US2011070210A1PendingUtilityA1
Systems and method for homeostatic blood states
Est. expirySep 1, 2025(expired)· nominal 20-yr term from priority
Inventors:Audrius Andrijauskas
A61P 7/04A61K 35/18A61P 7/00
21
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Claims
Abstract
Decades of investigations were focused on finding “gold standard” for evaluation of plasma dilution and osmolality, blood loss evaluation and prediction of bleeding or transfusion induced changes in hematocrit and hemoglobin concentration. Addressing deficiencies of existing methods, the current invention created new combined mathematical-physiological model applicable to manually operated nomograms and software in medical monitors. The mathematical model HBS Trends is used in blood transfusion and infusion therapy nomogram—HBS Nomogram—which is based on blood hemoglobin concentration and hematocrit. It is also an easy and practical tool for recording and dynamical interpretation of plasma osmolality, blood hemoglobin concentration, hematocrit and mean corpuscular hemoglobin concentration. The HBS Nomogram is a practical system for organizing blood test results in a patient's medical records. It can be used alone or, in line with existing guidelines for infusion and transfusion therapy making them more practical, cost effective and time saving in decision making.
Claims
exact text as granted — not AI-modified1 - 9 . (canceled)
10 . A HBS nomogram, wherein the HBS nomogram comprises a two-dimensional plot of red cell mass scale verses blood hemoglobin concentration, further wherein the HBS nomogram comprises at least one radiating line defining mean cell hemoglobin concentration (MCHC-RL).
11 . The HBS nomogram according to claim 10 , wherein the HBS nomogram further comprises a plot of blood hematocrit (Hct) verses blood hemoglobin concentration.
12 . A method of administering a calculated volume of packed red blood cells (PRBC) to achieve a therapeutically appropriate post-transfusion Hct (ptHct) in a patient requiring such treatment, comprising the steps of:
(a) determining baseline venous blood hematocrit (tHct) in the patient's blood sample just before starting PRBC transfusion and about 20 minutes after stopping maintenance rate intravenous crystalloid infusion for equilibration; (b) determining tRCM of patient based on tHct; (c) determining the ideal blood volume (IBV) of the patient; (d) calculating a therapeutically effective amount of packed red blood cells (PRBC) for transfusion into the patient to achieve the post-transfusion hematocrit (ptHct), wherein the therapeutically effective amount is directly proportional to k, where k is equivalent to about 30% of the IBV value, further wherein the therapeutically effective amount of packed red blood cells (PRBC) is defined by the mathematical formula:
PRBC=(ptHct×tBV)−tRCM;
(e) administering to the patient the calculated therapeutically effective amount of packet red blood cells to achieve a therapeutically appropriate post-transfusion Hct in the patient's blood.
13 . The method of increasing blood hemoglobin concentration according to claim 12 , wherein k is defined by one of the mathematical formulas:
k
=
I
P
V
+
RCM
LHL
-
I
B
V
=
I
B
V
(
1
-
Hct
ITM
)
+
RCM
LHL
-
I
B
V
and
k
=
I
B
V
-
RCM
UHL
-
I
P
V
=
I
B
V
-
RCM
UHL
-
I
B
V
-
(
1
-
Hct
ITM
)
.
14 . The method of administering a calculated volume of packed red blood cells (PRBC) to achieve a therapeutically appropriate post-transfusion Hct according to claim 12 , wherein the therapeutically appropriate post-transfusion Hct (ptHct) is within a range of 13.3% to 60%.
15 . The method of administering a calculated volume of packed red blood cells (PRBC) to achieve a therapeutically appropriate post-transfusion Hct according to claim 12 , wherein the therapeutically appropriate post-transfusion Hct (ptHct) approximates an ideal total match hematocrit (HctiTM).
16 . The method of administering a calculated volume of packed red blood cells (PRBC) to achieve a therapeutically appropriate post-transfusion Hct according to claim 12 , wherein the therapeutically appropriate post-transfusion Hct (ptHct-cor) comprises the further step of calculating loss of erythrocyte mass (cLEM) through wound drainage as follows:
ptHct-cor=½(tHct+ptHct) and cLEM=0.5−MDM·(ptHct−tHct),
whereby the calculated volume of packed red blood cells (PRBC) take into account loss of erythrocyte mass (cLEM) through wound drainage to achieve the therapeutically appropriate post-transfusion Hot (ptHct-cor).
