WO2021095035A1 - Appareil et procédé de mesure de la tension artérielle pulmonaire - Google Patents

Appareil et procédé de mesure de la tension artérielle pulmonaire Download PDF

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Publication number
WO2021095035A1
WO2021095035A1 PCT/IL2020/051175 IL2020051175W WO2021095035A1 WO 2021095035 A1 WO2021095035 A1 WO 2021095035A1 IL 2020051175 W IL2020051175 W IL 2020051175W WO 2021095035 A1 WO2021095035 A1 WO 2021095035A1
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WO
WIPO (PCT)
Prior art keywords
pressure
respiratory system
patient
static
generator
Prior art date
Application number
PCT/IL2020/051175
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English (en)
Inventor
Noam Hadas
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Suremedix Ltd.
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.)
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Publication date
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Publication of WO2021095035A1 publication Critical patent/WO2021095035A1/fr

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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
    • A61B5/08—Detecting, measuring or recording devices for evaluating the respiratory organs
    • A61B5/097—Devices for facilitating collection of breath or for directing breath into or through measuring devices
    • 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

Definitions

  • the present invention in some embodiments thereof, relates to chest compartment pressure fluctuation measurement and, more particularly, but not exclusively, to an apparatus and method for measuring pulmonary artery blood pressure.
  • Pulmonary hypertension is a serious medical disorder affecting millions of patients world-wide.
  • the pressure in the pulmonary artery is higher than normal due to many possible reasons. Measuring the pressure in the pulmonary artery is the only definitive diagnostic procedure, and is needed for diagnostic purposes, therapy evaluation, and long term follow-up. Measuring the pressure is also required as part of the differential diagnosis process for other cardiac, pulmonary and other disorders.
  • a device for measuring pulmonary arterial blood pressure including: a pressure generator; a patient interface configured to enable a gas pressure that is generated by the pressure generator to be applied to a respiratory system of a patient; and a pressure sensor that is configured to generate a signal that is indicative of the gas pressure in the respiratory system.
  • the pressure generator includes an air pump.
  • the air pump includes a centrifugal compressor.
  • the pressure generator includes a blocked tube such that exhalation against the tube increases the gas pressure in the respiratory system.
  • the patient interface includes a tube that is insertable into a mouth of the patient.
  • the tube includes a flange that enables the tube to be held by teeth of the patient.
  • the patient interface includes a flow-resistive element.
  • the patient interface includes a bacterial filter.
  • the pressure sensor is located within the patient interface.
  • the device includes a processor that is configured to analyze the signal that is generated by the pressure sensor to calculate an amplitude of pulsatile pressure in the respiratory system as a function of static pressure in the respiratory system.
  • the processor is further configured to utilize the calculated amplitude to calculate at least one of an average pressure, a systolic pressure and a diastolic pressure in the pulmonary artery.
  • a method for measuring pulmonary artery blood pressure including: automatically operating a pressure generator to change static pressure in a respiratory system of a patient; concurrently with operation of the pressure generator, automatically receiving signals from a pressure sensor, the signals indicative of gas pressure within the respiratory system; and analyzing the received signals to calculate an amplitude of a pulsatile pressure in the respiratory system as a function of the static pressure.
  • changing the static pressure includes increasing the static pressure to a first maximum pressure followed by enabling the pressure to fall.
  • the signals are received as the static pressure is falling.
  • the method includes calculating a systolic pressure of the pulmonary artery by determining a first static pressure at which the calculated amplitude begins to increase.
  • the method includes calculating a diastolic pressure of the pulmonary artery by determining a second static pressure that is lower than the first static pressure and at which the amplitude begins to decrease.
  • changing the pressure further includes, when no plateau followed by an increase of the amplitude as the static pressure decreases is detected, increasing the static pressure to second maximum pressure that is greater than the first maximum pressure followed by enabling the pressure to fall.
  • FIG. 1A schematically illustrates a pulmonary artery blood pressure measurement device, in accordance with an embodiment of the invention.
  • FIG. IB schematically illustrates components of a variant of the pulmonary artery blood pressure measurement device shown in Fig. 1A.
  • FIG. 2 is a flowchart depicting a method for pulmonary artery blood pressure measurement, in accordance with an embodiment of the invention.
  • Fig. 3A is a schematic graph depicting a pulmonary artery blood pressure measurement by the method of Fig. 2.
  • Fig. 3B is an alternative graphical depiction of a pulmonary artery blood pressure measurement.
