JP4300032B2 - パルス酸素測定データ信頼度インジケータ - Google Patents
パルス酸素測定データ信頼度インジケータ Download PDFInfo
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/145—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue
- A61B5/1455—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue using optical sensors, e.g. spectral photometrical oximeters
- A61B5/14551—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue using optical sensors, e.g. spectral photometrical oximeters for measuring blood gases
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/145—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue
- A61B5/1455—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue using optical sensors, e.g. spectral photometrical oximeters
-
- 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
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- 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
- A61B5/7214—Signal processing specially adapted for physiological signals or for diagnostic purposes for noise prevention, reduction or removal of noise induced by motion artifacts using signal cancellation, e.g. based on input of two identical physiological sensors spaced apart, or based on two signals derived from the same sensor, for different optical wavelengths
-
- 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
- A61B5/7221—Determining signal validity, reliability or quality
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/74—Details of notification to user or communication with user or patient ; user input means
- A61B5/746—Alarms related to a physiological condition, e.g. details of setting alarm thresholds or avoiding false alarms
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- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16Z—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS, NOT OTHERWISE PROVIDED FOR
- G16Z99/00—Subject matter not provided for in other main groups of this subclass
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- 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
- A61B5/024—Detecting, measuring or recording pulse rate or heart rate
- A61B5/02416—Detecting, measuring or recording pulse rate or heart rate using photoplethysmograph signals, e.g. generated by infrared radiation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/74—Details of notification to user or communication with user or patient ; user input means
- A61B5/7405—Details of notification to user or communication with user or patient ; user input means using sound
Description
出力n=c1ξ入力n+c2ξ出力n-1 ・・・(1)
即ち、n番目の出力804は入力及び前出力の重み付き平均であり、加算平均の量はc1及びc2の相対値によって決定される。
成人:
歪み出力 =
(Integ>0.01)+(フィルタ処理された完全性>0.0001)ξ(フィルタ処理されたPR密度<0.7) ・・・(2)
新生児:
歪み出力=(Integ>0.05)+
((フィルタ完全性>0.005)+(PR密度=0))ξ(フィルタ処理されたPR密度<0.8) ・・・(3)
ここで、論理「and」(論理積)は乗算「ξ」として示され、論理「inclusive or」(包含的論理和)は加算「+」として示される。
成人:
ピーク出力=(In9>0) 3i=1(In7−In7-i>0) 9i=3(In9−In9+i>−0.05) ・・・(4)
