Negative pressure therapy system and methods
A system for removing fluid from a urinary tract includes at least one sensor configured to detect signal(s) representative of pulmonary artery pressure and communicate signal(s) representative of the pulmonary artery pressure and a controller. The controller is configured to: receive and process the signal(s) from the at least one sensor to determine if the pulmonary artery pressure is above, below, or at a predetermined value; and provide a control signal, determined at least in part from the pulmonary artery pressure signal(s) received from the at least one sensor, to a negative pressure source to apply negative pressure to a urinary catheter to remove fluid from a urinary tract when the pulmonary artery pressure is above the predetermined value and to cease applying negative pressure when the pulmonary artery pressure is at or below the predetermined value.
1 . A system for removing fluid from a urinary tract, comprising:
at least one sensor configured to detect signal(s) representative of pulmonary artery pressure and communicate signal(s) representative of the pulmonary artery pressure; and
a controller configured to:
receive and process the signal(s) from the at least one sensor to determine if the pulmonary artery pressure is above, below, or at a predetermined value; and
provide a control signal, determined at least in part from the pulmonary artery pressure signal(s) received from the at least one sensor, to a negative pressure source to apply negative pressure to a urinary catheter to remove the fluid from the urinary tract when the pulmonary artery pressure is above the predetermined value and to cease applying the negative pressure when the pulmonary artery pressure is at or below the predetermined value.
2 . The system of claim 1 , wherein the at least one sensor comprises an implantable pressure transducer.
3 . The system of claim 2 , wherein the implantable pressure transducer is configured to be deployed in a right pulmonary artery.
4 . The system of claim 1 , wherein the at least one sensor comprises a passive sensor comprising an inductor-capacitor circuit configured to generate an electromagnetic field in response to an external radio frequency signal.
5 . The system of claim 4 , wherein the controller comprises a radio frequency antenna configured to cause the inductor-capacitor circuit of the at least one sensor to generate the electromagnetic field, and wherein the signal(s) received by the controller from the at least one sensor are representative of the generated electromagnetic field.
6 . The system of claim 1 , wherein the at least one sensor comprises at least one anchor comprising elongated tines formed from a flexible biocompatible material for securing the at least one sensor at an implant location.
7 . The system of claim 1 , wherein the negative pressure source comprises a pump configured to apply the negative pressure to the urinary catheter, the pump comprising at least one fluid port in fluid communication with a drainage lumen of the urinary catheter for receiving the fluid from a kidney.
8 . The system of claim 7 , wherein at least a portion of the pump is configured to be positioned external to the urinary tract.
9 . The system of claim 7 , wherein at least a portion of the pump is configured to be implanted in the urinary tract.
10 . The system of claim 7 , wherein the pump comprises at least one of a rotary pump, a rotodynamic pump, or a positive displacement pump.
11 . The system of claim 7 , wherein the pump is configured to provide negative pressure ranging from 0 mmHg to about 150 mmHg to the drainage lumen of the urinary catheter, as measured at the at least one fluid port of the pump.
12 . The system of claim 7 , wherein the pump is configured to produce a negative pressure sufficient for establishing a pressure gradient across a glomerulus of the kidney to facilitate urine flow towards the drainage lumen of the urinary catheter.
13 . The system of claim 7 , wherein the controller is an external controller electrically coupled to the pump to provide the control signal and, optionally, power to the pump.
14 . The system of claim 7 , wherein the controller is a pump controller disposed on a printed circuit board within a housing of the pump.
15 . The system of claim 1 , further comprising a remote computer device in wired or wireless communication with the controller, the remote computer device being configured to provide instructions to the controller for operating the negative pressure source and to receive information from the controller about at least one of the negative pressure source and/or about the pulmonary artery pressure.
16 . The system of claim 1 , further comprising the urinary catheter.
17 . The system of claim 16 , wherein the urinary catheter comprises a ureteral catheter comprising a distal portion comprising a retention portion and a proximal portion comprising a drainage lumen.
18 . The system of claim 17 , wherein the retention portion of the ureteral catheter comprises an outer periphery or protective surface area which prevents mucosal tissue from a kidney, renal pelvis and/or uretero-renal pelvis junction from occluding one or more protected drainage holes, ports, or perforations of the ureteral catheter upon application of the negative pressure through the ureteral catheter.
