FR3046676A1 - MULTIFUNCTIONAL SYSTEM IMPLANTABLE AND COMMUNICATING WIRELESS. - Google Patents

Abstract

The invention relates to a system for telemetry of physicochemical parameters in a fluid. According to the invention, this system comprises: - complementary equipment including an electronic circuit emitting a signal at a modulated carrier frequency for transmitting service signals, - said electronic circuit is devoid of transmitter and electric battery, and is powered by said antenna via a rectifier bridge and / or a voltage multiplier, associated with an energy storage capacitor, said electronic circuit comprising: - a control circuit consisting of a set of logic gates and memories for to control said at least one sensor and to code the signals transmitted by said at least one sensor - a demodulator delivering a signal controlling the communication functions of said control circuit - an encoder receiving the output signal of the control circuit and delivering a signal of controlling an impedance modulator connected to said antenna.

Description

Multifunctional system implantable and communicating wirelessly.

Field of the invention

The present invention relates to the field of teletransmission of physico-chemical information relating to a circulating fluid, and more specifically to the teletransmission of physiological information using a vascular implant.

For this purpose, expandable implants whose mechanical structure resembles a stent, but which do not necessarily have an endoprosthesis function, but mainly support and positioning of one or more sensors and radiocommunication means with outdoor equipment.

State of the art

Many solutions are known in the state of the art, which can be grouped into different families: • Stents whose metal structure provides a double function of mechanical connection with the vascular and antenna wall • Stents comprising radio-frequency or acoustic transceiver-type electronic components • Stents with a passive component whose deformation causes a variation in impedance or capacitance detected by the external equipment.

In the first family, for example, patent EP2385859 is known describing an implantable wireless monitoring device formed by an endoprosthesis. This system for the transmission of blood pressure in vivo. The system includes the following: a pressure sensor in which the blood pressure data is collected; a wireless transmitter, wherein said in vivo blood pressure data is transmitted to be received, externally disposed to a patient in which the system is installed; an endoprosthesis body, said body having an integral antenna, and a power source, the energy being supplied to the system.

Also known in this family patent application EP12700414 or US patent US7452334 which describe a stent comprising an antenna formed by two parts of the stent mechanically connected by a connecting piece supporting all the electronic components.

This first family of solutions poses technical problems resulting from the fact that the stent structure fulfills two distinct functions: that of mechanical support involving sizing and deformation characteristics determined by the section and the configuration of the implantation vascular zone - that electromagnetic radian involving characteristics determined by the electromagnetic interaction with complementary equipment.

Taking these two constraints into account requires compromises, particularly with regard to the choice of frequencies and the radioelectric performances. To remain in the dimensions corresponding to the configuration of a vascular cavity, the antenna must have strands of about ten centimeters, which implies, if the antenna operates in a "quarter wave" mode, the recourse at UHF, a hundred megahertz. These frequencies are not optimal for responding to good penetration through human tissues. Moreover, the geometry of the stent varies according to the more or less significant expansion, which results in poorly controlled radio characteristics and therefore a transmission mode whose quality can not be perfectly predefined.

Another family of solutions has been proposed in which the antenna is distinct from the mechanical structure of the stent.

International Patent Application WO2010019773 describes an example of an intelligent stent having a coil configured as a resonant circuit, and a reader. In use, oscillation is produced in the stent coil by applying a radiofrequency field to the stent. Then, a parameter associated with the oscillation is obtained to evaluate a flow of fluid through the stent.

European Patent EP2872863 discloses another example of a pressure sensor which comprises an accelerometer designed to produce a first current as it travels, a capacitor for receiving the first current charging it, a logic element operatively connected to said capacitor and enabling discharging a second current from the capacitor until said capacitor reaches a threshold voltage, a pressure sensor provided to receive the discharged current to generate a first signal corresponding to at least one pressure reading of said pressure sensor, and an emitter operatively connected to the pressure sensor and adapted to emit a second signal which is based on the first signal and for an external device for storing data corresponding to the second signal.

These solutions require an energy source integrated with the intracorporeal device to provide power to the transmitter and electronic components such as the pressure sensor to transmit an electromagnetic field strong enough to be picked up and processed by a complementary external equipment. Such a power source must supply enough current to power the electronic circuits, which results in a significant size, poorly adapted to an intravascular system.

