System and method for analyzing a patient status for respiratory insufficiency for use in automated patient care

1. A system for analyzing a patient status for respiratory insufficiency for use in automated care, comprising

a server system receiving a set of one or more physiological measures relating to patient information recorded on a substantially continuous basis or derived therefrom, the server system further receiving one or more baseline physiological measures relating to patient information recorded during an initial time period or derived therefrom;

a database module storing the physiological measures into a patient care record for an individual patient into a database, the database module further storing the baseline physiological measures into the patient care record for the individual patient into the database;

an analyzer analyzing one or more of the physiological measures in the physiological measures set relative to one or more other physiological measures to determine a patient status indicating at least one of a change and a status quo of respiratory insufficiency, the analyzer analyzing the physiological measures in the physiological measures set relative to the baseline physiological measures to determine a further patient status indicating at least one of a change and a status quo of respiratory insufficiency;

wherein the further patient status is selected to indicate a progression that is trending into a state of likely respiratory insufficiency.

2. A system according to claim 1 , further comprising:

the analyzer analyzing the physiological measures in the physiological measures set relative to the other physiological measures to determine a further patient status indicating at least one of a change and a status quo of diseases other than respiratory insufficiency.

3. A system according to claim 1 , further comprising:

the server system receiving one or more quality of life measures relating to patient information recorded on a substantially continuous basis or derived therefrom;

the database module storing the quality of life measures into the patient care record for the individual patient into the database; and

the analyzer analyzing the quality of life measures in the physiological measures set relative to the other quality of life measures to determine a further patient status indicating at least one of a change and a status quo of respiratory insufficiency.

4. A system according to claim 1 , wherein the further patient status to indicate the progression is inverted as the patient status to indicate a regression that is trending from a state of likely respiratory insufficiency.

5. A system according to claim 1 , wherein the patient status to indicate the progression into a state of likely respiratory insufficiency is selected from a group comprising:

an absolute limit of arterial oxygen less than 85 mm Hg; and

an absolute limit of arterial carbon dioxide falling below 25 mm Hg in an absence of marked exercise as indicated by hyperventilation; and

an absolute limit of arterial carbon dioxide greater than 50 mm Hg as indicated by hypoventilation.

6. A system according to claim 1 , further comprising:

a comparison module retrieving the other physiological measures from measures for at least one of an individual patient, a peer group, and a overall patient population.

7. A system according to claim 1 , further comprising:

stickiness indicators for the patient information, each stickiness indicator corresponding to a temporal limit related to a program of patient diagnosis or treatment;

a comparison module comparing a time span occurring between changes for each physiological measure to the stickiness indicator; and

a programming module determining a revised program of patient diagnosis or treatment responsive to the changes occurring subsequent to a time span exceeding the stickiness indicator.

8. A system according to claim 1 , wherein the trending is selected from the group comprising:

a respiratory rate that has increased over 1.0 SD from a mean respiratory rate in the baseline physiological measures;

a heart rate that has increased over 1.0 SD from a mean heart rate in the baseline physiological measures;

transthoracic impedance that has increased over 1.0 SD from a mean transthoracic impedance in the baseline physiological measures;

ventilatory tidal volume that has increased over 1.0 SD from a tidal volume score in the baseline physiological measures;

an arterial oxygen score that has decreased over 1.0 SD from an arterial oxygen score in the baseline physiological measures;

an arterial carbon dioxide score that has decreased over 1.0 SD from an arterial carbon dioxide score in the baseline physiological measures;

a patient activity score that has decreased over 1.0 SD from a mean patient activity score in the baseline physiological measures;

a temperature that has increased over 1.0 SD from a mean temperature in the baseline physiological measures;

short-lived spikes in the patient activity score that have occurred over time periods under 5 minutes compared to the baseline physiological measures;

short-lived spikes in a pulmonary arterial pressure score that have occurred over time periods under 5 minutes compared to the baseline physiological measures;

exercise tolerance quality of life measures that have decreased over 1.0 SD from a mean exercise tolerance in the baseline physiological measures;

respiratory distress quality of life measures that have deteriorated by more than 1.0 SD from mean respiratory distress quality of life measures in the baseline physiological measures;

short-lived spikes in right ventricular pressure that have occurred over time periods under 5 minutes compared to the baseline physiological measures;

short-lived spikes in the transthoracic impedance that have occurred over time periods under 5minutes compared to the baseline physiological measures; and

atrial fibrillation and a sequence of rhythm changes relative to the atrial fibrillation.

