WO2014018024A1 - Système de surveillance de pression sanguine non invasif, oscillométrique et auscultatoire combiné - Google Patents

Système de surveillance de pression sanguine non invasif, oscillométrique et auscultatoire combiné Download PDF

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Publication number
WO2014018024A1
WO2014018024A1 PCT/US2012/048019 US2012048019W WO2014018024A1 WO 2014018024 A1 WO2014018024 A1 WO 2014018024A1 US 2012048019 W US2012048019 W US 2012048019W WO 2014018024 A1 WO2014018024 A1 WO 2014018024A1
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WIPO (PCT)
Prior art keywords
blood pressure
auscultatory
cuff
monitoring component
data
Prior art date
Application number
PCT/US2012/048019
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English (en)
Inventor
Mohamad M. EL-GHOUCH
Original Assignee
Draeger Medical Systems, Inc.
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Publication date
Application filed by Draeger Medical Systems, Inc. filed Critical Draeger Medical Systems, Inc.
Priority to PCT/US2012/048019 priority Critical patent/WO2014018024A1/fr
Publication of WO2014018024A1 publication Critical patent/WO2014018024A1/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
    • A61B5/022—Measuring pressure in heart or blood vessels by applying pressure to close blood vessels, e.g. against the skin; Ophthalmodynamometers
    • 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
    • A61B5/02208—Measuring pressure in heart or blood vessels by applying pressure to close blood vessels, e.g. against the skin; Ophthalmodynamometers using the Korotkoff method
    • 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
    • A61B5/02225—Measuring pressure in heart or blood vessels by applying pressure to close blood vessels, e.g. against the skin; Ophthalmodynamometers using the oscillometric method
    • 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

Definitions

  • the subject matter described herein relates generally to the field of medical devices, and more particularly to devices, systems, articles, and methods used to improve the accuracy of non-invasive blood pressure measurements, especially in a patient where motion can be a factor.
  • NIBP non-invasive blood pressure
  • auscultatory method which involves using a sphygmomanometer and stethoscope, or other means to listen to the blood flow through a patient's arm.
  • An inflatable cuff is positioned around the upper arm of a patient roughly level with the patient's heart.
  • the cuff attached to a manometer, is inflated until the brachial artery at the elbow is completely occluded.
  • the stethoscope is used to listen to the brachial artery as the pressure in the cuff is slowly released.
  • the oscillometric method is another NIBP measurement method that involves the electronic observation of oscillations in the sphygmomanometer cuff pressure caused by the changes in arterial flow resulting from inflating and deflating the cuff.
  • the cuff pressure oscillations are observed using a pressure sensor or transducer and electronics to automatically interpret the oscillations.
  • the inflatable cuff suitably located on the limb of a patient is inflated to a predetermined pressure above the patient's estimated systolic pressure.
  • the cuff pressure is then gradually reduced over a relatively short period of time in predetermined decrements to below diastolic pressure.
  • the oscillations in the cuff are measured by the transducer.
  • a transducer converts cuff pressure to an electrical signal that is in turn converted to systolic and diastolic blood pressure values utilizing an algorithm.
  • the cuff pressure When blood flow is obstructed and when blood flow is unimpeded, the cuff pressure will be relatively constant and no oscillations present. When some blood flow is present, but restricted, the cuff pressure monitored by the pressure transducer will vary with the cyclic expansion and contraction of the brachial artery generating oscillation signals. As the decrementing continues, the peak amplitudes of the oscillations will normally increase from a lower level to a relative maximum, and thereafter will decrease. These amplitudes form an oscillometric envelope for the patient. The cuff pressure at which the oscillations have a maximum value has been found to be representative of the mean arterial pressure (MAP).
  • MAP mean arterial pressure
  • the oscillometric method provides certain advantages in that readings can be taken on a nearly continuous basis with minimal to no risk to the patient as compared to the invasive method.
  • the oscillometric method can also be performed automatically with minimal effort as compared to the auscultatory method, and unlike the auscultatory method, which can directly obtain only systolic and diastolic measurements, can obtain systolic, diastolic and mean arterial pressure measurements.
  • the readings can be performed by a lay person, and because they are automatic, in hospital settings, such readings serve as a surveillance tool to monitor blood pressure continuously, providing a trend of any changes in blood pressure and/or alerting a clinician of any significant change.
