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Methods, Systems and Devices for the Non-Invasive, Real-Time Monitoring of Anesthesia
All References Sections All References Search Report
Reference # 1 US6402697
Pub Date 06/11/2002
Title Non-invasive cardiac output and pulmonary function monitoring using respired gas analysis techniques and physiological modeling
Company Metasensors, Inc. (Rockville, MD)
col. 8, ln 63 to col. 9, ln 14 The main components of the cardiac output monitor of the present invention are: a low-cost respiratory gas analyzer, a respiratory gas flowmeter, and the appropriate numerical algorithms necessary to make the calculations of cardiac output and the physiological corrections. The multiple medical gas respiratory gas analyzer, examples of which are disclosed in the aforementioned Drzewiecki patent applications, has the capability to quantify gas concentrations, including inhaled and end-tidal concentrations (approximating arterial and mixed venous blood partial pressures), of any constituent of respiratory gas mixtures of a known number of possible constituents, in real time on a breath-by-breath basis. A respiratory flowmeter, described hereinbelow, accurately determines the volumetric and mass flow rates of any gas/gasses as calculated from the product of measured total respiratory flow and the measured volumetric concentration. With this flowmeter, the resulting inhaled/exhaled volumes of the respiratory gas mixture are quantified in real time on a breath-by-breath basis. col. 12, ln 15-27 Because of the ability to measure the rate and amount of uptake as well as the end-tidal partial pressures of unique indicators such as nitrogen, nitrous oxide, anesthetic agents, and other inert gasses in real time, and/or concentrations of respired gasses such as oxygen and carbon dioxide, it has been possible to develop this unique noninvasive cardiac output monitor using the Fick Principle. While conventional gas analysis technology, such as IR spectroscopy, could be used to measure nitrous oxide and anesthetic agent concentrations, it is the unique ability to inexpensively measure nitrogen and other inert gasses such as helium that offers both a non-invasive but also a non-affecting, non-toxic approach. 2 EP2055233A1 05/06/2009 METHOD AND APPARATUS FOR MONITORING INTRAVENOUS (IV) DRUG CONCENTRATION USING EXHALED BREATH UNIV FLORIDA
para [0011] The present invention solves the needs in the art by providing a method and apparatus for non-invasive monitoring of substance/compound concentration in blood, and, more particularly, to a method and apparatus for the detection, quantitation and trending of IV delivered drug concentration utilizing a breath detection system. The method includes the steps of receiving exhaled breath of a subject and measuring the concentration of one or more components in the exhaled breath. These measured components can then be used to monitor depth of anesthesia, for example. para [0053] Example I: Estimating the depth of intravenous propofol anesthesia by measurement of exhaled breath propofol vapor concentration para [0017] In one example, a breath detector of the present invention would be used during delivery of total intravenous anesthesia (TIVA) to monitor drug concentration of intravenous anesthetics such as propofol by measuring propofol concentration in exhaled breath. Moreover, sensing antibiotics with the exhaled breath detection method of the present invention, would allow for use of the method as a surrogate for blood antibiotic concentration. This would also be true for a wide range of medications for which blood concentration would be valuable. Exhaled
https://www.ipdashboard.com/Patents/Search/ViewSearch?id=18438&action=SearchReport[10/29/2013 5:54:05 PM]
breath detection using the method of the present invention may also evaluate pharmacodynamics and pharmacokinetics for both drug studies and in individual patients. Moreover, it may be used to sense endogenous compounds such as glucose, ketones and electrolytes which are normally found in blood. 3 US8399837 03/19/2013 Apparatus for measurement of gas concentrations in breath Isis Innovation Limited (Oxford, GB)
col. 2, ln 45 to col. 3, ln 2 Accordingly the present invention provides apparatus for measuring respiratory oxygen consumption in the breath of a human or animal subject, comprising:
a breathing tube for provision in an airway for the subject, an absorption spectrometer for measuring the concentration of molecular oxygen in gas passing through the breathing tube; a flow meter for measuring the rate of flow of gas through the breathing tube; and a processor for receiving the concentration and flow rate measurements and adapted to calculate from them and to output breath-by-breath measurements of oxygen consumption; wherein the absorption spectrometer comprises: an optical cavity disposed in the breathing tube in proximity to the subject and through which said gas passes, a light source for supplying light to the optical cavity and a light detector for detecting light emerging from the optical cavity, thereby to provide a signal representative of the absorption of the light by molecular oxygen in the gas in the optical cavity, and wherein the optical cavity and light source are arranged such that the light in the optical cavity retraces some or all of its path to excite one or more resonant modes in the optical cavity to provide cavity enhancement of the oxygen absorption signal. col. 5, ln 39-42 The invention extends to methods of measuring the concentration of oxygen and carbon dioxide, and/or anaesthetic gases in breath by using an optical cavity arrangement as described above. 4 US20120277612 11/01/2012 SYSTEMS FOR INTRAVENOUS DRUG MONITORING GENERAL ELECTRIC COMPANY Schenectady NY
para [0063] In one or more examples, the method provides a safety alarm if the concentration of anesthetic drug is higher than a safety threshold value preset by the anesthesiologist. The "safety threshold value" means a threshold value of the anesthetic drug concentration which is safe for the patient undergoing anesthesia procedure. In some examples of the method, the monitoring of anesthetic drug concentration in plasma is a continuous real time process. In this example, the real time anesthetic drug concentration in plasma helps the anesthesiologist to adjust the drug dosage. para [0026] In one or more embodiments of the system, the intravenous drug sensor used for measuring concentration of the drug in the breath sample may be a gas sensor or a vapor sensor depending on the drug being monitored. In accordance with one embodiment of the system, the gas sensor is used to detect the concentration of anesthetic drug from exhaled breath of patients during general and total intravenous anesthesia procedure. Measuring concentration of the anesthetic drug in the breath sample is performed using single breath sample or an average of several breath samples. The sensor reading is proportional to the concentration of the anesthetic drug in the breath sample. In one embodiment, the gas sensor measures the vapor concentration of intravenously delivered drug in the patient's exhaled breath. The gas sensor measurement is performed continuously or every few minutes. para [0014] In another embodiment, the system for monitoring the concentration of anesthetic drug in plasma is adapted for intravenous drug administration. The intravenously delivered anesthetic drug concentration in plasma is monitored using the system by measuring the drug vapor concentration in a patient's breath. For the intravenous anesthetics application, the quantity of drug required should induce a sufficient depth of anesthesia without accumulating an excessive amount of anesthetic drug. para [0006] In one embodiment, a system for monitoring a concentration of an anesthetic drugs using a patient's breath comprises a sampling subsystem for processing the patient's breath to form a breath sample, one or more sensors to measure drug concentration in the breath sample, one or more sensors to measure a concentration of gases in the breath sample; and one or more microprocessors for determining a concentration of the drug in a plasma of the patient using a transfer function and the concentration of the drug in the breath sample. 5 US4784486 11/15/1988 Multi-channel molecular gas analysis by laser-activated Raman light scattering Albion Instruments (Salt Lake City, UT)
col. 4, ln 47-68 More specifically, the invention relates to a method and system for the continuous breath-by-breath analysis of the multiple respiratory gases and anesthetic vapor agents comprising a patient's breath wherein an incident laser beam passes through a respiratory gas sample placed either within the resonant cavity of a laser or outside the resonant cavity. A series of light collection optics and interference filters is used to transmit Raman scattered light from the sample onto appropriate detectors for quantitating each specific Raman signal, and thus each specific gas comprising the respiratory sample. The gas analyzer of the present invention advantageously utilizes the principles of Raman scattering to provide continuous and simultaneous analysis of the multiple gases comprising a patient's breath. In contrast to the prior systems, it is cost effective and practical to dedicate use of the invention to a single patient. Single patient use improves detection response time and virtually eliminates most of the inherent limitations of a system shared by multiple patients. These advantages are achieved without sacrificing the quality of the analysis. col. 5, ln 1-15 Gas analyzers constructed in accordance with the present invention have the reliability and flexibility necessary for routine use in the operating room, intensive care unit, recovery room and other locations where continuous monitoring of a patient's respiratory gases is indicated. The capability to simultaneously monitor multiple gas species and perform real time analysis of the concentrations of the gases enables the medical personnel to more accurately monitor the condition of the patient. Additionally, the accidental administration of the wrong type of
anesthetic agent or the wrong dosage is reduced when the present invention is used, because the type and corresponding concentration of agents present in the patient's system are determined with each breath the patient takes. INTELLIGENT DRUG AND/OR FLUID DELIVERY SYSTEM TO OPTIMIZING MEDICAL TREATMENT OR THERAPY USING PHARMACODYNAMIC UNIV FLORIDA [US] AND/OR PHARMACOKINETIC DATA
WO2012024401
02/23/2012
pg. 57, ln 1-10 In one embodiment, where the warfigther is undergoing surgery or anesthesia/conscious sedation is otherwise reguired, a propofol sensor/monitor can be attached to the SPOC array, or alternatively in-line with an endotracheal tube, laryngeal mask airway, etc. to allow physicians and physician extenders to provide anesthesia/conscious sedation with propofol and propofol "cocktails" (e.g. combinations including analgesics and Ketamine). pg. 40, ln 11-31 Optimal anesthesia using total intravenous anesthesia (TIVA) in patients undergoing procedures, both in civilian and military environments, using PK (e.g. breath analysis used to measure blood levels of anesthetic agents)-, PD (e.g., effect of anesthetic agents on cardiorespiratory-derived parameters from PPG)-, and/or PK plus PD-based system to control an infusor device to safely deliver IV agents. Drugs in this example include but are not limited to propofol, ketamine, fentanyl, and combinations of these agents thereof. The IV anesthetics could be mixed in a single syringe and delivered as a "cocktail" as the preferred embodiment, but alternately, individual IV anesthetics could be placed in different syringes and multiple infusion systems controlled by the system. Likewise, the system would preferably operate in a closed loop mode, but could also operate in an open loop mode. Taken together, a PK-, PD-, and PK+PD-based propofol infusion system that provides drug effects on respiratory and cardiovascular systems is therefore enabled and is easily implemented by those skilled in the art in light of the teachings provided herein. 7 US8211035 07/03/2012 System and method for monitoring health using exhaled breath University of Florida Research Foundation, Inc. (Gainesville, FL)
