Index: firmware/App/Controllers/PresOccl.c =================================================================== diff -u -rafa33cca68071ee912f54d87879c18399b5aced8 -r1657771c89c13b6ce894bfd7835bc32fe50b8ecd --- firmware/App/Controllers/PresOccl.c (.../PresOccl.c) (revision afa33cca68071ee912f54d87879c18399b5aced8) +++ firmware/App/Controllers/PresOccl.c (.../PresOccl.c) (revision 1657771c89c13b6ce894bfd7835bc32fe50b8ecd) @@ -7,8 +7,8 @@ * * @file PresOccl.c * -* @author (last) Darren Cox -* @date (last) 08-Sep-2023 +* @author (last) Vinayakam Mani +* @date (last) 27-Feb-2024 * * @author (original) Sean * @date (original) 15-Jan-2020 @@ -86,6 +86,10 @@ /// Venous pressure low exemption period (in task intervals) conversion factor (from Qb in mL/min) following an air trap fill. static const U32 VENOUS_PRES_AT_FILL_DELAY_FACTOR = (U32)( VENOUS_PRES_AT_FILL_DELAY_MAX_BLOOD_VOL_ML * (F32)SEC_PER_MIN * ( (F32)MS_PER_SECOND / (F32)TASK_GENERAL_INTERVAL ) ); +#define MIN_TIME_BETWEEN_AIR_TRAP_FILL_EXEMPTIONS_MS ( 1200 ) ///< To monitor low Venous pressure in the defined interval in a case where continuous air fill event happens followed by exemption period to stabilize the pressure +#define MIN_TIME_BETWEEN_AIR_TRAP_FILL_EXEMPTIONS_WINDOW ( MIN_TIME_BETWEEN_AIR_TRAP_FILL_EXEMPTIONS_MS / \ + TASK_GENERAL_INTERVAL ) ///< Low Venous pressure monitoring window between air fill events based on the task interval time + #define PSI_TO_MMHG ( 51.7149F ) ///< Conversion factor for converting PSI to mmHg. #define VENOUS_PRESSURE_NORMAL_OP 0 ///< Venous pressure status bits indicate normal operation. @@ -111,6 +115,7 @@ static const U32 EMPTY_SALINE_BAG_PERSISTENCE = ( 250 / TASK_GENERAL_INTERVAL ); ///< Time that saline bag looks empty before saying it is empty. #define PRES_ALARM_PERSISTENCE ( 1 * MS_PER_SECOND ) ///< Alarm persistence period for pressure alarms. +#define HIGH_VEN_PRES_ALARM_PERSISTENCE 500 ///< Alarm persistence period for high venous pressure alarm #define PRES_OCCL_ALARM_PERSISTENCE ( 3 * MS_PER_SECOND ) ///< Alarm persistence period for occlusion alarms #define VEN_OCCL_ALARM_PERSISTENCE 100 ///< Alarm persistence period for venous occlusion alarm. #define AIR_PUMP_TOLERANCE_TIMEOUT_MS (1 * MS_PER_SECOND ) ///< Time to allow increased maximum venous high limit @@ -154,6 +159,7 @@ static PRESSURE_STATE_T presOcclState; ///< Current state of pressure monitor state machine. static U32 presOcclDataPublicationTimerCounter = 0; ///< Used to schedule pressure data publication to CAN bus. static U32 venLowPresExemptAfterAirTrapFillTimerCtr; ///< Exempt low ven pressure limit alarm for a time following an air trap fill. +static U32 prevVenLowPresExemptAfterAirTrapFillTimerCtr; ///< previous venous low pressure exempt fill time counter /// Interval (in ms) at which to publish pressure/occlusion data to CAN bus. static OVERRIDE_U32_T presOcclDataPublishInterval = { PRES_OCCL_DATA_PUB_INTERVAL, PRES_OCCL_DATA_PUB_INTERVAL, 0, 0 }; @@ -176,6 +182,8 @@ static F32 longFilteredVenousPressure; ///< Measured venous pressure after long (10 s) filter. static OVERRIDE_F32_T shortFilteredVenousPressure = { 0.0, 0.0, 0.0, 0 }; ///< Measured venous pressure after short (1 s) filter. static STABILIZATION_PERIODS_T pressureStabilizeTime; ///< Pressure stabilization time based on system events such as airpump, treatment param changes etc., +static BOOL resetFillExemptPeriod; ///< Flag to reset the exempt period after defined time expire. +static BOOL lowVenousPressureExemptCheck; ///< low venous pressure exempt check flag based on the air trap valve status static U32 bloodPumpOcclusionAfterCartridgeInstall; ///< Measured blood pump