Surgery – Diagnostic testing
Reexamination Certificate
1999-05-14
2001-08-14
Winakur, Eric F. (Department: 3736)
Surgery
Diagnostic testing
CD24S107000, C178S038000
Reexamination Certificate
active
06273855
ABSTRACT:
BACKGROUND OF THE INVENTION
The present invention relates to medical systems and particularly patient monitoring systems for the acquisition, processing and display of data of critically ill patients.
When monitoring critically ill patients, it is often necessary to obtain a variety of medical data related to the condition of the patient. Various options are available for this purpose. The most frequently chosen options are the use of patient monitoring devices for the acquisition of physiological parameters, such as those of the electrocardiogram, of the blood pressure, of the oxygen saturation or of the respiration; the laboratory analysis of physiological samples, e.g. of blood or tissue samples, and, in patients treated by artificial respiration, the evaluation of settings and measurement values of the respiration device. Recently, particularly the data acquired by a patient surveillance monitor have rapidly increased in number, on the one hand because the technical progress achieved in the fields of sensor technology and microelectronics is beneficial for the monitoring of patients, and on the other hand because the increasing insight into the medical interrelationships has initiated a demand for the acquisition of further parameters.
Due to this recent development, the number of a patient's physiological parameters which can be acquired, processed and displayed in modern intensive care wards and operating theaters has become so large that even very sophisticated display instruments make it hardly possible anymore to quickly acquire the massive bulk of data and that a reasonable evaluation of these data by the medical staff is hardly feasible either. Since humans can only visually observe a relatively limited number of curves and varying measurement values simultaneously and draw correct conclusions from these observations, state-of-the-art patient monitoring systems clearly entail a so-called “mental overload” effect, i.e. an overstrain of the mental receptivity. This makes it necessary to develop methods for avoiding the above effect.
The existence of a clear interrelationship between the form of representation of physiological data and the medical staff's ability to interpret these data has been demonstrated in a study published in Anesthesiology, Vol. 83, pp. 1184-1193 and entitled “Visual Display Format Affects the Ability of Anesthesiologists to Detect Acute Physiologic Changes”. This study evaluates different forms of presentation of physiological data and the speed and accuracy of the detection of changes in these physiological data as performed by the medical staff. This study comes to the conclusion that the physiological data can be interpreted in a distinctly faster and more accurate manner when presented in a graphical form. A similar result has been presented in a study published in Journal of Clinical Monitoring, Vol. 13, pp. 249-259 and entitled “An Integrated Graphic Data Display Improves Detection and Identification of Critical Events During Anesthesia” wherein a graphic representation of twenty anesthesia-related parameters is compared to a mode of representation performed by means of curves and numerical values of the type commonly used in patient monitoring devices according to the state of the art. As to the detection of relevant events by the medical staff, the conventional representation through curves and numerical values has proven to require several minutes, additional time in comparison to a new graphic representation.
Since, as described above, the number of parameters monitored in a critically ill patient is ever more increasing, whereas the size of the monitoring devices is hardly changing or is even reduced as a result of technical advances, the display of the totality of such parameters on the screen of a monitoring device will cause a dilemma. Frequently, certain monitored parameters are displayed not at all or only with insufficient size and quality on the screen of a monitoring device because the space. available on the monitoring screen is not sufficient for displaying all of the monitored parameters with satisfactory quality. Other parameters, although their monitoring would be beneficial from the medical viewpoint, are not monitored since the display space of the monitoring device is already exhausted by other parameters of higher medical importance.
Thus, it is an object of the present invention to provide a method and a device for the optical representation of medical data acquired by medical systems, wherein the data can be quickly acquired and evaluated by a viewer.
SUMMARY OF THE INVENTION
The present invention avoids the disadvantages of the display of medical data inherent to medical systems of the prior art in that the space requirements for the display of these medical data are considerably reduced. Further, the visual displays generated by the method according to the present invention can be surveyed by the medical staff distinctly more quickly and easier than displays according to prior art.
According to the present invention, monitoring is based on at least three medically relevant data which usually comprise measurement values obtained by measurement value detection devices or can be derived from such measurement values. A difference is made between data undergoing relatively quick changes, e.g. those of the electrocardiogram, the electro-encephalogram, the arterial pulse curve, the curve of the pressure of the respiratory tract and the like, and data undergoing relatively slow changes, e.g. those of the heart rate, the values of the systolic and diastolic blood pressure, the value of the oxygen saturation, the value of the respiratory rate and the like. In the description hereunder, the above data of the slow-changing type will be referred to as measurement values, and the above data of the fast-changing type are referred to as curves.
At least one of said medically relevant data is a datum which changes relatively quickly, i.e. a curve. Further, this curve must have a periodicity in so far as its basic patterns will be repeated in specific intervals, as is the case, for instance, in the electrocardiogram or the arterial pulse curve per heartbeat or in the curve of the pressure of the respiratory tract per breath.
By means of a display unit associated with the medical system and connected to one or a plurality of measurement value acquisition devices, said at least three medically relevant data are visually represented in a manner generating an apparent three-dimensional optical impression of the display as perceived by the user of the system. Preferably, the representation of said at least three medically relevant data is updated in periodic intervals; these intervals can be derived from those intervals which cause the periodicity of the curve.
If more than three data are to be displayed, the fourth and further dimensions can be represented by further characteristics of the three-dimensionally displayed curve or surface, such as color, various shades of grey, width of lines, brightness and other characteristics.
The above three-dimensional impression is generated by representing said at least three data in an at least three-dimensional coordinate system and by transforming this representation onto a two-dimensional display device according to a predefined arithmetic rule whose parameters can be changed by the user, as well as by use of characteristics suited to enhance the perceived three-dimensional effect, such as surface-effect representation, coloring, apparent illumination etc.
REFERENCES:
patent: 5111827 (1992-05-01), Rantala
patent: 6001060 (1999-12-01), Churchill et al.
patent: 6026320 (2000-02-01), Carlson et al.
Visual Display Format Affects the Ability of Anesthesiologists to Detect Acute Physiologic Changes: in Anesthesiology, vol. 83, pp. 1184-1193.
“An Integrated Graphic Data Display Improves Detection and Idnetification of Critical Events During Anesthesia” In Journal of Clinical Monitoring, vol. 13, pp. 249-259.
“Beatmungs- und Narkosetechniken”, A Gartner, TUV RheinTand.
“Beatmungsgerate i
Becker Uwe
Herzner Josef
Schmid Guenter
Astorino Michael C
B. Braun Melsungen AG
Diller Ramik & Wight
Winakur Eric F.
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