col. 1, ln 23-27 The present invention relates to non-invasive monitoring of substance/compound concentrations in blood; and more particularly, to a system and method for the determination of drug concentrations and endogenous compounds in blood utilizing a breath detection system. col. 8, ln 41-64 In one embodiment, the subject invention contemplates administering to a patient a therapeutic drug, wherein the therapeutic drug contains a therapeutic drug marker that is detectable in exhaled breath by a sensor of the subject invention. In certain embodiments of the invention, the therapeutic drug marker is the therapeutic drug itself or a metabolite of the drug, which is detectable in exhaled breath. As contemplated herein, the blood concentration of the therapeutic drug and the exhaled concentration of the therapeutic drug marker are substantially proportional. By using a sensor of the subject invention for analyzing the concentration of a therapeutic drug marker in exhaled breath, which substantially corresponds to the blood concentration of a therapeutic drug, the present invention enables non-invasive, continuous monitoring of therapeutic drug blood concentration. One particular application of the present invention is for predicting the depth of anesthesia utilizing a breath detection system. It has been shown that there is a good correlation between blood concentration of anesthetic agents (e.g., propofol) and depth of anesthesia. In a related embodiment, the present invention provides methods and apparatuses for the detection, quantitation, and trending of intravenous (IV) and/or inhalational delivered drug concentration utilizing a breath detection system. 8 US7364552 04/29/2008 Measuring system for the determination of the concentration of propofol (2,6Dragerwerk Aktiengesellschaft (Lubeck, DE) diisopropylphenol) in the respiratory flow
col. 2, ln 3-10 The object of the present invention is to provide a rapid measuring system that is easy to handle for the determination of propofol, specifically the active ingredient 2,6-diisopropylphenol, in the breathing gas, which is, moreover, part of a measuring and control circuit for the accurate intravenous dosing of a nonvolatile anesthetic such as propofol in a variant of the present invention. col. 3, ln 33-55; Fig 1 The measuring system according to Fig. 1 has the following main components: The respiratory flow of a patient being treated with the intravenous anesthetic propofol is drawn off in a breathing gas line 1, the said breathing gas line 1 comprising the main stream or a side stream of the breathing gas flow. Via a branch 4, e.g., with a shut-off valve to the breathing gas line 1, the breathing gas line 1 is in gas flow connection with the propofol sensor 5 and with a downstream pump 6 for sampling breathing gas. A breathing gas sensor 2, which is connected, just as the propofol sensor 5 and the pump 6, to an evaluating unit 3, is additionally located in the breathing gas line 1. As an alternative, the breathing gas sensor 2 receives respiration parameters of the respiration unit of an anesthesia apparatus or respirator and actuates the pump 6 such that the propofol sensor 5 measures, e.g., the end tidal propofol concentration in the respiratory flow breathed out. The mode of operation of the measuring system is such that depending on the measured signal of the breathing gas sensor 2, which is especially a CO2 sensor, the pump 6 is actuated by the evaluating unit, so that samples reproducible in respect to the propofol content, especially of alveolar air, are delivered for the propofol measurement from the respiratory flow. col. 5, ln 3-18; Fig 2 Fig. 2 shows the expansion of a measuring system according to Fig. 1 to a measuring and control device with A/D and D/A converters for the intravenous dosing of propofol. A breathing gas sample of a patient is taken from the breathing gas line 1 via the branch 4 by means of the pump 6 actuated by the evaluating unit 3 on the basis of a signal from the breathing gas sensor 2. The propofol sensor 5 designed specifically as an electrochemical gas sensor is used to determine the propofol concentration in the breathing gas. The particular propofol concentration measured currently is converted in the evaluating unit 3 into the particular corresponding propofol concentration in the patient's blood by means of stored algorithms and compared with
corresponding, especially patient-specific set points. 9 US4966141 10/30/1990 Endotracheal tube and mass spectrometer
col. 5, ln 12-25 The manifold body 43 has an L-shaped passage 46 therethrough, which extends through the reduced portion 43a and communicates with the large ventilating passage 15 of the inner tube 13. The manifold body is provided with a fitting 47 having a flexible hose 48 connected thereto, which is connected to a source of oxygen and anesthesia gas for ventilating the lungs of the human subject in a conventional manner, as best seen in Fig. 17. It will, therefore, be seen that a mixture of oxygen and anesthesia gas is circulated through the passage 46 and into the ventilation passage 15 of the endotracheal tube for circulation to the respiratory system of the human subject when the human subject is anesthetized. col. 1, ln 53 to col. 2, ln 7 It is an object of the present invention to provide a novel non-invasive device, which continuously measures the quantity and composition of the inhaled and expired gases from a human subject, and then calculates the pulmonary function and cardiac output from this data. More specifically, it is an object of this invention to provide a non-invasive system for determining the cardio-respiratory function comprised of a specially designed endotracheal tube having a miniature mass spectrometer mounted thereon, which is operable to continuously measure O2, CO2, total volume and temperature of respired air, as well as tissue PO2 and PCO2, and other gases exchanged from the tracheal tissue compartment. It will be appreciated that such measurements provide the data to permit rapid calculation of the cardiac output, as well as a determination of the adequacy of tissue perfusion. It, therefore, is an object of this invention to provide a novel endotracheal tube or a novel mouthpiece device and a novel miniature mass spectrometer which cooperate with each other and continuously and rapidly measure the cardio-respiratory function of a human subject. 10 US20120277613 11/01/2012 METHODS OF INTRAVENOUS DRUG MONITORING GENERAL ELECTRIC COMPANY SCHENECTADY NY
para [0022] The processing of the patient's breath is performed periodically or continuously. In one embodiment, for sampling end-tidal gases, samples may be collected throughout the exhalation phase of respiration. In another embodiment, breath samples are collected at the distal end of the endotracheal tube through a tube with a separate sampling port. This may improve sampling by allowing a larger sample to be collected during each respiratory cycle. para [0012]-[0014] [0012] One or more examples of a method are adapted for detecting a concentration of an anesthetic drug in plasma during general or total intravenous anesthesia operations. Anesthetic drugs may be administered parenterally, sublingually, transdermally, by intravenous bolus, and by continuous infusion. Anesthetic agents may be administered in an amount for analgesia, conscious sedation, or unconsciousness as per its known dose. The concentration of the anesthetic agent in exhaled breath reflects the condition of a patient under the anesthetic drug treatment. For example higher concentration of drug in blood stream provides information on accumulation of drugs in the blood stream, which may cause a deep level of anesthesia. In another example, if the concentration of anesthetic drug in the blood stream decreases more rapidly with time, this may possibly lead to inadequate anesthesia and premature emergence. [0013] One example of the method of monitoring a concentration of an anesthetic drug using a patient's breath, comprises forming a breath sample using the patient's breath, exposing one or more sensors to the breath sample, detecting one or more components of the anesthetic drug in the breath sample, measuring a concentration of at least one of the components of the anesthetic drug in the breath sample, and determining a concentration of the component in a plasma of the patient using a transfer function and the concentration of the component in the breath sample. [0014] In another example, the method is adapted to monitor the concentration of anesthetic drug in plasma, wherein the drug is administered intravenously. The intravenously delivered anesthetic drug concentration in plasma is monitored by measuring the drug vapor concentration in a patient's breath. For the intravenous anesthetics application, the quantity of drug required should include a sufficient depth of anesthesia without accumulating an excessive amount of anesthetic drug. 11 US20070010756 01/11/2007 Patient monitoring during drug administration
para [0039]; Fig 2 As shown in FIG. 2, the system may also comprise additional measurement units 27 for measuring drug concentrations or for enhancing patient safety. A typical measurement unit that is used in connection with inhaled drugs is a sensor for measuring the end tidal drug concentration exhaled by the patient. The feedback signal provided by the sensor is useful in the sense that it enables a simpler pharmacokinetic model to be used in the control unit when brain concentration is estimated. This is because the concentration of a drug in the end tidal breathing gases of the patient corresponds to the concentration in the lungs, which is very close to the concentration in the blood circulation of the patient. Knowing the concentration in the blood circulation in turn allows for the use of a simpler pharmacokinetic model to obtain the concentration in the brain. para [0030] The study indicates that for propofol only, LOC takes place at a lower entropy/BIS value than for the combination of propofol and remifentanil. The table below shows the values of State Entropy, Response Entropy, and BIS at which 50 percent of the patients had lost consciousness (95 percent confidence interval). The first column shows the results for a group of patients anesthetized with propofol only, while the second and third columns show the corresponding results for patient groups in which constant remifentanil effect-site concentrations of 2 and 4 ng/ml, respectively, were maintained with step-by-step increase of propofol concentration. TABLE-US-00001 remi 0 ng/ml remi 2 ng/ml remi 4 ng/ml SE 64 (62-66) 68 (67-69) 70 (68-72) RE 70 (68-72) 74 (73-75) 81 (80-83) BIS 61 (59-62) 68 (67-70) 71 (70-73) para [0017] Thus one aspect of the invention is providing a method for monitoring a patient. The method includes the steps of administering at least one drug to a patient, maintaining drug
administration data that identifies the at least one drug administered in the administering step, and obtaining physiological signal data from the patient. The method further includes the steps of determining, based on the physiological signal data, at least one state index indicative of a clinical state of the patient, and controlling the determining step in dependence on the drug administration data, thereby to produce values for the at least one state index, which remain substantially consistent regardless of the at least one drug administered to the patient. para [0001] The present invention relates generally to patient monitoring during drug administration. The invention finds a typical application in patient monitors monitoring the extent of the hypnotic state of a patient during anesthesia. 12 US6131571 10/17/2000 Ventilation apparatus and anesthesia delivery system University of Florida
col. 20, ln 51 to col. 21, ln 21; Fig 1-2 Steady state operation of the system 10 during mechanical ventilation requires control of the following: (1) (2) (3) (4) (5) (6) (7) (8) Concentration of anesthetics; Concentration of oxygen; Volume of gas within circulation loop 12; Pressure at specific points within circulation loop 12, e.g. at the Y-piece 14; An O2 flush event; Proper operation of the scavenging system; Maintenance of proper humidity and temperature of gas circulating within loop 12; and Monitoring of end tidal carbon dioxide concentration.