  • the oscillometric method can be, there are certain situations in which the accuracy of the blood pressure measurements obtained using the oscillometric method can be diminished. For example, a patient that is in frequent motion, such as a shivering patient or neonatal patient in high motion, may not allow for accurate oscillometric blood pressure measurements to be made.
  • a blood pressure monitoring system includes a monitor unit, a blood pressure cuff configured to attach to a patient's limb and to inflate and deflate while a transducer measures oscillometric blood pressure measurements, a hose coupling the blood pressure cuff to the monitor unit, and an auscultatory blood pressure monitoring component attached to the patient's limb concurrently with the blood pressure cuff to measure sound waves characterizing blood flow coincidentally with measurement of blood pressure suing the blood pressure cuff.
  • the auscultatory blood pressure monitoring component can transmit a waveform generated from the measured sound waves to the monitoring unit.
  • the monitor unit can generate accurate blood pressure measurement values based upon the oscillometric blood pressure measurements and the waveform generated from the measured sound waves.
  • the monitor unit can use the waveform to differentiate pulsating blood deflected by the blood pressure cuff when pressurized from one or more measurement disturbance events. Further, the monitoring unit can determine whether a waveform from the measured sound waves is below a threshold of a rushing blood waveform.
  • the sound waves can include Korotkoff sounds.
  • the auscultatory blood pressure monitoring component can be integrated into the blood pressure cuff.
  • the auscultatory blood pressure monitoring component can be separate from the blood pressure cuff and placed adjacent to the blood pressure cuff on a patient.
  • the system can include a band for housing the auscultatory blood pressure monitoring component and maintaining the auscultator blood pressure monitoring component in contact with the patient's limb.
  • the auscultatory blood pressure monitoring component can be wirelessly coupled to the monitor unit.
  • the auscultatory blood pressure monitoring component can be physically connected to the hose, and the hose can have a wired connection to the monitoring unit.
  • the auscultatory blood pressure monitoring component can be physically connected to the monitoring unit through a signal cable.
  • the auscultatory blood pressure monitoring component can include a recording device to capture Korotkoff sounds.
  • the recording device can include a high fidelity microphone.
  • the system can be one in which the auscultatory blood pressure monitoring component enables the monitor unit to derive an accurate blood pressure measurement value while the patient leans against a surface. Further, the auscultatory blood pressure monitoring component enables the monitor unit to derive an accurate blood pressure
  • the system may additionally be one in which the monitor unit performs one or more of: persisting at least a portion of the filtered blood pressure measurement data, loading at least a portion of the filtered blood pressure management data, displaying at least a portion of the filtered blood pressure measurement data, and transmitting at least a portion of the filtered blood pressure measurement data to a remote computing system.
  • a method for implementation by one or more data processor includes receiving oscillometric blood pressure measurement data, receiving a waveform from an auscultatory blood pressure monitoring component, determining that at least one measurement disturbance event has occurred, and filtering the oscillometric blood pressure measurement data.
  • Receiving oscillometric blood pressure measurement data is accomplished by at least one data processor and the oscillometric blood pressure measurement data is derived from a blood pressure cuff applied to an arm of a patient. Additionally, receiving a waveform from an auscultatory blood pressure monitoring component is
  • the waveform is from an
  • auscultatory blood pressure monitoring component applied to the arm of the patient during inflation and deflation of the blood pressure cuff. Further, determining that at least one measurement disturbance event has occurred is accomplished by at least one data processor and is based on the determination that at least one portion of the received waveform indicates that at least one measurement disturbance event has occurred. Also, filtering the oscillometric blood pressure measurement data includes filtering the data to ignore or adjust for the at least one measurement disturbance event utilizing at least one data processor.
  • the method can include inflating and deflating the blood pressure cuff and obtaining the waveform from the auscultatory blood pressure monitoring component before obtaining oscillometric blood pressure measurement data from the blood pressure cuff and using the waveform from the auscultatory blood pressure monitoring component to determine the maximum pressure to be used while obtaining the oscillometric blood pressure measurement data from the blood pressure cuff. Further, the method can include providing, by at least one data processor, the filtered blood pressure measurement data.
  • providing the filtered blood pressure measurement data can include persisting at least a portion of the filtered blood pressure measurement data, loading at least a portion of the filtered blood pressure measurement data, displaying at least a portion of the filtered blood pressure measurement data, and transmitting at least a portion of the filtered blood pressure measurement data to a remote computing system.