The third family of solutions avoids the problem of the on-board power source by the use of passive electromechanical sensors, formed by components whose characteristics change as a function of the deformation by pressure or temperature. Patent US7621036 describes an example of a patent in which the sensor is formed of two membranes whose distance varies according to the blood pressure, which modifies the capacitance placed in an LC bridge.

This family of solutions is limited to telemetry of rudimentary physical characteristics such as pressure or temperature.

Disadvantages of prior art

None of the solutions of the prior art makes it possible to achieve a physiological signal telemetry system optimized to allow radiofrequency communication without a source of electrical energy integrated in the implant, which limits the available energy. Some solutions propose to meet this limitation by passive solutions avoiding the need for electrical energy in the implant. But this is done at the expense of the nature of the physicochemical information that can be measured.

Solutions using an antenna as the metal structure of a stent has an additional disadvantage of a degraded quality of radiofrequency teletransmission, the compensation can be achieved by a higher transmission power, which is not desirable.

Solution provided by the invention

In order to overcome the disadvantages of the prior art, the invention relates, in its most general sense, to a system for telemetry of physicochemical parameters in a fluid, comprising firstly an expandable support mechanically associated with at least one electronic circuit receiving the signal. at least one sensor delivering a signal to an output connected to a passive antenna having a resonance frequency Fr <and secondly complementary equipment comprising a transmitter of an electromagnetic field at the frequency Fr comprising means for measuring the variation of the energy, characterized in that said complementary equipment comprises an electronic circuit emitting a signal at a carrier frequency, preferably greater than 1 Ghz, modulated to transmit service signals, said sensor is devoid of transmitter and battery electrical, and includes an electronic circuit powered by ladi the antenna via a rectifier bridge and / or a voltage multiplier, associated with an energy storage capacitor, said electronic circuit comprising: a control circuit consisting of a set of logic gates and memories for controlling said at least one sensor and for encoding the signals transmitted by said at least one sensor a demodulator delivering a signal controlling the communication functions of said control circuit - an encoder receiving the output signal of the control circuit and outputting a control signal an impedance modulator connected to said antenna.

For the purposes of this patent, the term "battery" is intended to mean an electrical source formed by an autonomous electrochemical component such as a rechargeable battery or battery, supplying an electric current without interaction with an element external to the component.

Preferably, this complementary equipment transmits a signal whose carrier is at a carrier frequency Fr greater than 1 Ghz.

According to one variant, said impedance modulator is furthermore connected to a passive component whose capacitance or impedance varies as a function of a physiological parameter. This variant makes it possible to deliver pressure or temperature information in addition to information provided by a sensor requiring a power supply.

For a medical application said expandable support is advantageously a stent.

According to another advantageous variant, said sensor is an accelerometer. This accelerometer provides information on the dynamics of a person, for example to detect a fall or ambulation disorders. This solution makes it possible to measure abnormal situations by avoiding the artifacts observed when the fall detection accelerometer is inserted into a wristband, the information of which is distorted by the natural erratic movements of the arm.

According to another variant, said sensor is a piezoelectric element for the detection and characterization of at least one biochemical element constituted by a piezoelectric substrate having at each of its opposite faces at least one conductive surface, said electrodes being connected to an electric generator, at least one of said surfaces being coated with a functionalized film.

This variant makes it possible to teletransmit biochemical analyzes in vivo in real time.

According to another variant, the sensor is: - a pH sensor, - a pressure and / or temperature sensor and in particular constituted by a passive mechanical element - a chemical sensor - an optical sensor.

Advantageously, said stent is made of a non-conductive material, for example at least partially by a bioabsorbable part.

Advantageously, said stent is made of a non-conductive material.

According to a variant, said stent further comprises at least one energy recovery means or a plurality of energy recovery means connected in series.

Advantageously, said energy recovery means is constituted by: - a microturbine - a photovoltaic source - a bio-battery - an electromechanical energy recuperator.

According to another variant, said stent further comprises a light source controlled by said control circuit. This variant makes it possible to proceed with the photoactivation of an active ingredient.

