WO2012059907A1 - Brassard de tensiomètre universel - Google Patents

Brassard de tensiomètre universel Download PDF

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Publication number
WO2012059907A1
WO2012059907A1 PCT/IL2010/000901 IL2010000901W WO2012059907A1 WO 2012059907 A1 WO2012059907 A1 WO 2012059907A1 IL 2010000901 W IL2010000901 W IL 2010000901W WO 2012059907 A1 WO2012059907 A1 WO 2012059907A1
Authority
WO
WIPO (PCT)
Prior art keywords
cuff
blood pressure
bladders
outer layer
patient
Prior art date
Application number
PCT/IL2010/000901
Other languages
English (en)
Inventor
Nissim Greisas
Eyal Wachtenberg
Original Assignee
Greisas, Peggy
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 Greisas, Peggy filed Critical Greisas, Peggy
Priority to PCT/IL2010/000901 priority Critical patent/WO2012059907A1/fr
Publication of WO2012059907A1 publication Critical patent/WO2012059907A1/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
    • A61B5/02—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
    • A61B5/02141—Details of apparatus construction, e.g. pump units or housings therefor, cuff pressurising systems, arrangements of fluid conduits or circuits
    • 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
    • A61B5/022—Measuring pressure in heart or blood vessels by applying pressure to close blood vessels, e.g. against the skin; Ophthalmodynamometers
    • A61B5/02233—Occluders specially adapted therefor

