WO1989006108A1 - Dispositif de mesure non-invasive du volume de sang dans les extremites du corps humain - Google Patents

Dispositif de mesure non-invasive du volume de sang dans les extremites du corps humain Download PDF

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Publication number
WO1989006108A1
WO1989006108A1 PCT/DE1988/000788 DE8800788W WO8906108A1 WO 1989006108 A1 WO1989006108 A1 WO 1989006108A1 DE 8800788 W DE8800788 W DE 8800788W WO 8906108 A1 WO8906108 A1 WO 8906108A1
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WO
WIPO (PCT)
Prior art keywords
extremity
weight
control
measurement
measured
Prior art date
Application number
PCT/DE1988/000788
Other languages
German (de)
English (en)
Inventor
Vladimir Blazek
Hans Schmitt
Original Assignee
Nattermann & Cie. Gmbh
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
Application filed by Nattermann & Cie. Gmbh filed Critical Nattermann & Cie. Gmbh
Publication of WO1989006108A1 publication Critical patent/WO1989006108A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/103—Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01G—WEIGHING
    • G01G19/00—Weighing apparatus or methods adapted for special purposes not provided for in the preceding groups
    • G01G19/44—Weighing apparatus or methods adapted for special purposes not provided for in the preceding groups for weighing persons
    • G01G19/445—Weighing apparatus or methods adapted for special purposes not provided for in the preceding groups for weighing persons in a horizontal position