All of these various control functions impact upon the proper operation of system 10 during mechanical ventilation. Considering first the introduction of gases into the circulation loop 12, and the maintenance of appropriate concentrations of various gases, the multi-gas analyzer 120 is effective to provide real time measurements of the concentrations of carbon dioxide, oxygen, nitrous oxide and volatile anesthetics. As noted above, the sampling port 122 of the multi-gas analyzer 120 is located at the distal tip 32 of endotracheal tube 16, near the carina 30 of the patient, thus enabling it to provide measurements of gas concentrations at the lungs without the influence of gases circulating within the loop 12. Signals from the multi-gas analyzer 120 are provided to the controller 34 which includes PID control algorithms effective to control the operation of syringe pump 40, and valves 200, 202, such that they open and close to introduce the required amount of volatile anesthetic, oxygen and nitrous oxide, respectively, into the circulation loop 12. It is noted that the syringe pump 40 introduces a liquid volatile anesthetic into loop 12, but because of the positioning of syringe pump 40 immediately downstream from the blower 36 and upstream from the bacterial filter 46, there is an extremely remote chance that any volatile anesthetic in liquid form would be introduced directly into the patient's lungs. col. 13, ln 25-44 As schematically depicted in FIGS. 1A and 2, a multi-gas analyzer 120, preferably of the type sold by Datex of Finland, is connected by a line 121 to a sampling port 122 located at the distal tip 32 of endotracheal tube 16. The sampling port 122 is placed at that location, because if gas concentrations were monitored at the Y-piece 14, for example, or any other location around the circulation loop 12, measurements would be diluted by the recirculating flow of fresh gases. The multi-gas analyzer 120 is capable of measuring concentrations of carbon dioxide, oxygen, nitrous oxide and volatile anesthetics, and produces signals representative of such concentrations which are sent to the controller 34 via line 124, as schematically depicted in Fig. 1. As discussed more fully below, in response to real time measurements of the gas concentrations at the distal tip 32 of endotracheal 16, control software within controller 34 is operative to control the introduction of volatile anesthetics, oxygen and nitrous oxide into the circulation loop 12 in relative proportions sufficient to maintain the desired concentrations of same for supply to the patient. 13 US20110028809 02/03/2011 PATIENT MONITOR AMBIENT DISPLAY DEVICE MASIMO CORPORATION Irvine CA
para [0033] One example parameter that may be displayed by indicator 114 in this manner is the Pleth Variable Index (PVI) developed by Masimo Corporation, Irvine, California that is a measure of the dynamic changes in the perfusion index (PI) that occur during the respiratory cycle. In an embodiment, the measurement of PI can be defined as a ratio of pulsatile blood flow to nonpulsatile blood in peripheral tissue. In this embodiment, the PVI is a noninvasive measurement indicative of peripheral perfusion that can be continuously determined with a pulse oximeter. para [0036]; Fig 1-2 An indicator 114 as disclosed herein can be advantageous for a number of situations. As explained, it can often be seen from a greater distance, and a caregiver does not need to be facing a patient monitor display 108 to derive an understanding or even a glimpse of a patient's condition. For example, an embodiment of the present disclosure may be particularly useful in an operating room, such that a surgeon can obtain a quick understanding of a PI reading for a patient by looking at a visual indicator 114 rather than having to ask someone else in the room or distracting his or her attention by trying to read a detailed alphanumeric display of a patient monitor. Similarly, indications of the depth of anesthesia can be calculated from a noninvasive monitor. In an embodiment, a surgeon can obtain a quick understanding of this measurement without asking the anesthesiologist who may be attending to other aspects of the patient's care. Similarly, it may be more important for the anesthesiologist to monitor the main display 108 of the patient monitor, and the display may be turned away from the surgeon interested in a general status indication. 14 US20120016252 01/19/2012 SYSTEM AND METHOD FOR MONITORING HEALTH USING EXHALED BREATH
para [0037] The present invention solves the needs in the art by providing a method and apparatus for non-invasive monitoring of substance/compound concentration in blood, and, more particularly
to systems and methods for non-invasive monitoring of endogenous compound and/or therapeutic drug concentration in blood. The systems and methods of the present invention utilize sensors that can analyze a patient's exhaled breath components to detect, quantify, and/or trend concentrations of endogenous compound markers in exhaled breath, which correlate to the endogenous compound concentration in the patient's body, in particular in blood. Endogenous compound markers detectable in exhaled breath can be the endogenous compounds themselves or substances derived from the endogenous compounds (such as metabolites of endogenous compounds). para [0040] One particular application of the present invention is for predicting the depth of anesthesia utilizing a breath detection system. It has been shown that there is a good correlation between blood concentration of anesthetic agents (e.g., propofol) and depth of anesthesia. In a related embodiment, the present invention provides methods and apparatuses for the detection, quantitation, and trending of intravenous (IV) and/or inhalational delivered drug concentration utilizing a breath detection system. para [0042] In one embodiment, the method of the invention includes measuring both exhaled breath concentrations of IV and inhalational anesthetics, and also the circuit concentration of inhalational anesthetic gases. The method includes the steps of both measuring the circuit concentration and measuring the concentration of one or more components in the patient's exhaled breath. These measured components can then be used to quantitate the concentration of anesthetics in the circuit (such as halothane, isoflurane, sevoflurane, desflurane and enflurane) and to detect, quantitate, and trend the delivered drug, and ultimately determine depth of anesthesia. 15 US6286360 09/11/2001 Methods and apparatus for real time fluid analysis Metasensors, Inc. (Rockville, MD)
col. 7, ln 19-42; Fig 1-2 Fig. 1 is a schematic representation of a real time gas analyzer 10 in accordance with an exemplary embodiment of the present invention. In this exemplary embodiment, gas analyzer 10 is preferably incorporated into a main passageway 11 of a breathing circuit through which inhaled and exhaled gasses flow. As illustrated in Fig. 2, passageway 11 can be coupled via a humivent 30 to a face mask 32 positioned over the nose and mouth of a subject (not shown). Face mask 32 directs respired gasses from the subject into passageway 11 and directs gasses supplied through passageway 11 to the subject. Referring to Fig. 1, gas analyzer 10 includes a low cost pressure-drop-type (fixed or variable orifice) flow element device 12 (e.g., a Venturi-type flowmeter, a bi-directional Hamilton variable area orifice device or a variable flap orifice), the pressure drop (delta P) across which is related in a known manner to the flowrate (Q) and the gas density (rho) and viscosity (mu). While device 12 can be a flowmeter or other pressure-drop device, it should be understood that device 12 is not used to measure the gas flow rate in gas analyzer 10. Rather, the measured pressure drop is used in determining the gas mixture density; thus, device 12 essentially functions as an orifice or densitometer. col. 12, ln 58 to col. 13, ln 7 The gas analyzer of the present invention may be utilized in various locations, such as the home within a home therapy device, or ambulances and other locations experiencing field trauma within an emergency medicine device for validating ventilation and checking for proper intubation of a patient. The gas analyzer may be used with ventilalor-dependent patients, patients with respiratory insufficiencies or patients having or suspected of having a compromised respiratory system wherein the monitor may be used in various locations, such as ambulances, hospitals and/or sub-acute care facilities, and during patient transport between these facilities. Further the gas analyzer of the present invention can be used in operating rooms, outpatient surgery centers or any facility that uses anesthetic gasses and/or sedation to monitor anesthesia gas administration by analyzing concentrations of multiple respired anesthetic gasses simultaneously. 16 US7582873 09/01/2009 Method and apparatus for detecting the type of anesthetic gas Shenzhen Mindray Bio-Medical Electronics Co., Ltd. (CN)
col. 1, ln 57 to col. 2, ln 8 An object of the present invention is to provide a method and apparatus capable of determining the type of anesthetic gas automatically. An advantage of the method and apparatus is that the complexity is low and the cost is reduced. A method for detecting the type of anesthetic gas according to the present invention, comprises the steps of: generating a light with a plurality of wavelengths, the light being able to be separated to a plurality of light beams whose central frequencies correspond to the plurality of wavelengths; passing said light through a gas chamber, wherein, the gas chamber being filled with said anesthetic gas, said anesthetic gas having absorption characteristic with respect to said plurality of light beams; detecting the light intensity of the attenuated light beams transmitted from the gas chamber respectively, to obtain the relative absorption characteristic of said attenuated light beams, which attenuated light beams having been absorbed by said anesthetic gas; and determining the type of said anesthetic gas based on the relative absorption characteristic between said attenuated light beams. 17 US7925338 04/12/2011 Determination of the anesthetic state of a patient General Electric Company
col. 1, ln 6-11 The present invention relates generally to the determination of the anesthetic state of a patient. The mechanism of the invention may be employed in connection with the administration of anesthetic drugs to a patient, either in a closed loop fashion or as a decision-support tool for an anesthesiologist. Abstract The invention relates to the determination of the anesthetic state of a patient. In order to achieve a mechanism that enables establishment and maintenance of balanced anesthesia, values are established for a set of diagnostic indices. The set includes at least two diagnostic indices of which a first diagnostic index is indicative of the level of hypnosis and a second diagnostic index of the level of nociception in the patient. The combination of the at least two index values obtained is employed for indicating the anesthetic state of the patient. The combination of the at least two index values may further be employed to control the administration of drugs to the patient. 18 US20130276785 10/24/2013 Central Site Photoplethysmography, Medication Administration, And Safety
para [0033] Accordingly, it is an object of this invention to provide a system, method, and apparatus for safe administration of fluid and/or at least one pharmaceutically active agent to a subject
along with means for increasing, decreasing or terminating the administration of the pharmaceutically active agent. para [0047]; Fig 11 FIG. 11 is a flow-chart showing the steps of a method implemented according to the system or apparatus of the invention to monitor a subject's breathing rate, breathing effort or both (plus other parameters such as oxygen saturation, end tidal carbon dioxide, heart rate, etc.), and interventions automatically implemented on detection of reduced breathing rate, increased breathing effort or both. para [0116]-[0123] [0116] Any medical therapy (e.g., drug and/or fluids) that modulates cardiorespiratory function (stimulates and/or depresses) in vivo, particularly those centers in the brain (e.g., brainstem) that regulate the respiratory and cardiovascular systems, can be controlled with the current invention in a manner that will substantially improve outcomes in terms of improved drug safety and efficacy, and reduce morbidity and mortality. In addition to the PD control of drug delivery described above, PK based strategies, used alone, or in combination with PD can be devised. Examples of medical therapies which can be controlled in this manner include: [0117] Conscious sedation or general anesthesia [0118] Pain relief [0119] Attention Deficit Hyperactivity Disorder (ADHD) [0120] Treatment of cardiovascular disorders, including trauma [0121] Migraine headaches [0121] A.VI. Drug Treatments: [0122] Narcotics (e.g., sufentanil, morphine, fentanyl, alfentanil, oxycodone, methadone, oxymorphone, Remifentanil), [0123] Anesthetics and anesthetic adjuncts (e.g., inhalational anesthetics [sevoflurane, xenon, isoflurane, desflurane], intravenous anesthetic agents [propofol, ketamine, dexmedetomidine, benzodiazepines], and local anesthetics [lidocaine, bupivacaine, ropivacaine]). para [0131] A.IX. Types of Sensors that Guide Therapy: PD (cardiorespiratory information used to determine drug effects): photoplethysmograph (PPG), capnograph (IR, etc), nasal pressure, nasal flow, electrocardiogram (ECG), chest wall and abdominal impedance, any parameter measurable using polysomnography or combinations thereof; PK (drug blood levels) information: nanosensors for breath; others for other biological media, etc.; integrated sensors that integrate PD and PK information. 19 US20130172759 07/04/2013 Systems And Methods For Using Photoplethysmography In The Administration Of Narcotic Reversal Agents
