Pulsus Paradoxus Monitor

奇脉监测仪

• 批准号: 6949921
• 负责人: GREGORY D. JAY
• 金额: $ 14.93万
• 依托单位: P2LETHLOGICS, LLC
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-17 至 2007-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6949921
• 关键词: adolescence (12-20); adult human (21+); age difference; asthma; biomedical equipment development; blood pressure; child (0-11); clinical research; computer program /software; computer system design /evaluation; emergency care; human subject; patient care management; patient monitoring device; portable biomedical equipment

DESCRIPTION (provided by applicant): Pulsus paradoxus (PP) is a valuable pathological vital sign in the management of asthma and in the rapid evaluation of patients with dyspnea in general. Early asthma management guidelines published by NHLBI in 1991 included a recommendation for physicians to measure PP in acutely asthmatic patients. Recent evidence continues to show that PP can play a role as a metric indicative of respiratory effort during dysfunction. Unlike peak flow rate and spirometry, PP measurement is non-effort dependent and would theoretically result in better assessment of asthma severity. Pulsus paradoxus is present in asthma, croup, and pericardial tamponade and tension pneumothorax. It appears prior to hypoxia in all of these conditions. For this reason, PP monitoring would prove useful not only to physicians but also to physician extenders who may be unfamiliar with the physiological dyscrasias of these conditions and would be assisted by an expert monitoring system. We propose 3 interconnecting specific aims: 1) Improve the automated PP detection algorithm resulting in at least a 95% agreement between automated PP and true PP measurement from a continuous non-invasive blood pressure monitor (NIBP). 2) Is the PP threshold of 12 mmHg for hospital admission in the 1991 NHLBI ED Asthma Management Guidelines valid as measured with an automated non-invasive PP monitor among acutely asthmatic children? 3) Is the PP threshold of 12 mmHg for hospital admission in the 1991 NHLBI ED Asthma management guidelines valid as measured with an automated non-invasive PP monitor among acutely asthmatic adults? In aim 1 we will improve upon our existing PP detection algorithm as it analyzes data in real time from a NIBP monitor. Aims 2 & 3 will test whether the original NHLBI emergency department asthma management guidelines, which included an actual PP threshold, are valid. Data from aims 2 & 3 will provide real world blood pressure data from acutely asthmatic patients for the iterative refinement efforts in aim 1. This Phase 1 effort will result in a refined PP monitor, for which we have a strong intellectual property position, and clinically relevant (validated) PP thresholds, which future asthma management guidelines will reference. Future Phase 2 activities could include prospective PP threshold testing in the emergency department and home monitoring of selected asthmatic patients, both of which would impact efficient clinical resource utilization.

描述（由申请人提供）： Pulsus Paradoxus（PP）是哮喘管理和对呼吸困难患者的快速评估中的有价值的病理生命体征。 NHLBI在1991年发表的早期哮喘管理指南提出了一项建议，要求医生在急性哮喘患者中测量PP。最近的证据继续表明，PP可以作为指示功能障碍期间呼吸努力的指标发挥作用。与峰流速和肺活量测定法不同，PP测量是非依赖性的，理论上会导致更好地评估哮喘的严重程度。 Pulsus Paradoxus存在于哮喘，臀部和心包填塞和张力气胸中。在所有这些情况下，它都出现在缺氧之前。 因此，PP监测不仅对医生，而且对可能不熟悉这些疾病生理性不熟悉的医师扩展器有用，并且会通过专家监测系统来协助。我们提出了3个互连特定目的：1）改进自动化PP检测算法，从而从连续的非侵入性血压监测仪（NIBP）进行自动PP和真实PP测量之间至少达成95％的一致性。 2）在1991年的NHLBI ED哮喘管理指南中，在急性哮喘儿童中使用自动化的非侵入性PP监测器测量的哮喘管理指南有效期为12 mmHg的PP阈值是否有效？ 3）在1991年的NHLBI哮喘管理指南中，在急性哮喘成年人中使用自动化的非侵入性PP监测器测量的NHLBI哮喘管理指南有效期为12 mmHg的PP阈值是否有效？在AIM 1中，我们将根据NIBP监视器实时分析数据，以改进我们现有的PP检测算法。 AIMS 2和3将测试最初的NHLBI急诊室哮喘管理指南（包括实际的PP阈值）是否有效。来自AIM 2和3的数据将为AIM 1提供急性哮喘患者的现实血压数据。这一阶段1的工作将导致精致的PP监测器，我们在该监视器中具有强大的知识产权位置，并且具有临床上相关的（经过验证的）PP阈值，这是未来哮喘管理指南的未来PP阈值。未来的第二阶段活动可能包括急诊科的前瞻性PP阈值测试以及对选定哮喘患者的家庭监测，这两者都会影响有效的临床资源利用。