19 . The system of claim 18 , wherein the retention portion comprises a coil, and wherein the one or more protected drainage holes, ports, or perforations extend through a radially inwardly facing portion of a sidewall of the coil.
20 . The system of claim 16 , wherein the urinary catheter comprises a percutaneous kidney catheter.
21 . The system of claim 20 , wherein the percutaneous kidney catheter comprises:
a proximal portion configured to pass through a percutaneous opening; and
a distal portion comprising a retention portion,
wherein the retention portion comprises an outer periphery or protective surface area that inhibits mucosal tissue from a kidney, renal pelvis and/or uretero-renal pelvis junction from occluding one or more protected drainage holes, ports, or perforations of the percutaneous kidney catheter upon application of the negative pressure through the percutaneous kidney catheter.
22 . The system of claim 21 , wherein the retention portion comprises a proximal end sized to be positioned in the kidney and a distal end sized to be positioned in the uretero-renal pelvis junction.
23 . The system of claim 21 , wherein the retention portion comprises a coiled retention portion comprising at least a first coil having a first diameter and at least a second coil having a second diameter, the first diameter being greater than the second diameter.
24 . The system of claim 1 , wherein the controller is further configured to:
as the negative pressure source is applying the negative pressure to the urinary catheter, periodically compare the pulmonary artery pressure to the predetermined value for pulmonary artery pressure; and
provide additional control signals to the negative pressure source to increase a magnitude of the negative pressure applied by the negative pressure source to the urinary catheter when the pulmonary artery pressure is greater than the predetermined value.
25 . The system of claim 24 , wherein the controller is configured to provide the additional control signals to the negative pressure source to cause the negative pressure source to continue providing the increased magnitude of the negative pressure to the urinary catheter until the pulmonary artery pressure decreases below the predetermined value.
26 . The system of claim 24 , wherein the periodic comparison between the pulmonary artery pressure and the predetermined value occurs at least one of every hour, every four hours, every eight hours, or every twenty four hours.
27 . A system for providing mechanical assistance for blood circulation and for removing fluid from a urinary tract, the system comprising:
at least one sensor configured to detect signal(s) representative of pulmonary artery pressure and communicate the signal(s) representative of the pulmonary artery pressure; and
a controller in communication with the at least one sensor configured to:
receive and process the signal(s) from the at least one sensor to determine the pulmonary artery pressure;
provide a first control signal determined at least in part based on the determined pulmonary artery pressure to a negative pressure source to control applying negative pressure to a urinary catheter to remove the fluid from the urinary tract; and
provide a second control signal determined at least in part based on the determined pulmonary artery pressure to a blood pump to control output of the blood pump.
28 . The system of claim 27 , wherein the blood pump comprises a left ventricular assist device.
29 . The system of claim 27 , wherein the controller is configured to determine if the pulmonary artery pressure is within or outside of a target range for pulmonary artery pressure.
30 . The system of claim 29 , wherein the second control signal adjusts the output of the blood pump when the pulmonary artery pressure is outside of the target range.
31 . The system of claim 29 , wherein the first control signal causes the negative pressure source to apply the negative pressure to the urinary catheter to remove the fluid from the urinary tract when the pulmonary artery pressure is outside of the target range, and the first control signal causes the negative pressure source to cease applying the negative pressure to the urinary catheter when the pulmonary artery pressure is within the target range.
32 . The system of claim 31 , wherein the controller is further configured to:
as the negative pressure source is applying the negative pressure to the urinary catheter, periodically compare the pulmonary artery pressure to the target range for pulmonary artery pressure; and
provide a signal to the negative pressure source to increase a magnitude of the negative pressure applied by the negative pressure source to the urinary catheter when the pulmonary artery pressure is greater than the predetermined value.
33 . The system of claim 32 , wherein the controller is configured to cause the negative pressure source to continue providing the increased magnitude of negative pressure to the urinary catheter until the pulmonary artery pressure determined by the at least one sensor decreases below the predetermined value.
34 . The system of claim 27 , wherein the at least one sensor comprises an implantable pressure transducer.
35 . The system of claim 34 , wherein the implantable pressure transducer is configured to be deployed in a right pulmonary artery.
