Nellcor Incorporated

Aradigm Corporation

Sextant Medical Corporation

Other

David E Goodman

Reid M Rubsamen

James E Corenman

Daniel S Goldberger

David A Benaron

Robert S Smith

Paul David Mannheimer

Robert T Stone

Jessica A Warring

Deborah A Briggs

Andras Boross

William New, Jr

Mark Yelderman

Apparatus and methods for delivering an amount of aerosolized medicine for inspiration by a patient in response to the occurrence of appropriate delivery point or points in the patient's detected breath flow. The aerosol medication may be administered as one or more pulses having a pulse width, shape, and frequency that will maximize the respirable fraction of the aerosolized compound being administered. The delivery point or points may be predetermined or determined from a prior inspiratory flow for depositing the selected medication at one or more desired locations in the patient's airway. Determined delivery points are recursively lowered for each inspiratory flow that does not satisfy one of the predetermined and previously lowered threshold. Changes in the patient's breath flow patterns during the course of an aerosolized medication inspiration therapy program may be detected and used to adjust the controlled amount of medication to be delivered in a given administration and/or to inform the patient of the patient's condition or change in condition. The device also may contain a library of administration protocols or operating parameters for different medications and a means for identifying from the canister the medicinal contents of the canister for customizing operation of the apparatus.

Delivery of aerosol medications for inspiration

Delivery of aerosol medication for inspiration

A tool for nondestructive interrogation of the tissue including a light source emitter and detector which may be mounted directly on the surgical tool in a tissue contacting surface for interrogation or mounted remotely and guided to the surgical field with fiber optic cables. The light source may be broadband and wavelength differentiation can be accomplished at the detector via filters or gratings, or using time, frequency, or space resolved methods. Alternatively, n discrete monochromatic light sources may be provided which are subsequently multiplexed into a single detector by time or by frequency multiplexing. The optical sensing elements can be built into a surgical tool end effector tip such as a tissue grasping tool which has cooperating jaws (bivalve or multi-element). In the preferred embodiment the light source (or the fiber optic guide) is mounted on one jaw and the detector (or fiber optic guide) is mounted in the opposing jaw so that the light emitter and detector are facing one another either directly (i.e., on the same optical axis when the tool is closed) or acutely (i.e., with intersecting optical axes so that the light emitted is detected). In this case, the sensor is working in a transmission modality. Arrangements with the optical components mounted on the same member of a single member or a multi member structure, operating in a reflective modality, are disclosed.

Noninvasive system for characterizing tissue in vivo

Tissue interrogating device and methods

A class of novel surgical tools constructed from the surgical tools and a tissue state monitoring device to assess or image changes in the chemical or structural composition of tissue over time, which give feedback to surgeons during dynamic surgical interventions that change the character of tissue, such as tissue welding.

Device and method for analysis of surgical tissue interventions

Delivery of aeerosol medications for inspiration

A tissue penetrating apparatus including a surgical appliance having a sharp tip for penetrating tissue, a first optical element for emitting one or more selected monochromatic wavelengths of light, and a second optical element for sensing light corresponding to the one or more selected monochromatic wavelengths of light. The first and second optical elements are optical transmission fibers secured to the appliance proximate to the tip so that one fiber passes one or more monochromatic wavelengths of light into the tissue to be penetrated, and the other fiber passes the light sensed to a light detector. A control circuit is used to illuminate the one or more light sources to emit light out one of the first and second optical fibers, and to provide an electrical signal corresponding to the light sensed at the other of the first and second optical fibers. The electrical signal includes sensed light at each of the monochromatic wavelengths of light emitted, and sensed light in the absence of emitted light. An analysis circuit or a microprocessor based device may be used for processing the electrical signals and determining when the appliance tip has entered a body cavity. An annunciator is actuated to indicate the relative extent of passage through the tissue and when penetration has occurred.