  • the data from the blood pressure cuff can be received before the data from the auscultatory blood pressure monitoring component.
  • the data from the blood pressure cuff can be received after the data from the auscultatory blood pressure monitoring component.
  • the data from the blood pressure cuff can be received at the same time as the data from the auscultatory blood pressure monitoring component.
  • a further related aspect describes a non-transitory computer program product storing instructions, which when executed by at least one data processor, implements any of the methods described herein.
  • Computer program products are also described that comprise non- transitory computer readable media storing instructions, which when executed by at least one data processor of one or more computing systems, causes the at least one data processor to perform operations herein.
  • computer systems are also described that may include one or more data processors and a memory coupled to the one or more data processors.
  • the memory may temporarily or permanently store instructions that cause at least one processor to perform one or more of the operations described herein.
  • methods can be implemented by one or more data processors either within a single computing system or distributed among two or more computing systems.
  • an auscultatory blood pressure measurement with an oscillometric measurement can enable a physician or other care provider to obtain an accurate blood pressure measurement while a patient is shaking or while the blood pressure measuring cuff is subjected to disturbance events, and can concurrently provide the mean arterial pressure.
  • FIG. 1 is a schematic representation of a combined oscillometric and auscultatory blood pressure monitor system
  • FIG. 2 is a representative flow diagram of use of a non-invasive blood pressure monitoring system
  • FIG. 3 is a representative flow diagram of a second use of a noninvasive blood pressure monitoring system.
  • FIG. 4 is a representative flow diagram of a third use of a noninvasive blood pressure monitoring system.
  • NIBP non-invasive blood pressure
  • NIBP monitor systems, devices, articles, and methods in which a user can easily and accurately determine the blood pressure in a patient without requiring a still, low motion patient. More particularly, disclosed herein are NIBP monitor systems, devices, articles, and methods which allow for the accurate measurement of blood pressure utilizing oscillometric, auscultatory, or both oscillometric and auscultatory measuring techniques in an automated fashion.
  • the systems, devices, articles, and methods described herein are appropriate for continuous, automatic NIBP readings and as such can be used for real-time patient monitoring in a variety of medical facilities such as in the hospital ward, operating room, intensive care unit, recovery, and the emergency room. It should be appreciated that the systems, devices, articles, and methods described herein can be used wherever a patient is being treated and should not be limited to a particular medical facility.
  • FIG. 1 is a schematic representation of a combined oscillometric and auscultatory blood pressure monitor system 100 according to an implementation.
  • the blood pressure monitor system has a monitor unit 105 that is connected to a hose 110 that is, in turn, connected to a blood pressure monitoring cuff 115 that is placed on a patient 130. Also connected to the monitor unit 105, is a signal cable 120 that connects to an auscultatory blood pressure monitoring component 125.
  • the auscultatory blood pressure monitoring component 125 can be any recording device to capture the Korotkoff sounds.
  • Recording devices can include a high fidelity microphone placed over a patient's artery, a stethoscope positioned over a patient's artery connected to a means of digitally recording Korotkoff sounds, and the like.
  • the signal cable 120 can be a separate cable from the auscultatory blood pressure monitoring component 125 to the monitor unit 105, or it can be integrated into the hose 110 that connects the blood pressure cuff 115 to the monitor unit 105.
  • the auscultatory blood pressure monitoring component 125 can communicate to the monitor system 100 wirelessly, such as through Bluetooth, WiFi, or the like.
  • the auscultatory blood pressure monitoring component 125 can be integrated into the blood pressure cuff 115, such as placed within a band attached to the portion of the cuff that inflates or incorporated into the portion of the cuff that inflates. Conversely, the auscultatory blood pressure monitoring component 125 can be separate from the blood pressure cuff 115, but applied to a patient's limb adjacent to the cuff 115 while the cuff 115 is attached to the patient 130.
  • the mechanical components to cause the inflation and deflation of the blood pressure monitoring cuff 115.
  • Such mechanical components can include a pump and one or more valves.
  • the electronics to power the system, control the mechanical components, and allow for exchange of commands and information between a user and the system are also located within the monitor unit 105.
  • These electronic components include a display 135, a user interface 140, a memory 145, and a control system 150.
  • electronics to process the signals from the auscultatory blood pressure monitoring component 125 and the blood pressure monitoring cuff 115 are located within the monitor unit 105.
