EP0148221A1 - Sphygmomanometre - Google Patents

Sphygmomanometre

Info

Publication number
EP0148221A1
EP0148221A1 EP19840902495 EP84902495A EP0148221A1 EP 0148221 A1 EP0148221 A1 EP 0148221A1 EP 19840902495 EP19840902495 EP 19840902495 EP 84902495 A EP84902495 A EP 84902495A EP 0148221 A1 EP0148221 A1 EP 0148221A1
Authority
EP
European Patent Office
Prior art keywords
pressure
blood
artery
cavity
liquid
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP19840902495
Other languages
German (de)
English (en)
Inventor
Falko Skrabal
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from AT0242383A external-priority patent/AT391262B/de
Application filed by Individual filed Critical Individual
Publication of EP0148221A1 publication Critical patent/EP0148221A1/fr
Withdrawn legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
    • A61B5/021—Measuring pressure in heart or blood vessels
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/04—Measuring blood pressure
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
    • A61B5/7203—Signal processing specially adapted for physiological signals or for diagnostic purposes for noise prevention, reduction or removal
    • A61B5/7207—Signal processing specially adapted for physiological signals or for diagnostic purposes for noise prevention, reduction or removal of noise induced by motion artifacts
    • A61B5/721—Signal processing specially adapted for physiological signals or for diagnostic purposes for noise prevention, reduction or removal of noise induced by motion artifacts using a separate sensor to detect motion or using motion information derived from signals other than the physiological signal to be measured

