WO2009125327A1 - Détection de rétention de fluide chez un patient - Google Patents
Détection de rétention de fluide chez un patient Download PDFInfo
- Publication number
- WO2009125327A1 WO2009125327A1 PCT/IB2009/051411 IB2009051411W WO2009125327A1 WO 2009125327 A1 WO2009125327 A1 WO 2009125327A1 IB 2009051411 W IB2009051411 W IB 2009051411W WO 2009125327 A1 WO2009125327 A1 WO 2009125327A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- circumference
- garment
- patient
- measuring sensor
- electrical
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Ceased
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/103—Measuring devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
- A61B5/107—Measuring physical dimensions, e.g. size of the entire body or parts thereof
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
- A61B5/6801—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be attached to or worn on the body surface
- A61B5/6802—Sensor mounted on worn items
- A61B5/6804—Garments; Clothes
- A61B5/6807—Footwear
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/103—Measuring devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
- A61B5/107—Measuring physical dimensions, e.g. size of the entire body or parts thereof
- A61B5/1075—Measuring physical dimensions, e.g. size of the entire body or parts thereof for measuring dimensions by non-invasive methods, e.g. for determining thickness of tissue layer
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/103—Measuring devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
- A61B5/107—Measuring physical dimensions, e.g. size of the entire body or parts thereof
- A61B5/1077—Measuring of profiles
Definitions
- the invention relates generally to the field of cardiovascular disease management and, in particular, to a system for detection of fluid retention in a patient, especially for treating patients with heart failure.
- Heart failure is a principal complication of virtually all forms of heart disease, e.g. coronary artery disease and heart attack.
- heart failure blood moves through the heart and body at a slower rate, and pressure in the heart increases.
- the kidneys often respond by causing the body to retain fluid, i.e. water, and sodium. If fluid builds up in the arms, legs, ankles, feet, lungs or other organs, the body becomes congested.
- HF is a progressive condition characterized by frequent hospital admissions and ultimately high mortality rates.
- the prevalence of HF increases dramatically with age, occurring in 1 to 2 percent of persons aged 50 to 59 and up to 10 percent of individuals older than the age of 75.
- With the overall aging population it is expected that the number of chronic cardiovascular disease patients - especially for congestive heart failure and atrial fibrillation - will increase in the coming years and, thus, the costs of disease management will increase, too.
- HF is the most frequent cause of hospitalization among patients over 65.
- Heart failure may affect the left, right, or both sides of the heart. If the left half of the heart fails (left ventricular failure), fluid builds up in the lungs due to congestion of the veins of the lungs. In case of right ventricular failure, general body vein pressure will increase and fluid will accumulate in the body, especially the tissues of the legs and abdominal organs. Often, left heart failure leads to right heart failure causing biventricular failure.
- the treatment focuses on treating the symptoms and signs of HF and preventing the progression of disease.
- Patients with HF are educated to undertake various non-pharmacological measures to improve symptoms and prognosis. Such measures include moderate physical activity, weight reduction, sodium and fluid restriction.
- HF patients The life expectancy and quality of life of HF patients has improved by more than 60 % due to the introduction of new pharmacological and device therapies.
- a key factor in order to alleviate symptoms and prolong the survival has been the extension of the range of medications from diuretics and cardiac glycosides to include angiotensin converting enzyme inhibitors (ACEI), beta-blockers, angiotensin receptor blockers (ARB), aldosterone receptor antagonists in the main treatment line.
- ACEI angiotensin converting enzyme inhibitors
- beta-blockers beta-blockers
- ARB angiotensin receptor blockers
- aldosterone receptor antagonists aldosterone receptor antagonists
- Peripheral edemas are also common in many other conditions: renal or hepatic insufficiency, diabetes, overweight, pregnancy, elderly population and people with limited mobility. In all these cases it is desirable to monitor the fluid accumulation in the limbs of these patients.
- a system for detection of fluid retention in a patient comprising: a garment provided with a circumference measuring sensor and adapted to be worn around a patient's limb, and an analyzer for analyzing circumference data acquired by the circumference measuring sensor.
- the term "garment” means any kind of wearable piece of clothing, bandage, tape or the like, like medical, therapeutical and/or compression stockings, hosiery etc.
- the term "limb” means any extremity of the human body which is suitable for wearing a respective garment, e.g. calf, leg, arm, wrist etc.
- the garment may be reusable or disposable.
- the analyzer may be a passive or an active device.
- the analyzer may comprise a current or voltage source for providing the circumference measuring sensor with electrical energy or for analyzing a property of the circumference measuring sensor that varies with circumference of the garment.