  • Such electronics can include processors to execute algorithms that convert waveforms corresponding to sounds recorded by the auscultatory blood pressure monitoring component 125 and pressure indicators from the cuff 115 into values for systolic and diastolic arterial blood pressure, as well as processors to execute algorithms to calculate blood pressure values from the oscillometric measurement method.
  • Electronics that receive the sounds recorded by the auscultatory blood pressure monitoring component 125 can execute algorithms to filter the audio signals to remove extraneous sound, as well as algorithms to detect the various types of Korotkoff sounds, such as the turbulences created from initial blood flow and the change in sound indicating the transition to laminar blood flow.
  • the user interface, or user input module, 140 allows a user, such as a health care provider, to direct the operation of the system.
  • the input provided by the user into the user interface 140 is translated into commands by the control system 150 to operate the pump, the blood pressure monitoring cuff 115, and the auscultatory blood pressure monitoring component 125.
  • the pump provides compressed gas, such as air, through the hose 110.
  • compressed gas such as air
  • the pump can be interchanged in practice with any source of compressed gas that can be controlled to provide an appropriate amount of gas in response to commands from a control system.
  • the blood pressure monitoring cuff 115 inflates and slowly deflates as a transducer that detects fluctuations in the pressure during the deflation creates a signal that is processed using an algorithm by electronics in the monitor unit 105 to obtain blood pressure measurements.
  • the monitor unit 105 can store the measurements in memory 145, display the measurements on the display 135, or both store and display the measurements.
  • the transducer can be a part of the monitor unit 105, and in such configurations the oscillations in pressure at the blood pressure monitoring cuff 115 are detected through the hose 110.
  • the transducer can be in the blood pressure monitoring cuff 115, and pressure oscillation data can be sent to the monitor unit 105 wirelessly or through a signal cable or the like.
  • the monitor unit 105 can further process the measurements to derive values for systolic and diastolic blood pressure and display these values along with the original measurements when oscillometric blood pressure measurements are taken. Additionally, the monitor unit 105 can further process the measurements to derive values for the difference in measurements from the osciUometric component, that is to say the cuff 115, transducer, and electronic components in the monitor unit 105 that process the pressure oscillation data from the transducer, and auscultatory blood pressure monitoring component 125 and display these values along with the original measurements.
  • the monitor unit 105 can store multiple blood pressure measurement values, associate each with a particular time, date, and/or patient, and can display these values on the display 135 or transmit the information to an external location. The user can use the user interface 140 to indicate what type of values he or she wishes to see on the display 135 or to be stored in the memory 145.
  • the user interface 140 can include a graphical user interface (GUI), a key board, a key pad, scrolling buttons, soft buttons whose functions change depending on the menu presented to the user, a jog dial, a mouse, a track pad, fixed buttons with unchanging actions associated with the buttons, or any combination thereof.
  • GUI graphical user interface
  • the user interface 140 can be integrated with the display 135.
  • the display 135 can include an interactive or touch-sensitive screen such as a resistive touchscreen, a surface acoustic wave touchscreen, a capacitive touchscreen, an infrared touchscreen, an optical imaging touchscreen, a dispersive signal technology touchscreen, an acoustic pulse recognition touchscreen, or the like.
  • the user interface 115 can accept input using a stylus.
  • the display can include any of: a liquid crystal display (LCD), light emitting diodes (LEDs), plasma screen technology, organic light emitting diodes (OLEDs), electroluminescent display (ELD) panels, and the like.
  • the display can include a screen, such as a LCD screen, for indicating numerical values for the blood pressure measurements, displaying values entered by a user, indicating the acceptable range for types of blood pressure measurement values and the like.
  • the display can further include LEDs to indicate an alarm state, as described further below.
  • the monitor system 100 can enter an alarm state when one or more blood pressure measurements acquired by the blood pressure monitoring cuff 115 and/or the auscultatory blood pressure monitoring component 125 are not within an acceptable range.
  • An alarm state can be triggered when one or more blood pressure measurements are not within an acceptable range that is based upon a preset value.
  • the preset value can be a value for mean arterial pressure, systolic pressure, or diastolic pressure.
  • the preset value can be a value for the difference between any of systolic pressure, or diastolic pressure measured by the blood pressure measuring cuff 115 and the auscultatory blood pressure monitoring component 125.
  • the preset value can be a value that is entered by a health care provider or a user.
  • the preset value can be one that is calculated by the monitor unit 105 based upon information entered by the user via the user interface 140.