para [0304]; Fig 27 In FIG. 27, there is shown a system according to this invention, 5000, operatively adhered to a subject 5001, shown in outline. A harness system 5002 is shown for keeping an air exchange housing 5003 of a system 5000 in proper position and alignment on the face of the subject 5001. As will be seen from the further description below, the air exchange housing 5003 comprises means for sealingly measuring CO.sub.2 in exhaled air, means 5010 for provision of positive pressure ventilation of the subject 5000, a source of gas, which is considered a fluid for purposes of this invention, 5020, which may include a source of high oxygen gas, ordinary breathing air, inhalational anesthetic or other volatile agents and the like. The source of gas 5020 is under control of the system of this invention, such that, upon detection of hypoventilation, the system initiates positive pressure ventilation, preferably with oxygen enriched air. para [0075] In the methods described herein, any suitable CNS depressant may be administered to the individual, provided that there is a corresponding narcotic reversal agent that can be administered to counteract, at least in part, the effects of the CNS depressant on the individual's respiratory system. Examples of CNS depressants include tramadol, benzodiazepines such as diazepam, alprazolam, lorazepam, flurazepam; barbiturates such as secobarbital, pentobarbital and Phenobarbital; and opiods such as codeine, oxycodone, fentanyl, alfentanyl, morphine, sufentanil, diamorphine, methadone, levorphanol, pentazocine, propoxyphene, butorphanol, oxymophone, remifentanil, nalbuphine and buprenorphine. The term CNS depressant also includes anesthetic agents. Combinations of different CNS depressants may also be used. In some cases, any medical therapy that depresses cardiorespiratory function depresses in vivo, particularly those centers in the brain (e.g., brainstem) that regulate the respiratory and cardiovascular systems, may be used. para [0060] As described above, in some embodiments of the invention, methods of monitoring and treating respiratory depression include securing to the individual at least one additional sensor. In some embodiments, the narcotic reversal agent is administered if (a) the PPG signals or a physiological parameter derived therefrom are outside a first preset value; and (b) a parameter determined by an additional sensor is outside a second preset value. The additional sensor(s) may be configured to determine the same parameters as the PPG sensor (e.g., respiration rate, etc.) and/or they may be configured to determine parameters that are not derived from the PPG signal. Examples of additional sensors include those that can be used to determine respiration rate, end-tidal carbon dioxide content, blood pressure, heart rate and heart rate variability. Further examples of sensors include accelerometers, nasal pressure (NAP) or flow (NAF) sensors, humidity detectors, temperature detector/thermistors, ECGs, pulse oximeters, capnometers, chest wall and abdominal impedance sensors, polysomnography sensors, drug blood level sensors, nanosensors for breath and sensors for other biological media (e.g., blood, sweat, urine). para [0008]-[0009] [0008] Provided according to embodiments of the present invention are methods of monitoring and treating respirator); depression that include securing a photoplethysmography (PPG) sensor to a central source site of an individual; administering a central nervous system (CNS) depressant to the individual; processing PPG signals from the PPG sensor with a controller in communication with the PPG sensor; and administering a narcotic reversal agent to the individual if the PPG signals or a physiological parameter derived therefrom are outside a preset value range. Physiological parameters include, for example, respiration rate and respiratory effort. [0009] In some embodiments of the invention, the methods further include securing to the individual an additional sensor configured to determine at least one parameter selected from respiration rate, end-tidal carbon dioxide content, blood pressure, heart rate and heart rate variability. In such cases, in some embodiments, the narcotic reversal agent is administered if
(a) the PPG signals or a physiological parameter derived therefrom are outside a first preset value range; and (b) a parameter determined by the additional sensor is outside a second preset value range. In some embodiments of the invention, the methods further include measuring a concentration of a component in the individual's breath. In some cases, the component in the individual's breath includes the CNS depressant and/or a metabolite of the CNS depressant. 20 US5402779 04/04/1995 Method for the non-invasive detection of an intravascular injection of an anesthetic by the use of an indicator dye
col. 3, ln 29-47 These and other objects of the invention are achieved in a method and apparatus for determining improper anesthetic conduit placement. In particular, in one aspect of the invention, a conduit is positioned in the epidural space and an indicator dye/local anesthetic mixture is injected/infused through the conduit. The patient's blood is non-invasively monitored at a distant site, for example, the fingertip, to determine if the dye and therefore the local anesthetic has inadvertently entered the blood stream directly. This invention will allow the early detection of a dye which was previously mixed with a substance (local anesthetic) within the blood stream before high levels of local anesthetic cause medical complications for the patient. Non-invasive detection of the dye at a distant site of the body will indicate vascular injection of the dyelocal anesthetic mixture as can follow improper conduit placement. col. 4, ln 31-40 In order to detect whether the conduit has entered a blood vessel, a dye or a mixture of a dye with a local anesthetic ("dye/local anesthetic") is injected immediately after catheter placement. If the conduit has inadvertently entered a blood vessel, the dye or dye/local anesthetic passes into the patient's bloodstream. Non-invasive detection of the dye at a distant site of the body will indicate vascular injection of the dye/local anesthetic mixture as can follow improper catheter placement. col. 4, ln 66 to col. 5, ln 4; Fig 3 Referring to Fig. 3, a non-invasive transducer 41 is positioned over the patient's finger 43. Transducer 41 is in the form of a spring biased clip 51. A light source, for example, a light emitting diode LED (not shown), is housed in clip 51 and transmits light of a specific wavelength through the finger and onto a photosensor, for example, a photodiode (not shown). 21 US7783343 08/24/2010 Monitoring of the cerebral state of a subject The General Electric Company (Helsinki, FI)
col. 4, ln 15-22 The present invention seeks to improve the reliability and thus also to extend the applicability of existing patient monitors based on the determination of the known Bispectral Index, BIS.TM.. The invention further seeks to provide a method and apparatus, which are applicable for determining a reliable measure of the depth of anesthesia or sedation when NMDA antagonists are involved in producing anesthesia or sedation. col. 9, ln 15-32; Fig1, 3 Although the invention is primarily intended for improving the BIS algorithm, the EMG Ratio may also be used without the burst suppression index (BSR/QUAZI) and the bispectrum value (the traditional SynchFastSlow or the modified SynchFastSlow described below). More specifically, as the EMG Ratio is a reliable indicator of the depth of hypnosis at light levels of anesthesia, one embodiment of the invention involves the use of the EMG Ratio as the sole indicator of the depth of hypnosis at light levels of anesthesia or sedation, which refers to levels 5 to 2 in the Observer's Assessment of Alertness and Sedation (OAAS) scale to obtain an indication of the level of consciousness. Outside this area, any other known mechanism may be used, if necessary. The OAAS is a scale that defines the level of consciousness based on a patient's response to external stimuli. In this embodiment, the calculation of the measure of the depth of anesthesia or sedation thus involves steps 11, 12, 14, and 17 of Fig. 1, the EMG Ratio being now calculated at step 17. 22 US6002960 12/14/1999 Passive, non-invasive method to quantify objectively the level and density of The Johns Hopkins University (Baltimore, MD) a neural blockade
col. 1, ln 13-17 The invention relates to the monitoring of the effectiveness of anesthetics in humans or animals and, more specifically, provides a method for passively, non-invasively and objectively quantifying the level and density of a neural blockade. col. 6, ln 27-43 The use of passive and non-invasive monitors to objectively distinguish the level and density of neural blockade as a function of time, and as related to the administration of local anesthetic, has been examined. The data from the EMG, temperature, and EKG monitors, combined with the clinical assessment provided by the anesthesiologist and the conditions of the operative procedure, confirm that an objective measure of block level and density can be performed in the clinical setting. A universal neural blockade monitor must be fully functional regardless of when it is applied, relative to the administration of the anesthetic agent. The rate of change, or gradient, of the absolute signals presents salient information. The most compelling indicator is the change in EMG signal level between the time of zero minutes and 10 minutes, as shown in Fig. 2. Level L2 decreases approximately 1.5 times that of T10 and 2.5 times that of T4. col. 6, ln 54-63 The onset of neural blockade can be objectively monitored by placement of one or more sensors and quantifying a decrease in signal amplitude of a surface EMG; an increase in skin temperature; and changes in heart rate. Moreover, the blockade density determined by these objective means appears to compare favorably with the traditional subjective method of pinch-tests. The invention provides the anesthesiologist with a passive, objective tool for real-time, non-invasive monitoring of the level and density of neural blockade. 23 US20030168063 09/11/2003 Pressure face mask and nasal mask
para [0025]-[0026]; Fig 1 [0025] A breathable gas is a gas containing sufficient oxygen to sustain a user. A breathable gas may contain inert gases, for example nitrogen, helium, or water vapor. A breathable gas may also contain anesthetics, medications, and the like in admixture. The term "user" as used herein includes persons using a full-face mask or nasal mask in both medical and nonhttps://www.ipdashboard.com/Patents/Search/ViewSearch?id=18438&action=SearchReport[10/29/2013 5:54:05 PM]
medical applications. The terms "lpm" and "LPM" mean liters per minute. The term "ppi" means pores per inch. [0026] Referring to FIG. 1, a preferred embodiment of the disclosed full-face mask 10 comprises a dome 12 and a cuff 14. The cuff 14 is preferably mounted on a flange 16 on the dome 12. The dome 12 is sized to cover the nose and mouth of the user. The dome 12 is generally convex, providing clearance for the user's nose and other facial features. para [0016] A third embodiment provides a method of providing a breathable gas to a user comprising placing a positive pressure full-face mask comprising a dome secured to a foam cuff, wherein the cuff contacts the user's face, over the nose and mouth of the user, applying sufficient pressure to form a seal between the facemask and the user's face, and providing a breathable gas through an inlet port on the facemask. 24 US8512273 08/20/2013 Automatic calibration of the sensitivity of a subject to a drug General Electric Company (Schenectady, NY)
col. 1, ln 6-11 The invention relates to a method, apparatus, and computer product for calibrating the sensitivity of a subject to a drug. According to the invention, the sensitivity of the subject to a drug is determined by detecting the change in a signal measured from the subject caused by blood or effect site concentration change of a drug. col. 4, ln 4-7 In another embodiment of the invention, said measured signal responsive to the drug is a signal describing the depth of anesthesia. col. 4, ln 66 to col. 5, ln 10; Fig 1 An embodiment of the method for calibrating the sensitivity of the patient is depicted in a block diagram in Fig. 1. In the method, the patient is given a drug by infusion at an infusion rate I and the response of the patient to the drug is measured 2. The drug may be any drug that has a measurable effect on the patient, e.g. a blood pressure drug, an anesthetic drug or a muscle relaxant or such. The measured signal can be any signal that is responsive to the given drug. For example, when giving muscle relaxants, electromyogram (EMG) of the patient is measured from a chosen part of the body or in the case of an anesthetic drug, the depth of anesthesia is measured. col. 6, ln 50-56 The patient's response and the current anesthetic level of the patient are measured in this example by determining an entropy signal. The entropy signal is determined in the EEG complexity determination unit 20 from the electroencephalographic (EEG) signal and the frontalis electromyographic (FEMG) which are measured by placing electrodes on the forehead of the patient 19. 25 US7693697 04/06/2010 Anesthesia drug monitor University of Utah Research Foundation (Salt Lake City, UT)
col. 2, ln 23-31 It is desirable to provide a method, system, and apparatus, which facilitates the rapid and accurate analysis of complex and quickly changing anesthesia drug data. Moreover, it is desirable that such a system and method be capable of estimating, predicting and displaying drug dosages, infusions, effect site concentrations and drug effects during anesthesia. It is desirable that such a system and method be capable of analyzing time based, real-time, and historical data and that it be able to graphically show the relationships between various data. col. 31, ln 56-60 A study was performed to determine if in the presence of the drug display, the anesthesiologist's delivery of drugs will be more judicious and efficient, resulting in better control of the patient's vital signs and depth of anesthesia during the surgery. 26 WO11146806A1 11/24/2011 METHODS FOR REDUCING ANESTHETIC-INDUCIBLE EPILEPTOGENIC AND NEUROTOXIC EFFECTS UNIVERSITY OF FLORIDA RESEARCH FOUNDATION INC