Definitions

  • the invention relates to a device for measuring blood pressure, consisting of at least one pressure transducer filled with fluid lying above an artery, with a pressure line to a pressure measuring device with a connected computer and display or registration.
  • an inflatable cuff mostly on the upper arm, has mainly been used for blood pressure measurement, and just below this is usually the Korotkoff noise with a stetoscope, or more rarely with an ultrasound probe with sound transmitter and sound receiver, which was caused by the Doppler effect Frequency or phase shift measured between the transmitted and reflected sound.
  • These devices have the disadvantages that the pressure in the cuff must be increased again and again above the value of the systolic blood pressure, and thus the blood supply to the extremity is interrupted, furthermore that it is impossible to continuously record the individual pressure values of each individual pulse beat, and that the pressure values are influenced by the position of the extremity relative to the heart.
  • This device is therefore not suitable for continuous pressure recording of each individual pulse, it works in principle like a conventional blood pressure monitor, in which the pressure is increased above the systolic value and then slowly released, and then when the pressure is released, the Doppler signal of an individual Display heartbeat as a systolic value and a single heartbeat as a diastolic pressure.
  • the air is suitable, and only with this does the device work, only as a poor medium for the transmission of the Doppler signal.
  • the device cannot work either because the deformable membrane, after being applied to the body, also absorbs part of the arterial pressure and, due to the possible deformation, cannot pass it on to the pressure transducer, so that the pressure transducer only part of the pressure and therefore not the real values registered.
  • a cardiac diagnosis system has also been described (US Pat. No. 4,154,231) which is intended to receive a series of signals such as EKG, sound, Doppler signals and pulse waves from the heart and to process them via a computer by attaching the device between the ribs on the chest , wherein liquid is used as the transmission medium for the energy signals.
  • this device is not intended or suitable for measuring blood pressure, because although pulse waves can be registered by the contraction of the heart, the device cannot be calibrated because the pressure in this device cannot be changed. Rather, this device is only suitable for diagnosing cardiac diseases by observing cardiac electrics, cardiac muscle mechanics and heart valve movements.
  • the invention aims to avoid the difficulties described by creating a new pressure transducer for the registration of several signals for the exact determination of the blood pressure.
  • the blood pressure monitor according to the invention is characterized in that at least one, but advantageously several liquid-filled devices with pressure-resistant outer wall and easily deformable inner wall are attached to the body over an artery in such a way that the pressure-resistant outer wall lies in a stable position with respect to the body in such a way that said easily deformable inner wall comes to lie over an artery, at least one pressure-resistant, liquid-filled line leading from said device to an inertia-free pressure measuring device and to a pressure control device, which are best placed in the opposite side of the heart, with an additional rigid connection with the pressure-resistant outer wall of said device at least one recording device, such as a transmitter and receiver of energy sources, such as an ultrasound transmitter and ultrasound receiver or to a transmitter and receiver of laser beams or a device for recording sound waves, such as a microphone, so a What is required is that the signal coming from the artery
  • the progress achieved with the blood pressure measuring device can be seen in the fact that, on the one hand, by measuring the pressure fluctuations in said device, the pressure fluctuations of each individual pulse beat, which are constantly communicated by the underlying artery, can be registered without the artery being increased by an excessive increase in the Pressure in said device must be depressed, on the other hand, by intermittent pressure increase or decrease above the level of the systolic or below the diastolic pressure, the changing signal, such as a change in the amplitude of the pressure waves, or a change in the signals, such as the sound waves or the
  • the ultrasound reflected from the artery which is recorded by the at least one recording device attached to the pressure-resistant outer wall, can be used to determine the exact absolute level of the systolic and diastolic blood pressure l
  • the pulse waves of the artery are continuously recorded by the volume sensor in said device and a force directed against these pulse waves is generated by a mechanism controlled by the volume sensor, so that a complete relaxation of the artery wall is continuously achieved during the
  • the membrane by generating the back pressure to the arterial pressure, the membrane also adapts ideally to the body surface, so that a liquid-filled cushion between pressure transducers and body surface (in contrast to EP-AI 41696) or between sound transducer and / or ultrasound transducer and body surface (eg in contrast to US-PS 4202348 and US-PS 4127114) always represents an ideal connection to the body surface, which simultaneously ensures optimal absorption of pressure waves, Sound waves and Utral sound waves allows.
  • the blood pressure measuring device is preferably attached above an artery which is not solely responsible for the blood supply to the extremity, so that the blood supply in the underlying artery, but not in the extremity, is interrupted by intermittent pressure increase via the level of the systolic blood pressure.
  • a further advantage is brought about by the preferred attachment of the inertia-free pressure measuring device in the area of the heart, whereby pressure values that are always measured absolutely correctly are guaranteed, regardless of the position of the extremity.
  • up to three different signals are available in the device according to the invention in order to determine the absolute level of the blood pressure: 1) A change in the amplitude of the pressure fluctuations in said device with a change in the absolute pressure in said liquid-filled device. 2) A change in the quality of the sound waves with increasing the pressure above the systolic blood pressure and lowering the pressure in the device under the diastolic blood pressure and 3) a phase or frequency shift of the ultrasound reflected from the artery upon increasing and decreasing the pressure in said device.
