Method and apparatus for multiple patient parameter variability analysis and display

Abstract

A method and apparatus ( 100 ) for providing continuous analysis and display of the variability of multiple patient parameters monitored by multiple beside monitors ( 106 a- 106 c) for each patient ( 102 ). Each monitor is connected to a patient interface and to a patient data storage unit ( 115 ) and a processor ( 113 ). Each monitored patient parameter is measured in real-time. Data artifacts are removed, and variability analysis is performed based upon a selected period of observation. Variability analysis yields variability of the patient parameters, which represents a degree to which the patient parameters fluctuate over time, to provide diagnostic information particularly useful in the detection, prevention and treatment of multiple organ dysfunction syndrome (MODS).

1. A method of simultaneously monitoring variability of a plurality of patient  physiological parameters for multiple organ systems using data acquired from a plurality of patient monitoring interfaces, comprising:
 collecting data points acquired by each of the plurality of patient monitoring interfaces for each of the plurality of patient  physiological parameters;  
 continuously computing a measure of variability of each of the plurality of patient  physiological parameters over each of a plurality of time intervals, the measure of variability representing an estimate of a degree and character to which each patient  physiological parameter fluctuates over time  over a respective one of said plurality of time intervals; and  
 continuously displaying a graphic representation of the variability computed for each of the plurality of the patient  physiological parameters and continuously displaying a correlation between the variability of the plurality of patient  physiological parameters to indicate changes in variability of multiple physiological parameters for determining change in variability from interval to interval over a period of time.  
 
     
     
       2. The method as claimed in  claim 1 , further comprising a step of selecting for each of the plurality of patient  physiological parameters a method of computing the variability from among a plurality of different methods of variability analysis. 
     
     
       3. The method as claimed in  claim 1 , further comprising a step of selecting the plurality of patient  physiological parameters for which the graphic representation of the variability is to be displayed. 
     
     
       4. The method as claimed in  claim 1 , wherein continuously computing further comprises continuously removing artifacts from the collected data points for each of the plurality of patient  physiological parameters. 
     
     
       5. The method as claimed in  claim 4 , wherein continuously removing the artifacts comprises using a Poincaré plot to identify data points that are artifacts in the collected data points. 
     
     
       6. The method as claimed in  claim 1 , wherein continuously displaying the graphic representation of the variability further comprises continuously displaying the graphic representations in real time. 
     
     
       7. The method as claimed in  claim 1 , wherein continuously displaying the graphic representation of the variability further comprises continuously displaying variability histograms. 
     
     
       8. The method as claimed in  claim 7 , wherein continuously displaying the graphic representations of the variability further comprises continuously displaying the variability histograms in one color if a value of the patient  physiological parameter is within a normal range and displaying one or more of the variability histograms in a different color when the value of a corresponding patient  physiological parameter rises above or falls below the normal range. 
     
     
       9. The method as claimed in  claim 8  further comprising displaying a standard deviation of a most recently selected period of variability analysis as an “I” bar super-imposed on at least one of the variability histograms. 
     
     
       10. The method as claimed in  claim 1  further comprising providing a review display mode that presents a time-compressed, animated display of the variability of selected patient  physiological parameters during any selected time period for which data exists. 
     
     
       11. The method as claimed in  claim 1  further comprising providing a combined display mode that provides a combination of real-time display of current patient  physiological parameters, and a display of the variability of patient  physiological parameters during a specified previous period of time. 
     
     
       12. A system for simultaneously monitoring variability of a plurality of patient  physiological parameters for multiple organ systems, said system comprising:
 a processor coupled to a plurality of patient monitors for receiving data points respectively associated with the plurality of patient  physiological parameters, the processor continuously computing, for each of the plurality of patient  physiological parameters, a variability of each patient  physiological parameter over each of a plurality of time intervals representative of an estimate of a degree and character to which the respective patient  physiological parameters fluctuates over time  over a respective one of said plurality of time intervals; and  
 a console for continuously displaying a graphic representation of the variability computed for each of the plurality of the patient parameters and continuously displaying a correlation between the variability of the plurality of patient parameters to indicate changes in variability of multiple physiological parameters for determining change in variability from interval to interval over a period of time.  
 
     
     
       13. The system as claimed in  claim 12 , further comprising a user interface for permitting a user to select a method of computing each variability parameter from among a plurality of methods of variability analysis. 
     
     
       14. The system as claimed in  claim 12  further comprising a user interface for permitting a user to select a subset of patient physiological parameters from the monitored plurality of patient  physiological parameters for which the variability is to be continuously displayed on the console. 
     
     
       15. The system as claimed in  claim 12 , wherein the processor removes artifacts from the collected data points for each of the plurality of patient  physiological parameters. 
     
     
       16. The system as claimed in  claim 15 , wherein the processor generates a Poincaré plot to identify the artifacts to be removed from the collected data points. 
     
     
       17. The system as claimed in  claim 12 , wherein the console displays the variability parameter for each of the plurality of patient  physiological parameters as a plurality of dynamic variability histograms. 
     
     
       18. A patient monitoring system for simultaneously monitoring variability of a plurality of physiological parameters for multiple organ systems, comprising:
 a processor that performs continuous data acquisition from multiple patient  physiological parameter monitors to compile respective data sets, the processor removing artifacts from the data sets, and computing a variability , using the data sets of each monitored patient parameter, a measure of variability over each of a plurality of time intervals for a respective one of said multiple physiological parameters, each measure of variability being indicative of a degree and character to which a respective patient parameter changes over a respective one of said plurality of time intervals;  
 a user interface that permits a user to select a method of data selection and variability analysis from among a plurality of pre-defined methods for selecting data and computing the variability of each of the patient  physiological parameters; and  
 a console for continuously displaying a graphic representation of the variability computed for each of the plurality of the patient  physiological parameters and continuously displaying a correlation between the variability of the plurality of patient  physiological parameters to indicate changes in variability of multiple physiological parameters for determining change in variability from interval to interval over a period of time.  
 