Tissue penetrating apparatus and methods

An apparatus for use in measuring fetal blood flow characteristics. The apparatus includes a non-invasive pulse oximetry probe that is inserted into the uterus between the fetus and the uterine wall. The probe is deformable and is positively attached to the fetal tissue surface using a vacuum pump which causes the probe to deform from a pre-set curvature to the curvature of the fetal tissue surface and to form a gasket-type seal with the fetal tissue surface. The probe is manually inserted into the uterus using a curved insertion tool, and is shaped to fit through a slightly dilated cervix. In a preferred embodiment, the probe includes fetal and maternal ECG sensors and additional sensing devices, and is provided with apparatus for improving the efficiency of the pulse oximetry optics.

Perinatal pulse oximetry sensor

A method and apparatus for improving the calculation of oxygen saturation and other blood constituents by non-invasive pulse oximeters. The method and apparatus permit more accurate determination of blood flow by collecting time-measures of the absorption signal at two or more wavelengths and processing the collected time-measure to obtain composite pulsatile flow data from which artifacts have been filtered. The processing may occur in the time domain or in the frequency domain. In the preferred time domain embodiment, successive portions of periodic information are weighted and added together in synchrony to obtain the composite pulse information. In the preferred frequency domain embodiment, the time-measure in Fourier transformed into its spectral components to form the composite information. A new method and apparatus for correlating the heartbeat and optical pulse is provided whereby a product of the ECG R-wave and optical pulse signals corresponding to the same heartbeat is obtained, and one signal is time shifted relative to the other until a maximum waveform product corresponding to the heartbeat is determined.

Method and apparatus for detecting optical pulses

A method and apparatus for measuring and correlating a patient's heart activity with optical detection of the patient's blood flow. The method and apparatus permit more accurate determination of blood flow characteristics such as oxygen saturation and pulse rate. In a preferred embodiment, the heart activity is detected by monitoring the patient's EKG waveform, and the blood flow is detected by a non-invasive pulse oximeter. The occurrence of the R wave portion of the EKG signal is detected and the time delay by which an arterial pulse follows the R wave is determined to establish a time window in which an arterial is to be expected. The established time window provides the oximeter with a parameter enabling the oximeter to analyze the blood flow only when it is likely to present an arterial blood pulse for waveform analysis. The invention also includes adjusting the polarity of the detected EKG signal to have a preselected uniform upgoing or downgoing polarity.

A method and apparatus for improving the calculation of oxygen saturation and other blood constituents by non-invasive pulse oximeters. The method and apparatus permit more accurate determination of blood flow by collecting time-measures of the absorption signal at two or more wavelengths and processing the collected time-measure to obtain composite pulsatile flow data from which artifacts have been filtered. The processing may occur in the time domain or in the frequency domain. In the preferred time domain embodiment, successive portions of periodic information are weighted and added together in synchrony to obtain the composite pulse information. In the preferred frequency domain embodiment, the time-measure is Fourier transformed into its spectral components to form the composite information. A new method and apparatus for correlating the heartbeat and optical pulse is provided whereby a product of the ECG R-wave and optical pulse signals corresponding to the same heartbeat is obtained, and one signal is time shifted relative to the other until a maximum waveform product corresponding to the heartbeat is determined.

A sensor for trans-illumination of a blood perfused portion of flesh to measure light extinction during trans-illumination is disclosed. The sensor is preferably mounted on a fingertip but any digit or blood perfused portion of flesh will work. The sensor includes a first end for disposition on one side of the trans-illuminated flesh and a second end for disposition on the opposite and opposed side of the trans-illuminated flesh. A light source is mounted to the first side and a photo-sensor is mounted to the second side. If an elongated flexible strip is used, it is provided with adhesive and is suitably windowed that light is allowed to take an optical path through the finger. If no flexible strip is used, the two ends are aligned and secured to the flesh such that the light emitted takes an optical path through the finger. When the adhesive fastener is used, the effect of the light source and photo-detector substrates being integrated into the adhesive fastener is that they become, in effect, a part of the skin. The resulting device is resistant to accidental removal and avoids constriction of blood vessels. Most importantly, the low mass of the sensor itself and its conformance to, so as to effectively become a part of, the skin, prevents relative motion between the light source and sensor and the perfused flesh. This eliminates the common interference associated with the operation of conventional plethysmographs and oximeters.

Growing community of inventors

San Francisco, CA, United States of America

David E Goodman