  • a pulmonary artery blood pressure measurement device is configured to measure pulmonary artery blood pressure by monitoring changes in pulsatile pressure in the respiratory system while changing static pressure (e.g., components of the pressure in the respiratory system with frequencies that are lower than 0.3 Hz).
  • static pressure e.g., components of the pressure in the respiratory system with frequencies that are lower than 0.3 Hz.
  • a method for measuring pulmonary artery blood pressure using the device is based on the measured changes of the pulsatile pressure. For example, when the static pressure is increased to the diastolic blood pressure of the pulmonary artery ( Pdiastoiic ), the pulsatile component of respiratory pressure begins to increase.
  • the pulsatile component reaches a maximum at a static pressure that is between Pdiastoiic and the systolic blood pressure of the pulmonary artery ( P S ystoUc ) ⁇
  • the pulsatile component decreases when the static pressure exceeds P sys toiic ⁇
  • the method may be understood as equivalent to application of the oscillatory method typically used for measuring systemic blood pressure, with the lungs functioning as a cuff for creating a static pressure field around the blood vessels of the lungs.
  • the pulmonary artery blood pressure measurement device includes a controllable pressure generator.
  • the pressure generator may include an electrically powered air pump or compressor, a valve of a gas tank or canister, or another source of pressurized air or of another suitable pressurized gas.
  • the pressure generator may include a completely or blocked tube against which the patient is requested to forcefully exhale. In this case, an indication of the pressure may be measured and presented to the patient while exhaling in order to assist the patient in adjusting the pressure to a required level.
  • a controlled air outlet or other regulating device may be included, e.g., in a patient interface or in the blocked tube, to assist the patient in maintaining a steady pressure.
  • the pressure generator is connected to, or is connectable to, a patient interface, e.g., that is insertable into or otherwise connectable to one or more of the mouth of a patient or to other openings (e.g., one or both nostrils) of the respiratory system.
  • the patient interface is configured to form a fluidic connection between the pressure generator and the patient's respiratory system, such that a gas pressure that is generated by the pressure generator may be applied to the patient's respiratory system.
  • the patient interface may include a tube with a flange that may be held between the teeth of the patient.
  • the patient interface may include a mask that is placed over one or both of the mouth and nose of the patient, a tube that is inserted into the patient's mouth (e.g., and that includes a flange to enable the tube to be held in place by the patient's teeth), a tube that is inserted into nostrils of the patient, or another component.
  • the pressure generator may be operated to force air or another gas at a controlled pressure into the patient's respiratory system.
  • a tube of the patient interface, or a tube that connects the patient interface with the pressure generator may include a flow-resistive element (e.g., a constriction, a one-way valve, a baffle, filter, or other element that restricts flow at least from the respiratory system to the pressure generator).
  • the flow-resistive element may be considered to be placed as close as possible to the mouth (or other opening to the respiratory system).
  • the flow- resistive element may function to limit the volume that is affected by pulsation of blood vessels in the lungs. Limiting the volume may prevent or limit a decrease in the pressure of the pulses that are generated by the volume changes in the lungs due to the pulsating blood vessels.
  • This flow resistance element may be or may include a bacterial filter that may function to prevent the flow of bacteria or other potentially harmful microscopic organisms or particles from flowing between the patient and the pulmonary artery blood pressure measurement device.
  • the device also includes a pressure sensor, e.g., a pressure transducer or other sensor, that is also configured to be placed in fluidic connection with the patient's respiratory system.
  • the pressure sensor may be placed on or in (e.g., as close as possible to) the patient's mouth or nostril, within the patient interface of the pressure generator, or at another location that is in fluidic contact with the upper airways of the patient. In both locations there should be a bacterial filter in line with the sensor input to prevent sensor contamination.
  • the pressure sensor may generate electrical signals that are indicative of gas pressure in the respiratory system at the time of the measurement.
  • the gas pressure may be considered to be the sum of the static pressure, e.g., that is caused by the pressure generator, and a varying pulsatile pressure.
  • the pulsatile pressure typically results from blood pressure in the pulmonary artery or in other blood vessels flowing through components of the patient's respiratory system, e.g., as caused by fluctuations due to heart contractions.
  • Signals from the pressure sensor may be utilized to control operation of the pressure generator. Regulation of the pressure sensor using feedback from a pressure sensor that is located at the patient interface may be advantageous over regulation based on measurement of pressure at the pressure generator (e.g., at the outlet of a compressor).
  • a processor of the pulmonary artery blood pressure measurement device may analyze the resulting measured signals and calculate medically significant quantities.
  • Medically significant quantities may include pulmonary artery blood pressure or other properties of the pulmonary blood flow, or of blood flow in other structures in the chest compartment, such as an aortic aneurism.