Definitions

  • the invention relates to a device for the non-invasive measurement of the blood volume in human extremities with a balance according to the preamble of claim 1.
  • Methods for determining the blood volumes of the lower extremities under selected physiological tests such as e.g. Vein occlusion test, change of position test, muscle pump test. From the change in blood volume during these tests, important hemodynamic parameters can be defined, e.g. enable thrombosis detection or provide information about the function of the peripheral vessels (arteries, veins).
  • the qualitative method is skin temperature measurement or thermography and the semi-quantitative method: ultrasound Doppler technology, external electromagnetic flow measurement, external calorimetry, photoplethysmography (including light reflection rheography), impedance plethysmography to call.
  • ultrasound Doppler technology external electromagnetic flow measurement
  • external calorimetry external calorimetry
  • photoplethysmography including light reflection rheography
  • impedance plethysmography to call.
  • venous occlusion plethysmography is recognized as a qualitative, non-invasive procedure. Depending on the measuring principle used, it can be divided into
  • strain gauge plethysmography change in resistance of the strain gauge as a result of the change in volume, also called straingauge plethysmography
  • photogrammetric plethysmography shadow change of the extremity due to the volume change, also called video plethysmography
  • a volume change method is also known in which the extremity to be examined is in a water bath.
  • the amount of water displaced by the increase in volume is determined gravimetrically using a balanced balance.
  • Various other disadvantages are associated with the use of this method.
  • the water bath causes a hydrostatic pressure on the skin and the tissue and this influences the blood accumulation in the skin veins
  • the so-called perfusion pressure can be reduced from the increased pressure on the venous system.
  • the influence of the skin's blood circulation by thermal stimuli in a water bath can hardly be excluded.
  • the invention has for its object to develop a device for non-invasive measurement of blood volume in human extremities with a balance according to the preamble of claim 1 such that accurate statements about hamodynamic parameters are possible without the systematic measurement errors of the known devices.
  • a solution to this problem according to the invention is characterized by its developments in the claims.
  • the scale used is not a scale operating according to the two-bowl principle, but rather an electronic weighing device, on the weighing pan of which the extremity is placed, and the output signal of which is applied to a control and computing unit is that controls the course of the investigation and processes and outputs measured weight values.
  • Such weighing devices are known with a measuring range of 0 to approx. 30 kg and a resolution of 1 g, so that their training need not be discussed in more detail at this point.
  • the unavoidable body movements of the person who is preferably lying or sitting examined require the output signal of the weighing device to be corrected.
  • This correction takes into account, among other things, the shape of the leg position on the weighing pan, the specific weight of the blood and in particular the inevitable adjustment movements of the examined person until a quasi-static positioning process of the extremity on the weighing pan is achieved.
  • the weight of the extremity is measured in short time intervals and the actual measuring process is only started when the weight measurements carried out within a certain time period are less than differ a predetermined weight value.
  • FIG. 1 schematically shows a device according to the invention in a venous occlusion test and the patient positioning used therein,
  • Fig. 2 shows schematically the measurement curve in a venous occlusion test and another form of ' leg position.
  • Fig. 4 shows an example of a computer protocol in a venous occlusion test
  • FIG. 1 shows, schematically based on classic venous occlusion plethysmography with strain gauges, the patient positioning when performing the so-called venous occlusion tests.
  • the patient P lies on an examination table T
  • the limb UE to be examined (lower leg in the example shown) lies on the bowl 1a of the scale 1.
  • the scale 1 is brought to the necessary height with a base 2 .
  • the shell la is preferably made of a soft material and adapted to the anatomical shape of the lower leg.
  • a tourniquet 6 is attached to the thigh. This leg position results in a "division" of the weight of the lower extremity between the scales and the knee joint / hip joint. Under these special conditions, the scale delivers a signal that corresponds to half the weight of the lower leg.
  • This signal is fed to a computer.
  • the computer accepts the scale signal several times per second, corrects it by the above-mentioned positioning factor 2 and also takes into account other correction factors such as:
  • the vein occlusion test is computer-controlled as follows:
  • the current resting weight values are output on the monitor, either in numerical or curve representation, as desired.
  • the first measurement phase is carried out by pressing a start button at time A (see FIG. 2, here with a different form of leg support, which is very advantageous in practice)
  • the measuring system checks the measuring signal until the patient is at rest (ie until a maximum difference of, for example, 50 g of two successive pairs of values is undershot over a period of 10 seconds).
  • the computer therefore only releases another measurement when the patient is in an idle state. This is signaled to the examination person acoustically via loudspeaker 3c and optically via monitor 3b.
  • the examiner After pressing the start button at time C (see FIG. 2), the examiner initiates the actual test phase III.
  • This test phase preferably lasts 4 minutes.
  • a pressure is built up in the tourniquet 6 which is above the venous pressure.
  • This dynamic pressure is preferably 80 mm Hg. Blood therefore flows into the extremity via the arterial system, but cannot flow away because of the venous congestion.
  • this purple congestion phase which lasts, for example, 3 minutes, it is also called the occlusion phase, the blood volume increases in the extremity or the weight also directly.
  • the examiner can monitor the weight gain on the monitor.
  • the patient is prompted with acoustic signals during the not breathing for the next 15 seconds (Phase Illb).
  • Phase Illb acoustic signals during the not breathing for the next 15 seconds
  • 5 seconds after the first tone there is a further signal (which is intended for the examinee and therefore preferably has a different pitch).
  • the pressure in the cuff is released.
  • the jammed blood can flow freely from the extremity.
  • the emptying of blood is normally completed in a few seconds (so-called waterfall effect).
  • the end of the respiratory pause is preferably signaled to the patient with a third tone.
  • the measurement is then ended automatically after 240 seconds. Now the measurement values are analyzed. Since these various circulatory fluctuations are subject (cf. curve a in FIG. 3), the curve can also be filtered (curve b in FIG. 3) or idealized by calculated kinetic functions (curve e in Fig. 3) are output.
  • various evaluation parameters of the venous occlusion test carried out are determined and the entire data set (measured values and results) is stored in a storage medium 4 and optionally also output to a printer 5.
  • 4 shows an example of an examination protocol obtained in this way.
  • the computer uses different factors for data correction.
  • the information required for this (such as the angle of the lower leg / thigh, per size) via the keyboard 3a to the computer 3.
  • the computer can also control the manometer system 7 directly and thereby fully automate the measuring process.
  • Fig. 5 shows schematically the application of the invention in a novel, combined positioning and muscle pump test.
  • the blood drains from the lower leg while the leg is raised.
  • the leg is kept still on the scales.
  • the initial resting weight M rises slowly, since the leg fills with blood flowing "downhill” through the arteries.
  • Important parameters of arterial blood flow to the extremity can be obtained from the kinetics of this filling.
  • Phase B follows phase A.
  • a leg movement program is carried out (eg 10 "accelerator pedal movements" within 15 seconds). Through this movement (muscle pump!)
  • the blood is pumped out of the extremity "uphill” through the veins; the vein pressure drops, ie the leg weight also drops.
  • the leg fills up with blood again. If the venous system is intact, this filling phase C is relatively long. In the case of so-called venous insufficiency, this phase shortens considerably due to the pathological reflux in the leg veins themselves.
  • the presented measuring device succeeds for the first time non-invasively, but directly quantifies the so-called muscle pump effectiveness.
  • FIG. 6 An example of this is shown in FIG. 6, registered on a recorder that was connected to the analog output of the scale 1. As mentioned, the device described detects the "integral" change in weight of the entire extremity (application also possible on the forearm).
  • the method presented can also be expanded according to the invention by multi-channel photoplethysmographic scanning of the skin reflection in different leg floors (see FIG. 7).
  • the scale provides a signal that is proportional to the total change in blood volume. From the relative change in the signals of the optical sensors S to S to one another, which can be detected by control electronics 8, possibly also controlled by computer 3, a statement can be made about changes in blood volume in the individual sensor areas of the leg.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Physics & Mathematics (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Molecular Biology (AREA)
  • Dentistry (AREA)
  • Biophysics (AREA)
  • Pathology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • General Physics & Mathematics (AREA)
  • Medical Informatics (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Measuring Pulse, Heart Rate, Blood Pressure Or Blood Flow (AREA)
  • Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)