  • the information can include information about the patient such as weight, height, age, pre-existing medical conditions or any
  • the pre-existing medical conditions can include heart and circulation problems, arterial sclerosis, arrhythmia, preeclampsia, pulsus alternans, pulsus paradoxus, obesity, and the like.
  • the monitor unit 105 can produce a warning on the display 135 or send a message to a health care professional or remote location where such an alarm can trigger a course of action to assist the patient.
  • a transmission module can be a part of the monitor system 100.
  • the transmission module can be used to transmit blood pressure measurements or blood pressure values for mean arterial pressure, systolic pressure, diastolic pressure, or any combination thereof. Additionally, the transmission module can be used to send a message to a health care professional, a medical records repository, or a remote location as described above.
  • the transmission module can be configured only to send information. Alternatively, the transmission module can be configured to send and receive information, including preset values used in determining an alarm state and updates for the operation of the electrical and/or mechanical components.
  • the modes of sending and receiving information can include wired or wireless communication.
  • the transmission module can include a transmitter and/or receiver that uses any of the following: IEEE 802.11 (WiFi) connection, IrDA (infrared data association), ZigBee® (communications based upon IEEE 802 standard for personal area networks), Z-wave, RFID, wireless USB, Bluetooth, firewire, RS-232 data cables, USB or the like.
  • the monitor system 100 can be in communication with a central patient monitor via the transmission module.
  • FIG. 2 is a flow diagram showing use of the system described above as executed in an implementation.
  • the user attaches a blood pressure measuring cuff and an auscultatory blood pressure monitoring component to an arm of a patient, 205.
  • the next step is to power on the system, 210.
  • the system can be powered on prior to attachment of the blood pressure cuff.
  • the user indicates, using the user interface on the monitor unit, that the system can begin obtaining blood pressure measurements, shown in 215.
  • the user makes these indications on the user interface.
  • the user can indicate at this time what types of blood pressure measurement values he or she desires to see on the display, to store in the memory, or to transmit via the transmission module. Alternatively, such indications regarding blood pressure measurement values can be made after obtaining the measurements.
  • the monitor system begins inflation of the blood pressure measuring cuff to attempt to obtain an oscillometric blood pressure measurement using the blood pressure measuring cuff, as shown in 220.
  • a transducer in the monitor unit or cuff obtains pressure oscillation measurements as the cuff deflates, and then the pressure oscillation measurements are processed by an algorithm using electronics in the monitor system.
  • the monitor system also determines the accuracy of the oscillometric measurement, 225.
  • the oscillometric blood pressure measurement can be stored in memory, displayed, or transmitted to another device or location after the monitor system receives the measurement.
  • the monitor system After the oscillometric blood pressure the measurement is sent to the monitor system, the monitor system inflates and deflates the blood pressure measuring cuff while recording sounds (i.e. Korotkoff sounds) from the auscultatory blood pressure monitoring component, 230. Following recording of the Korotkoff sounds, the monitor system determines the blood pressure values based upon the auscultatory blood pressure measurement, as shown in 235. Determination of the blood pressure values from the recorded sounds can include transforming the sounds into waveforms that are applied to algorithms by the monitor system, particularly one or more processors within the monitor system. After measurement from the auscultatory blood pressure monitoring component is recorded by the monitor system, the measurement can be stored in memory, displayed, or transmitted to another device or location.
  • recording sounds i.e. Korotkoff sounds
  • the monitor system determines the blood pressure values based upon the auscultatory blood pressure measurement, as shown in 235. Determination of the blood pressure values from the recorded sounds can include transforming the sounds into waveforms that are applied to algorithms
  • the monitor system then displays the blood pressure measurement values desired by the user, and, if appropriate, enters an alarm condition, as in 240.
  • the blood pressure measurement shown can be solely based upon the measurement from the auscultatory blood pressure monitoring component, such as in the case where the patient is shivering or otherwise moving too much for an accurate oscillometric measurement from the blood pressure measuring cuff.
  • the blood pressure measurement shown can be a calculated result based upon both the oscillometric and auscultatory measurements, or only the blood pressure values based upon the oscillometric measurement can be shown.
  • the determination of which measurements to use as the basis for the blood pressure values can be made by a user, such as a physician or care giver, or the determination can be made by an algorithm applied by the monitoring system to the measurements.
  • the monitor system After accepting input from the user, the monitor system can store or transmit the displayed blood pressure measurement values. Blood pressure measurement values can be stored on the memory of the monitor system or they can be stored remotely after transmission via the transmission module.
