows the pathways of the individual EIS measurements
  • FIG. 4 shows the HRV signal and time domain and frequency domain analysis
  • Figure 5 shows the body system tissue diagram with zones marked to assess risk
  • Figure 6 shows the brain system tissue diagram with zones marked to assess risk
  • Figure 7 shows the photoelectrical plesthysmography or DPA class risk
  • Figure 8 shows class risk from HRV assessment
  • FIG 9 shows the various elements contributing to the calculation of the homeostasis score Bio Impedance Bipolar Mode (EIS sensor) technology
  • EIS sensor is a programmable electro medical system (PEMS) including: • USB plug and play hardware devices including interface box , disposable electrodes, reusable plates and reusable cables
  • Successive measurements are typically made with weak Direct Current and very low frequency (700 Hz) between six tactile electrodes placed symmetrically on the left and right forehead, palm of hands, and sole of the feet of the subject.
  • the hand and foot electrodes are typically at least 250 cm2 and in metal
  • the forehead electrodes are typically disposable (single use) and preferably in AgAgCl.
  • Each electrode is alternatively cathode then anode (bipolar mode), which permits in the particular embodiment described the recording of the intensity/ voltage/ resistance and conductivity (Law of Ohm) of 1 1 segments (segments means interstitial fluid pathways) of the human body.
  • odd numbered segments are measured from the anode to the cathode and even segments are measured from the cathode to anode.
  • the measurements relate to estimations of parameters related to living tissue:
  • NAKA Na+/K+ATPase pump activity
  • the EIS may be used for children (over 5 years) and adult patients.
  • the device is not intended for use in life support situations and is not for continuous monitoring.
  • the system should be used by a practitioner taking into account the clinical context of each individual patient.
  • Data acquisition Diagram Description for one segment from anode (active electrode) to cathode (passive electrode) Figure 1.
  • the signal waveform is rectangular, is continuous during 1 or 3 seconds / per human body segment located between 2 electrodes. Each electrode is alternatively anode then cathode for each segment/ pathway
  • the software receives 32 or 255 measurements according to the time of current
  • the selected conductivity value for each sequence of measurement is the value SPA (After stabilization of the measurement)
  • the curve can be straight or inverse. This curve is similar to the chronoamperometry measurement which is an electrochemical measurement (intensity related with a chemical substance concentration i.e. below)
  • the current is sent from the anode to cathode for the odd numbered segments
  • the current is sent from the cathode to anode for the even segments
  • This sequence is a programmed sequence and can be changed and this change does not affect the results of the device.
  • the full cycle comprises the measurement of the 11 segments/pathways measured in the polarity anode-cathode and in second time in the polarity cathode-anode. This operation is performed 4 times (ml , m2, m3 and m4) 2 measurements in DC and 2 measurements with a very low frequency 700 Hz .
  • the graph is an average of the 4 measurements.
  • SDC + Conductivity in ⁇ 8 of each odd numbered segment/pathway normal range 8 to 18 ⁇ 8 and pathway brain ( segment 9/10) normal range 3.40 tolO.33 8
  • SDC - Conductivity in ⁇ 8 of each even segment/pathway normal range 8 to 18 ⁇ 8 and pathway brain ( segment 9/10) normal range 3.40 tol0.33 ⁇ 8
  • the full cycle comprises the measurement of the 1 1 segments/pathways measured in the polarity anode-cathode and in second time in the polarity cathode-anode. This operation is performed 4 times (ml, m2, m3 and m4) 2 measurements in DC and 2 measurements with a very low frequency 700 Hz .
  • the graph is an average of the 4 measurements.
  • the conductivity measurements are in abscissa and segments in ordinate.
  • EIS HF Components of the FFT: EIS HF, EIS LF, EIS VLF.
  • EIS HF High frequencies from 0.1875 to 0.50Hz. Normal range from 22 to 34 %.
  • EIS LF Low frequencies from 0.05 to 0.1875 Hz. Normal range from 22 to 46%. EIS VLF (Very Low frequencies from 0 to 0.05 Hz). Normal range from 22 to 50 %.
  • EIS HF/VLF ratio Normal range from 0.44 to 1.54.
  • the entrance and exit of the EIS current are the eccrine sweat glands and the system operates via the large tactile planar electrodes in the parts the body with the higher density of sweat glands (palms of hands, soles of feet and left and right forehead).