  • the analysis may include application of digital or analog filtering to the signals in order to separate lower frequency signals (e.g., less than 0.3 Hz or another threshold value) that are indicative of static pressure from higher frequency signals (e.g., greater than 0.5 Hz, or another threshold value) that are indicative of pulsatile pressure.
  • the processor may be configured to automatically evaluate the signals or the calculated results to determine the validity or reliability of the results, and to calculate any required changes in operation parameters in order to obtain a valid or reliable result.
  • the analysis may enable auscultation of sounds from the heart or chest cavity. In some cases, such auscultation may be advantageous over auscultation using a stethoscope.
  • the processor may include one or more computers or computing devices that are configured to operate in accordance with programmed instructions.
  • the processor may include one or more components that are incorporated into, or dedicated to, the pulmonary artery blood pressure measurement device.
  • the processor may include one or more general purpose computers that are configured to communicate with one or more components of the pulmonary artery blood pressure measurement device via a cabled or wireless connection.
  • a controller of the pulmonary artery blood pressure measurement device may be configured to control operation of one or more components of the device.
  • the controller may be configured to control operation of one or both of the pressure generator or the pressure sensor.
  • the controller may be incorporated into, or may be in communication with, the processor, or may include a separate processing unit.
  • the controller may include one or more separate control units, e.g., one for each controlled component of the device.
  • a user interface may be incorporated into, or may communicate with, one or both of the processor or the controller.
  • the user interface may include one or more controls to enable a user to initiate or control operation of the device.
  • the user interface includes a patient-controllable abort button to enable the patient to immediately release airway pressure (e.g., in the case of discomfort).
  • the user interface may include one or more output devices.
  • the output devices may be utilized to output one or more results of the measurement or analysis.
  • the processor, the controller, or both are configured (e.g., by programming) to automatically execute a method for pulmonary artery blood pressure measurement.
  • the method may be executed when the patient interface of the pressure source and the pressure sensor have been placed into fluidic contact with the respiratory system of a patient whose pulmonary artery blood pressure is to be measured. For example, all or part of the patient interface may be inserted into or cover one or more of the patient's mouth or nostrils.
  • operation of the pulmonary artery blood pressure measurement device may be monitored by the user, e.g., a health professional, via the user interface.
  • the user interface may enable the user to abort or otherwise modify operation of the pulmonary artery blood pressure measurement device during the course of execution of the pulmonary artery blood pressure measurement method.
  • an automatic pulmonary artery blood pressure measurement method may include initially operating the pressure generator to introduce a maximum pressure into the patient's respiratory system, via the patient interface, that is greater than the normal pulmonary artery systolic pressure P systolic-
  • signals that are generated by the pressure sensor may be continually or intermittently sampled so as to measure the pressure of the respiratory system at frequent intervals.
  • the signals from the pressure sensor may be temporarily or permanently stored in a memory or data storage device of the controller or of the processor.
  • the controller may be configured to regulate the introduced pressure in a closed loop in accordance with a received signal from the pressure sensor.
  • the pressure in the respiratory system may then be reduced slowly in a controlled manner to a minimum pressure that is less than the normal diastolic pulmonary artery blood pressure PdiastoUc ⁇
  • the patient interface may include a venting orifice to facilitate a gradual and quiet drop in static pressure from the maximum to the minimum pressure.
  • the process may analyze the received signals to determine the amplitude of the pulsatile component of the pressure that is indicated by the signals that are received from the pressure sensor. For example, a digital filter may be applied to the signals so as to separate the pulsatile component of the pressure (which may be assumed to be produced by blood flow through the pulmonary artery) from the static component (which may be assumed to be produced primarily by the pressure generator). The resulting pressure data may then be expressed as the pulsatile component as a function of the static component.
  • the pressure sensor may include two or more sensors for separately measuring the static and pulsatile pressures.
  • a sensor for measuring static pressure may include a standard microelectromechanical system (MEMS) pressure sensor.
  • a sensor for measuring pressure pulses may include microphone or other sound or wave sensor based on a piezoelectric, dynamic, MEMS, or other operating principle.
  • Analysis of the amplitude of the pulsatile component e.g., graphically represented as an envelope of the pulsatile component
  • these blood pressure values may include diastolic, average and systolic artery pressure.