  • Another embodiment of the device described would consist in that two devices close to the body (closer to the heart) and distant from the body (further to the heart) with pressure-resistant outer and easily deformable inner wall come to lie over the same artery, in which case two pressure lines lead to two inertias Pressure gauges and lead to two pressure control devices, the additional registration devices, such as ultrasound transmitters and ultrasound receivers or microphones, being mounted in the device remote from the body, so that in the device close to the body, the pressure can be changed as desired above the level of the systolic or below the level of the diastolic pressure, in order to register the signals thereby changed in the device away from the body.
  • the additional registration devices such as ultrasound transmitters and ultrasound receivers or microphones
  • a further embodiment could consist in that three described devices with an outer pressure-resistant wall and an inner, easily deformable wall come to lie one behind the other in a row over an artery, in which case three pressure lines would lead to inertia-free pressure measuring devices and inertia-free pressure control devices, in which case said registration devices, such as ultrasound transmitter and ultrasound receiver or microphone would come to rest in the middle of the three devices, in order to be able to change in the near-body and in the distant device, regardless of pressure above the systolic and below the diastolic pressure, in order to be able to change the to register changed signals.
  • This can be advantageous if the artery receives arterial blood from another body through another artery.
  • the outer pressure-resistant wall consists of a common or several separate pieces, as long as only the liquid-filled devices are separated from one another by intermediate walls, so that different pressures can be generated in the individual devices.
  • the body-near and the body-far device could have a common pressure-resistant line to a common pressure measuring device and pressure control device separate from the middle device.
  • the measuring device described is suitable in different complex versions for different purposes, for example in a small portable version for the permanent monitoring of living beings throughout the day or in more complex versions for stationary monitoring, or with the display of each one Blood pressure fluctuation of every single pulse beat for complex circulatory examinations.
  • Fig. 1 shows a preferred embodiment of said blood pressure measuring device, consisting of a device with a pressure-resistant outer wall -1-, the cavity -8-. is attached above an artery -3-, the edge -2- of the exemplary embodiment being fixed by a double-adhesive film -4-, an additional, stretchable or non-stretchable band -5- around the extremity -7- is placed to hold the device in place when the pressure in the cavity -8-, which is delimited by the deformable membrane -9- from the extremity -7-, is held in place.
  • At least one further device for generating a pressure such as a bag filled with liquid or gas -6-
  • a further device for generating a pressure can be attached exactly visavis from said device -1- to said extremity, the sole purpose of which is to lift off said device - 1- to prevent from the body surface when the pressure in it is increased by synchromically generating a pressure in this device -6- which increases the tension of the band -5- when the pressure in the device -8- increases and reduces the tension of the belt -5- when the pressure in device -8- falls.
  • This device -6- can be arranged so that an increase in pressure in devices 1 and 6 does not affect the blood flow through the veins -18-.
  • the device -6- could also have a pressure-resistant outer wall in order to accommodate the capacity of the device -6 To keep the pressure increase as small as possible.
  • 2 pressure transducers -21a- are attached to the edge -2- of the pressure-resistant wall -1-, via which the contact pressure of the device -1- can be regulated on the body -7-, for example by changing the pressure in device -6-.
  • An additional pressure control unit -22 - to be available.
  • both a microphone -10- and an ultrasonic transmitter and receiver -11 are attached to the pressure-resistant wall - 1 so that the liquid contained in the cavity -8- as a conductive medium between the microphone -10- uride ultrasonic transmitter and receiver -11 on the one hand and artery -3- on the other.
  • a pressure-resistant line -12- leads from the cavity -8- to an inertia-free pressure measuring device -13- on the one hand and to an inertia-free pressure control device -14- on the other.
  • This inertia-free pressure control device can be, for example, either in a controlled pump device with a controlled drain valve or in a container with compressed gas, a reducing valve with a subsequent control device and a controlled drain valve for the exact setting of the pressure, so that any pressure in the cavity -8- is inertia-free.
  • additional signals from the microphone -10- and ultrasound transmitter and receiver -11- can be transmitted via corresponding analyzers of Korotkoff's noise -16- or analyzers of the ultrasound advance -17- to the computer -15- who can process them in any desired form, so that the true systolic and diastolic blood pressure and its current fluctuations can be brought to the attention of the display and recorder -19 and are available for further processing by storage -20-.
  • FIG. 2 shows a further exemplary embodiment of said blood pressure measuring device in longitudinal section, wherein in the said device with pressure-resistant outer wall -1- a central cavity -8- contains the sound pickup -10 and ultrasound transmitter and receiver -11-, but additionally a further cavity -23 - Body-close to cavity -8- and in addition a further cavity -24- distant from cavity -8- is attached above the same artery -3, all of which are separated from the extremity -7- by a deformable membrane -9a-c.
  • Both cavity -23- has a separate pressure line -25- to a pressure control device -26- and to a pressure measuring device -27-
  • cavity -24- has a separate pressure line -28- to a pressure measuring device -29- and a pressure control device - 30- leads so that separate prints can be generated in all three cavities -8-, -23- and -24-, all signals arriving from the pressure chambers -8-, -23- and -24- being processed in the computer -15-
  • This embodiment has the advantage that, by increasing the pressure in the liquid-filled cavity -24-, specific changes in the signals from the liquid-filled central cavity -8- are brought about, namely changes in the pressure fluctuations in the cavity -8- communicated by the artery -3- , which are registered in the pressure measuring device -13, or changes in the signals arriving at the microphone -10- and at the ultrasound receiver -11-.