- the terms “circumference”, “circumference data” and “circumference variations” are related to the total circumference (360°) or only part of the total circumference ( ⁇ 360°).
- Heart failure patients and people with diseases where fluid build-up can occur in the legs are often elderly with limited technical expertise and little mental capacity to be able to carry out complex measurements to monitor their health status. Patients' capacity to assess their own health status may be limited:
- a system is proposed that gives reliable measurements of the circumference of a limb, e.g. an ankle, and - derived from this - the swelling level, e.g. in the leg. These measurements can be carried out without requiring any extra patient effort, while preferably wearing a garment that the patient would be wearing anyway.
- a system that comprises at least one circumference measuring sensor which is incorporated into a garment, like a sock.
- This can be for example a widely used medical sock, to measure the circumference of a limb, e.g. an ankle, and thus the fluid retention in the lower legs in an unobtrusive way.
- the system can store the circumference values measured over several days, allowing significant changes in these values to be detected. Further, according to a preferred embodiment of the invention, the system can then warn of a dangerous change in the fluid level by alerting the patient, using a visual or audible signal, or the caregiver, e.g. using a wireless connection without the patient being actively involved.
- An accurate assessment of the limb circumference, and thus the accumulated fluid helps physicians to optimize therapies for their patients.
- the system according to the invention can be tuned specifically for the patient concerned, thus improving the accuracy of the warning system. Further, according to a preferred embodiment of the invention, the system can be combined with other measurement and therapy technologies integrated into the garment, such as thermal measurement used in treatment of phlebitis or venous stasis, or adaptive compression, used in the treatment of varicose veins or thrombophlebitis.
- the sensor endowed garment will be easy to wear and easy to wash.
- the garment can be made of different materials.
- the garment comprises an elastic material. This makes the garment more comfortable to wear and supports circumference variations which directly relate to variations of the circumference of the limb.
- the garment is a sock to be worn on a patient's foot.
- therapeutic socks are available and are common items for bed-ridden people.
- these socks are only used to minimize the symptoms, and are not used for monitoring the patient's condition.
- the limb circumference measurements proposed according to this invention, to be preferably carried out in a sock, will give valuable health status information without being a burden for the patient.
- limb circumference may increase or decrease if the patient is walking or otherwise exercising the muscles, preferably this is to be taken into account when deriving the level of accumulation.
- building an average value of the day and comparing this to a series of values rather than relying on a single measurement will consider this.
- the garment is provided with an electrical conductor having two electrical contacts.
- an electrical conductor Preferably, as an electrical conductor an electric cable is used.
- Such an electrical conductor provides for different possibilities of measuring circumference variations.
- At least one contact is a sliding contact such that the length of the electrical conductor between the contacts varies according to circumference variations of the garment.
- the analyzer is adapted for measuring the resistance of the electrical conductor between the two contacts. This way, circumference variations of the limb can be measured by variations of the electrical resistance of the conductor.
- the ends of the electrical conductor are fixed to a respective electrical contact in a non-movable manner.
- the electrical conductor is spirally wound. This provides for the possibility of detecting circumference variations of the limb based on the inductance of the electrical conductor.
- a coil is formed, the inductance value of which is proportional to the loop area of the coil.
- the analyzer is adapted for measuring the inductance of the electrical conductor between the two electrical contacts.
- an elastic core is provided around which the electrical conductor is wound, which makes the design more robust and easy to apply.
- the garment is provided with a strain gauge for indicating variations in the circumference of the garment.
- a strain gauge for indicating variations in the circumference of the garment.
- the strain gauge is provided with an electrostatic shielding, preferably made of a metal foil, e.g. an aluminum foil.
- the garment is provided with an optical fiber.
- the analyzer is adapted for detecting variations in the circumference of the garment based on an electromagnetic signal guided in the optical fiber.
- an emitted light or radio frequency signal can be transmitted inside a flexible optical fiber transversal to the limb.
- a detector at the other end of the circumference, it is possible to estimate the length of the fiber based on the signal received, e.g. via phase detection, attenuation in amplitude, interference, distortions etc.
- the circumference data can be dispatched in different ways.
- the analyzer is adapted for wireless communication with an external unit.
- the circumference data can be sent, e.g. via a Bluetooth connection, to a patient mobile station and from there to a nurse or GP mobile station for further evaluation.
- the system is preferably equipped with a battery, preferably with a rechargeable battery.
- a preferred application of the invention is decompensation detection of right ventricular HF patients.
- the system is suitable for home or hospital application.