pg. 5, ln 8-15 Yet another aspect of the disclosure encompasses embodiments of a method of determining the likelihood of an animal or human subject developing a side-effect of an anesthetic administered to said subject, the method comprising determining whether the subject has an abnormality in a level of aldosterone or oxytocin compared to a normal level, or an abnormality in the physiological function or response thereto of aldosterone or oxytocin in the animal or human subject, wherein the presence of the abnormality indicates the likelihood of an animal or human subject developing a side-effect of an anesthetic administered to said subject. pg. 28, ln 10-14 Anesthesia and electroencephalogram recording: To determine the effects of sevoflurane on cortical activity, postnatal days 4 to 20 (P4-P20) rat pups were instrumented for electroencephalogram recording. Half of the P5 and earlier rats were anesthetized by cold immersion (to avoid additional exposure to anesthetic); the remaining half and older rats were anesthetized by inhalation anesthesia with isoflurane (1.8-2.5 percent). pg. 28, ln 23-29 Sevoflurane (Fushimi-machi, Osaka, Japan) anesthesia was induced with 6 percent sevoflurane and 1.5 L/min oxygen over 3 min, and maintained with 2.1 percent sevoflurane and 1.5 L/min oxygen over 30-360 min in a thermostated chamber. Backdraft through wall vacuum was used to scavenge waste gases. Onset and offset of anesthesia were monitored via electroencephalogram and by loss and return of righting reflex, respectively. Anesthesia gas monitoring was performed using a calibrated Datex side stream analyzer that sampled from the interior of the animal chamber. 27 US20100068141 03/18/2010 USE OF HEAT SHOCK TO TREAT OCULAR DISEASE
para [0164]-[0166] [0164] The pre-surgical preparation of the animals involves making sure that they are physically active and able to undergo anesthesia. The mice need to be without any evidence of
ocular discharge or evidence of a cataract so as to make it feasible to visualize the retina to perform laser burn treatment. Prior to the laser treatment the animals will be anesthetized with intraperitoneal injection of a mix of 80-100 mg/kg ketamine and 5-10 mg/kg xylazine. No corneal edema or cataract formation is attributed to the use of these anesthetics. The level of anesthesia is monitored by a footpad pinch and breathing rate. A lack of the reflex-response to the footpad pinch indicates that the animal is properly anesthetized. No ocular ointment is applied before or during the laser treatment because this would prevent effective laser treatment. Some antibiotic ointment is applied to protect the untreated eye. If no response is demonstrated after footpad pinch then the laser treatment will proceed. [0165] Pain, distress or discomfort is suggested by movement of the animal during the time required for laser treatment. If the animal shows increased movement just prior to or during laser surgery then anesthesia is supplemented by exposing the animal to isoflurane for 10 seconds. Approximately 1 mL isoflurane is soaked onto a crumpled Kimwipe placed in the bottom of a 50 mL plastic centrifuge tube and the tube is capped. If necessary the open end of this tube can be held briefly near the animal's nose. This procedure is performed in a fume hood. After this the animals' breathing rate will continue to be monitored and the animal's pain response will be monitored by footpad pinch. If no movement is demonstrated after footpad pinch, then the laser surgery will proceed. The laser treatment takes approximately 30 seconds per mouse. An intraperitoneal injection of yohimbine (2 mg/kg body weight) is used to reverse the effect of the ketamine/xylaxine. This will reduce the amount of time that the eyes are at risk due to the loss of the blink reflex under anesthesia. No abnormal behavior is expected following surgery. [0166] Pain, distress and discomfort can occur after laser treatment. The literature indicates that human recovery from laser treatment is helped by application of ketorolac to the cornea at the end of the procedure (Kosrirukvongs et al, Topical ketorolac tromethamine in the reduction of adverse effects of laser in situ keratomileusist, J. Med Assoc That, 2001; 84:804-810 and Price, et al, Pain reduction after laser in situ keratomileusis with ketorolac tromethamine ophthalmic solution 0.5%: a randomized, double-masked, placebo-controlled trail, J. Refeact Surg, 2002:18:140-144). Therefore, after laser treatment drops of a solution of ketorolac (0.5% OP) will be applied to the eyes of the mice for 48 hours following treatment, and longer if needed. The commercial name of this solution is Acular PF Solution. This duration of treatment with Acular PF has no adverse effects on the mice and has no effect on neovascularizaion as evidenced by analysis of the vehicle injected animals. The animals will be maintained in their cages and held at room temperature (18-26.degree. C.), or on a 37.degree. C. warming tray and visually monitored continuously until they show signs of recovery from anesthesia. Full recovery from anesthesia occurs only when the animal is fully alert and ambulatory in the cage. para [0160] Retinal function of treated and untreated eyes is evaluated by ERG (a non-invasive technique used to determine photoreceptor function) on a periodic (e.g., monthly) basis to determine the effect of laser or pharmacological agent therapy. Electroretinography is a non-invasive technique in which the corneal electrical response to light is measured in anesthetized animals. Mice are anesthetized with intraperitoneal injections of a mix of 80-100 mg/kg ketamine and 5-10 mg/kg xylazine for anesthesia (Phoenix Pharmaceuticals, St. Joseph, Mo.). The mouse corneas are anesthetized with a drop of 0.5% proparacaine HCl (Akorn, Buffalo Grove, Ill.), and dilated with a drop of 2.5% phenylephrine HCl (Akorn). Measurement electrodes tipped with gold wire loops are placed upon both corneas with a drop of 2.5% hypromellose (Akorn) to maintain electrode contact and corneal hydration. A reference electrode is placed subcutaneously in the center of the lower scalp of the mouse, and a ground electrode is placed subcutaneously in the hind leg. The mouse rested on a homemade sliding platform that keeps the animal at a constant temperature of 37.degree. C. The animal is positioned so that its entire head rested inside of the Ganzfeld (full-field) illumination dome of a UTAS-E 2000 Visual Electrodiagnostic System (LKC Technologies, Inc., Gaithersburg, Md.). Full-field scotopic ERGs are measured by 10 msec flashes at an intensity of 0.9 and 1.9 log cd m-2 at 1 minute intervals. 28 US6250132 06/26/2001 Method and apparatus for real time gas analysis metaSENSORS, Inc.
col. 19, ln 66 to col. 20, ln 35; Fig 7a As disclosed in the above-mentioned provisional applications, the above-described three-gas analyzer can be used to determine concentrations of respired anesthesia gasses. In this case, after analysis, the exhaled gasses may be scrubbed of carbon dioxide in a scrubber filter and returned to the anesthesia machine. By way of example, the present invention may be utilized to analyze a set of gas mixtures that are typically encountered in actual anesthesia practice, such as oxygen, O2, carbon dioxide, CO2, and the potent anesthesia agent, halothane, C2 HBrCIF3. This gas mixture is one that occurs after a short time (e.g., about 7 minutes) after a patient has expelled all residual dissolved nitrogen and, under a relatively common situation, where the potent anesthetic is administered alone without nitrous oxide (e.g., standard practice is to reduce the concentration of potent anesthetic by providing a high dose of nitrous oxide, N2 O, which is thought to mitigate side effects of the potent anesthetic). This simpler mixture is now often used with children and obstetric cases as it is advantageous because the danger of suffocation in nitrous oxide in the event of a loss of oxygen is reduced. The administration of a single anesthesia agent without nitrous oxide, however, is still typically not standard general practice. FIG. 7a shows three exemplary real time traces of the concentration histories during simulated respiration of an anesthetic mixture. Respiration is simulated by periodically adding about ten percent carbon dioxide. When CO2 is added, the concentrations of oxygen and halothane decrease (e.g., if the gas was actually respired, the concentration of halothane remains approximately constant because the amount of oxygen and carbon dioxide relative to the halothane is fixed since the oxygen is metabolized into carbon dioxide, that is, only O2 and CO2 are out of phase). Halothane is resolved to about.+-.0.05 percent volume concentration. By specifically measuring the physical properties of the mixture, specificity of the individual concentrations is automatically ensured. 29 US7980245 07/19/2011 Informative accessories The General Electric Company (Schenectady, NY)
col. 3, ln 11-32; Fig 1 The anesthesia delivery system 12 supplies medical gases to the patient 10 via a series of modular components 40. The anesthesia delivery system 12 applies a positive pressure of anesthetic medical gases through an inspiration valve 14 to the inspiratory limb 16 of a breathing circuit 18 and out the patient end 20 of the breathing circuit 18. The patient end 20 may be connected to a gas sampling module 22 that provides, via gas sampling ports 24, a sample of the gas provided to patient 10 to the spirometer/gas analyzer 26. Spirometer/gas analyzer 26, which may include the ability to measure gas concentration, pressure, and flow, may be a part of a larger general patient monitoring module (not pictured) for the monitoring of a wide variety of commonly monitored patient physiological parameters that are associated with the anesthetic delivery system 12. A patient connection 30, which may be a face mask, an endotracheal tube, nasal cannula, non-invasive helmet, or otherwise is connected at one end to the gas sampling module 22 and at the patient connection end facilitates the delivery of the medical gases to the patient 10. Gases expired by the patient 10 are returned to the anesthesia delivery system 12 via the breathing circuit 18, directed
through the expiratory limb 32 and the expiratory valve 34. 30 US20100204093 08/12/2010 USE OF HEAT SHOCK ACTIVATORS FOR TISSUE REGENERATION University of Florida Research Foundation, Inc Gainsville FL
para [0162]-[0165] [0162] Retinal examination of treated and untreated eyes is evaluated by funduscopic examination. Funduscopy is a non-invasive technique in which retinal photographs are taken of anesthetized animals. Mice are anesthetized, and their corneas are anesthetized and dilated as described above for ERG analysis. Fundus photography is performed with a specialized camera and lens, a Kowa Genesis hand held fundus camera (Kowa Company, Ltd., Tokyo, Japan) focused through a Volk Super 66 Stereo Fundus Lens (Keeler, Berkshire, England). Two pictures of each eye are generally taken to ensure a properly focused image. The animals receive triple antibiotic ointment (Vetropolycin) in their eyes to maintain moisture following the procedure, and are allowed to regain consciousness on a 37.degree. C. warming tray before they are returned to the vivarium. Animals receiving Ketamine/Xylazine anesthesia will also receive 0.01-0.02 ml/g of body weight of warm LRS SQ. Laser Treatment [0163] The pre-surgical preparation of the animals involves making sure that they are physically active and able to undergo anesthesia. The mice need to be without any evidence of ocular discharge or evidence of a cataract so as to make it feasible to visualize the retina to perform laser burn treatment. Prior to the laser treatment the animals will be anesthetized with intraperitoneal injection of a mix of 80-100 mg/kg ketamine and 5-10 mg/kg xylazine. No corneal edema or cataract formation is attributed to the use of these anesthetics. The level of anesthesia is monitored by a footpad pinch and breathing rate. A lack of the reflex-response to the footpad pinch indicates that the animal is properly anesthetized. No ocular ointment is applied before or during the laser treatment because this would prevent effective laser treatment. Some antibiotic ointment is applied to protect the untreated eye. If no response is demonstrated after footpad pinch then the laser treatment will proceed. [0164] Pain, distress or discomfort is suggested by movement of the animal during the time required for laser treatment. If the animal shows increased movement just prior to or during laser surgery then anesthesia is supplemented by exposing the animal to isoflurane for 10 seconds. Approximately 1 mL isoflurane is soaked onto a crumpled Kimwipe placed in the bottom of a 50 mL plastic centrifuge tube and the tube is capped. If necessary the open end of this tube can be held briefly near the animal's nose. This procedure is performed in a fume hood. After this the animals' breathing rate will continue to be monitored and the animal's pain response will be monitored by footpad pinch. If no movement is demonstrated after footpad pinch, then the laser surgery will proceed. The laser treatment takes approximately 30 seconds per mouse. An intraperitoneal injection of yohimbine (2 mg/kg body weight) is used to reverse the effect of the ketamine/xylaxine. This will reduce the amount of time that the eyes are at risk due to the loss of the blink reflex under anesthesia. No abnormal behavior is expected following surgery. [0165] Pain, distress and discomfort can occur after laser treatment. The literature indicates that human recovery from laser treatment is helped by application of ketorolac to the cornea at the end of the procedure (Kosrirukvongs et al, Topical ketorolac tromethamine in the reduction of adverse effects of laser in situ keratomileusist, J. Med Assoc That, 2001; 84:804-810 and Price, et al, Pain reduction after laser in situ keratomileusis with ketorolac tromethamine ophthalmic solution 0.5%: a randomized, double-masked, placeb0-controlled trail, J. Refeact Surg, 2002:18:140-144). Therefore, after laser treatment drops of a solution of ketorolac (0.5% OP) will be applied to the eyes of the mice for 48 hours following treatment, and longer if needed. The commercial name of this solution is Acular PF Solution. This duration of treatment with Acular PF has no adverse effects on the mice and has no effect on neovascularization as evidenced by analysis of the vehicle injected animals. The animals will be maintained in their cages and held at room temperature (18-26.degree. C.), or on a 37.degree. C. warming tray and visually monitored continuously until they show signs of recovery from anesthesia. Full recovery from anesthesia occurs only when the animal is fully alert and ambulatory in the cage. 31 US20130253334 09/26/2013 WIRELESS PATIENT MONITORING DEVICE MASIMO CORPORATION Irvine CA