  • a marked increase in the amplitude as the static pressure decreases is typically indicative of systolic pressure.
  • a marked decrease in the amplitude of the pulsatile component after a further decrease of the static pressure is typically indicative of diastolic pressure.
  • No change (e.g., a zero slope of the envelope curve) between these two values is typically indicative of the average pressure.
  • analysis of the amplitude may indicate that the systolic pressure was higher than the initial static pressure or that the diastolic pressure was lower than the final static pressure.
  • analysis of the amplitude of the pulsatile pressure may indicate a lack of a plateau followed by an increase of the amplitude as the static pressure decreases.
  • the processor may automatically readjust parameters of the measurement (e.g., increasing the initial static pressure in the first case, or decreasing the final static pressure in the second case) and repeat the measurement process.
  • the measuring process may be divisible into two or more pressure-sweep segments, covering different (e.g., partially overlapping) ranges of static pressure. Such division may enable shortening of the measurement periods during which the patient is not allowed to breathe naturally.
  • the patient may be allowed to breathe normally during the test.
  • operation of the pressure generator, the processor, or both may be configured to cancel any pressure changes due to the patient's respiratory effort.
  • the measurement process may be repeated at different lung volumes.
  • a pulmonary artery blood pressure measurement device may include a pressure generator in the form of a low-noise pump that does not generate pressure pulses (such as a centrifugal compressor or other device lacking reciprocating elements or pressure pulses).
  • the measurement may be performed while increasing the static pressure from ambient pressure to the maximal value (e.g., greater than P S ystoiic) ⁇
  • Additional components or accessories may be provided as needed to facilitate the measurement or to minimize discomfort to the patient.
  • the patient may wear a rigid vest to prevent over-expansion of the chest due to the higher-than-normal pressure in the lungs.
  • the patient may wear passive or pressurized ear plugs to minimize discomfort due to high pressure buildup in the ears.
  • the blood vessels in the lungs are arranged in a hierarchical tree-like structure with gradually decreasing diameters.
  • the blood pressure in these vessels may be different for each blood vessel, depending on its position in the hierarchy and the pressure drop due to flow through that vessel and other vessels. Therefore, the changes in the amplitude of the pulsatile components are expected to be gradual with increasing or decreasing static pressure. Therefore, the functional relationship between pulsatile amplitude and static pressure may provide information regarding the distribution of pressures in the lung's arterial tree. This information may be utilized to assist in the diagnosis of arterial obstructions of different types.
  • a sclerotic process where arterial diameter decreases and flow resistance increases in most parts of the system may be manifested as a relatively (e.g., to other diagnoses) long, shallow and smooth curve of amplitude versus static pressure.
  • a clot that blocks part of the arterial tree may be manifest as a segment with a markedly larger slope in the amplitude vs. pressure curve, where the number of pulsating vessels increases significantly as the pressure increases beyond the pressure in the blocked artery.
  • the waveform of each pressure pulse due to vessel pulsation may be indicative of the dynamics of pressure within the vessels, and may also be dependent on the static pressure at the time of the measurement. Therefore, information about blood pressure and blood vessel dynamics may be derivable from these waveforms at different static pressures. For example, tricuspid valve regurgitation can be estimated from the rate of pressure drop after pulse maximum pressure, and the rate at which this drop increases with increasing static pressure in the lungs.
  • the interaction between lung volume and pressure and changes in volume of the heart and aorta in the confined chest volume may enable diagnosis of other conditions in the cardiac/circulatory system by detecting specific features in one or both of the pulse waveform or the pulse amplitude vs. static pressure curve.
  • diagnosed conditions may include aortic aneurism, aortic valve prolapse, or other conditions.
  • the static pressure in the lungs may be generated by asking the patient to blow against a blocked mouthpiece.
  • a stable pressure or pressure gradient may be achieved in this case by adding a pressure- actuated valve, or employing a pressure sensor and a controlled release valve.
  • the test may be executed as a step-wise process where with each blow by the patient, only a few (e.g., one or two) static pressure values are measured.
  • the static pressure in the lungs may be generated by requesting the patient to inhale as deep as possible, followed by closing of the patient's mouth and nose. Operation of a mechanical or pneumatic vest that is worn by the patient may apply sufficient pressure to the chest to generate the desired pressure in the airways.
  • a pulmonary artery blood pressure measurement device or method as described herein may be advantageous over other techniques for measuring pulmonary artery blood pressure.
  • diagnosis of pulmonary hypertension typically involves right heart catheterization, where a catheter is inserted through the right ventricle and atrium into the pulmonary artery to measure the pressure. This invasive procedure is expensive and difficult to perform.