Advantageously, said stent further comprises an electromechanical actuator controlled by said control circuit. This variant makes it possible to proceed to the controlled release of an active ingredient for example. The invention also relates to an implant for the telemetry of physicochemical parameters in a fluid, comprising an expansible support mechanically associated with at least one electronic circuit receiving the signal from at least one sensor delivering a signal to an output connected to an antenna passive having a resonant frequency Fri characterized in that said electronic circuit is devoid of emitter and electric battery, and is supplied by said antenna via a rectifier bridge and / or a voltage multiplier, associated with a capacitor energy storage device, said electronic circuit comprising: - a control circuit consisting of a set of logic gates and memories for controlling said at least one sensor and for encoding the signals transmitted by said at least one sensor a demodulator delivering a signal controlling the communication functions of said control circuit - an encoder receiving the signal from the of the control circuit and delivering a control signal of an impedance modulator connected to said antenna. The invention also relates to equipment for the telemetry of physicochemical parameters in a fluid characterized in that it comprises a transmitter of an electromagnetic field at the frequency Fr comprising means for measuring the variation of the energy during the interaction with an implant. The invention also relates to a personalized delivery system for at least one active principle, characterized in that it comprises a system for telemetry of physico-chemical parameters in a fluid and in that it comprises a control circuit whose output controls the active agent delivery means and the input receives the signals from said means for measuring the variation of the energy of said complementary equipment. The invention also relates to a monitoring system for a patient characterized in that it comprises a system for telemetry of physicochemical parameters in a fluid and in that it comprises a control circuit whose output controls at least one monitoring means and the input receives signals from said means for measuring the variation of the energy of said complementary equipment.

Detailed Description of a Non-Limiting Example of the Invention

The present invention will be better understood on reading the detailed description of a nonlimiting example of the invention which follows, with reference to the appended drawings in which: FIG. 1 represents a schematic view of an exemplary embodiment of a implant according to the invention - Figure 2 shows a schematic view of the electronic circuit fitted to the reading equipment of the information measured by the implant - Figure 2 shows a schematic view of the electronic circuit equipping an example of reading equipment according to the FIG. 3 represents a schematic view of the electronic circuit fitted to an exemplary stent according to the invention; FIG. 4 represents a view of the antennas; FIG. 5 represents the equivalent electrical diagram of the antennas; FIG. embodiment comprising a pressure sensor - Figure 7 shows an embodiment of a stent variant. The implant is constituted by an expandable deformable mesh structure (1) of the "stent-endoprosthesis" type enabling it to be inserted into the human body endoscopically and positioned in a zone of interest by anchoring to the wall (10) of a vessel in which blood circulates (11) or a hollow organ of the human body.

A flexible printed circuit (2) is connected to the deformable mesh structure (1). The electronic components (3) are mounted on the printed circuit (2) which supports an antenna (4) formed by two radiating strands formed by a conductive track. This track is coated with an insulation varnish when the mesh structure is conductive.

In the example described, the printed circuit (2) comprises a first pressure sensor (6) formed by a metal membrane subjected to the pressure of the fluid (11) flowing in the vessel (10) and defining to a variable capacity capacitor modifying the resonance frequency of the antenna (4). It comprises a biochemical second biochemical sensor constituted by a surface of a piezoelectric plate (7) whose surface (8) is activated to selectively fix a type of molecule or microorganism and whose frequency is modified by the amount of 'fixed elements. The detection is performed by exciting the piezoelectric plate (7) at a reference frequency corresponding to the nominal natural frequency of the blade (7) and by measuring the energy absorbed.

Description of the implant reading equipment

The circuit diagram of the electronic circuit is shown in FIG.

The circuit includes a synthesizer (20) generating the carrier frequency of 13.56MHz. The rectangular shaped signal is transmitted to a phase shifter circuit (22) for generating two INT + and INT- signals of rectangular shape, in phase opposition, from a single signal provided by the synthesizer (20). These signals are amplified by power amplifiers (23, 24). The perfect phase shift between the two signals ensures a differential attack of the antenna (25) to not transmit the signal mass and increase the power transmitted to the load.

The signal is modulated by a type amplitude modulation, AS K (Amplitude Shift Keying in the English literature) type A with a modulation rate of 100% and type B with a modulation rate of 10%.

The modulator (26) outputs a MIDX * DATA output signal created from the DATA input signal and the MIDX input signal. When the data DATA takes the binary value 1, the signal in the antenna corresponds to the maximum power, and when DATA takes the binary value 0, the power in the antenna corresponds to a modulation index of 10% or 100% according to the type of transmission. The output signal MIDX * DATA controls both power amplifiers (23, 24). The antenna (25) is connected to a rectifier circuit (27) and a comparator circuit (28) via a resistor (29) for delivering a signal DATAS is a digital signal with a frequency varying between 106 kHz and 847 kHz corresponding the interaction of the circuit installed on the implant with the electromagnetic field produced by the external equipment.