Definitions

  • the invention is related to the field of medical instrumentation. Particularly the invention relates to devices for measuring the blood pressure of humans. More particularly the invention relates to inflatable durable or disposable cuffs for use with noninvasive blood pressure measuring instruments.
  • a blood pressure cuff normally comprises an outer band of inelastic cloth with an expandable elastic bladder attached to its inner surface. Blood pressure is usually measured by placing a blood pressure cuff around the patient's upper arm, inflating the bladder to occlude the flow of blood in the brachial artery and slowly deflating the bladder allowing measurement of the systolic and diastolic pressures as the pressure inside the bladder drops. The reliability of the measurement is known to be dependent upon the relation between the bladder size and the patient's arm circumference. It is widely accepted in the medical procession that the "ideal" cuff should have a bladder length that is about 80% of arm circumference and a width that is about 40% of arm circumference.
  • Another approach is to provide a cuff having a single bladder and an arrangement to limit the dimensions of the part of the bladder that can be inflated in order to adapt the effective dimensions of the bladder to the dimensions of the patient's arm.
  • Examples of cuffs using this approach are:
  • US 5,243,991 teaches a blood pressure cuff having hook and loop fasteners on one side that are used to adjust the width of the bladder by folding one side of the cuff over itself. In this way the width, but not the length, of the bladder can be adjusted according to the circumference of the patient's arm.
  • This patent provides a solution to the problem of providing a cuff of the recommended dimensions, however it is not as simple to use as conventional cuffs, since care must be taken to properly locate it on the arm and to apply the clamp to be sure that the inflatable part is not too loosely or tightly wound around the arm.
  • a third approach to solving the problem of providing a properly fitting blood pressure cuff is to provide a cuff having multiple bladders. Examples of cuffs based on this approach are:
  • a switch is provided in the supply line of the air used to inflate the bladders in order to manually select the bladder to be inflated. In essence, because of its reliance on the average arm circumference, this bladder contributes very little to the solution of the problem of providing multiple bladder sizes.
  • a commercially available cuff called the TRICUFF bladder Pressure Group AB & Co KB, AJ Medical HB, Sweden
  • the smallest bladder is on the side of the cuff closest to the skin, covered by the middle-sized bladder, with the largest bladder on the outside.
  • Each of the bladders is connected by its own inlet from a common air supply hose.
  • a first layer of the cuff is wrapped around the arm once, a clamp is applied, which pinches of the air supply hose to prevent the bladders having length greater than the circumference of the arm from being connected to the air supply. Then the remainder of the cuff is wrapped around the arm on top of the first layer and the clamp. Since there is no valve to regulate the flow of air to each individual bladder, when the air supply is activated all bladders having a length shorter than the circumference of the arm are inflated, i.e. if the circumference of the arm is longer than the length of the middle bladder and shorter than that of the largest bladder, then both the smallest and the medium sized bladders are inflated. This cuff is reported to improve the accuracy of the measurements but to suffer from several disadvantages including high cost, difficulty to apply in clinical practice and stiffness [O'Brien, op. cit., p. 834].
  • the invention is a universal blood pressure cuff used for accurately measuring the blood pressure of a patient irrespective of the circumference of the limb on which the measurements are taken.
  • the cuff comprises three or more different sized pieces of material that are superimposed on top of each other combined together to form two or more different sized bladders and a control unit.
  • the control unit is characterized in that it is adapted to allow only one of the bladders to be inflated at a time.
  • the universal blood pressure cuff of the invention is characterized in that it comprises a simple means for indicating or automatically determining which of the bladders should be inflated according to the arm circumference of the patient.
  • Embodiments of the universal blood pressure cuff of the invention comprise four different sized pieces of material superimposed on top of each other to form three different sized bladders.
  • the means for indicating or automatically determining which of the bladders should be inflated according to the arm circumference of the patient comprises one or more bands created on or attached to the back side of the outer layer of the cuff.
  • Each of the one or more bands can comprise one or more segments, wherein each of the segments has one or more of the following distinct physical properties: visible pattern, color, texture, reflectivity, capacitance, resistance, or magnetic properties.
  • the control unit is adapted to comprise a manually or automatically operated arrangement adapted to divert the flow of air from the air supply tube into one of the bladders while simultaneously blocking the flow of air to the other bladders.
  • the manually operated arrangement can comprise buttons, a lever, or a slider.
  • Manual embodiments of the cuff can comprise a band, which is divided into three segments that can be distinguished by different patterns or by three different colors attached to the outer layer, and three buttons on the control unit; wherein, when the outer layer is wrapped once around the limb of a patient, one of the segments of the band will be visible through a window in the control unit, thereby indicating which of the bladders is most appropriate for the circumference of the limb and which button should be depressed thereby inflating the appropriate bladder.
  • Another manual embodiment of the cuff of the invention comprises a band, which is divided into three segments that can be distinguished by different patterns or by three different colors attached to the outer layer.
  • the outer layer is wrapped once around the limb of a patient, one of the segments of the band is lined up with a pointer created on the surface of the lower edge of the back side of the backing strip of the cuff; thereby indicating which of the bladders is most appropriate for the circumference of said limb and how the arrangement adapted to divert the flow of air should be operated.
  • Automatic embodiments of the cuff can comprise two bands having different lengths and made of material having a distinctive physical property that are created on or attached to the outer layer of the cuff.