para [0137]-[0138] [0137] In several embodiments, the wireless patient monitoring system includes one or more sensors, including, but not limited to, a sensor 930 to monitor oxygen saturation and pulse rate. These physiological parameters can be measured using a pulse oximeter. In general, the sensor 930 has light emitting diodes that transmit optical radiation of red and infrared wavelengths into a tissue site and a detector that responds to the intensity of the optical radiation after absorption (e.g. by transmission or transreflectance) by pulsatile arterial blood flowing within the tissue site. Based on this response, a processor determines measurements for SpO.sub.2, pulse rate, and can output representative plethsmorgraphic waveforms. Thus, "pulse oximetry" as used herein encompasses its broad ordinary meaning known to one of skill in the art, which includes at least those noninvasive procedures for measuring parameters of circulating blood through spectroscopy. [0138] The wireless monitoring system 900 can include any of the sensors described herein in addition to or in alternative to the pulse oximeter. For example, the wireless monitoring system 900 can also include sensors for monitoring acoustics, sedation state, blood pressure, ECG, body temperature, and/or cardiac output. The wireless monitor may also include an accelerometer or gyroscope. The wireless patient monitoring system may include any of the above-mentioned sensors alone or in combination with each other. para [0056]; Fig 1A Referring to FIG. 1A, the blood pressure device 110a includes an inflatable cuff 112, which can be an oscilometric cuff that is actuated electronically (e.g., via intelligent cuff inflation and/or based on a time interval) to obtain blood pressure information. The cuff 112 is coupled to a wireless transceiver 116. The blood pressure device 110a is also coupled to a fingertip optical sensor 102 via a cable 107. The optical sensor 102 can include one or more emitters and detectors for obtaining physiological information indicative of one or more blood parameters of the patient 101. These parameters can include various blood analytes such as oxygen, carbon monoxide, methemoglobin, total hemoglobin, glucose, proteins, glucose, lipids, a percentage thereof (e.g., concentration or saturation), and the like. The optical sensor 102 can also be used to obtain a photoplethysmograph, a measure of plethysmograph variability, pulse rate, a measure of blood perfusion, and the like. para [0009] One aspect of the disclosure is a wireless patient monitoring device including one or more sensors configured to obtain physiological information. The one or more sensors can include an optical sensor, an acoustic respiratory sensor, and/or a blood pressure measurement device. Other sensors, including but not limited to, an EEG, ECG, and/or a sedation state sensor can also be used with the present disclosure. The one or more sensors are connected to a wireless monitor configured to receive the sensor data and to wirelessly transmit sensor data or physiological parameters reflective of the sensor data to a bedside monitor. The bedside monitor can be configured to output the physiological parameters,
communication channel, and/or communication status. 32 US20080317672 12/25/2008 DETECTION OF ANOMALIES IN MEASUREMENT OF LEVEL OF HYPNOSIS
para [0010] The present invention seeks to accomplish a novel mechanism for detecting anomalies in connection with a measurement of the level of hypnosis of a patient. The present invention further seeks to accomplish a mechanism that prevents such situations from degrading the reliability of systems or applications in which decisions are made based on the level of hypnosis, such as drug administration systems. The present invention rests on the discovery that during anesthesia the level of hypnosis normally depends only on the hypnotic component of the anesthetic drug effect and on the surgical stimulation which may cause lightening of hypnosis via an arousal reaction. Any change observed in an EEG based measure should thus be logically traceable to either a consistent change in the administered drug levels or to an autonomic arousal response of the subject. If a change in the measure cannot be related to either of these causes, it is highly likely that the change is due to an anomaly, such as those discussed above. para [0040] With reference to FIG. 5 again, the system of the invention may further include a drug delivery system 57 which is controlled by the control unit. The drug delivery system typically comprises an anesthesia delivery unit, which may comprise an intravenous infusion pump 58 for intravenously administered drugs and/or a vaporizer 59 for inhaled drugs. The number and selection of the drugs available in the delivery unit may vary, and a practical and cost-effective implementation may include only one drug for each effect type. The drug delivery system may further include the pharmacokinetic and pharmacodynamic models for the drugs that may be administered through the drug delivery system. These models may be stored in the memory or database 56. As discussed above, the pharmacokinetic model typically provides the drug effect information required by the consistency check, since it indicates the brain concentration of the hypnotic drug administered to the subject. 33 US8190227 05/29/2012 Signal processing apparatus and method MASIMO Corporation (Irvine, CA)
col. 1, ln 28-33 The present invention is especially useful for physiological monitoring systems including blood oxygen saturation systems and pulserate measurement systems. The present invention further relates to a method and apparatus for signal processing of signals in order to compute an estimate for pulserate col. 22, ln 61 to col. 23, ln 6 One skilled in the art will realize that many different types of physiological monitors may employ the teachings of the present invention. Other types of physiological monitors include, but are in not limited to, electro-cardiographs, blood pressure monitors, blood constituent monitors (other than oxygen saturation) monitors, capnographs, heart rate monitors, respiration monitors, or depth of anesthesia monitors. Additionally, monitors which measure the pressure and quantity of a substance within the body such as a breathalyzer, a drug monitor, a cholesterol monitor, a glucose monitor, a carbon dioxide monitor, a glucose monitor, or a carbon monoxide monitor may also employ the above described techniques. 34 US5352195 10/04/1994 Apparatus for intravenous regional anesthesia IVRA Systems, Inc. (Vancouver, CA)
Abstract Apparatus for assisting in the administration of anesthesia in a portion of a patient's limb distal to a cuff comprises in combination: applied pressure transducing means for generating an applied pressure signal representative of a pressure applied to a limb by a cuff which encircles the limb and applies pressure to the limb; anesthetic pressure sensing means for sensing the pressure of anesthetic liquid in a vein distal to the cuff and for generating an anesthetic liquid pressure signal indicative of the pressure; and alarm means for producing an alarm signal when the difference between the pressures corresponding to the applied pressure signal and the anesthetic liquid pressure signal is less than a preassigned safety limit. The apparatus may include anesthetic control means responsive to the alarm signal for stopping the introduction of anesthetic liquid when the difference is less than a preassigned limit, anesthetic concentration sensing means for estimating the concentration of anesthetic liquid in the blood, and anesthetic level estimation means for estimating the level of anesthesia in the portion of the limb distal to the cuff. 35 US8423381 04/16/2013 Patient monitor with integrated closed loop controller Koninklijke Philips Electronics N.V. (Eindhoven, NL)
col. 2, ln 1-10 This object is achieved by a system for monitoring and controlling a patient, with a patient sensor for capturing a patient signal, and a user interface for providing a user with information on the captured patient signal, wherein the system comprises an integrated closed loop controller which is fed with the patient signal and which controls a patient treating device for treating the patient. col. 5, ln 9-20 The inventions can be used in various, preferably closed loop control systems. One of ordinary skill in the art will recognize that the purpose of controlling is not limited to a single type of control loop and includes several variations and different implementations of control loops, e.g. closed loop controls, supervised controls and open loop controls. Examples are: FiO2 control, infusion pumps medication control, e.g. to control the blood pressure of a patient, control for depth of anaesthesia, e.g. control of intravenous-aesthetic agents during non-volatile anaesthesia procedures, and glycemic control. 36 US7079888 07/18/2006 Method and apparatus for monitoring the autonomic nervous system using non-stationary spectral analysis of heart rate and respiratory activity Ansar, Inc. (Philadelphia, PA)
col. 3, ln 54 to col. 4, ln 3 The present invention is a method and apparatus for non-invasive, real-time monitoring of the autonomic nervous systems. The present invention allows for monitoring of the autonomic nervous system using non-stationary spectral analysis of both heart rate and respiratory signals. A preferred embodiment uses continuous wavelet transformation in real-time so that the dynamic interactions between the sympathetic and parasympathetic divisions of the autonomic nervous system can be independently monitored in the frequency domain. The method in accordance with the present invention allows spectral analysis, formerly limited to the study of
stationary data, to be applied to time-varying biological data such as heart rate variability and respiratory activity. In addition, a preferred embodiment of the present invention uses the same techniques to monitor other biological or physiological data, including blood pressure. col. 11, ln 19-27 The method in accordance with the present invention can be applied in various environments. In a lab setting, testing can be performed in a short period of time to determine any indication of the Orthostatic condition set forth above, as well any indication of syncope. In an operating room setting, continuous monitoring of the patient will be performed. Physicians can use data from the monitor output to provide feedback on the depth of anesthesia, hypovolemia, sudden cardiac death, and recovery from anesthesia. 37 US20080083414 04/10/2008 DETECTING TIME PERIODS ASSOCIATED WITH SURGICAL PHASES AND/OR INTERVENTIONS GENERAL ELECTRIC COMPANY Schenectady NY
para [0030]; Fig 1 For example, the patient 110 may be connected to the patient monitor 112 for monitoring, displaying, and/or transmitting the patient's 110 vital signs, such as their blood pressure, heart rate, oxygen level, and/or other parameters, as needed or desired. In particular, the patient monitor 112 can be used to reflect the changing conditions of the patient 110 during the various surgical phases and/or interventions to which the patient 110 may be subjected. para [0032] In like fashion, the detector 114 can also be in electronic communication with the controller 116, again by techniques well-known in the art, including any wired, wireless, or combinations thereof, or any other suitable alternatives. In any event, the controller 116 preferably receives data and/or other information from the detector 114 and/or patient monitor 112 and/or other medical equipment (e.g., the anesthesia machine 120, IV pump 122, and/or electronic record system 118). para [0035] Preferably, the electronic record system 118, for example, can be interconnected to the detector 114 to provide information related to surgical protocols, drug names used during surgery, patient demographics, etc. Likewise, the anesthesia machine 120 can be interconnected between the patient 110 and detector 114 to provide information such as ventilation readings, drug concentrations used during surgery, etc. The IV pump 122 can also be interconnected between the patient 110 and detector 114 to provide information related to infusion rates and the like. It should also be appreciated that the system 100 can also discern surgical phases and/or interventions with 100 or near-100 percent confidence with manual input of surgical phases and/or interventions to the detector 114 and/or controller 116, as by a clinician 124 or the like, so as to permit overriding an automated response, for example, preferably manually. 38 US5335656 08/09/1994 Method and apparatus for inhalation of treating gas and sampling of exhaled Salter Laboratories (Arvin, CA) gas for quantitative analysis
col. 3, ln 12-30 The present invention overcomes the foregoing deficiencies of the prior art and provides a combined adminstration and sampling device for treating gas insufflation into an awake patient and simultaneous sampling giving accurate and reliable quantitative measurements of a gaseous component in exhaled breathing gas. Thus, the nasal cannulae of the present invention is capable of administering oxygen to an awake patient while providing measurements of end-tidal carbon dioxide which are quantitatively equivalent to measurements of endtidal carbon dioxide obtained by sampling via an endotracheal tube inserted into the trachea (intubation) of a sedated or anesthetized patient. The quantitative measurements available with the present invention thus have a direct correspondence to the actual levels of arterial carbon dioxide. The sampling and analysis regimen may be carried out alone or simultaneously with a regimen for insufflating a treating gas, such as oxygen, into the natural air being inhaled by the patient. col. 12, ln 2-24 In comparison, the present invention provides a non-invasive method of quantitively analyzing exhaled gases as compared to the invasive method provided by sampling from an endotracheal tube. The availability of the present invention in combination with infrared capnography or mass spectrometry to obtain reliable measurement of a component of exhaled gases during supplemental oxygen administration thus provides a new methodology for non-invasive monitoring of the respiratory status of living bodies, particularly human beings and warm-blooded animals. The present invention is believed to afford better patient management for those individuals recovering from general anesthesia and those undergoing a variety of procedures as awake patients under local or regional anesthesia. The present invention is particularly advantageous for use during relatively short-term regional procedures, such as cataract surgery. It is also believed that the invention is appropriate for use in longer term settings, such as for monitoring awake patients in an intensive care unit. 39 US5360006 11/01/1994 Automated method for digital image quantitation University of Florida Research Foundation, Inc.