The circuit (27) is based on the principle of diode envelope detection. The circuit (28) amplifies the signal provided by the circuit (27) and the comparison with respect to a reference.

Description of the implant circuit

FIG. 3 represents a schematic view of the electronic circuit equipping an exemplary stent according to the invention.

The electronic circuit of the implant is divided into several functional blocks: - Sensor blocks (30): capture of the physico-chemical signal comprising one or more sensors (31 to 33) - Analog-digital converter block (34) ensuring the transformation of the sensor data in digital data - Block (40) for digital signal processing of the sensor and the communication protocol - Received signal recovery block (37) for providing a continuous and stable power supply to the transponder integrated circuit and a signal circuit overload protection; - Block (35) for demodulating the incident signal; A charge modulation block (36) for transmitting the transponder signals to the external reader; - Block (39) for recovery, regeneration and supply of a clock signal to the internal logic of the circuit to ensure its operation; - One or more antennas (38) for the recovery of electromagnetic waves and for telecommunication.

The first block (30); The sensors (31 to 32)

The sensor or the sensors (31 to 32) are adapted to measure a physical or chemical quantity and to provide an analog electrical signal proportional to this magnitude. For each type of parameter a suitable type of sensor is chosen. One variant consists in using two sensors of the same type and the others of different types. Two sensors of the same type make it possible to measure a parameter in two different places or in two different ways.

The second block (34); The digital analog converter

Its role is to transform the analog signal provided by the sensor or sensors into a digital word, coded in binary. This numerical value is proportional to the electrical level of the physical or chemical measurement.

There are different types of converters that will differentiate by their conversion time and cost (Silicon Surface).

The third block (40); The digital processing unit The digital processing unit (40) comprises the control logic. In addition to the management of the communication protocol between the external reader and the implant, the internal control logic makes it possible to check whether the planned and the transmitted passwords are in agreement, as well as several other logical service operations such as the conformances of frame format, CRC type error correction code, etc.

The digital data of the analog-digital converter will be processed so that it can be sent via electromagnetic waves (OEM) to the outside of the human body. The frequency is part of the ISM band. The means of communication may correspond to the protocols proposed by ISO / IEC for radiofrequency communication.

The fourth block; Modulator (36) / demodulator (35)

In order to receive commands from the external base or the smartphone, a demodulation of the received signal is necessary so that the processing unit can understand the beginning and the end of the communication according to the protocol in force.

A modulation of the signal is necessary in order to be able to transmit an OEM containing the information of the data to be transmitted. This modulation is for example carried out according to the protocols ISO / IEC. Load modulation is an example of modulation that provides backscattering of the modulated signal.

The fifth block: clock recovery (37)

It is possible to filter the received signal to recover the clock. This makes it possible to use the carrier wave to obtain a clock signal for the operation of the circuit. This system has the advantage of defining precise synchronizations between the reader and the device signals and of promoting the quality of communications over much greater distances. Another advantage is that of energy saving for the generation of the clock. In the other case, the device is driven by a local clock and the carrier frequency is only used to remote power the transponder.

The sixth block; The energy generator (39)

The device will, among other applications, implanted in the human body and not accessible. The electronic platform is designed so that it can communicate without using batteries.

The recovery of electrical energy delivered by OEMs will be essential to power the entire circuit. The implant then retrieves electromagnetic waves from the environment or those emitted by the reader, the smartphone, etc. The recovered power strongly depends on the distance and the nature of the medium separating the two elements and the impedance matching of the antennas. The antenna of the implant recovers the electromagnetic waves and this block transforms them into an electrical signal; the energy recovery could be through the inductance of the antenna sized on the flex for example to wind and gain space. This makes it possible to have an AC voltage induced at its terminals which will have to be rectified, filtered and regulated to supply the rest of the circuit of the implanted device.

This block manages, regulates and stores energy. It must be able to provide enough power to operate the device. The energy will be stored in miniature capacities or accumulators that allow to keep a communication or a recording of long duration.

Figures 4 and 5 show the antennas (25) of the reader (45) and the stent (46).