スロープ出力=(In9>0) 18i=3(Ini-1−Ini>−0.005)
・・・(5)
新生児:
ピーク出力=3i=1(In7−In7-i>0) 9i=3(In9−In9+i>−0.05) ・・・(6)
スロープ出力=18i=3(Ini-1−Ini>−0.005) ・・・(7)
ここで、Iniは、19サンプルIR波形612におけるi番目の波形サンプルである。
成人且つ歪みなし:
エッジ出力=(下りこう配出力>3)ξピーク出力 ・・・(8)
新生児且つ歪みなし:
エッジ出力=(下りこう配値>1)ξピーク出力 ・・・(9)
歪み有り(成人又は新生児):
エッジ出力=(下りこう配値>0.65)ξピーク出力 ・・・(10)
成人:
対称ピーク出力=偽 ・・・(11)
新生児且つ歪みなし:
対称ピーク出力=
(下りこう配>1)ξ(上りこう配>1)ξ(|下りこう配−上りこう配|δ0.5)ξピーク ・・・(12)
新生児且つ歪み有り:
対称ピーク出力=
(下りこう配>0.35)ξ(上りこう配>0.35)ξ(|下りこう配−上りこう配|δ0.5)ξピーク ・・・(13)
成人且つ歪みなし:
減少傾向=(3<(下りこう配−上りこう配)<6)ξスロープ
・・・(14)
新生児且つ歪みなし:
減少傾向=(0.5<(下りこう配−上りこう配)<2)ξスロープ
・・・(15)
歪み有り(成人又は新生児):
減少傾向=(0.5<(下りこう配−上りこう配)<8)ξスロープ
・・・(16)
最小ギャップ(=0.8×(60/脈拍数)×62.5=3000/脈拍数)
・・・(17)
動作に伴い、パルス酸素計に表示されるプレチスモグラフは変形されることが多く、アーチファクトによって不明瞭になることもある。動作中に飽和度を正確に計算できるパルス酸素計の出現により、プレチスモグラフだけでは、動脈波又は信号品質を十分に表示できない。本発明による視覚パルス・インジケータは、患者の脈拍の発生を識別するためにプレチスモグラフ表示を補足し、さらに飽和度及び脈拍数の計算値における信頼度を示すことができる。動脈動のピークと一致する垂直ラインとして示される視覚パルス・インジケータは、プレチスモグラフが歪められたりアーチファクトによって不明瞭になる場合でも患者の脈拍を示している。垂直ラインの高さはデータ完全性を示している。高い垂直ラインは飽和度及び脈拍数の測定における信頼度を示し、一方、小さい垂直バーは信頼度が低いことを示している。
図15及び図16は、上記の図12乃至図14に関して説明された視覚パルス・インジケータを補完する介護者アラートの生成を示している。信号品質が非常に低い場合、計算による脈拍数と飽和度の正確度は信用できなくなることがあり、介護者警告がなされるのが正当である。このアラートは表示メッセージであったり、固有の音調を有するアラームであったり、あるいは介護人の注意を引くまた別の形式の視覚/音響方法であってもよい。
図17及び図18は、酸素飽和度や脈拍数等の生理学的データに応答する信頼度に基づくアラームを示している。本発明による信頼度に基づくアラーム1700は、データ信頼度の高い期間に真のアラームを見落とす確率を低減し、データ信頼度の低い期間に偽のアラームの確率を低減するように適合されている。図17に示すように、信頼度に基づくアラーム1700は、生理学的データ(PD)1710、信号品質測度(SQM)1720、及びアラームしきい値1730を入力として有し、さらにアラーム・トリガ出力1740を有する。PD入力1710は例えば、飽和度又は脈拍数でもよい。SQM入力1720は、データ完全性、脈拍数密度、調波比率、又は、その他の測度や、信号歪みや乱れ、動作アーチファクト、若しくはノイズのレベルに関した測度の結合でもあり得る。アラーム・トリガ1740は、患者のバイタルサインがアラームしきい値1730によって設定されるような許容範囲内にないこと、例えば、最小飽和度であったり、脈拍数が最大若しくは最低であることを生理学的データが示す時にはいつでも介護者に警告する音響及び/又は視覚的な警告を起動する。特定のパルス酸素計には1つ以上のアラーム1700がある。
Claims (7)
- 体の組織からの光の減衰に対応する生理学的センサ出力であって、前記生理学的センサ出力は1つまたは複数の体組織の生理学的パラメータが表れる生理学的センサ出力と、
前記生理学的センサ出力から導出される複数の生理学的データと、
前記生理学的センサ出力の品質にそれぞれ表す複数の信号品質測度と、
前記信号品質測定の1つにそれぞれ対応する複数のしきい値と、
前記信号品質測度の1つ、及びそれに対応する前記複数のしきい値の1つにそれぞれ応答する複数の比較器出力と、
前記比較器出力を結合するアラート・トリガ出力と、
前記アラート・トリガ出力に応答して生成される低信号品質警告と、
を含み、前記しきい値は、前記データにおける信頼度が低い時間にわたって前記警告が生じるように設定される、データ信頼度インジケータであって、
前記信号品質測度が、完全性測度、脈拍数密度の測度、及び調波比率の測度の内の少なくとも1つを含み、
前記しきい値が0.3未満の完全性値と、0.7未満の脈拍数密度値と、0.8未満の調波比率値と、を含むデータ信頼度インジケータ。 - 生理学的信号から時間依存生理学的データセットと、複数の時間依存信号品質測度と、を導出するように構成されるプロセッサと、
遅延されたデータセットを生成するために遅延時間だけ前記データセットをタイムシフトするように構成され、前記遅延は前記信号品質測度の内の少なくとも1つの関数である、バッファと、
前記データセット及び前記遅延されたデータセットに対し限界を設けるしきい値と、
前記データセットのレベルと前記遅延されたデータセットとが前記しきい値を超える場合に生成される警告と、
を含む、データ信頼度インジケータであって
前記データセット及び前記しきい値に応答する第1の比較器出力と、
前記遅延されたデータセットと前記しきい値とに応答する第2の比較器出力と、
前記警告に対しアラーム・トリガをもたらす前記各比較器の出力の結合と、
を更に含む、データ信頼度インジケータ。 - 前記データセットにおける信頼度が低い場合に警告を発するようにアラート・トリガをもたらす前記信号品質測度の結合を更に含む、請求項2に記載のデータ信頼度インジケータ。
- 生理学的センサから信号を取得するステップと、
前記信号から生理学的データセットを計算するステップと、
前記信号から複数の信号品質測度を計算するステップと、
前記信号品質測度の少なくとも1つに基づいて前記データセットにおける信頼度をディスプレイ上に表示するステップと、
を含むデータ信頼度表示方法であって、