  • the EIS Technology uses a very low frequency close to the DC, therefore, the current flows around the cells very close to the cell membrane in the area of the interstitial fluid and does not penetrate the cell in accordance with the fickle circuit and peer reviews related to the BIA (Bio Impedance Analysis). This fact is confirmed by the EIS very high measured resistance (membrane resistance)
  • the EIS current goes deeper in the living tissue interstitial fluid.
  • the electrode reaction is not an oxidation-reduction reaction, but is performed by chronoamperometry (Cottrell equation application) and therefore by physical diffusion of the chemical substance to the electrode surface.
  • the electronic box receives from the passive electrode the measurement of the intensity and voltage after passage into the interstitial fluid of the body and the digital analogic converter microchip transmits the data in numeric form (from 0-100) to the software which converts the data in resistance and conductivity in ⁇ .
  • A electrode surface :
  • the conductivity is proportional to the cellular mitochondrial ATP production.
  • the electrical Bioimpedance dispersion of the current (a parameter) is related with the morphology of the extra-cellular spaces.
  • the EIS estimation of the mitochondrial ATP production and the interstitial fluid morphology will be use in the hypoxia / ischemia detection.
  • the BIA sensor measures the resistance and reactance between 2 other passive tactile electrodes (tetra-polar mode).
  • the resistance and reactance calculate will be converting in estimated body composition parameters (TWB, Fat Free mass, fat mass) according to the predictive equations of BIA (Body Impedance Analysis) issue from the peer reviews.
  • TWB estimated body composition parameters
  • BIA Body Impedance Analysis
  • the E.S.O system is using the spectrophotometry technology (oximeter) with 3 features and signal processing analysis managed by software.
  • the Pulse Oximeter displays Sp02%, pulse rate value and vertical bar graph pulse amplitude.
  • the Photoelectrical Plethysmography or DPA (Digital Pulse Analysis) feature is the signal processing analysis of the pulse waveform provided by the oximeter.
  • the mathematical analyses provide indicators to estimate the hemodynamic parameters.
  • the Heart Rate detection feature
  • QRS complex Signal processing analysis of the heart rate variability: analysis both in the time domain and in the frequency domain (spectral analysis).
  • spectral analysis Each QRS complex is detected and the so-called normal -to-normal (NN) or Rate-to-Rate (RR) intervals between adjacent QRS complexes are the result of sinus node depolarization.
  • N normal -to-normal
  • RR Rate-to-Rate
  • the signal processing analysis of the measurement provides indicators to estimate the ANS (Autonomic Nervous System) activity.
  • MAP Means Arterial Pressure from the Non Invasive blood pressure device
  • MAP Diast. Pressure - ((syst.-diast.)/3)
  • This type of device is in routine and does not need more clinical data and validation.
  • Homeostasis Score This type of device is in routine and does not need more clinical data and validation.
  • the higher risk is the risk 1
  • Abscissa a parameter Ordinate: SDC in scale 0-100 corresponding to the conductivity value related to the brain segments.. Brain risk: according to the zone number Figure 6
  • the invention can further comprise additional or alternative monitoring devices to provde a medical device system as described herein.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Physics & Mathematics (AREA)
  • Engineering & Computer Science (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Pathology (AREA)
  • Veterinary Medicine (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • Biophysics (AREA)
  • Pulmonology (AREA)
  • Optics & Photonics (AREA)
  • Cardiology (AREA)
  • Physiology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Radiology & Medical Imaging (AREA)
  • Emergency Medicine (AREA)
  • Spectroscopy & Molecular Physics (AREA)
  • Dermatology (AREA)
  • Signal Processing (AREA)
  • Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)
  • Measurement And Recording Of Electrical Phenomena And Electrical Characteristics Of The Living Body (AREA)
  • Measuring Pulse, Heart Rate, Blood Pressure Or Blood Flow (AREA)
PCT/IB2010/003114 2009-12-08 2010-12-06 Medical device system WO2011070422A1 (en)