occlusion reading taken after cartridge install. @@ -232,7 +240,7 @@ initPersistentAlarm( ALARM_ID_HD_ARTERIAL_PRESSURE_LOW, 0, PRES_ALARM_PERSISTENCE ); initPersistentAlarm( ALARM_ID_HD_ARTERIAL_PRESSURE_HIGH, 0, PRES_ALARM_PERSISTENCE ); initPersistentAlarm( ALARM_ID_HD_VENOUS_PRESSURE_LOW, 0, PRES_ALARM_PERSISTENCE ); - initPersistentAlarm( ALARM_ID_HD_VENOUS_PRESSURE_HIGH, 0, PRES_ALARM_PERSISTENCE ); + initPersistentAlarm( ALARM_ID_HD_VENOUS_PRESSURE_HIGH, 0, HIGH_VEN_PRES_ALARM_PERSISTENCE ); initPersistentAlarm( ALARM_ID_HD_ARTERIAL_PRESSURE_OUT_OF_RANGE, 0, PRES_ALARM_PERSISTENCE ); initPersistentAlarm( ALARM_ID_HD_VENOUS_PRESSURE_OUT_OF_RANGE, 0, PRES_ALARM_PERSISTENCE ); initPersistentAlarm( ALARM_ID_HD_BP_OCCLUSION_OUT_OF_RANGE, 0, PRES_OCCL_ALARM_PERSISTENCE ); @@ -248,22 +256,25 @@ setPressureLimitsToOuterBounds(); - currPresLimitsState = PRESSURE_LIMITS_STATE_OFF; - pressureLimitsActive = FALSE; - stabilizationStartTimeMs = 0; - stableArterialPressure = 0; - stableVenousPressure = 0; - venLowPresExemptAfterAirTrapFillTimerCtr = 0; + currPresLimitsState = PRESSURE_LIMITS_STATE_OFF; + pressureLimitsActive = FALSE; + stabilizationStartTimeMs = 0; + stableArterialPressure = 0; + stableVenousPressure = 0; + venLowPresExemptAfterAirTrapFillTimerCtr = 0; + prevVenLowPresExemptAfterAirTrapFillTimerCtr = 0; resetArtVenPressureOffsets(); - longFilteredArterialPressure = 0.0F; - shortFilteredArterialPressure.data = 0.0F; - longFilteredVenousPressure = 0.0F; - shortFilteredVenousPressure.data = 0.0F; - presOcclDataPublicationTimerCounter = DATA_PUBLISH_COUNTER_START_COUNT; - presOcclState = PRESSURE_WAIT_FOR_POST_STATE; - presOcclPostState = PRESSURE_SELF_TEST_STATE_START; - bloodPumpOcclusionAfterCartridgeInstall = 0; - pressureStabilizeTime = USE_NORMAL_STABILIZATION_PERIOD; + longFilteredArterialPressure = 0.0F; + shortFilteredArterialPressure.data = 0.0F; + longFilteredVenousPressure = 0.0F; + shortFilteredVenousPressure.data = 0.0F; + presOcclDataPublicationTimerCounter = DATA_PUBLISH_COUNTER_START_COUNT; + presOcclState = PRESSURE_WAIT_FOR_POST_STATE; + presOcclPostState = PRESSURE_SELF_TEST_STATE_START; + bloodPumpOcclusionAfterCartridgeInstall = 0; + pressureStabilizeTime = USE_NORMAL_STABILIZATION_PERIOD; + resetFillExemptPeriod = TRUE; + lowVenousPressureExemptCheck = TRUE; } /*********************************************************************//** @@ -859,9 +870,9 @@ * @brief * The checkVenousPressureInRange function checks that venous pressure is * within the set alarm limits. Alarm is triggered if not. - * @details Inputs: venousPressure, pressureLimitsActive, currentVenousMinLimit - * currentVenousMaxLimit, venLowPresExemptAfterAirTrapFillTimerCtr - * @details Outputs: venLowPresExemptAfterAirTrapFillTimerCtr, alarm if out of range + * @details Inputs: venousPressure, pressureLimitsActive, currentVenousMinLimit, resetFillExemptPeriod + * currentVenousMaxLimit, venLowPresExemptAfterAirTrapFillTimerCtr, prevVenLowPresExemptAfterAirTrapFillTimerCtr + * @details Outputs: venLowPresExemptAfterAirTrapFillTimerCtr,alarm if out of range * @return none *************************************************************************/ static void checkVenousPressureInRange( void ) @@ -870,13 +881,19 @@ OPN_CLS_STATE_T airTrapValveState = getValveAirTrapStatus(); // track time since last air trap fill - if ( STATE_OPEN == airTrapValveState ) + if ( ( STATE_OPEN == airTrapValveState ) && ( TRUE == resetFillExemptPeriod ) ) { venLowPresExemptAfterAirTrapFillTimerCtr = 0; + resetFillExemptPeriod = FALSE; + lowVenousPressureExemptCheck = FALSE; } else { - venLowPresExemptAfterAirTrapFillTimerCtr++; + // Increment