The device will be implanted inside the body the signal will have to cross typically 10 to 20 cm of human tissues. Since most of the body is water (70%), the transmission frequency should not be attenuated by the medium. For this, it is advisable to stay below 2.4 GHz knowing that the frequency from which the water becomes partially absorbent is 30 MHz. Another constraint will be the wavelength of the carrier frequency that characterizes the length of the antenna, a compromise is made.

One or more antennas will be used. The radio antenna imposes many constraints on the characteristics of the transmission chain. The antenna will be made on flex, ceramic or made with any other biocompatible or non-biocompatible material and subsequently sealed from the aqueous medium or coated with a biocompatible product. The sizing of the antenna is done according to the choice of the transmission frequency, the quality of the signal and the transmission distance as well as the amount of energy transferable.

As regards sensors, an alternative is to implement sensors incorporating an analog digital converter, in order to provide a signal directly to the processing circuit (40) via an I2C data bus (acronym for an Inter-Integrated Circuit, in English) that can be implemented. by software in a microcontroller.

The sensor may also include another type of connection, of the SPI (Serial Peripheral Interface) type corresponding to a binary synchronous serial bus which operates in full-duplex mode. The circuits communicate according to a master-slave scheme, where the master deals fully with the communication. Several slaves can coexist on the same bus, in this case, the selection of the recipient is done by a dedicated line between the master and the slave called chip select. Mechanical realization of the implant

FIG. 6 represents an exemplary embodiment comprising a pressure sensor.

A biocompatible cell (50) forms a variable capacity as a function of pressure. To make the cell biocompatible, several methods are possible by applying a biocompatible coating or by using initially biocompatible products such as those used for the animal tissue-based heart valve. Then it will be possible to glue, crimp, solder or other on the support.

The cell (50) has a biocompatible membrane (52) (hermetically sealed). A conductive part (53) (metal or semiconductor) is integral with the membrane (52). It forms with a second piece (55) a variable capacitor. Springs (54) hold the two separate pieces (53, 55) with a varying spacing depending on the pressure applied to the diaphragm (52). Mechanical realization of an implant

FIG. 7 represents an embodiment of a variant of an endoprosthesis comprising a microphone or a nanosensor (70). The circuitry is protected by a biocompatible membrane (71) such as an animal vessel, ensuring a tight seal. A biocompatible adhesive (72) or a crimping of this membrane (71) ensuring the fixing and sealing.

The cell comprises one or more sensors, thus possibly a energy recuperator, the electronics and the antenna. It may also include a drug delivery assistant to a sensor or all alone. The cell can be assembled by brazing, crimping, gluing, sliding system (rails), or any other method of assembly which allows the attachment of the two elements in the middle or on the periphery of the capsule.

In other cases, the support will be cut to ensure an electrical link to convey the continuous current or signals requiring a physical link.

Communicating autonomous cells via RF, US or all types of wireless communication. Each cell may be the same or different from the other: having sensors and actuators delivering drugs in the same cell or several. For example: pressure sensor, temperature, pH, accelerometer, etc., and / or insulin injector or homeopathic product, or any other molecule that is intended to heal the part of the target organism.

All these cells communicate with each other and if necessary with a base outside the body to collect physiological signals and provide and target areas to heal (eg stenosis, diabetes, hypertension) allowing treatment and monitoring in real time and dosing medicines adapted to the state of the patient at time t. This option will make the drugs more effective and avoid side effects. The doctor prescribes a drug at a given time, but the diseases evolve and the patients take or lose weight or change their diet from one day to the next which makes the dosage inadequate and the treatment less effective.

The energy recovery cells will be placed in series and connected by the support (stent) which provides an electrical connection allowing a longer and longer operating time and more powerful.

Indeed, in this kind of implant energy is a key element. The cells can recover the energy of the electromagnetic waves that propagate in the environment (WiFi, mobile phone, GSM antenna, ...) or by the outer base of the body intended to communicate with one or more cells.

The energy recovery can be electromagnetic, or a bio-battery or a turbine adapted to the environment in which the device will be used (for example in the vessel, it would be blood)

A cell No. 1 for RF communication (for example) with the outside and another cell No. 2 positioned to communicate for example ultrasound to explode microbubbles or activate drugs passing into the cavity or near the cavity at a well-defined location to target treatment eg cancer; or communicating in IR (Infra Red) for the measurement of the flow or the detection or passage of objects in the light of the pipe.