  • Other non-invasive methods to assess pulmonary hypertension such as Doppler ultrasound measurements of blood speeds at specific parts of the heart at specific times and using estimation formulas, are complex and inaccurate, and are thus of limited utility.
  • FIG. 1A schematically illustrates a pulmonary artery blood pressure measurement device, in accordance with an embodiment of the invention.
  • Pulmonary artery blood pressure measurement device 10 includes a pressure generator 12. Pressure generator 12 is connected to patient interface 16. In the example shown, patient interface 16 is in the form of a mask that covers the nose and mouth of a patient 11 and that is connected to pressure generator 12. Thus, operation of pressure generator 12 may force air into, or otherwise increase the gaseous pressure within, the respiratory system of patient 11.
  • Patient interface 16 may include flow -resistive element 15 (e.g., a bacterial filter, a constriction, a one-way valve, a baffle, or other element) to assist in maintaining pressure within the respiratory system.
  • Pressure sensor 14 is configured to measure the gas pressure within the respiratory system. In the example shown, pressure sensor 14 is located at a connection to patient interface 16.
  • Analog-to-digital (A/D) converter 18 is configured to generate a digital signal that is indicative of a pressure that is measured by pressure sensor 14.
  • Processor 20 (a computer in the example shown), is configured to receive the signals that are produced by pressure sensor 14, A/D converter 18, or both, by a cable or wireless connection. Processor 20 may also communicate via a cabled or wireless connection with pressure generator 12. For example, processor 20 may send commands to a controller (e.g., one or more of a device or a software module) to control operation of pressure generator 12.
  • a controller e.g., one or more of a device or a software module
  • Processor 20 may communicate with one or more user controls 22 (in the example shown, represented by a keyboard and pointing device of a computer). Processor 20 may also communicate with an output device (represented by a computer screen in the example shown).
  • user controls 22 in the example shown, represented by a keyboard and pointing device of a computer.
  • Processor 20 may also communicate with an output device (represented by a computer screen in the example shown).
  • FIG. IB schematically illustrates components of a variant of the pulmonary artery blood pressure measurement device shown in Fig. 1A.
  • patient interface 32 includes a tube that is insertable into the mouth of patient 11.
  • the tube may include flanges that enable patient interface 32 to be held by the teeth of patient 11.
  • FIG. 2 is a flowchart depicting a method for pulmonary artery blood pressure measurement, in accordance with an embodiment of the invention.
  • Pulmonary artery blood pressure measurement method 100 may be executed by a processor or controller of pulmonary artery blood pressure measurement device 10 or 30. Pulmonary artery blood pressure measurement method may be executed in response to a user operating a control of user controls 22.
  • Pulmonary artery blood pressure measurement method 100 may be executed when patient interface 16 or 32 is connected to the respiratory system of patient 11 (block 110).
  • Pressure generator 12 may be operated to change the static pressure in the patient's respiratory system (block 120). In some cases, operation of pressure generator 12 may include increasing the static pressure and then allowing the static pressure to gradually fall, e.g., in a stepwise or continuous manner. In some cases, operation of pressure generator 12 may include gradually increasing the static pressure, e.g., in a stepwise or continuous manner. Changes in static pressure may be performed continually or intermittently.
  • Signals may be received from pressure sensor 14 to measure the pressure in the respiratory system during the pressure changes (block 130). In some cases, the measurements may be made as the pressure is increasing. In some cases, the measurements may be made as the pressure is decreasing. In some cases, the received signals may separately indicate static pressure and pulsatile pressure.
  • the received signals may be analyzed to yield the amplitude of a pulsatile component of the measured pressure as a function of the static pressure (block 140). Further analysis may yield physiologically significant characteristics of the blood pressure in the lungs.
  • Fig. 3A is a schematic graph depicting a pulmonary artery blood pressure measurement by the method of Fig. 2.
  • pressure curve 42 indicates the measured pressure as a function of time.
  • Pulsatile pressure curve 44 indicates the pulsatile pressure component (e.g., derived by applying a high-pass filter to pressure curve 42, or otherwise separating the pulsatile component from the static component of the measured pressure) as a function of time (as the static pressure slowly drops from a maximal value at the left side of graph 40).
  • the increase in amplitude of the pulsatile pressure as the static pressure falls at time 46 indicates that the corresponding static pressure is approximately equal to the measured systolic pressure.
  • the decrease in amplitude at time 48 indicates that the corresponding static pressure is approximately equal to the diastolic pressure.
  • the lack of change in the amplitude at time 50 is indicative of the average pressure.
  • Fig. 3B is an alternative graphical depiction of a pulmonary artery blood pressure measurement.
  • Pressure curve 52 represents the envelope of pulsatile pressure curve 44, clarifying the described changes in amplitude as a function of static pressures 54, 56, and 58 (occurring at times 46, 48, and 50, respectively).