前記データセットに対しアラーム限界を設定するステップと、
前記アラーム限界に基づいてアラーム・トリガを生成するために前記データセットをフィルタ処理するステップと、
前記低信号品質期間に更なるフィルタ処理が適用されるように、前記信号品質の測度に従って前記フィルタ処理ステップの特性を調整するステップと、
を更に含み、
前記フィルタ処理ステップは、
遅延されたデータセットを作成するために前記データセットをタイムシフトするサブステップと、
第1のトリガ入力を生成するために前記データセットをしきい値と比較するサブステップと、
第2のトリガ入力を生成するために前記遅延されたデータセットを前記しきい値と比較するサブステップと、
前記アラーム・トリガを生成するために前記トリガ入力を結合するサブステップと、
を含む、データ信頼度表示方法。 - 前記調整が、前記信号品質測度により前記タイムシフトの量を変化させるサブステップを含む、請求項4に記載のデータ信頼度表示方法。
- 生理学的センサから信号を取得するステップと、
前記信号から生理学的データセットを計算するステップと、
前記信号から複数の信号品質測度を計算するステップと、
前記データセットに対しアラームしきい値を設定するステップと、
偽のアラームの確率を低減するために、前記データセットが前記信号品質測度の少なくとも1つの関数として前記しきい値を超える場合に、アラーム・トリガを遅延させるステップと、
を含むデータ信頼度表示方法であって、
前記遅延させるステップは、
遅延されたデータセットを生成するために、前記信号品質測度の少なくとも1つの関数である遅延だけ前記データセットをタイムシフトするサブステップと、
第1のリミット出力を生成するために前記データセットを前記しきい値と比較するサブステップと、
第2のリミット出力を生成するために前記遅延されたデータセットを前記しきい値と比較するサブステップと、
前記アラーム・トリガを生成するために前記リミット出力を結合するサブステップと、
を含む、データ信頼度表示方法。 - 複数のトリガ入力を生成するために、前記信号品質測度を複数のしきい値のうちの対応する1つと比較するステップと、
低信号品質警告をトリガするために前記トリガ入力を結合するステップと、
を更に含む請求項6に記載のデータ信頼度表示方法。
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US09/858,114 US6684090B2 (en) | 1999-01-07 | 2001-05-15 | Pulse oximetry data confidence indicator |
PCT/US2002/015213 WO2002091918A2 (en) | 2001-05-15 | 2002-05-13 | Pulse oximetry data confidence indicator |
Related Child Applications (1)
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JP2009022568A Division JP2009160415A (ja) | 2001-05-15 | 2009-02-03 | データ信頼度インジケータ、データ信頼度表示方法及び患者モニタ |
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JP2004528913A JP2004528913A (ja) | 2004-09-24 |
JP4300032B2 true JP4300032B2 (ja) | 2009-07-22 |
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JP2002588840A Expired - Fee Related JP4300032B2 (ja) | 2001-05-15 | 2002-05-13 | パルス酸素測定データ信頼度インジケータ |
JP2009022568A Pending JP2009160415A (ja) | 2001-05-15 | 2009-02-03 | データ信頼度インジケータ、データ信頼度表示方法及び患者モニタ |
JP2014130209A Pending JP2014198260A (ja) | 2001-05-15 | 2014-06-25 | データ信頼度インジケータ、データ信頼度表示方法及び患者モニタ |
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JP2009022568A Pending JP2009160415A (ja) | 2001-05-15 | 2009-02-03 | データ信頼度インジケータ、データ信頼度表示方法及び患者モニタ |
JP2014130209A Pending JP2014198260A (ja) | 2001-05-15 | 2014-06-25 | データ信頼度インジケータ、データ信頼度表示方法及び患者モニタ |
Country Status (4)
Country | Link |
---|---|
US (6) | US6684090B2 (ja) |
EP (1) | EP1389945A2 (ja) |
JP (3) | JP4300032B2 (ja) |
WO (1) | WO2002091918A2 (ja) |
Families Citing this family (683)
Publication number | Priority date | Publication date | Assignee | Title |
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MX9702434A (es) * | 1991-03-07 | 1998-05-31 | Masimo Corp | Aparato de procesamiento de señales. |
CA2105682C (en) * | 1991-03-07 | 2003-09-02 | Mohamed K. Diab | Signal processing apparatus and method |
US5490505A (en) * | 1991-03-07 | 1996-02-13 | Masimo Corporation | Signal processing apparatus |
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