Claims (22)

Revendreations 1 - System for telemetry of physicochemical parameters in a fluid, comprising firstly an expansible support mechanically associated with at least one electrical circuit receiving the signal from at least one sensor and delivering a signal to an output is connected to an antenna passive device having a resonance frequency FC (and secondly complementary equipment comprising an emitter of an electromagnetic field at the frequency Fr comprising means for measuring the variation of the energy, characterized in that: said complementary equipment comprises a electronic circuit emitting a signal at a modulated carrier frequency for transmitting service signals, - said electronic circuit is devoid of emitter and electric battery, and is powered by said antenna via a bridge rectifier and / or a voltage multiplier, associated with an energy storage capacitor, said electrical circuit onique comprising: - a control circuit consisting of a set of logic gates and memories for controlling said at least one sensor and for encoding the signals transmitted by said at least one sensor - a demodulator delivering a signal controlling the communication functions of said circuit control unit - an encoder receiving the output signal of the control circuit and delivering a control signal of an impedance modulator connected to said antenna. 2 - System according to claim 1 characterized in that said impedance modulator is further connected to a passive component whose capacitance or impedance varies according to a physiological parameter. 3 - System according to claim 1 characterized in that said expandable support is an endoprosthesis. 4 - System according to claim 1 characterized in that said sensor is an accelerometer. 5 - System according to claim 1 characterized in that said sensor is a piezoelectric element for the detection and characterization of at least one biochemical element constituted by a piezoelectric substrate having at each of its opposite faces at least one conductive surface said electrodes being connected to an electrical generator, at least one of said surfaces being coated with a functionalized film. 6 - System according to claim 1 characterized in that said sensor is a pH sensor. 7 - System according to claim 1 characterized in that said sensor is a pressure sensor and / or temperature. 8 - System according to the preceding claim characterized in that said pressure sensor or temperature is constituted by a passive mechanical element. 9 - System according to claim 1 characterized in that said sensor is a chemical sensor. 10 - System according to claim 1 characterized in that said sensor is an optical sensor. 11 - System according to claim 1 characterized in that said stent is made of a conductive material. 12 - System according to claim 1 characterized in that said stent is made of a non-conductive material. 13 - System according to claim 1 characterized in that said stent further comprises at least one energy recovery means. 14 - System according to the preceding claim characterized in that said stent comprises a plurality of energy recovery means connected in series. 15 - System according to claim 13 or 14 characterized in that said energy recovery means is constituted by a microturbine. 16 - System according to claim 13 or 14 characterized in that said energy recovery means is constituted by a photovoltaic source. 17 - System according to claim 13 or 14 characterized in that said energy recovery means is constituted by a bio-battery. 18 - System according to claim 13 or 14 characterized in that said energy recovery means is constituted by an electromechanical energy recuperator. 19 - System according to claim 1 characterized in that said endoprosthesis further comprises a light source controlled by said control circuit. 20 - System according to claim 1 characterized in that said endoprosthesis further comprises an electromechanical actuator controlled by said control circuit. 21 - Implant for the telemetry of physicochemical parameters in a fluid, comprising an expandable support mechanically associated with at least one electronic circuit receiving the signal from at least one sensor delivering a signal to an output connected to a passive antenna having a frequency characterized in that said electronic circuit is devoid of emitter and electric battery, and is supplied by said antenna via a bridge rectifier and / or a voltage multiplier, associated with a storage capacitor d energy, said electronic circuit comprising: a control circuit constituted by a set of logic gates and memories for controlling said at least one sensor and for encoding the signals transmitted by said at least one sensor a demodulator delivering a command signal; communication functions of said control circuit - an encoder receiving the output signal of the control circuit e control and delivering a control signal of an impedance modulator connected to said antenna. 22 - Equipment for the telemetry of physicochemical parameters in a fluid characterized in that it comprises a transmitter of an electromagnetic field at the frequency Fr comprising means for measuring the variation of the energy during the interaction with an implant according to the preceding claim. 23 - Personalized delivery system for at least one active principle, characterized in that it comprises a system for telemetry of physico-chemical parameters in a fluid according to claim 1, and in that it comprises a control circuit of which the output controls the active agent delivery means and the input receives the signals from said means for measuring the variation of the energy of said complementary equipment. 24 - Monitoring system of a patient characterized in that it comprises a physico-chemical telemetry system in a fluid according to claim lf and in that it comprises a control circuit whose output controls at least monitoring means and the input receives signals from said means for measuring the variation of the energy of said complementary equipment.