  • FIG. 3 is a representative flow diagram of a second use of a noninvasive blood pressure monitoring system.
  • a user attaches a blood pressure measuring cuff and an auscultatory blood pressure monitoring component to an arm of a patient, powers on the system, and indicates to the system to begin measuring the blood pressure of a patient.
  • the blood pressure measuring cuff and auscultatory blood pressure monitoring component can be attached to the patient prior to or after powering on the system.
  • the user can indicate what types of blood pressure measurement values he or she desires to see on the display, to store in the memory, or to transmit via the transmission module either upon indicating that a blood pressure measurement should be taken or after the measurement has been completed.
  • the implementation shown in FIG. 3 is one in which both the oscillometric and the auscultatory blood pressure measurements occur simultaneously.
  • the monitor system attempts to obtain blood pressure measurements from both the blood pressure cuff and the auscultatory blood pressure monitoring component at the same time.
  • This simultaneous measurement using both the oscillometric and auscultatory methods can reduce the likelihood that the monitor system will excessively or repeatedly inflate the blood pressure cuff and cause the patient discomfort.
  • This potential reduction in over-inflation or re-inflation is due to the fact that the auscultatory method compensates for the short comings of the oscillometric method with respect to disturbances to the blood pressure cuff, such as someone touching the cuff or a patient leaning against a surface during measurement.
  • the deflections caused in the oscillometric signals due to a disturbance event such as applying external pressure to, touching, or moving the blood pressure cuff during measurement, will be checked against the audio signals from the auscultatory blood pressure monitoring component, and if the deflections do not correlate with a change in the sound waveform correlated to blood flow, the deflections can be ignored, and inflation can proceed within normal ranges.
  • the monitor system inflates and deflates the blood pressure measuring cuff and records sounds from the auscultatory blood pressure monitoring component while receiving oscillometric blood pressure measurements from the transducer, as shown in 325.
  • the monitor system determines blood pressure values that are accurate based upon the auscultatory blood pressure measurements, the oscillometric blood pressure measurements, or both types of measurements in 330, as described further hereinabove. Then, as in FIG. 2, the monitor system displays the blood pressure measurement values desired by the user, and, if appropriate, enters an alarm condition, 240.
  • FIG. 4 is a representative flow diagram of a third use of a noninvasive blood pressure monitoring system that is initially similar to those shown in FIGS. 2 and 3.
  • a user attaches a blood pressure measuring cuff and an auscultatory blood pressure monitoring component to an arm of a patient, powers on the system, and indicates that the system begins measuring the blood pressure of a patient.
  • the blood pressure measuring cuff and auscultatory blood pressure monitoring component can be attached to the patient prior to or after powering on the system. Also as in FIGS.
  • the user upon indicating that a blood pressure measurement should be taken, the user can indicate what types of blood pressure measurement values he or she desires to see on the display, to store in the memory, or to transmit via the transmission module upon indicating that a blood pressure measurement should be taken. Alternatively, such decisions regarding the blood pressure measurement values can be made after the measurement has been completed.
  • the user can direct the system to inflate and deflate the blood pressure measuring cuff and record sounds from the auscultatory blood pressure monitoring component, 420.
  • the user can direct the monitor system to attempt an auscultatory blood pressure measurement alone or before an oscillometric blood pressure measurement when the patient is moving or when the probability of an accurate blood pressure measurement from an oscillometric method is low.
  • the monitor system can determine the patient's blood pressure based upon that measurement, as shown in 425.
  • the system can attempt to obtain an oscillometric blood pressure measurement using the blood pressure measuring cuff.
  • the monitor system determines blood pressure values that are accurate based upon the auscultatory blood pressure measurements, the oscillometric blood pressure measurements, or both types of measurements in 435. Then, as in FIGS. 2 and 3, the monitor system displays the blood pressure measurement values desired by the user, and, if appropriate, enters an alarm condition, 240.
  • the display can indicate the condition and a message can be sent to a health care professional or remote location where such an alarm can trigger a course of action to assist the patient. Subsequently, the user can administer to the patient and then subject the patient to further blood pressure measurements.
  • the user can remove the blood pressure measuring cuffs from the patient.
  • a user such as a health care provider, can desire to take the blood pressure of a patient at regular intervals that are short in duration, that is to say for example every 20 minutes. As such, the user may not remove the blood pressure measuring cuff and auscultatory blood pressure monitoring component from the patient if the comfort of the patient allows.