     
     
       19. The system as claimed in  claim 18  wherein the processor comprises a central processor for multiple patient data collection and the system further comprises;
 a patient data store for storing patient data collected from multiple patient  physiological parameter monitors for each of a plurality of patients; and  
 a console for displaying a multiple patient variability display.  
 
     
     
       20. A method of simultaneously monitoring variability of a plurality of physiological parameters for multiple organ systems using data acquired from a plurality of respective patient monitoring interfaces, said method comprising:
   obtaining a set of data for each of said physiological parameters acquired by a respective one of said plurality of patient monitoring interfaces;        using each set of data to compute a measure of variability over each of a plurality of time intervals for a respective one of said plurality of physiological parameters, each measure of variability being indicative of a degree and character to which a respective physiological parameter changes over a respective one of said plurality of time intervals; and        for each physiological parameter, providing information pertaining to each said measure of variability over its corresponding time interval to thereby indicate changes in variability of multiple physiological parameters for determining change in variability from interval to interval over a period of time, and providing an integration of said information for said multiple organ systems.      
     
     
       21. The method according to  claim 20 , said measure of variability being computed continuously and said information being generated continuously as said measure of variability is computed.  
     
     
       22. The method according to  claim 20 , comprising displaying graphically a representation of said measure of variability.  
     
     
       23. The method according to  claim 22 , said representation being displayed continuously as said measure of variability is computed.  
     
     
       24. The method according to  claim 20 , comprising generating a correlation between the variability of said plurality of physiological parameters.  
     
     
       25. The method according to  claim 24 , comprising displaying graphically said correlation between the variability of said plurality of physiological parameters.  
     
     
       26. The method according to  claim 25 , said correlation being displayed continuously as said measure of variability is computed.  
     
     
       27. The method according to  claim 20 , comprising enabling the selection of a method of computing variability from among a plurality of different methods of variability analysis for each of said plurality of physiological parameters.  
     
     
       28. The method according to  claim 22 , comprising enabling a selection for each of said plurality of physiological parameters for which said representation of said measure of variability is to be displayed.  
     
     
       29. The method according to  claim 20 , wherein said computing comprises removing artifacts from said data points for each of said plurality of physiological parameters.  
     
     
       30. The method according to  claim 29 , wherein said removing utilizes a Poincaré plot.  
     
     
       31. The method according to  claim 22 , comprising displaying said representative in real- time.    
     
     
       32. The method according to  claim 22 , comprising displaying variability histograms.  
     
     
       33. The method according to  claim 32 , wherein said variability histograms are displayed in one colour if a value of said physiological parameter is within a normal range and displayed one or more of said variability histograms in a different colour when the value of a corresponding physiological parameter rises above or falls below said normal range.  
     
     
       34. The method according to  claim 33 , comprising displaying a standard deviation of a most recently selected period of variability as an “I” bar super- imposed on at least one of said variability histograms.    
     
     
       35. The method according to  claim 22 , comprising providing a review display mode that presents a time- compressed, animated display of the variability of selected physiological parameters during any selected time period for which data exists.    
     
     
       36. The method according to  claim 22 , comprising providing a combined display mode that provides a combination of real- time display of current physiological parameters, and a display of the variability of physiological parameters during a specified previous period of time.    
     
     
       37. A system for simultaneously monitoring variability of a plurality of physiological parameters, comprising:
   an interface for obtaining a set of data acquired by a respective one of a plurality of patient monitors for each of said plurality of physiological parameters;        a processor coupled to said interface for using each set of data to compute a measure of variability over each of a plurality of time intervals for a respective one of said plurality of physiological parameters, each measure of variability being indicative of a degree and character to which a respective physiological parameter changes over a respective one of said plurality of time intervals, for each physiological parameter, said processor also providing information pertaining to each said measure of variability over its corresponding time interval to thereby indicate changes in variability of multiple physiological parameters for determining change in variability from interval to interval over a period of time, and providing an integration of said information for said multiple organ systems; and        a data store for storing said sets of data.      
     
     
       38. The system according to  claim 37 , said processor computing said measure of variability continuously and generating said information continuously as said measure of variability is computed.  
     
     
       39. The system according to  claim 37 , comprising a console for displaying graphically a representation of said measure of variability.  
     
     
       40. The system according to  claim 39 , said representation being displayed continuously as said measure of variability is computed.  
     
     
       41. The system according to  claim 37 , said processor generating a correlation between the variability of said plurality of physiological parameters.  
     
     
       42. The system according to  claim 41 , comprising a console for displaying graphically said correlation between the variability of said plurality of physiological parameters.  
     
     
       43. The system according to  claim 42 , said correlation being displayed continuously as said measure of variability is computed.  
     
     
       44. The system according to  claim 37 , comprising a user interface for permitting a user to select a method of computing each parameter from among a plurality of different methods of variability analysis.  
     
     
       45. The system according to  claim 39 , comprising a user interface for permitting a user to select a subset of parameters from said plurality of physiological parameters for which said variability is to be displayed on said console.  
     
     
       46. The system according to  claim 37 , said processor removing artifacts from said data points for each of said plurality of physiological parameters.  
     
     
       47. The system according to  claim 46 , said processor generating a Poincaré plot to remove said artifacts.  
     
     
       48. The system according to  claim 39 , said console displaying the variability parameter for each of said plurality of physiological parameters as a plurality of dynamic variability histograms.