Decision-assist method of resuscitation of patients
Inventors
Salinas, Jose • Kramer, George C. • Cancio, Leopoldo C. • Chung, Kevin • Mann, Elizabeth • Wolf, Steven E. • Drew, Guy A.
Assignees
University of Texas System • United States Department of the Army
Publication Number
US-8585675-B2
Publication Date
2013-11-19
Expiration Date
2028-03-19
Interested in licensing this patent?
MTEC can help explore whether this patent might be available for licensing for your application.
Abstract
A method for providing decision-assist to medical staff resuscitating a burn patient includes receiving patient information, calculating an infusion rate, outputting the infusion rate, obtaining a urinary output, calculating a new infusion rate using infusion rate model based constants, and outputting the new infusion rate. In some embodiments, the method includes notifying medical staff when problems arise, displaying information regarding the resuscitation, and setting limits regarding the infusion rates.
Core Innovation
The invention is a decision-assist method and system for resuscitation of patients suffering trauma, particularly burn injuries. It provides recommendations to medical staff by calculating infusion rates based on patient data such as percentage of total body surface area burned, patient's weight, hours post burn, and current urinary output. The system outputs an initial infusion rate, obtains urinary output, calculates new infusion rates using infusion rate model-based constants with modifiers, and outputs updated infusion rates to assist in fluid therapy management.
The method addresses the problem of over-resuscitation and under-resuscitation in burn patients caused by variability in clinical expertise and the lack of continuous, precise control of infusion rates. Current methods rely on formulas like Brooke and Parkland and manual adjustments based on urinary output, often leading to fluid overload and associated complications such as abdominal compartment syndrome and increased morbidity and mortality. The invention aims to reduce workload on specialized burn centers and improve care quality by enabling less specialized medical staff to deliver more accurate fluid resuscitation using a decision-assist or closed-loop system.
Claims Coverage
The patent includes multiple independent claims detailing various methods for providing decision-assist during patient resuscitation, emphasizing infusion rate calculation based on patient data and urinary output.
Calculation and output of infusion rates using patient data and urinary output
A method that receives patient data including percentage of total body surface area, calculates an initial infusion rate, outputs it, obtains current urinary output, calculates a new infusion rate using the current infusion rate, urinary output, an infusion rate constant, and an urinary constant, and outputs the new infusion rate.
Incorporation of patient weight and total body surface area modifiers into infusion rate calculation
A method calculating a new infusion rate based on current infusion rate, urinary output, infusion rate constant, urinary constant, and modifiers derived from the patient's weight and percentage total body surface area, allowing individualized infusion rate adjustments.
Adjustment of infusion rate constants based on hours post burn
A method where infusion rate constants and urinary constants are selected based on time elapsed since burn injury, utilizing exponential or phase-based functions representing initial, middle, and late phases of resuscitation.
Problem detection and medical staff notification based on urinary output analysis
Analyzing urinary output for potential issues such as equipment failure, low output, or non-responsiveness; notifying medical staff with identification of problems and recommended actions; and receiving instructions to continue or terminate resuscitation.
The claims collectively cover a systematic approach to decision-assist in burn patient resuscitation involving calculation of infusion rates via model-based equations, adjustment for patient-specific characteristics and resuscitation phase, continuous monitoring of urinary output, problem detection, notification to medical staff, and optional closed or semi-closed-loop control to optimize fluid therapy.
Stated Advantages
Improves control of urinary outputs during burn resuscitation resulting in better resuscitation outcomes.
Reduces workload on specialized burn centers by enabling less experienced medical staff to manage fluid therapy effectively.
Potentially reduces complications from over-resuscitation such as abdominal compartment syndrome, pulmonary edema, and delayed wound healing.
Allows more frequent and automated adjustments of infusion rates than manual oversight, increasing response speed to patient condition changes.
Supports use in austere or combat environments where burn care expertise is limited.
Documented Applications
Assisting medical staff in civilian emergency rooms, forward military medical facilities, and ad hoc medical facilities for burn patient resuscitation.
Providing fluid therapy recommendations in mass casualty events involving burn injuries where medical expertise and resources are limited.
Use in burn centers such as the U.S. Army Institute of Surgical Research burn unit and the University of Texas Medical Branch for improving fluid resuscitation outcomes.
Implementation on devices including infusion pumps, urine output meters, personal digital assistants, tablet PCs, and clinical monitors to support bedside decision-making or automated control.
Interested in licensing this patent?