counter on airtrap valve close state. Also, when next fill happens within exempt period, counter will be keep incremented irrespective of valve state. + if ( TRUE == lowVenousPressureExemptCheck ) + { + venLowPresExemptAfterAirTrapFillTimerCtr++; + } } #ifndef _RELEASE_ @@ -897,26 +914,40 @@ U32 qBx = ( 0 == qB ? MIN_SET_BLOOD_FLOW_RATE : (U32)qB ); // compute exemption period (in general task intervals) for low venous pressure alarms after air trap fills U32 exemptPeriod = VENOUS_PRES_AT_FILL_DELAY_FACTOR / qBx; + // minimumMonitoring Window helps to check and raise low venous pressure alarm on a case where repeated fill events occurrence. + // During this interval, if another airtrap fill occurs, there is no exemptions provided to stabilize the pressure and low venous pressure being raised when it goes below threshold value. + U32 minimumMonitoringWindow = exemptPeriod + MIN_TIME_BETWEEN_AIR_TRAP_FILL_EXEMPTIONS_WINDOW ; venPresLow = ( venPres < (F32)currentVenousMinLimit ? TRUE : FALSE ); venPresHigh = ( venPres > (F32)currentVenousMaxLimit ? TRUE : FALSE ); // Check venous pressure is within alarm limits - if ( ( airTrapValveState != STATE_OPEN ) && ( venLowPresExemptAfterAirTrapFillTimerCtr > exemptPeriod ) ) + // Low venous pressure is checked after exemption period and before end of reset period(minimum monitoring window) or until next air trap fill occurs + if ( ( venLowPresExemptAfterAirTrapFillTimerCtr > exemptPeriod ) && + ( ( venLowPresExemptAfterAirTrapFillTimerCtr <= minimumMonitoringWindow ) || + ( venLowPresExemptAfterAirTrapFillTimerCtr > prevVenLowPresExemptAfterAirTrapFillTimerCtr ) ) ) { if ( TRUE == isPersistentAlarmTriggered( ALARM_ID_HD_VENOUS_PRESSURE_LOW, venPresLow ) ) { SET_ALARM_WITH_2_F32_DATA( ALARM_ID_HD_VENOUS_PRESSURE_LOW, venPres, (F32)currentVenousMinLimit ); } } - else - { // clear persistence if air trap valve is open + // during reset period, if airTrapValve open, still alarm needs to be raised , hence persistence clearance should happen before or after reset period. + if ( ( airTrapValveState == STATE_OPEN ) && + ( ( venLowPresExemptAfterAirTrapFillTimerCtr < exemptPeriod ) || + ( venLowPresExemptAfterAirTrapFillTimerCtr > minimumMonitoringWindow ) ) ) + { isPersistentAlarmTriggered( ALARM_ID_HD_VENOUS_PRESSURE_LOW, FALSE ); } + if ( TRUE == isPersistentAlarmTriggered( ALARM_ID_HD_VENOUS_PRESSURE_HIGH, venPresHigh ) ) { SET_ALARM_WITH_2_F32_DATA( ALARM_ID_HD_VENOUS_PRESSURE_HIGH, venPres, (F32)currentVenousMaxLimit ); } + + // Reset exempt flag only after exempt period for the last fill and after reset period (minimum monitoring window) + resetFillExemptPeriod = ( venLowPresExemptAfterAirTrapFillTimerCtr > minimumMonitoringWindow ? TRUE : FALSE ); + prevVenLowPresExemptAfterAirTrapFillTimerCtr = venLowPresExemptAfterAirTrapFillTimerCtr ; } else { // Reset persistence if limits inactive @@ -1028,6 +1059,19 @@ /*********************************************************************//** * @brief + * The signalLowVenousPressureCheck function sets the low venous pressure Exempt check flag to increment the counter. + * @details Inputs: lowVenousPressureExemptCheck + * @details Outputs: lowVenousPressureExemptCheck + * @return none. + *************************************************************************/ +void signalLowVenousPressureCheck( void ) +{ + // When flag set, low venous pressure exempt counter increments. + lowVenousPressureExemptCheck = TRUE; +} + +/*********************************************************************//** + * @brief * The getMeasuredArterialPressure function gets the current arterial pressure. * @details Inputs: arterialPressure * @details Outputs: none