- Other target groups are patients suffering from renal or hepatic insufficiency, diabetes, overweight, pregnancy, elderly population and people with limited mobility.
- the system can be included in a patient monitoring system, predicting either decompensation for HF patients or reporting fluid accumulation for the above diseases where peripheral edemas are common.
- the system according to the invention can also be used for assessing the hydration level in elderly or sick people, covering also the problem of monitoring the adequate fluid intake in these populations. In this case, the term "fluid retention" applies to the degree of hydration of these patients.
- the invention also concerns a garment with a circumference measuring sensor and adapted to be worn around a patient's limb, wherein the circumference measuring sensor comprises an electrical conductor having two electrical contacts for electrically contacting the conductor.
- the measuring principle of the circumference measuring sensor is based on a resistive or an inductive principle.
- the circumference measuring sensor comprises at least one strain gauge and/or an optical fiber.
- Fig. 1 shows a schematic depiction of a preferred embodiment of the invention
- Fig. 2 shows a schematic depiction of another preferred embodiment of the invention using a resistive principle
- Fig. 3 shows a schematic depiction of another preferred embodiment of the invention using an inductive principle
- Fig. 4 shows a schematic depiction of another preferred embodiment of the invention using strain gauges
- Fig. 5 shows a schematic depiction of another preferred embodiment of the invention using an optical fiber.
- the system for detection of fluid retention in a patient comprises a sock 1 provided with a circumference measuring sensor 2 and adapted to be worn around a patient's foot, an analyzer 3 for analyzing circumference data acquired by the circumference measuring sensor 2 and a wireless communication unit 4 for transmitting circumference data to an external unit like a patient mobile station 5, a nurse mobile station 6 and/or a doctor's office station 7 by a wireless connection 8.
- the circumference measuring sensor 2 and the analyzer 3 for analyzing circumference data acquired by the circumference measuring sensor 2 can be designed in different ways as set out in the following:
- a resistive flexible but not stretchable electrical cable 9 is positioned transversal to the ankle as can be seen from Fig. 2.
- This cable 9 is connected to a current source 10 by a fixed contact 11 and a sliding contact 12.
- a current source 10 By measuring the voltage between the two contacts 11, 12, with a voltmeter 13, it is possible to extract the value of the resistance of the cable 9 between the two contacts 11, 12, which is directly proportional to the length of the circumference of the ankle on which the sock 1 is worn.
- the electrical cable 9 described is not stretchable but changes its circumference by the mechanism described.
- the garment 1 adjacent to the electrical cable 9 in the contrary is normally stretchable to a certain amount, as the garment 1 can be designed as common having common textile fibers.
- a circumference measurement via an elastic coil is used.
- an electrical cable 14 is wound spirally around an elastic core 15, so that the cable 14 is stretchable in longitudinal direction.
- a coil is formed which is positioned transversally relative to the ankle, and the inductance value of which is proportional to the loop area S of the coil as shown in Fig. 3.
- the inductance of the coil can be expressed in terms of the geometry of the solenoid:
- N is the number of loops, and / is the length, i.e. the circumference diameter.
- An alternating current is injected into the cable 14 from an alternating current source 18.
- strain gauges 20 integrated into the flexible material of a therapeutic sock 1 may yield a signal indicating changes in the circumference of the ankle.
- an emitted light or radio frequency signal is transmitted inside a flexible optical fiber 22 transversal to the ankle.
- a sender 23 at the one end and a detector 24 at the other end of the fiber 22 it is possible to estimate the length of the fiber 22 based on the received signal, e.g. via phase detection, attenuation in amplitude, interference, distortions etc.