  • FIG. 3 shows a further exemplary embodiment of the blood pressure monitor, in which a further cavity -32 extends from the cavity -8-, which communicates with the pressure line -12, through a deformable membrane -31- is delimited, whereby the volume shifts in the cavity-8- caused by the blood waves in said artery -3 can be registered in that one or more strain gauges -33- are attached to said membrane -31-, the signal of which controls a pressure control device -34- that there is always so great a pressure in the cavity -32- that the membrane -31 is brought back to its starting position as inertia as possible.
  • FIG. 4 shows a further exemplary embodiment of the blood pressure measuring device, in which, in addition to sound transducer -10- and ultrasound transmitter and receiver -11-, also the volume transducer in the form of a deformable membrane -31- directly in the wall of the device with pressure-resistant outer wall -1- is installed in such a way that deformations of the membrane (drawn as -31a and -31 b-) immediately bring about a pressure adjustment in the cavity -32-, so that the membrane -31- returns to its original position.
  • Fig. 5 shows an example of a way to determine the absolute level of the systolic blood pressure with the help of the described blood pressure measuring device.
  • This calculation of the systolic blood pressure has the advantage that the rate of change of the pressure in device -23- can be significantly higher than if the level of systolic blood pressure only from the pressure in device -23- at the time the first blood flow appeared in the device -8- is determined.
  • an optimized mathematical function for example a logarithmic-exponential - or power function
  • the function -37 given by the changing amplitude summit -33- to -36- could also be obtained during a pressure increase in device -23-, or also by pressure changes in device -8-,
  • the function obtained -37- does not represent a linear regression
  • another mathematical function could also be used with a mathematical optimization method, e.g. a logarithmic, exponential or power function can be used.
  • the evaluation method described has the advantage that the pressure change in device -8- or / and -23- could take place much more quickly than in conventional blood pressure measurements, than one does not look closely at the appearance or complete disappearance of blood flow from a single heartbeat is instructed how this is necessary in the blood pressure monitors described so far.
  • the method described has the
  • the pressure in the device -8- and / or -23- does not have to be changed above the systolic or below the diastolic blood pressure, so one
  • Modulation of blood flow with changing pressure in device -8- and / or -23 could be used with a function, for example to determine the diastolic pressure.
  • 6 shows a further exemplary embodiment of the blood pressure monitor in which the edge -2- of the pressure-resistant wall -1- consists at least partially of a deformable membrane - 40 - which bears against the body - 7 - and a further liquid or gas-filled cavity - 41 - in connection with the pressure-resistant wall - 1 -, which at least partially surrounds the liquid-filled cavity - 8, but is separated from the cavity - 8 - but by the pressure-resistant wall - 1.
  • This embodiment has the advantage that the device with pressure-resistant wall - 1 - the body - 7 - regardless of its individually varying shape, always fits ideally if adequate filling of the cavity - 40 - is taken care of with liquid or gas. For example, a viscous liquid could also be suitable for filling the cavity.
  • a pressure transducer -22a- the application pressure of the device with a pressure-resistant wall - 1 - to the body - 7 - can be observed or regulated.
  • this is accomplished in that the device for increasing the contact pressure - 6 - is attached to the side of the pressure-resistant wall - 1 - facing away from the liquid-filled cavity - 8 - so that when the pressure in device - 6 is increased by mediation of the the body - 7 - placed tape -5 - the application pressure of the device with pressure-resistant wall - 1 - to the body - 7 - is increased.
  • a rigid device could also be attached to the body - 7 - for example.
  • the example embodiment has the further advantage that the device for increasing the contact pressure - 6 - the sound pickup -10 - and the ultrasound pickup - 11 - are particularly well shielded against interference from the environment, and the pressure-resistant.
  • Wall - 1 - could be made of sound-insulating, pressure-resistant but deformable material.
  • the pressure control device 22b for regulating the pressure in device 6 could also be controlled by the pressure measuring device 13.
  • the area ratio of the membrane - 9 - to the pressure-exerting surface of the device - 6 - for determining the optimal contact pressure of the device - 1 - on the body could also be used.
  • a pressure transducer - 22a - provided for this purpose is particularly advantageous. It is also obvious that the recording of the ultrasound signals by the ultrasound transducer - 11 - could be improved, that more than one ultrasound transducer -11 - is available, so that even with small displacements of the device with pressure-resistant wall -1- on the body -7- through whose movements a constant ultrasound signal is nevertheless guaranteed.
  • Fig. 7 shows an example view of the device with pressure-resistant
  • the membrane -9- delimiting the cavity -8 - being drawn in transparently, so that the position of the sound receiver - 10 - and the ultrasonic transmitter and receiver -11- can see back there, and wherein the deformable membrane - 40 - the membrane -9 - encloses, for example, on all sides. This makes it more uniform on all sides
  • Fig. 1 to 7 explained in more detail at game sweian embodiments of the blood pressure monitor are not only suitable for continuously recording the blood pressure, but the continuous recording and registration could also give the possibility of additionally measuring the blood pressure by non-pharmacological measures such as eg, through biofeedback or through pharmacological measures, such as by using computer -15- controlled infusion pumps with antihypertensive or antihypertensive medication to the desired level.
  • non-pharmacological measures such as eg, through biofeedback or through pharmacological measures, such as by using computer -15- controlled infusion pumps with antihypertensive or antihypertensive medication to the desired level.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • General Health & Medical Sciences (AREA)
  • Biomedical Technology (AREA)
  • Biophysics (AREA)
  • Cardiology (AREA)
  • Pathology (AREA)
  • Physics & Mathematics (AREA)
  • Engineering & Computer Science (AREA)
  • Public Health (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • Veterinary Medicine (AREA)
  • Radiology & Medical Imaging (AREA)
  • Hematology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Vascular Medicine (AREA)
  • Physiology (AREA)
  • Measuring Pulse, Heart Rate, Blood Pressure Or Blood Flow (AREA)

