US-12622612-B2 - Method for providing decision support in relation to a patient receiving oxygen treatment

US12622612B2US 12622612 B2US12622612 B2US 12622612B2US-12622612-B2

Abstract

The invention relates to a computer implemented method, and a data processing system, for providing decision support in relation to a patient receiving oxygen treatment, the patient having a medical condition requiring a supplemental oxygen device providing an oxygen flow, wherein the decision support assists a health care person in adjusting the oxygen flow from said supplemental oxygen device to the patient, and wherein the decision support uses an arterial oxygenation value to calculate whether the oxygen flow to the patient is sufficient based on a desired input from the health care person.

Inventors

Bruno Graversen
BJARNE FLOU

Assignees

OBI APS

Dates

Publication Date: 20260512
Application Date: 20200226
Priority Date: 20190226

Claims (5)

1 . A computer-implemented oxygen treatment and decision support system for a patient having a medical condition requiring a supplemental oxygen flow, the system comprising: an oxygen device configured to supply oxygen flow from a source to the patient; a device configured to provide a measured arterial oxygenation value of the patient; a blood gas measurement device configured to acquire a baseline blood gas value from at least one of a venous blood sample of the patient or a capillary blood sample of the patient, and a processing unit configured to: transform the baseline blood gas value into an arterial equivalent by simulating a metabolic oxygen addition to and metabolic carbon dioxide removal from the venous blood sample in a ratio determined by a constant respiratory quotient set that is bounded by a value that corresponds to an aerobic metabolism of fat and a value that corresponds to an aerobic metabolism of carbohydrate; calculate a target arterial oxygenation value based on an oxygen dissociation curve between the arterial equivalent of the baseline blood gas value level of the patient and the measured arterial oxygenation value; and automatically adjust the oxygen flow from the oxygen device to the patient until the target arterial oxygenation value is reached.
2 . The computer-implemented decision support system according to claim 1 , in which the blood gas measurement device measures the baseline blood gas value based on a venous blood sample.
3 . The computer-implemented decision support system according to claim 1 , in which the blood gas measurement device measures the baseline blood gas value based on a capillary blood sample.
4 . The computer-implemented decision support system according to claim 1 , in which the device configured to provide an arterial oxygenation value comprises a pulse oximeter such that the measured arterial oxygenation value is a measured peripheral arterial oxygen saturation value.
5 . The computer-implemented decision support system according to claim 1 , wherein the physiologically possible range of the respiratory quotient is between of 0.7 and 1.0.

Description

FIELD OF THE INVENTION The present invention relates to a method of providing decision support and a data processing system in relation to a patient receiving oxygen treatment (OT) or long-term oxygen treatment (LTOT), said patient having a medical condition, such as COPD, requiring a supplemental oxygen device for providing an oxygen flow, typically on a continuous or permanent way. The decision support assists a health care person, such as a nurse, in titrating the oxygen flow from said supplemental oxygen device to the patient. The invention also relates to a corresponding decision support system (DSS), preferably a portable data processing system, and a corresponding computer program product. BACKGROUND OF THE INVENTION A proportion of patients with respiratory problems (e.g. COPD) are receiving treatment where a target pO2 is of interest. An example is LTOT (Long Term Oxygen Therapy) which in some cases are delivered at home. Titration of LTOT is handled different from country to country using arterial blood gas, capillary blood gas etc. As an example, the guidelines from UK is using arterial blood gas and describes that use of capillary blood gas will result in patients receiving LTOT without need. In Germany where capillary blood gas (CBG) is more commonly used studies find that 20-30% of the patients receive LTOT without a clinical need when using capillary blood gas, see Kapillärer PO2 reflektiert nicht adäquat den arteriellen PO2 bei hypoxämischen COPD-Patienten; Magnet F S et. al.; Int J COPD 2017; 12:2647-2653. The Danish guideline is based on arterial blood gas with a baseline and one sample per litre oxygen increase. This method will also allow for optimization of oxygen titration for patients following any of these guidelines. Complexity, patient pain and resource constraints is driving hospital towards more patient-friendly methods which at the same time can be delivered by a wider pool of resources e.g. CBG (capillary blood gas) with the limitation this method has. Current methods are based on guidelines using arterial blood gas. A baseline sample is typically drawn and oxygen flow is increased in steps of 1 litre/minute. After a set period, e.g. 30 minutes, another sample is drawn and if paO2 is below a set threshold, e.g. 8 kPa/60 mmHg, the process is repeated until the threshold is achieved. Due to resource constraints clinical practice is often different and capillary blood gas is used as alternative. Based on input from Germany, a process when titrating oxygen using CBG is as follows: 1. Oxygen is removed2. Baseline CBG (including vasodilation crème applied 10 minutes before sampling)3. Adjust+1|O24. New CBG5. Compare with target pO2 (e.g. 65 mmHg)6. If target achieved continue—if not jump to step 37. Subscribe achieved oxygen flow rate to patient. This current method implies a baseline CBG and a review CBG for each step of oxygen (0 litre/min=1 sample; 1 litre/min=2 samples etc.). Review of 10 patients resulted in 26 samples in total (2.6 per patient), however this group had 3 litre/min as the highest flow-rate. Feedback from clinics indicates that some patients have up to 7-8 samples drawn during titration, which could indicate that the average number of samples would be higher. Even though best practice is based on ABG and most guidelines recommends ABG over alternatives, CBG increasingly being used due to resource constraints and increasing number of patients. There is a need for continuous innovation in the healthcare system due to an increasing number of patients requiring support from a healthcare system, which cannot expand with the same rate. Patients receiving too much oxygen is at risk of harm. E.g. COPD patients are risking hypercapnia and acidosis. Even worse is some patients receiving home oxygen without a clinical need, since receiving home oxygen is costly and impacts the patient's social life. Hence, an improved method for providing decision support in relation to a patient receiving oxygen treatment (OT), preferably long-term oxygen treatment (LTOT), would be advantageous, and in particular a more efficient and/or reliable method would be advantageous. OBJECT OF THE INVENTION It is a further object of the present invention to provide an alternative to the prior art. In particular, it may be seen as an object of the present invention to provide a decision support in relation to a patient receiving oxygen treatment (OT), that solves the above-mentioned problems of the prior art with a complex, unnecessary and/or unsafe adjustment of the supplemental oxygen flow for the patient. SUMMARY OF THE INVENTION Thus, the above described object and several other objects are intended to be obtained in a first aspect of the invention by providing a computer implemented method for providing decision support in relation to a patient receiving oxygen treatment, said patient having a medical condition requiring a supplemental oxygen device providing an oxygen flow, wherein the decision