  • a sensor which is located in the control unit and that is adapted for detecting the distinctive physical property of the bands will determine which of the bladders is most appropriate for the circumference of the limb by counting the number of the bands that it detects and will automatically activate a three-way solenoid valve inside the control unit to connect the appropriate cuff to the blood pressure monitor via an air supply tube.
  • Embodiments of the universal blood pressure cuff of the invention can comprise an outer sleeve or additional layer of material attached to cover at least a part of the bladders and the inside of the outer layer thereby providing a more esthetic device or a more comfortable surface to be placed in contact with the skin.
  • FIG. 1A schematically shows the general structure of the cuff of the invention
  • Fig. IB is a side view schematically showing the main external features of one embodiment of the control unit of cuff of the invention.
  • Fig. 2 schematically shows the configuration of the system of tubes used to inflate the bladders
  • Figs. 3A to 3C show the cuff of the invention wrapped around a limb of a patient with the smallest, middle, and largest bladder respectively inflated;
  • Fig. 4 and Figs. 5A to 5C schematically illustrate the manual embodiment of the cuff of the invention
  • Fig. 6 and Figs. 7A to 7C schematically illustrate the automatic embodiment of the cuff of the invention
  • Fig. 8 to Fig. 11 show alternative embodiments of the cuff of the invention.
  • Fig. 12 schematically illustrates an embodiment of the manual embodiment of the cuff of the invention.
  • the invention is a "universal" blood pressure cuff used for accurately measuring the blood pressure of a patient irrespective of the circumference of the limb on which the measurements are taken. Universality is achieved through the use of multiple bladders combined together and sharing a common outer layer to form a single cuff.
  • the cuff of the invention has two basic embodiments in which the effective length and width of the bladder that is inflated is selected either manually or automatically respectively to most closely fit the cuff to the circumference of the arm, thereby ensuring accurate and reliable measurements at all times.
  • the cuff can be made to be durable having a lifetime at least as long as currently available durable blood pressure cuffs or can be made in embodiments that are inexpensive enough to be discarded after one or a limited number of measurements.
  • Fig. 1A schematically shows the general structure of the cuff (10) of the invention, with the inner side, i.e. the side facing the skin when cuff (10) is attached to the patient visible.
  • the cuff comprises four layers of material superimposed one on top of each other.
  • a long rectangular outer layer (12) provides the base to which the other components of cuff (10) are attached.
  • Outer layer (12) is made of inelastic material, which is impervious to air, such as nylon.
  • the outer layer is wrapped around the upper arm of the patient to make the blood pressure measurements.
  • outer layer (12) comprises strips of hook and loop material (14), e.g. Velcro®, on opposite sides or any other suitable fastening means known in the art to hold it firmly in place while the bladder is being inflated and deflated to take the measurements.
  • elastomeric material e.g. rubber or elastomeric polymer
  • outer layer (12) Three different sized rectangular pieces (16', 18' 20') of elastomeric material, e.g. rubber or elastomeric polymer, are attached to outer layer (12), one on top of the other with the smallest piece on the bottom closest to the outer layer and the largest on the top as shown in Fig. 1A.
  • the edges of each of these pieces of elastomeric material are sealed to the outer layer (12) so that air can not pass through the seals, thereby forming three different sized airtight bladders.
  • the smallest bladder (16) is closest to the outer layer
  • the middle bladder (18) is on top of the smallest one
  • the largest bladder (20) on top of the other two.
  • a sleeve or an additional layer of material e.g. cotton or polyester, can be attached to or slipped over the cuff to cover at least a part of the bladders and the inside of the outer layer to provide a
  • Typical measurements of the three pieces of material that form the bladders for a cuff (10) designed to be wrapped around the upper arm of adult humans would be those that conform to the recommendations of the AHA referenced herein above, i.e. 12x24 cm for bladder (16), 13x30 cm for bladder (18), and 16x38 cm for bladder (20).
  • the universal cuff of the invention can be made having bladders of different sizes, for example the cuff can comprise three bladders suitable for the arms of children or of youth or to be wrapped around the legs of adults, youth, or children.
  • the cuff of the invention may comprise only two or more than three bladders if desired.
  • Cuffs designed for use in specialized clinics for specific types of patients can also be supplied. For example gynecologists and obstetricians could use; a cuff whose bladders are dimensioned according to average measurements for females, which are typically smaller than those for males. »
  • Fig. 2 schematically shows the configuration of the system of tubes used to inflate the bladders.
  • the cuff (10) is connected to a supply of air through air supply tube (24), which connects control unit (22) to any conventional device for inflating blood pressure cuffs known in the art, e.g. mechanical, semi automatic or fully automatic electronic blood pressure monitor.
  • control unit (22) Inside of control unit (22) is a three-way valve, or any equivalent arrangement known in the art, that directs the incoming air through only one of tubes (26), (28), or (30) into bladders (16), (18), and (20) respectively according to a command provided either manually or automatically, as will be described herein below.
  • Air is also allowed to escape from the inflated bladder through tube (26), (28), or (30) in the conventional manner to measure the blood pressure as the bladder slowly deflates.
  • all of the bladders are shown partially or completely inflated as in Fig. 2.
  • Figs. 3A to 3C show the cuff of the invention wrapped around a limb (42) of a patient with the smallest (16), middle (18), and largest (20) bladder respectively inflated.
  • Fig. IB is a side view schematically showing the main external features of one embodiment of the control unit (22).
  • control unit (22) is attached to outer layer (12) at the lower edge of outer layer (12) as seen in Fig. 1A.
  • the lower part of control unit (22) hangs below the cuff (10) and the upper part of control unit (22) is on the outside of the cuff, i.e. on the opposite side of the outer layer (12) from the bladders.
  • Fig. 4 and Figs. 5A to 5C schematically illustrate an embodiment of the manual embodiment of the cuff of the invention.
  • Fig.4 shows the outer side of cuff (10).