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Veterinary Medicine (AREA)
- Biophysics (AREA)
- Pathology (AREA)
- Engineering & Computer Science (AREA)
- Public Health (AREA)
- Physics & Mathematics (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Surgery (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Dentistry (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Measuring And Recording Apparatus For Diagnosis (AREA)
Abstract
L'invention porte sur un système pour la détection d'une rétention de fluide chez un patient, comprenant un vêtement 1 comportant un détecteur de mesure de circonférence 2 et apte à être porté autour d'un membre du patient, tel qu'une cheville, et un analyseur 3 pour analyser des données de circonférence acquises par le détecteur de mesure de circonférence 2. Des variations de circonférence du membre peuvent être mesurées de différentes façons, par exemple sur la base d'un principe résistif ou inductif. De cette façon, une possibilité fiable et facile à utiliser pour la détection d'une rétention de fluide chez un patient est fournie.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| EP08103490 | 2008-04-10 | ||
| EP08103490.2 | 2008-04-10 |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| WO2009125327A1 true WO2009125327A1 (fr) | 2009-10-15 |
Family
ID=40887068
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| PCT/IB2009/051411 Ceased WO2009125327A1 (fr) | 2008-04-10 | 2009-04-03 | Détection de rétention de fluide chez un patient |
Country Status (1)
| Country | Link |
|---|---|
| WO (1) | WO2009125327A1 (fr) |
Cited By (13)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO2012154224A3 (fr) * | 2011-01-10 | 2013-04-11 | Bioguidance Llc | Dispositif de surveillance de patient |
| WO2013182985A1 (fr) | 2012-06-05 | 2013-12-12 | Koninklijke Philips N.V. | Procédé et appareil pour estimer la quantité de fluide dans une partie du corps d'un sujet |
| US8827930B2 (en) | 2011-01-10 | 2014-09-09 | Bioguidance Llc | System and method for patient monitoring |
| WO2016011307A1 (fr) * | 2014-07-17 | 2016-01-21 | Cardimetrix Llc | Dispositif pour détecter la présence et la gravité d'un oedème |
| WO2017127157A1 (fr) * | 2016-01-21 | 2017-07-27 | Plethy, Inc. | Dispositifs, systèmes et procédés pour surveillance de santé utilisant des changements circonférentiels d'une partie du corps |
| US9786148B2 (en) | 2016-01-21 | 2017-10-10 | Plethy, Inc. | Devices, systems, and methods for health monitoring using circumferential changes of a body portion |
| EP3351173A1 (fr) * | 2017-01-24 | 2018-07-25 | Nokia Technologies Oy | Appareil de détermination d' oedème et procédés associés |
| CN108697374A (zh) * | 2016-01-13 | 2018-10-23 | 丹麦专用绷带股份有限公司 | 一种用于提供身体部位的周长的量度的装置和方法 |
| WO2020113204A1 (fr) * | 2018-11-30 | 2020-06-04 | Arizona Board Of Regents On Behalf Of The University Of Arizona | Systèmes et procédés de détection et d'évaluation de changements de dimension d'un corps ou d'un appendice |
| US10842415B1 (en) | 2019-10-25 | 2020-11-24 | Plethy, Inc. | Devices, systems, and methods for monitoring and assessing gait, stability, and/or balance of a user |
| US10895453B2 (en) | 2014-04-10 | 2021-01-19 | Peracutus Holding B.V. | Process for the determination of the cross-sectional area and volume of an object |
| WO2022093962A1 (fr) * | 2020-10-28 | 2022-05-05 | Impact Ip, Llc | Traitement de données de capteur générées associées à l'utilisation d'un dispositif de thrombose veineuse profonde (tvp) |
| US11672477B2 (en) | 2017-10-11 | 2023-06-13 | Plethy, Inc. | Devices, systems, and methods for adaptive health monitoring using behavioral, psychological, and physiological changes of a body portion |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| US3853118A (en) * | 1973-08-29 | 1974-12-10 | Measurand Syst | Swelling detector |
| US4383533A (en) * | 1981-02-10 | 1983-05-17 | The United States Of America As Represented By The Administrator Of The National Aeronautics And Space Administration | Apparatus for determining changes in limb volume |
| US5497787A (en) * | 1994-08-05 | 1996-03-12 | Nemesdy; Gabor | Limb monitoring method and associated apparatus |
| US5891059A (en) * | 1997-10-28 | 1999-04-06 | Mr. Jared Arnold Anderson | Method for detecting edema |
| US5915386A (en) * | 1997-10-28 | 1999-06-29 | Alere Medical Incorporated | Method and device for detecting edema |
| WO2007097635A1 (fr) * | 2006-02-24 | 2007-08-30 | Carsten Sandholdt | Dispositif permettant de combattre et de détecter un hématome ou une hémorragie sub-épithéliale après une intervention coronarienne percutanée |
-
2009
