Non-invasive device for synchronizing chest compression and ventilation parameters to residual myocardial activity during cardiopulmonary resuscitation

Patent metadata

Field	Value
Publication number	US-9833378-B2
Application number	US-201615040682-A
Country	US
Kind code	B2
Filing date	Feb 10, 2016
Priority date	Oct 25, 2004
Publication date	Dec 5, 2017
Grant date	Dec 5, 2017

Abstract

A system for improving cardiac output of a patient suffering from pulseless electrical activity or shock and yet displays myocardial wall motion including: a sensor to detect myocardial activity to determine the presence of residual left ventricular pump function having a contraction or ejection phase and a filling or relaxation phase, a device to prompt the application of or apply a compressive force repeatedly applied to the chest based on the sensed myocardial activity such that the compressive force is applied during at least some of the ejection phases and is ceased during at least some of the relaxation phases to permit residual cardiac filling, thereby enhancing cardiac output and organ perfusion.

First claim

What is claimed is:

1. A system to treat a patient having a heart and a chest, the system comprising:
a least one sensor monitoring cardiac activity in the patient by detecting at least one of myocardial pump activity, myocardial mechanical activity, hemodynamics and organ perfusion; and
a logic controller receiving signals and executing an algorithm stored in a non-transitory memory accessible by the logic controller, which causes the system to:
determine whether the patient is in a pulseless electrical activity (PEA) condition,
in response to the determination that the patient is in the PEA condition, determine a pattern of myocardial motion or residual pulsatile blood flow occurring in the patient during the PEA condition and based on the received signals, and
in response to the determined pattern and during the PEA condition, generating a command to repeatedly apply a phasic therapy to the patient, wherein the command causes or prompts the application of the phasic therapy repeatedly and in synchrony with the pattern of the actual myocardial motion or the pulsatile blood flow.

2. The system of claim 1 wherein the logic controller executes the algorithm to further cause the system to:
sense the actual myocardial motion or residual pulsatile blood during the application of the phasic therapy;
change the application of the phasic therapy, and
determine if the changed application of the phasic therapy improves the myocardial pump activity or residual pulsatile blood flow.

3. The system of claim 1 wherein the command to cause or prompt the application of the phasic therapy causes the phasic therapy to be applied during at least a portion of an ejection phase of the heart and ceasing the application of the phasic therapy during at least a portion of a relaxation phase of the heart.

4. The system of claim 1 further comprising a medical device configured to apply a compressive force to the chest in response to the command.

5. The system of claim 4 wherein the compressive force is applied to at least one of a sternal, a parasternal or an intercostal area of the chest.

6. The system of claim 4 wherein the compressive force is applied during each ejection phase of the heart in which the phasic therapy is applied.

7. The system of claim 4 wherein the compressive force or an electrical shock is applied during less than all of an ejection phase of the heart during a period in which the phasic therapy is applied.

8. The system of claim 4 wherein the command causes the compressive force to be applied during a predetermined portion of an ejection phase and the compressive force to cease during another portion of the ejection phase.

9. The system of claim 8 further comprising a medical device configured to actively lift or actively decompress the chest during the relaxation phase and during the cessation of the compressive force, and in response to the command.

10. The system of claim 1 further comprising a medical device configured to apply, in response to the command, at least one of active chest decompression, abdominal compression, ventilation, phasic limb-compression, myocardial electrical stimulation, intravascular fluid shifting, intravascular or internal visceral balloon inflation-deflation, and application of transthoracic electromagnetic irradiation.

11. The system of claim 10 wherein the command causes the lifting or decompression to be applied during an entirety of the relaxation phase.

12. The system of claim 10 wherein the medical device is at least one of a mechanical compression device; an inflatable vest, a nerve or muscle stimulator; and a suction based compression-decompression device.

13. The system of claim 1 wherein the at least one sensor is a plurality of sensors each monitoring the cardiac activity and the algorithm causes the logic controller to:
analyze the signals from the sensors during the application of the phasic therapy to determine which of the sensors generate signals representative of the myocardial motion or the pulsatile blood flow;
select the signals from at least one of the sensors producing signals representative of the myocardial motion or the pulsatile blood flow to determine the pattern, and
use the selected signals to determine the pattern of myocardial motion or residual pulsatile blood flow.

14. The system of claim 13 wherein the signals from the sensors are analyzed and the selection of the signals are performed periodically while the patient is in the PEA condition.

15. The system of claim 1 further comprising a ventilator and the logic controller executing the algorithm causes the ventilator to apply ventilations, gas flow or airway pressure of the patient in the PEA condition.

16. The system of claim 1 wherein the at least one sensor comprises a sensor of echocardiography, Doppler ultrasonography, plethysmography and phonocardiography.

17. The system of claim 1 wherein the at least one sensor is an array of sensors applied to the patient.

Assignees

• Zoll Medical Corp

Inventors

• Paradis Norman
• Barash David
• Halperin Henry R
• Freeman Gary A

Classifications

• A61M2205/581

  by audible feedback · CPC title

• A61H2230/00

  Measuring physical parameters of the user · CPC title

• A61H31/005

  with feedback for the user · CPC title

• A61H31/006 Primary

  Power driven · CPC title

• A61M2205/583

  by visual feedback · CPC title