Priority Applications (12)

Application Number Priority Date Filing Date Title
CA2782858A CA2782858A1 (en) 2009-12-08 2010-12-06 Medical device system
US13/514,353 US20130204103A1 (en) 2009-12-08 2010-12-06 Medical device system
BR112012013294A BR112012013294A2 (pt) 2009-12-08 2010-12-06 sistema para dispositivo médicos,utilização de um sistema,sistema,para dispositivos médicos para avaliar a homeostase de um indivíduo e classificação de homeostase de um indivíduo
JP2012542630A JP2013524860A (ja) 2009-12-08 2010-12-06 医療装置システム
CN201080054967.8A CN102781314B (zh) 2009-12-08 2010-12-06 医疗装置系统
EP10814724A EP2509493A1 (en) 2009-12-08 2010-12-06 Medical device system
AU2010329611A AU2010329611A1 (en) 2009-12-08 2010-12-06 Medical device system
US13/991,694 US20130324814A1 (en) 2010-12-06 2011-12-06 Estimation of systemic vascular resistance and cardiac output using arterial pulse oximetry waveforms
PCT/IB2011/002935 WO2012076957A1 (en) 2010-12-06 2011-12-06 Estimation of systemic vascular resistance and cardiac output using arterial pulse oximetry waveforms
US14/681,297 US20150313477A1 (en) 2009-12-08 2015-04-08 Medical device system
US15/082,823 US9629559B2 (en) 2009-12-08 2016-03-28 Measuring homeostatic risk
US15/497,170 US20170224232A1 (en) 2009-12-08 2017-04-25 Measuring homeostatic risk

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
US26751009P 2009-12-08 2009-12-08
US26754209P 2009-12-08 2009-12-08
US61/267,510 2009-12-08
US61/267,542 2009-12-08

Related Parent Applications (1)

Application Number Title Priority Date Filing Date
PCT/IB2013/002595 Continuation-In-Part WO2014080267A2 (en) 2009-12-08 2013-11-21 Method and apparatus for detection of insulin resistance, diabetes and cardiovascular disease

Related Child Applications (2)

Application Number Title Priority Date Filing Date
US13/514,353 A-371-Of-International US20130204103A1 (en) 2009-12-08 2010-12-06 Medical device system
US201414259282A Continuation 2009-12-08 2014-04-23

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WO2011070422A1 true WO2011070422A1 (en) 2011-06-16

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US (1) US20130204103A1 (zh)
EP (1) EP2509493A1 (zh)
JP (1) JP2013524860A (zh)
CN (1) CN102781314B (zh)
AU (1) AU2010329611A1 (zh)
BR (1) BR112012013294A2 (zh)
CA (1) CA2782858A1 (zh)
WO (1) WO2011070422A1 (zh)

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WO2012076957A1 (en) * 2010-12-06 2012-06-14 Albert Maarek Estimation of systemic vascular resistance and cardiac output using arterial pulse oximetry waveforms
WO2014080267A2 (en) * 2012-11-21 2014-05-30 Albert Maarek Method and apparatus for detection of insulin resistance, diabetes and cardiovascular disease
GB2513476A (en) * 2013-03-27 2014-10-29 Bosch Gmbh Robert Method and device for determining the hydration state of a human or animal body
US8918170B2 (en) 2007-02-23 2014-12-23 Impeto Medical Electrophysiological analysis system
US8934954B2 (en) 2011-08-23 2015-01-13 Impeto Medical Assessment of sudomor function for peripheral diabetic neuropathy evaluation
CN108135504A (zh) * 2015-09-23 2018-06-08 皇家飞利浦有限公司 具有可互换模块的模块化监控设备平台
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FR2994821B1 (fr) 2012-08-28 2014-08-29 Impeto Medical Systeme d'analyse electrophysiologique ameliore
US9668701B2 (en) * 2012-11-21 2017-06-06 Medical Screening Corporation Detection of insulin resistance, diabetes, cardiovascular disease and autonomic neuropathy
FR3028744A1 (fr) 2014-11-25 2016-05-27 Impeto Medical Dispositif de releve de donnees electrophysiologiques de fiabilite accrue
WO2019169192A1 (en) * 2018-02-28 2019-09-06 The Regents Of The University Of California Electrochemical biosensor array devices, systems, and methods for point-of-care detection

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