17 . The method of administering a calculated volume of packed red blood cells (PRBC) of claim 12 , wherein
the predetermined mean cell hemoglobin concentration (MCHC) parameter is selected using a HBS nomogram, wherein the HBS nomogram comprises a two-dimensional plot of Hct verses blood hemoglobin concentration, further wherein the HBS nomogram comprises at least one radiating line defining mean cell hemoglobin concentration (MCHC-RL).
18 . The method of administering a calculated volume of packed red blood cells (PRBC) claim 12 , wherein the tRCM corresponds to a desired target blood hemoglobin concentration in the patient's blood, wherein the target blood hemoglobin concentration is selected to correspond to a MCHC of 300 g/l (+/−15 g/l).
19 . The method of administering a calculated volume of packed red blood cells (PRBC) according to claim 12 , wherein a therapeutic amount of artificial hemoglobin is administered to the patient, wherein the therapeutic amount of artificial hemoglobin is equivalent to the amount of hemoglobin contained in the therapeutic amount of packet red blood cells (PRBC) defined by the mathematical formula.
20 . The method of administering a calculated volume of packed red blood cells (PRBC) according to claim 12 , wherein the predetermined mean cell hemoglobin concentration (MCHC) parameter is selected using a HBS nomogram in combination with an Osmonomogram, wherein the Osmonomogram defines tables of normal mean cell hemoglobin content (MCH), mean cell volume (MCV), and mean cell hemoglobin concentration (MCHC) values, wherein the HBS nomogram comprises a two-dimensional plot of red cell mass scale and corresponding hematocrit (Hct) verses blood hemoglobin concentration, further wherein the HBS nomogram comprises at least one radiating line defining mean cell hemoglobin concentration (MCHC-RL).
21 . The method of administering a calculated volume of packed red blood cells (PRBC) according to claim 12 , wherein the predetermined mean cell hemoglobin concentration (MCHC) parameter is selected using a HBS nomogram in combination with at least one nomogram selected from the group consisting of: an Osmonomogram and a Devi-safe nomogram, wherein the Osmonomogram defines tables of normal mean cell hemoglobin content (MCH), mean cell volume (MCV), and mean cell hemoglobin concentration (MCHC) values, wherein the Devi-safe nomogram comprises a two-dimensional plot of blood hematocrit (Hct) verses ideal blood circulating volume (IBV), and wherein the HBS nomogram comprises a two-dimensional plot of red cell mass scale verses blood hemoglobin concentration, further wherein the HBS nomogram comprises at least one radiating line defining mean cell hemoglobin concentration (MCHC-RL).
22 . An HBS nomogram for graphic representation of a quantitative relationship among hemeostatic blood states in a patient, comprising: a plurality of scales and a solid support, the plurality of scales being disposed on the support and comprising a scale for a plurality factors including Hb, tRCM, Hct, and at least one scale for MCHC, wherein the scales for Hb, tRCM, Hct, and MCHC each have values on the scales, and wherein the scales for Hb, tRCM, Hct, and MCHC are disposed on the solid support with respect to the points scale so that each of the values on Hb, tRCM, Hct, and MCHC can be correlated to predict a therapeutically effective amount of packet red blood cells for transfusion into a patient to increase the patient's red cell mass.
23 .- 24 . (canceled)
25 . A Devi-safe nomogram comprising two coordinate axes, wherein one axis comprises a target red cell mass (tRCM) scale specific to the corresponding values of target hematocrit (tHct) within the homeostatic Hct range from 13.3% (UHL, upper homeostatic hematocrit limit) to 60.0% (LHL, lower homeostatic hematocrit limit), wherein the other axis comprises a scale specific to plasma and blood volume deviations from normal, wherein the Devi-safe nomogram enables a medical worker to determine a patient's target state's blood volume (tBV) deviation from ideal value (IBV) and thereby determine an appropriate plasma volume expansion for a given volume of plasma to facilitate a patient in achieving normovolemia.
26 .- 27 . (canceled)Join the waitlist — get patent alerts
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