col. 17, ln 13-32 The invention has great practical potential in both the clinical and operating room setting. An anesthesiologist caring for an increasingly older patient lead and with increasingly more cardiovascular disease would benefit from an automated, non-invasive echocardiographic system which would monitor their patients for early signs of ischemia. Such a device would alert the physician of the need for alterations in anesthetic depth and technique. Recent literature indicates that with current technology, anesthesiologists cannot easily detect the early signs of ischemia. With the availability of a system which provides a more rapid and more accurate analysis of two-dimensional short-axis cardiac images, cardiologists would have an increased ability to study patients over a longer period of time and in more diverse situations. As pre-operative ischemia and post-operative ischemia becomes more recognized as a significant indicator of risk, such a system would allow automated monitoring of patients both before and after surgery. 40 US4685464 08/11/1987 Durable sensor for detecting optical pulses Nellcor Incorporated (Hayward, CA)
col. 9, ln 6-27 Pads 70 and 80 are preferably compression molded to the desired shape having a relatively uniform thickness in the range from about 0.030" to about 0.050" to provide sufficient
support so that the pads will conform to a finger, will not collapse when closed about a finger, and yet are not so rigid as to affect the flow of blood into the areas, cause pressure points, patient discomfort, or compression marks, or affect the accuracy of the measurements by significantly deforming the tissue. The resiliency of the pad absorbs some of the force generated by spring 50 and spreads the force along the interface between pads 70 and 80 and the tissue. Ridges 192 and 194 aid in distributing the force along tissue contacting surface 190, which has enough resiliency to conform to the tissue with which it is in contact, and thereby prevent any localized pressure spots that could adversely affect the tissue or blood flow measurements being taken. Ridges 192 and 194 also help orient sensor 10 relative to the finger so that the deformable pads can straddle and be closed about the finger and maintain the hold of sensor 10 for a variety of different sized fingers for which preferred sensor 10 can be used. col. 10, ln 10-27 Furthermore, by permitting the interior cavity of pads 70 and 80 to have air exchange, the sterilants used to clean the sensor can penetrate the cavity, thereby significantly reducing the risk of infection resulting from use of the sensor. Cleanliness is especially important because an intended use of the sensor is in connection with monitoring anesthetized patients during surgery. 41 US6010459 01/04/2000 Method and apparatus for the measurement of components of exhaled breath in humans
col. 3, ln 55-63 Preferably, the method measures nitric oxide. However, a variety of other components of exhaled breath can be measured, including carbon dioxide, oxygen, nitric oxide, nitrogen, nitrogen dioxide, hydrogen peroxide, proteins, surfactants, DNA, acetone, ammonia, sulfur compounds, acetylene, carbon monoxide, ethane and pentane. For purposes of the present invention, the component of exhaled breath to be measured substantially arises from the respiratory tract below the glottis. col. 9, ln 48-67 3. Study to Assess Nasal NO Leak with Intra-airway Sampling In two healthy volunteers, after local anaesthesia with 4 percent lidocaine, a fine flexible catheter (8 and 10 gauge French) was passed via the nose and positioned in the trachea (confirmed by dysphonia) and withdrawn to 20 cm corresponding to the level of the vocal chords (continuing dysphonia). The placement was achieved in Subject 1 with a fiber optic laryngoscope. The presence of the catheter did not compromise velum closure. The NO analyzer sample line was connected via a three-way tap to the catheter and to the sideport of the mouthpiece. The subject then performed the NO measurements as described above at a flow rate of 20.7 ml/s. For each exhalation, the NO analyzer initially sampled at the mouth, and then once NOPLAT had been reached, was switched to sample from the catheter during the same exhalation maneuver. The same protocol was repeated with the catheter positioned in the oropharynx (confirmed by return of phonation) and additionally in the nasal cavity Abstract Methods and related equipment for measuring components of exhaled breath of a subject are provided which involve causing the subject to exhale into an appropriate apparatus for receiving exhaled breath; increasing the pressure in the mouth of the subject to a level sufficient to close the vellum and isolate the nasopharynx during exhalation; a means of monitoring nasal CO.sub.2 to conrirm vellum closure; and measuring the level of one or more components of the collected exhaled breath. Endogenous nitric oxide is a preferred component of exhaled breath for monitoring and analysis. 42 US7963917 06/21/2011 System and method for continuous non-invasive glucose monitoring Echo Therapeutics, Inc. (Franklin, MA)
col. 4, ln 10-27; Fig 1 Once the permeability of the skin is increased, by ultrasound or by another means, the system of the present invention may be implemented. Fig. 1 illustrates a block diagram of a system for continuous, noninvasive monitoring of a subject's glucose levels according to one embodiment of the invention. System 100 generally includes remote device 110 and base device 150. Remote device 110, which preferably includes sensor 120, is provided to a subject and produces a signal (e.g., an amperometric current signal) related to an analyte concentration, such as glucose, in the subject. Remote device 110 may consist of a reusable assembly that produces a signal that represents the magnitude of the current produced by transdermal sensor. Remote device may also produce signals that represent the subject's skin temperature and the charge level of batteries. Remote device 110 also preferably includes transmission unit 130 that transmits the signal to base device 150. Remote device may also include a unique identifier, such as an identification number. 43 US8396526 03/12/2013 Method for spectrophotometric blood oxygenation monitoring CAS Medical Systems, Inc. (Branford, CT)
col. 2, ln 17-29 According to one aspect of the present invention, a method and apparatus for non-invasively determining the blood oxygen saturation level within a subject's tissue is provided. In one embodiment, the method includes the steps of: 1) providing a near infrared spectrophotometric sensor operable to transmit light along a plurality of wavelengths into the subject's tissue; 2) sensing the light transmitted into the subject's tissue using the sensor, and producing signal data representative of the light sensed from the subject's tissue; 3) processing the signal data, including accounting for physical characteristics of the subject; and 4) determining the blood oxygen saturation level within the subject's tissue using a difference in attenuation between the wavelengths. col. 3, ln 46-54 The present method of and apparatus for non-invasively determining the blood oxygen saturation level within a subject's tissue is provided that utilizes a near infrared spectrophotometric (NIRS) sensor that includes a transducer capable of transmitting a light signal into the tissue of a subject and sensing the light signal once it has passed through the tissue via transmittance or reflectance. The present method and apparatus can be used with a variety of NIRS sensors, and is not therefore limited to any particular NIRS sensor. 44 US8471713 06/25/2013 Interference detector for patient monitor Cercacor Laboratories, Inc. (Irvine, CA)
col. 4, ln 53 to col. 5, ln 2; Fig 1 FIG. 1 illustrates a perspective view of a patient monitoring system 100, according to an embodiment of the disclosure. The system 100 includes a portable patient monitor 103 capable of noninvasively determining one or more psychological parameters and also interference levels. The portable patient monitor 103 communicates with an optical sensor 101 through a
cable 112. In some embodiments, the patient monitor 103 drives the sensor 101 to emit light of different wavelength into a body tissue (not shown). The sensor 101 detects the light after attenuation by the body tissue and outputs a signal indicative of the amount of light received by the sensor 101 (which can include attenuation) through the cable 112. In addition, in some embodiments, the monitor 103 communicates with a temperature sensor and a memory device associated with one or more of the sensor 101 and the cable 112, through the cable 112. In some embodiments, the monitor 103 communicates with other storage devices and remote devices via a network interface (not shown). 45 US7914460 03/29/2011 Condensate glucose analyzer University of Florida Research Foundation, Inc. (Gainesville, FL) Xhale, Inc. (Gainesville, FL)
col. 3, ln 66 to col. 4, ln 8 The present invention solves the needs in the art by providing methods and systems for non-invasive monitoring of glucose concentration in blood, as well as systems and methods for non-invasive monitoring of the effects of one or more therapeutic regimens on the concentration of glucose in a subject. The systems and methods of the present invention utilize sensors that can analyze a subject's EBC to detect, quantify, and/or trend concentrations of glucose present in the EBC, which correlate to the glucose concentration in the subject's body, in particular in blood. col. 8, ln 23-38 The preferred device of the present invention includes the following parts: 1) an exhaled breath sampling device, wherein the device samples end-tidal exhaled breath; 2) a condensate extracting system for extracting the condensates from the sample of end-tidal exhaled breath; 3) a sensor having the ability to detect and/or quantify glucose present in the condensates; and 4) a signaling means, coupled to the sensor, for producing an electrical signal indicative of the presence and/or amount of glucose in the breath condensate detected by the sensor. The signaling means may be further operative to determine the approximate concentration of glucose present in the condensates and/or subject (such as blood glucose levels). In certain embodiments, the signaling means is coupled to a processor, 112, which can store, track, trend, and interpret the signals to provide useful information regarding glucose amount or concentration for display to the user. 46 US7052468 05/30/2006 Method and apparatus for detecting environmental smoke exposure University of Florida Research Foundation, Inc.