Abstract

Un dispositif de mesure non-invasive du volume de sang dans les extrémités (UE) du corps humain comprend une balance (1) qui sert à mesurer le poids momentané de l'extrémité en question et se caractérise par une combinaison des caractéristiques suivantes: l'extrémité à examiner est posée sur un plateau (1a) de la balance; la balance (1) est un dispositif électronique de pesage dont le signal de sortie est fourni à une unité de commande et de calcul (3, 8) qui commande le déroulement de l'examen et qui prépare et fournit les valeurs mesurées du poids; on peut fournir un signal de correction à l'unité de commande et de calcul au moyen d'une unité d'entrée (3a), de façon à prendre en considération la position de l'extrémité examinée (UE) par rapport au corps de la personne (P); une fois l'extrémité posée sur le plateau de la balance, le dispositif de pesage mesure à de courts intervalles le poids de l'extrémité posée sur le plateau et ne commence l'examen proprement dit que lorsque les mesures du poids effectuées pendant une période déterminée donnent des résultats qui diffèrent de moins d'une valeur prédéterminable.
PCT/DE1988/000788 1987-12-30 1988-12-30 Dispositif de mesure non-invasive du volume de sang dans les extremites du corps humain WO1989006108A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE19873744538 DE3744538A1 (de) 1987-12-30 1987-12-30 Vorrichtung zur nichtinvasiven messung des blutvolumens in menschlichen extremitaeten
DEP3744538.3 1987-12-30

Publications (1)

Publication Number Publication Date
WO1989006108A1 true WO1989006108A1 (fr) 1989-07-13

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Application Number Title Priority Date Filing Date
PCT/DE1988/000788 WO1989006108A1 (fr) 1987-12-30 1988-12-30 Dispositif de mesure non-invasive du volume de sang dans les extremites du corps humain

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EP (1) EP0357690A1 (fr)
DE (1) DE3744538A1 (fr)
WO (1) WO1989006108A1 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102004016376A1 (de) * 2004-03-17 2005-10-06 Software + Systeme Erfurt Gmbh Vorrichtung zur nichtinvasiven Ermittlung hämodynamischer Funktionen, einschließlich des Endothels sowie Arbeitsverfahren hierfür

Families Citing this family (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE4100121A1 (de) * 1991-01-04 1992-07-09 Mann Helmut Prof Dr Med Verfahren und einrichtung zur messung des absoluten blutvolumens
GB2413078C (en) 2004-01-08 2012-08-15 Dialog Devices Ltd A system or method for assessing a subject's pedalblood circulation.

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3270558A (en) * 1962-12-12 1966-09-06 Engineering Res Corp Chiropractic balance
FR1480470A (fr) * 1966-05-09 1967-05-12 Procédé de mesure du volume d'un objet et dispositif pour la mise en oeuvre de ce procédé
DE2839016A1 (de) * 1978-09-07 1980-03-20 Keiper Trainingsysteme Gmbh Waage
DE2949195A1 (de) * 1979-03-14 1980-09-25 Kubota Ltd Elektronische waage
JPS59193321A (ja) * 1983-04-19 1984-11-01 Citizen Watch Co Ltd 小型体重計

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3270558A (en) * 1962-12-12 1966-09-06 Engineering Res Corp Chiropractic balance
FR1480470A (fr) * 1966-05-09 1967-05-12 Procédé de mesure du volume d'un objet et dispositif pour la mise en oeuvre de ce procédé
DE2839016A1 (de) * 1978-09-07 1980-03-20 Keiper Trainingsysteme Gmbh Waage
DE2949195A1 (de) * 1979-03-14 1980-09-25 Kubota Ltd Elektronische waage
JPS59193321A (ja) * 1983-04-19 1984-11-01 Citizen Watch Co Ltd 小型体重計

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
Patent Abstracts of Japan, Band 9, Nr. 58 (P-341)(1781), 14. M{rz 1985; & JP-A-59193321 (CITIZEN TOKEI K.K.) 1. November 1984 *

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102004016376A1 (de) * 2004-03-17 2005-10-06 Software + Systeme Erfurt Gmbh Vorrichtung zur nichtinvasiven Ermittlung hämodynamischer Funktionen, einschließlich des Endothels sowie Arbeitsverfahren hierfür

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Publication number Publication date
EP0357690A1 (fr) 1990-03-14
DE3744538A1 (de) 1989-07-13

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