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  • Health & Medical Sciences (AREA)
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  • Heart & Thoracic Surgery (AREA)
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  • Measuring Pulse, Heart Rate, Blood Pressure Or Blood Flow (AREA)

Abstract

La présente invention concerne un dispositif de mesure de la tension artérielle pulmonaire comprenant un générateur de pression et une interface patient conçue pour permettre à une pression du gaz qui est générée par le générateur de pression d'être appliquée au système respiratoire d'un patient. Un capteur de pression est conçu pour générer un signal qui est indicatif de la pression du gaz dans le système respiratoire. Un procédé de mesure de la tension artérielle pulmonaire comprend le fonctionnement du générateur de pression pour changer la pression statique dans le système respiratoire, et recevoir simultanément les signaux provenant du capteur de pression, les signaux étant indicatifs de la pression du gaz à l'intérieur du système respiratoire. Les signaux reçus sont analysés pour calculer l'amplitude d'une pression de pulsation dans le système respiratoire comme une fonction de la pression statique.
PCT/IL2020/051175 2019-11-13 2020-11-12 Appareil et procédé de mesure de la tension artérielle pulmonaire WO2021095035A1 (fr)

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Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20140275901A1 (en) * 2013-03-13 2014-09-18 Ino Therapeutics Llc Devices and Methods For Monitoring Oxygenation During Treatment With Delivery Of Nitric Oxide
WO2020009631A1 (fr) * 2018-07-06 2020-01-09 Maquet Critical Care Ab Estimation non invasive de la pression artérielle pulmonaire

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20140275901A1 (en) * 2013-03-13 2014-09-18 Ino Therapeutics Llc Devices and Methods For Monitoring Oxygenation During Treatment With Delivery Of Nitric Oxide
WO2020009631A1 (fr) * 2018-07-06 2020-01-09 Maquet Critical Care Ab Estimation non invasive de la pression artérielle pulmonaire

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