  • a band (32) On the back of the outer layer (12) is created or attached a band (32), which is divided into three segments (34), (36), and (38) as shown.
  • the different segments of band (32) can be distinguished by different patterns as shown, by texture, or preferably by three different colors.
  • the cuff is wrapped once around the limb of the patient at the position where the blood pressure is to be measured.
  • the edge of the outer layer where band (32) is located is slipped into space (50) (see Fig. IB). Now looking through window (48) one of the segments of band (32) will be visible indicating which of the bladders is most appropriate for the circumference of the limb.
  • Fig. IB Now looking through window (48) one of the segments of band (32) will be visible indicating which of the bladders is most appropriate for the circumference of the limb.
  • segment (34) is visible in window (48) indicating that bladder (16) should be used to make the blood pressure measurements
  • segment (36) is visible in window (48) indicating that bladder (18) should be used to make the blood pressure measurements
  • Fig. 5C segment (38) is visible in window (48) indicating that bladder (20) should be used to make the blood pressure measurements.
  • buttons (40) are preferably coded to match the pattern or color of the segments of band (32).
  • the bladder appropriate to the size of the patient's arm will be inflated.
  • the pressure exerted by the expanding bladder will occlude the flow of blood through the artery.
  • the three buttons can be replaced by a lever or other arrangement to divert the flow of air from air supply tube (24) into the bladder appropriate to the circumference of the patient's arm.
  • Fig. 12 schematically illustrates another embodiment of the manual embodiment of the cuff of the invention.
  • the control unit (22) is suspended from the lower edge of cuff 10 by the three air inlets (26), (28), and (30). Therefore, there is no space between outer layer (12) and the upper part of control unit (22) in which to slip the edge of the cuff when it is wound around the limb.
  • a pointer (56) is created on the surface of the lower edge of the back side of the backing strip (12).
  • the pointer (56) can be created by printing, sewing, or any other method known in the art.
  • control unit (22) comprises an arrangement adapted to divert the flow of air from the air supply tube into the appropriate bladder.
  • the arrangement comprises a three way switch with a slider (66) that can be moved by the thumb of the user from one position to another to simultaneously allow air to flow via air supply tune (24) through one of the air inlets (26), (28), or (30) while blocking the air flow to the other two inlets.
  • Fig. 6 and Figs. 7A to 7C schematically illustrate an embodiment of the automatic embodiment of the cuff of the invention.
  • Fig.6 shows the outer side of cuff (10).
  • bands (44) and (46) On the back of the outer layer (12) are created or attached two bands (44) and (46) having different lengths as shown.
  • Bands (44) and (46) are made of material having a distinctive physical property; e.g. reflective, metallic, capacitive, resistive, magnetic.
  • the cuff (10) is wrapped once around the limb of the patient at the position where the blood pressure is to be measured.
  • the edge of the outer layer where bands (44) and (46) are located is slipped into space (50) (see Fig. IB).
  • a sensor and appropriate electronics including a processing device and power supply, that are appropriate for detecting the physical property of which bands (44) and (46) are made, e.g. an optical sensor if the bands are made of reflective material.
  • the number of bands detected by the sensor will indicate which of the bladders is most appropriate for the circumference of the limb.
  • the remainder of the cuff is wrapped about the arm on and attached using the hook and loop arrangement (14).
  • the control unit will then be given a signal, either manually by the user, for example by pressing a button on it or from a sensor that detects when the cuff has been firmly attached to the arm, to automatically activate a three-way solenoid valve inside control unit (22) to connect the appropriate cuff to the blood pressure monitor via air supply tube 24.
  • a signal either manually by the user, for example by pressing a button on it or from a sensor that detects when the cuff has been firmly attached to the arm, to automatically activate a three-way solenoid valve inside control unit (22) to connect the appropriate cuff to the blood pressure monitor via air supply tube 24.
  • neither of bands (44) or (46) will be detected by the sensor indicating that bladder (16) should be used to make the blood pressure measurements
  • band (46) will be detected by the sensor indicating that bladder (18) should be used to make the blood pressure measurements
  • Fig. 7C band (44) will be detected by the sensor indicating that bladder (20) should be used to make the blood pressure measurements.
  • each of the segments would have, for example a different reflectivity when an optical sensor is used.
  • the bands can be created on the backing strip by any method known in the art, e.g. created as a pattern woven into the material of the backing strip, painted onto the cloth, or created as separate strips that are attached by means of adhesive or sewing. In other embodiments the bands can be created on the borders of the backing strip or the backing strip or portions of it can be made of transparent material to facilitate viewing the strips and determining which bladder should be inflated.
  • Fig. 2 shows only one of many possible ways of attaching the four pieces of material together to form the three bladders of the cuff.
  • Fig. 8 through Fig. 11 show alternative embodiments for the cuff of the invention.
  • the embodiment shown in Fig. 8 is similar to that of Fig. 2 in that the bottom and left edges of all four pieces of material are joined together and the top and right edges of pieces of material (16', 18', 20') are attached separately to backing strip (12).
  • the difference between the two embodiments is that in Fig.2, the cuff is wrapped around arm (42) such that the smallest bladder (16) is against the arm while in Fig. 8 the cuff is wrapped around the arm (42) such that the largest bladder (20) is against the arm (in Figs.
  • the arrows (52) indicate how cuff (10) is wrapped around arm (42)).
  • the bottom edges of all of the pieces of material are joined together, but each of the other three edges of pieces of material (16', 18', 20') are attached separately to the piece of material beneath it.
  • the cuff must be inserted inside a sleeve (54), symbolically shown by a rectangle in the figures.
  • the sleeve (54) made of a non-elastic material such as cotton, is necessary to restrict the expansion of the bladders so that they will exert the desired force against the arm, i.e. the artery.