col. 2, ln 47-55 The present invention solves the problems in the art by providing a method and apparatus for detecting environmental smoke exposure by providing a device for analyzing the patient's breath to confirm exposure to vapors in tobacco smoke. The method of the present invention can be used to monitor smoking behavior. For example, it can be used to monitor whether subjects are abstaining from smoking or continuing to smoke and whether children and adults are being exposed to environmental tobacco smoke. col. 3, ln 19-27 Preferably, the patient's breath is analyzed to confirm exposure to vapors in tobacco smoke by sensor technology selected from semiconductor gas sensor technology, conductive polymer gas sensor technology, surface acoustic wave gas sensor technology, aptamers (aptamer biosensors), and amplifying fluorescent polymer (AFP) sensors. The sensor technology produces a unique electronic fingerprint to characterize exposure to vapors in tobacco smoke such that the presence and concentration is determined. 47 WO2012126798 09/27/2012 NON-INVASIVE OXYGEN DELIVERY MEASUREMENT SYSTEM AND METHOD BMEYE B V [NL]
pg. 3, ln 18-24 This object is solved according to the present invention by a method of determining the oxygen delivery, comprising the steps of non-invasive measurement of the arterial blood pressure waveform, determination of cardiac output from a waveform analysis of said measured blood pressure waveform, non-invasive measurement of oxygen saturation and hemoglobin concentration, and real time calculation of oxygen delivery based on the measured quantities. pg. 7, ln 23 to pg. 8, ln 9 In another aspect, the oxygen delivery parameter is combined with an analysis of respiratory variations in beat-to-beat data, so that information about the oxygen delivery as well as about the fluid responsiveness state of a patient is available. From such an analysis of respiratory variations in beat-to-beat data such as for instance pulse pressure variation and/or stroke volume variation, information about the oxygen delivery as well as about the fluid responsiveness state of a patient is available. According to another aspect, the pulse pressure variation and stroke volume variation are monitored using the arterial blood pressure waveform. In yet another aspect, the arterial blood pressure is measured non- invasively with at least one sensor on a finger and wherein the oxygen saturation and the hemoglobin concentration are non-invasively measured with at least one multi-wavelength sensor. This sensor could be placed on another finger. 48 US20100192952 08/05/2010 Methods and Devices for Central Photoplethysmographic Monitoring Methods
para [0030] FIG. 2 shows a cross-sectional side view of the nasal probe embodiment 10 shown in FIG. 1. The LED(s) 12 and photodetector 14 are positioned across from each other. To monitor oxygen saturation, two or more LEDs are typically required. For plethysmography, only one IR LED is needed. However, multiple LEDs are contemplated as well for increased reliability, or for reliable measurement of dyshemoglobin, carbon monoxide, other inhaled pollutants, or blood analytes such as glucose and electrolytes. In addition, various types of CO2 sensors could be incorporated in the nasal probe. These sensors could include infrared spectroscopy, raman spectroscopy, colorimetry, and various nanotechnology sensors. The CO2 sensor provides important ventilation information that could be used in hazardous material scenarios, ventilatory support, or sleep disorders. Further, without being limited to any specific mechanism or theory, it is the belief of the inventors that the plethysmogram will show signs of reduced blood flow to the head such as GLOC far earlier than changes in oxygen saturation. However, it is contemplated that the probes and methods of the subject invention may be designed and used to monitor both plethysmography and oxygen saturation of the user. para [0036] Furthermore, the mask and/or helmet embodiments may include a CO2 sensor that is associated with the mask or helmet. The CO2 sensor may be a part of the pulse oximeter probe
or as a separate sensor. Alternatively, a sampling apparatus to obtain exhaled gases for determination of carbon dioxide content, may be associated with the mask and/or helmet. See PCT/US2004/043610. 49 US20080059226 03/06/2008 Methods and Systems for Preventing Diversion Of Prescription Drugs
para [0123] Thus, when a drug is administered to a patient, the preferred embodiment of the invention detects and quantifies a therapeutic drug marker almost immediately in the exhaled breath of the patient (or possibly by requesting the patient to deliberately produce a burp) using a sensor (for example, an electronic nose). Certain drug compositions might not be detectable in the exhaled breath. Others might have a coating to prevent the medication from dissolving in the stomach. In both instances, as an alternate embodiment, a non-toxic olfactory marker (such as volatile organic vapors) can be added to the pharmaceutically acceptable carrier (for example, the coating of a pill, in a separate fast dissolving compartment in the pill, or solution, if the drug is administered in liquid or suspension form) to provide a means for identifying/quantifying the marker in exhaled breath and thus determine whether a patient has taken a medication in accordance with a prescribed regimen. para [0119]-[0120] [0119] According to the subject invention, after taking a prescribed drug (wherein the therapeutic drug is the marker or the therapeutic drug is manufactured to include a detectable marker), a patient provides a sample of bodily fluid to a portable device of the invention. Marker detection can occur under several circumstances in the portable device. In one example, where the drug is administered orally, the marker can "coat" or persist in the mouth, esophagus and/or stomach upon ingestion and be detected with exhalation (similar to the taste or flavor that remains in the mouth after eating a breath mint). [0120] In one embodiment, where the prescribed drug is administered orally, the drug may react in the mouth or stomach with acid or enzymes to produce or liberate the marker(s) that can then be detected upon exhalation. Thirdly, the drug and/or marker can be absorbed in the gastrointestinal tract and be excreted in the lungs (for example, alcohol is rapidly absorbed and detected with a Breathalyzer). para [0072] In one embodiment, the sample providing means is a chamber for collecting samples of exhaled breath. A variety of systems have been developed to collect and monitor exhaled breath components, particularly gases. para [0012]-[0013] [0012] One objective of the subject invention is to provide systems and methods for monitoring patient compliance in taking a medication as prescribed. Another objective of the invention is to provide systems and methods for verifying the origins of a medication. Accordingly, the system of the invention comprises a central computer and a portable device equipped with at least one sensor specific for a marker. For example, a portable device of the invention can be provided with at least one sensor specific for a marker that is representative of a prescribed medication and/or at least one sensor specific for a marker that represents the medication's proper origins. [0013] In certain embodiments of the invention, the portable device includes any number of known identification systems such as fingerprinting or retinal scanning technology. The portable device of the invention can also include, without limitation, a means for receiving a sample (for example, from a patient and/or headspace from a prescription medication container) and a processing means. Preferably, the portable device can detect a marker of a specifically prescribed medication in exhaled breath. The processing means includes a means for receiving data provided via the sensor(s) and a means for determining whether an action/event (such as, a biological sample that has been provided to the portable device of the invention) has occurred within a configurable time interval. 50 US5081871 01/21/1992 Breath sampler The United States of America as represented by the Secretary of the (Washington, DC)
col. 2, ln 57-62 It is another object of the present invention to provide a breath sampling device capable of sampling trace amounts of compounds in large volumes of human breath for analysis by conventional gas analyzer apparatus or other analytical procedures to determine the presence of trace levels of volatile compounds. col. 13, ln 16-25 (5) The sidestream port enables the sampler to be connected to an appropriate continuous monitor for breath-by-breath measurements. In this manner, the sidestream port facilitates frequent and continuous analysis of breath samples which are uncontaminated by the analytes in the work environment. (6) Pressure-sensors or flow-sensors may be connected to the sidestream port to measure the number of breaths and or the pressure/flow profile of each breath. Abstract An apparatus for sampling volumetric quantities of human exhaled breath has three conduits and may be provided in "Y" or "T" shaped configuration. The free end of one of the conduits is adapted to connect with the mouth of the subject being tested. Another of the conduits is adapted to pass ambient air to the subject, this conduit being provided with a suitable filtering mechanism such as a charcoal inhalation canister and an inlet check valve. The third of the three conduits supports an appropriate sampling canister for receiving exhaled breath from the subject, and this conduit also is provided with a one-way check valve. In another aspect of the invention, there is also provided a method for collecting a sample of exhaled breath from a subject to collect therefrom a selected analyte and to accurately quantify its presence in the subject's breath. 51 WO2012143854 10/26/2012 IN VIVO BIOLUMINESCENCE MONITORING APPARATUS UNIV GENEVE [CH]
pg. 5, ln 23-28 Also disclosed herein is a method for non-invasive real-time in vivo bioluminescence monitoring in a small conscious animal comprising: placing a small animal expressing a luminescent reporter gene under the control of a gene of interest in the apparatus; and monitoring the light emitted by said small animal which is detected by the bioluminescence detector system.
pg. 7, ln 24-28 The apparatus may further include an animal activity related system either for monitoring certain activities of the animal, such as its movements, or for generating animal activity depending on the experiment to be conducted. The apparatus may also include a drug administration system (not shown) for administering luciferin, anesthetics, or other drugs used in the in vivo monitoring process. 52 US8277385 10/02/2012 Method and apparatus for non-invasive assessment of hemodynamic and functional state of the brain Advanced Brain Monitoring, Inc. (Carlsbad, CA)
col. 2, ln 63-67 In accordance with principles of the present invention, the methods disclosed herein teach the use of rheoencephalography (REG) and optical measurements (e.g., near-infrared spectroscopy) for the assessment of cerebral blood flow and blood volume in the arterial and venous portion of the cerebral vasculature. col. 5, ln 35-40 A method and apparatus for noninvasive assessment of the hemodynamic state of the brain is described herein. In some embodiments, the method and apparatus further provide information about the presence of silent seizures, magnitude and regional distribution of cerebral blood flow, and absolute value of intracranial pressure (ICP). 53 US3996010 12/07/1976 Breathing gas analyzer Searle Cardio-Pulmonary Systems Inc. (Emeryville, CA)
Abstract A breathing gas analyzer, especially for pulmonary use, has a frame supporting a centrally mounted radiation or analyzing chamber of about 1 and one-half to 25 millimeters (0.06 to 1.0 inches) substantially uniform inside diameter, having a circular-cylindrical transparent wall with closed ends connected in an electrical circuit and providing an anode of brass or stainless steel and a cathode of tantalum and constituting a discharge tube. Leading from a patient's breathing tube is a conduit passing axially through the cathode, the conduit having an inside diameter of about 0.03 to 0.25 inches (0.7 to 6.4 millimeters). The chamber is subjected to subatmospheric pressure of about 0.2 to 10.0 torr through a duct from about one thirty-second to one-quarter inches (0.8 to 6.4 millimeters) inside diameter, passing through the anode to a vacuum pump. Arrayed equidistantly from the axis and around the chamber are one or more radiation detection devices positioned opposite the negative glow region of the discharge. The detection devices may be connected to a display device. There are individual apertures and filters interposed between the chamber and each of the detecting devices. 54 US20090198145 08/06/2009 COMPOSITIONS, METHODS, AND SYSTEMS FOR RAPID INDUCTION AND MAINTENANCE OF CONTINUOUS REM SLEEP
para [0027] According to the present invention, the hypnotic pharmacological agent may be any sedative (promoting or aiding unconsciousness) and hypnotic (producing unconsciousness) agent, such as benzodiazepines, cyclopyrrones, neurosteroids, barbiturates, alcohol, narcotics, and anesthetics (e.g., etomidate, propofol, fospropofol, and ketamine). Preferably, the hypnotic or sedative agent is a GABA-A agonist which causes sedation and hypnosis effects primarily through selective GABA-A agonist action in the brain. In one embodiment, the hypnotic or sedative agent is propofol, or its prodrug, metabolite, analog, and derivative. 55 US6315736 11/13/2001 Anesthetic-depth monitor apparatus Colin Corporation (Komaki, JP)
Abstract An apparatus for monitoring an anesthetic depth of a living subject, including at least two devices of (a) an arousal-index determining device which determines an arousal index indicating a degree of arousal of the subject, (b) a pain-index determining device which determines a pain index indicating a degree of pain of the subject, and (c) a muscular-relaxationindex determining device which determines a muscular-relaxation index indicating a degree of muscular relaxation of the subject, and an anesthetic-depth determining device for determining, based on at least two indexes determined by the at least two devices, an anesthetic depth of the subject according to a predetermined relationship between anesthetic depth and the at least two indexes.
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Home Docket IDEAS Searches Alerts

Pub Date 06/11/2002

Company Metasensors, Inc. (Rockville, MD)

https://www.ipdashboard.com/Patents/Search/ViewSearch?id=18438&action=SearchReport[10/29/2013 5:54:05 PM]

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