- 2009-04-03 WO PCT/IB2009/051411 patent/WO2009125327A1/fr not_active Ceased
Patent Citations (6)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US3853118A (en) * | 1973-08-29 | 1974-12-10 | Measurand Syst | Swelling detector |
| US4383533A (en) * | 1981-02-10 | 1983-05-17 | The United States Of America As Represented By The Administrator Of The National Aeronautics And Space Administration | Apparatus for determining changes in limb volume |
| US5497787A (en) * | 1994-08-05 | 1996-03-12 | Nemesdy; Gabor | Limb monitoring method and associated apparatus |
| US5891059A (en) * | 1997-10-28 | 1999-04-06 | Mr. Jared Arnold Anderson | Method for detecting edema |
| US5915386A (en) * | 1997-10-28 | 1999-06-29 | Alere Medical Incorporated | Method and device for detecting edema |
| WO2007097635A1 (fr) * | 2006-02-24 | 2007-08-30 | Carsten Sandholdt | Dispositif permettant de combattre et de détecter un hématome ou une hémorragie sub-épithéliale après une intervention coronarienne percutanée |
Cited By (23)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US8827930B2 (en) | 2011-01-10 | 2014-09-09 | Bioguidance Llc | System and method for patient monitoring |
| US8915869B2 (en) | 2011-01-10 | 2014-12-23 | Bioguidance Llc | Patient monitoring device |
| WO2012154224A3 (fr) * | 2011-01-10 | 2013-04-11 | Bioguidance Llc | Dispositif de surveillance de patient |
| US12390160B2 (en) | 2011-01-10 | 2025-08-19 | Bodiguide Inc. | System and method for patient monitoring |
| US10993658B2 (en) | 2011-01-10 | 2021-05-04 | Bodiguide Inc. | System and method for patient monitoring |
| WO2013182985A1 (fr) | 2012-06-05 | 2013-12-12 | Koninklijke Philips N.V. | Procédé et appareil pour estimer la quantité de fluide dans une partie du corps d'un sujet |
| US9955916B2 (en) | 2012-06-05 | 2018-05-01 | Koninklijke Philips N.V. | Method and apparatus for estimating the fluid content of a part of the body of a subject |
| US10895453B2 (en) | 2014-04-10 | 2021-01-19 | Peracutus Holding B.V. | Process for the determination of the cross-sectional area and volume of an object |
| WO2016011307A1 (fr) * | 2014-07-17 | 2016-01-21 | Cardimetrix Llc | Dispositif pour détecter la présence et la gravité d'un oedème |
| US10932694B2 (en) | 2014-07-17 | 2021-03-02 | Cardimetrix Llc | Device for detecting presence and severity of edema |
| CN108697374A (zh) * | 2016-01-13 | 2018-10-23 | 丹麦专用绷带股份有限公司 | 一种用于提供身体部位的周长的量度的装置和方法 |
| WO2017127157A1 (fr) * | 2016-01-21 | 2017-07-27 | Plethy, Inc. | Dispositifs, systèmes et procédés pour surveillance de santé utilisant des changements circonférentiels d'une partie du corps |
| US10722145B2 (en) | 2016-01-21 | 2020-07-28 | Plethy, Inc. | Devices, systems and methods for health monitoring using circumferential changes of a body portion |
| US9786148B2 (en) | 2016-01-21 | 2017-10-10 | Plethy, Inc. | Devices, systems, and methods for health monitoring using circumferential changes of a body portion |
| EP3351173A1 (fr) * | 2017-01-24 | 2018-07-25 | Nokia Technologies Oy | Appareil de détermination d' oedème et procédés associés |
| US11672477B2 (en) | 2017-10-11 | 2023-06-13 | Plethy, Inc. | Devices, systems, and methods for adaptive health monitoring using behavioral, psychological, and physiological changes of a body portion |
| US11826165B2 (en) | 2017-10-11 | 2023-11-28 | Plethy, Inc. | Devices, systems, and methods for adaptive health monitoring using behavioral, psychological, and physiological changes of a body portion |
| US12133742B2 (en) | 2017-10-11 | 2024-11-05 | Plethy, Inc. | Devices, systems, and methods for adaptive health monitoring using behavioral, psychological, and physiological changes of a body portion |
| WO2020113204A1 (fr) * | 2018-11-30 | 2020-06-04 | Arizona Board Of Regents On Behalf Of The University Of Arizona | Systèmes et procédés de détection et d'évaluation de changements de dimension d'un corps ou d'un appendice |
| US10842415B1 (en) | 2019-10-25 | 2020-11-24 | Plethy, Inc. | Devices, systems, and methods for monitoring and assessing gait, stability, and/or balance of a user |
| US11950901B2 (en) | 2019-10-25 | 2024-04-09 | Plethy, Inc. | Systems and methods for assessing gait, stability, and/or balance of a user |
| US12329516B2 (en) | 2019-10-25 | 2025-06-17 | Plethy, Inc. | Systems and methods for assessing gait, stability, and/or balance of a user |
| WO2022093962A1 (fr) * | 2020-10-28 | 2022-05-05 | Impact Ip, Llc | Traitement de données de capteur générées associées à l'utilisation d'un dispositif de thrombose veineuse profonde (tvp) |
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