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

Abstract

L'invention porte sur un brassard de tensiomètre « universel » utilisé pour mesurer avec précision la pression sanguine d'un patient indépendamment de la circonférence du membre sur lequel les mesures sont prises. L'universalité est obtenue par utilisation de multiples vessies combinées ensemble et partageant une couche externe commune pour former un seul brassard. Le brassard de l'invention a deux modes de réalisation essentiels dans lesquels les longueur et largeur effectives de la vessie qui est gonflée sont sélectionnées respectivement soit manuellement soit automatiquement pour adapter d'une manière la plus étroite le brassard à la circonférence du bras, permettant ainsi d'assurer des mesures précises et fiables à tous les instants.
PCT/IL2010/000901 2010-11-01 2010-11-01 Brassard de tensiomètre universel WO2012059907A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PCT/IL2010/000901 WO2012059907A1 (fr) 2010-11-01 2010-11-01 Brassard de tensiomètre universel

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/IL2010/000901 WO2012059907A1 (fr) 2010-11-01 2010-11-01 Brassard de tensiomètre universel

Publications (1)

Publication Number Publication Date
WO2012059907A1 true WO2012059907A1 (fr) 2012-05-10

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Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102015012127A1 (de) * 2015-09-17 2017-03-23 Seca Ag Vorrichtung zur Blutdruckmessung
FR3051346A1 (fr) * 2016-05-19 2017-11-24 Spengler Sas Methode de selection d'un brassard pour sphygmomanometre
CN111150382A (zh) * 2020-01-17 2020-05-15 重庆医科大学附属儿童医院 一种适应各个年龄段的血压测量袖带
WO2023056790A1 (fr) * 2021-10-09 2023-04-13 华为技术有限公司 Procédé et appareil de détection de coussin gonflable pour dispositif pouvant être porté et dispositif pouvant être porté

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3699945A (en) * 1970-07-30 1972-10-24 Paul M Hanafin Blood pressure cuff with calibrated holding means
US4817625A (en) * 1987-04-24 1989-04-04 Laughton Miles Self-inductance sensor
US6332869B1 (en) * 1999-05-07 2001-12-25 Colin Corporation Superior-and-inferior-limb blood-pressure index measuring apparatus
US7051452B2 (en) * 2002-10-16 2006-05-30 Jeffrey S. Brooks, Inc. Foot scanning and measurement system and method
US7250030B2 (en) * 2004-12-10 2007-07-31 Omron Healthcare Co., Ltd. Cuff for blood pressure monitor and blood pressure monitor having the same

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3699945A (en) * 1970-07-30 1972-10-24 Paul M Hanafin Blood pressure cuff with calibrated holding means
US4817625A (en) * 1987-04-24 1989-04-04 Laughton Miles Self-inductance sensor
US6332869B1 (en) * 1999-05-07 2001-12-25 Colin Corporation Superior-and-inferior-limb blood-pressure index measuring apparatus
US7051452B2 (en) * 2002-10-16 2006-05-30 Jeffrey S. Brooks, Inc. Foot scanning and measurement system and method
US7250030B2 (en) * 2004-12-10 2007-07-31 Omron Healthcare Co., Ltd. Cuff for blood pressure monitor and blood pressure monitor having the same

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102015012127A1 (de) * 2015-09-17 2017-03-23 Seca Ag Vorrichtung zur Blutdruckmessung
FR3051346A1 (fr) * 2016-05-19 2017-11-24 Spengler Sas Methode de selection d'un brassard pour sphygmomanometre
CN111150382A (zh) * 2020-01-17 2020-05-15 重庆医科大学附属儿童医院 一种适应各个年龄段的血压测量袖带
CN111150382B (zh) * 2020-01-17 2022-10-11 重庆医科大学附属儿童医院 一种适应各个年龄段的血压测量袖带
WO2023056790A1 (fr) * 2021-10-09 2023-04-13 华为技术有限公司 Procédé et appareil de détection de coussin gonflable pour dispositif pouvant être porté et dispositif pouvant être porté

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