36 . The system of claim 27 , wherein the at least one sensor comprises a passive sensor comprising an inductor-capacitor circuit configured to generate an electromagnetic field in response to an external radio frequency signal.
37 . The system of claim 36 , wherein the controller comprises a radio frequency antenna configured to cause the inductor-capacitor circuit of the at least one sensor to generate the electromagnetic field, and wherein the signal(s) received by the controller from the at least one sensor are representative of the generated electromagnetic field.
38 . The system of claim 27 , wherein the at least one sensor comprises at least one anchor comprising elongated tines formed from a flexible biocompatible material for securing the at least one sensor at an implant location.
39 . The system of claim 27 , wherein the negative pressure source comprises a pump configured to apply the negative pressure to the urinary tract, the pump comprising at least one fluid port in fluid communication with a drainage lumen of the urinary catheter for receiving the fluid from a kidney.
40 . The system of claim 27 , wherein the controller is a pump controller disposed on a printed circuit board contained within a housing of the pump.
41 . The system of claim 40 , wherein the controller wirelessly transmits the second control signal to the blood pump.
42 . The system of claim 27 , wherein the controller is configured to receive negative pressure feedback regarding at least one of a flow rate of fluid passing through the urinary catheter, a total fluid volume of fluid passing through the urinary catheter, and/or an analyte concentration of fluid passing through the urinary catheter, and
wherein the second control signal is determined based, at least in part, of the received negative pressure feedback.
43 . The system of claim 42 , wherein the second control signal comprises an instruction to increase an output of the blood pump when the negative pressure feedback indicates fluid overload and/or pulmonary edema, and an instruction to decrease or maintain the output of the blood pump when the negative pressure feedback indicates no fluid overload and/or pulmonary edema.
44 . A method for removing fluid from a urinary tract, the method comprising:
monitoring a pulmonary artery pressure;
determining if the pulmonary artery pressure is above, below, or at a predetermined value; and
applying negative pressure to a urinary catheter to remove the fluid from the urinary tract when the pulmonary artery pressure is above the predetermined value or ceasing application of the negative pressure when the pulmonary artery pressure is at or below the predetermined value.
45 . The method of claim 44 , wherein monitoring the pulmonary artery pressure comprises applying a radio frequency signal to a passive sensor comprising an inductor-capacitor circuit configured to be generate an electromagnetic field in response to the radio frequency signal, and detecting changes in the generated electromagnetic field to determine the pulmonary artery pressure.
46 . The method of claim 45 , wherein the radio frequency signal is applied to the passive sensor by an external control device comprising a radio frequency antenna that generates the radio frequency signal and detects a signal response from the inductor-capacitor circuit of the sensor.
47 . The method of claim 45 , wherein the passive sensor is implanted in a right pulmonary artery.
48 . The method of claim 45 , wherein the radio frequency signal is periodically applied to the passive sensor at least one of once every hour, once every two hours, once every four hours, or once every twenty-four hours.
49 . The method of claim 44 , wherein applying the negative pressure to the urinary catheter when the pulmonary artery pressure is above the predetermined value comprises applying the negative pressure for a predetermined duration.
50 . The method of claim 49 , wherein, following the predetermined duration, the method further comprises determining the pulmonary artery pressure and applying the negative pressure for another instance of the predetermined duration when the pulmonary artery pressure is above the predetermined value or ceasing to apply the negative pressure when the pulmonary artery pressure is at or below the predetermined value.
51 . The method of claim 49 , wherein the predetermined duration comprises at least twelve hours.
52 . The method of claim 44 , further comprising, as the negative pressure is being applied to the urinary catheter, continuing to monitor the pulmonary artery pressure, and increasing a magnitude of the negative pressure applied by the negative pressure source when the pulmonary artery pressure is above the predetermined value.
53 . The method of claim 44 , wherein the negative pressure source comprises a pump configured to apply the negative pressure to the urinary tract, the pump comprising at least one fluid port in fluid communication with a drainage lumen of the urinary catheter.
54 . The method of claim 44 , further comprising causing an implanted blood pump to provide blood flow at an output determined based, at least in part, on the pulmonary artery pressure.
55 . The method of claim 44 , wherein the blood pump comprises a left ventricular assist device.