Abstract

Sphygmomanomètre comportant au moins un dispositif (8) rempli de liquide et placé contre une artère (3) du corps, dispositif permettant l'enregistrement continu par un manomètre exempt d'inertie (13) de la pression artérielle communiquée au liquide, permettant une modification continue de la pression au moyen d'un appareil de régulation de la pression (14) et dans lequel au moins un appareil d'enregistrement, comme un appareil de captage acoustique (10) ou un émetteur et récepteur à ultra-son (11), est disposé de telle manière que les signaux provenant de l'artère parviennent par l'intermédiaire du liquide à l'appareil d'enregistrement, et dans lequel est en outre à disposition un capteur de volume (31) pouvant enregistrer les variations de volume dans ledit dispositif, qui sont communiquées de manière continue au dispositif à partir de l'artère, et pouvant réagir de façon exempte d'inertie envers celles-ci par un mécanisme.
EP19840902495 1983-07-01 1984-06-27 Sphygmomanometre Withdrawn EP0148221A1 (fr)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
AT0242383A AT391262B (de) 1983-07-01 1983-07-01 Blutdruckmessgeraet
AT2423/83 1983-07-01
AT1349/84 1984-04-24
AT134984 1984-04-24

Publications (1)

Publication Number Publication Date
EP0148221A1 true EP0148221A1 (fr) 1985-07-17

Family

ID=25595609

Family Applications (1)

Application Number Title Priority Date Filing Date
EP19840902495 Withdrawn EP0148221A1 (fr) 1983-07-01 1984-06-27 Sphygmomanometre

Country Status (3)

Country Link
EP (1) EP0148221A1 (fr)
AU (1) AU3068984A (fr)
WO (1) WO1985000278A1 (fr)

Families Citing this family (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4838675A (en) * 1987-06-19 1989-06-13 Sola International Holdings, Ltd. Method for improving progressive lens designs and resulting article
US4873987A (en) * 1988-06-30 1989-10-17 Ljubomir Djordjevich Noninvasive continuous monitor of arterial blood pressure waveform
US6086533A (en) * 1998-06-12 2000-07-11 Children's Medical Center Corporation Non-invasive in vivo pressure measurement
EP2710961B1 (fr) * 2012-09-24 2019-08-07 Veinpress GmbH Dispositif de mesure de pression destiné à mesurer la pression d'une veine ou d'un organe et destiné à se combiner à une unité de mesure par ultrasons, ainsi que système et procédé de mesure de la pression d'une veine/d'un organe
US11000258B2 (en) 2015-09-08 2021-05-11 Kurume University Noninvesive arteriovenous pressure measurement device and arteriovenous pressure measurement method using the measurement device

Family Cites Families (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3123068A (en) * 1964-03-03 bigliano
US3219035A (en) * 1963-05-06 1965-11-23 Stanford Research Inst Blood pressure measuring transducer
DE2622129A1 (de) * 1976-05-18 1977-12-01 Alois Hoerl Vorrichtung zur messung des pulsverlaufes
US4154231A (en) * 1977-11-23 1979-05-15 Russell Robert B System for non-invasive cardiac diagnosis
HU176288B (en) * 1977-12-21 1981-01-28 Medicor Muevek Apparatos to determine blood-pressure, in the first place, of babies not in a invasive way
US4271843A (en) * 1978-10-10 1981-06-09 Flynn George J Method and apparatus for diastolic pressure measurement
EP0041222A1 (fr) * 1980-05-30 1981-12-09 Jutta Geb. Federlein Rieckmann Procédé et dispositif pour la mesure non-invasive de la pression sanguine
DE3021658A1 (de) * 1980-06-10 1981-12-17 Peter Dr. 6719 Altleiningen Rieckmann Vorrichtung zur blutdruckmessung

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
See references of WO8500278A1 *

Also Published As

Publication number Publication date
WO1985000278A1 (fr) 1985-01-31
AU3068984A (en) 1985-02-07

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