9. A method for analyzing a patient status for respiratory insufficiency for use in automated patient care, comprising:

receiving from a medical device a set of one or more physiological measures relating to patient information recorded on a substantially continuous basis or derived therefrom;

receiving from a medical device one or more baseline physiological measures relating to patient information recorded during an initial time period or derived therefrom;

storing the physiological measures into a patient care record for an individual patient into a database;

storing the baseline physiological measures into the patient care record for the individual patient into the database;

analyzing on a server one or more of the physiological measures in the physiological measures set relative to one or more other physiological measures to determine a patient status indicating at least one of a change and a status quo of respiratory insufficiency;

analyzing the physiological measures in the physiological measures set relative to the baseline physiological measures to determine a further patient status indicating at least one of a change and a status quo of respiratory insufficiency; and

selecting the further patient status to indicate a progression that is trending into a state of likely respiratory insufficiency.

10. A method according to claim 9 , further comprising:

analyzing the physiological measures in the physiological measures set relative to the other physiological measures to determine a further patient status indicating at least one of a change and a status quo of diseases other than respiratory insufficiency.

11. A method according to claim 9 , further comprising:

receiving one or more quality of life measures relating to patient information recorded on a substantially continuous basis or derived therefrom;

storing the quality of life measures into the patient care record for the individual patient into the database; and

analyzing the quality of life measures in the physiological measures set relative to the other quality of life measures to determine a further patient status indicating at least one of a change and a status quo of respiratory insufficiency.

12. A method according to claim 9 , further comprising:

inverting the further patient status to indicate the progression as the patient status to indicate a regression that is trending from a state of likely respiratory insufficiency.

13. A method according to claim 9 , wherein the patient status to indicate the progression into a state of likely respiratory insufficiency is selected from a group comprising:

an absolute limit of arterial oxygen less than 85 mm Hg; and

an absolute limit of arterial carbon dioxide falling below 25 mm Hg in an absence of marked exercise as indicated by hyperventilation; and

an absolute limit of arterial carbon dioxide greater than 50 mm Hg as indicated by hypoventilation.

14. A method according to claim 9 , further comprising:

retrieving the other physiological measures from measures for at least one of an individual patient, a peer group, and a overall patient population.

15. A method according to claim 9 , further comprising:

defining stickiness indicators for the patient information, each stickiness indicator corresponding to a temporal limit related to a program of patient diagnosis or treatment;

comparing a time span occurring between changes for each physiological measure to the stickiness indicator; and

determining a revised program of patient diagnosis or treatment responsive to the changes occurring subsequent to a time span exceeding the stickiness indicator.

16. A method according to claim 9 , wherein the trending is selected from the group comprising:

a respiratory rate that has increased over 1.0 SD from a mean respiratory rate in the baseline physiological measures;

a heart rate that has increased over 1.0 SD from a mean heart rate in the baseline physiological measures;

transthoracic impedance that has increased over 1.0 SD from a mean transthoracic impedance in the baseline physiological measures;

ventilatory tidal volume that has increased over 1.0 SD from a tidal volume score in the baseline physiological measures;

an arterial oxygen score that has decreased over 1.0 SD from an arterial oxygen score in the baseline physiological measures;

an arterial carbon dioxide score that has decreased over 1.0 SD from an arterial carbon dioxide score in the baseline physiological measures;

a patient activity score that has decreased over 1.0 SD from a mean patient activity score in the baseline physiological measures;

a temperature that has increased over 1.0 SD from a mean temperature in the baseline physiological measures;

short-lived spikes in the patient activity score that have occurred over time periods under 5 minutes compared to the baseline physiological measures;

short-lived spikes in a pulmonary arterial pressure score that have occurred over time periods under 5 minutes compared to the baseline physiological measures;

exercise tolerance quality of life measures that have decreased over 1.0 SD from a mean exercise tolerance in the baseline physiological measures;

respiratory distress quality of life measures that have deteriorated by more than 1.0 SD from mean respiratory distress quality of life measures in the baseline physiological measures;

short-lived spikes in right ventricular pressure that have occurred over time periods under 5 minutes compared to the baseline physiological measures;

short-lived spikes in the transthoracic impedance that have occurred over time periods under 5 minutes compared to the baseline physiological measures; and

atrial fibrillation and a sequence of rhythm changes relative to the atrial fibrillation.