  • the auscultatory blood pressure measurement is completed before the oscillometric blood pressure measurement.
  • the auscultatory blood pressure measurement can yield a waveform that can indicate a maximum pressure for the oscillometric blood pressure measurement.
  • hoses that convey pressurized gas to blood pressure measuring cuffs.
  • Such hoses can be single lumen hoses, dual lumen hoses, or hoses with more than two lumina. Some implementations include single lumen hoses. Other implementations employ dual lumen hoses. Additionally, other implementations can include both single and dual lumen hoses.
  • recordings and measurements can be digital recordings, such that the recordings can be represented as waveforms that can be interpreted, filtered, or otherwise manipulated by algorithms utilized by the described monitor system.
  • aspects of the subject matter described herein can be realized in digital electronic circuitry, integrated circuitry, specially designed ASICs (application specific integrated circuits), computer hardware, firmware, software, and/or combinations thereof.
  • ASICs application specific integrated circuits
  • These various implementations can include implementation in one or more computer programs that are executable and/or interpretable on a programmable system including at least one programmable processor, which can be special or general purpose, coupled to receive data and instructions from, and to transmit data and instructions to, a storage system, at least one input device, and at least one output device.

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  • Measuring Pulse, Heart Rate, Blood Pressure Or Blood Flow (AREA)

Abstract

L'invention concerne un système, qui comprend une unité de surveillance de pression sanguine, un moyen oscillométrique et un moyen auscultatoire de mesure de pression sanguine, et au moins un processeur. Le processeur est configuré pour manipuler des mesures provenant des moyens à la fois auscultatoire et oscillométrique pour arriver à un ensemble de valeurs de mesure de pression sanguine précises à l'aide d'un ou plusieurs algorithmes. L'invention concerne également un appareil, des systèmes, des procédés et/ou des articles associés.
PCT/US2012/048019 2012-07-24 2012-07-24 Système de surveillance de pression sanguine non invasif, oscillométrique et auscultatoire combiné WO2014018024A1 (fr)

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PCT/US2012/048019 WO2014018024A1 (fr) 2012-07-24 2012-07-24 Système de surveillance de pression sanguine non invasif, oscillométrique et auscultatoire combiné

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WO2016007577A1 (fr) * 2014-07-08 2016-01-14 The Regents Of The University Of Michigan Système pour fournir une mesure de pression sanguine systolique continue pour maintenir une hypotension permissive
WO2016055356A1 (fr) * 2014-10-10 2016-04-14 Koninklijke Philips N.V. Dispositifs de surveillance non invasifs de la pression sanguine, procédés et programme informatique pour les exploiter
CN105615859A (zh) * 2014-08-29 2016-06-01 周嘉璐 血压测量辅助装置和血压测量设备及其设计方法
CN111990982A (zh) * 2020-08-31 2020-11-27 中国计量科学研究院 血压采集装置、处理系统及血压采集方法

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US5054495A (en) * 1989-07-10 1991-10-08 Colin Electronics Co., Ltd. Automatic blood-pressure measuring apparatus
JPH05329112A (ja) * 1992-06-02 1993-12-14 Terumo Corp 電子血圧計
US6511435B1 (en) * 2000-04-14 2003-01-28 Computerized Screening, Inc. Blood pressure measurement system
DE10214220A1 (de) * 2002-03-22 2003-10-02 Sectorcon Ingenieurgesellschaf Verfahren und Vorrichtung zur nichtinvasiven, belastungsarmen und kontinuierlichen Blutdruckmessung und -überwachung
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JP2010200895A (ja) * 2009-03-02 2010-09-16 Terumo Corp 血圧計

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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2016007577A1 (fr) * 2014-07-08 2016-01-14 The Regents Of The University Of Michigan Système pour fournir une mesure de pression sanguine systolique continue pour maintenir une hypotension permissive
US10271740B2 (en) 2014-07-08 2019-04-30 The Regents Of The University Of Michigan System for providing continuous systolic blood pressure measurement to maintain permissive hypotension
CN105615859A (zh) * 2014-08-29 2016-06-01 周嘉璐 血压测量辅助装置和血压测量设备及其设计方法
EP3187106A4 (fr) * 2014-08-29 2018-04-18 Zhou, Jialu Dispositif auxiliaire de mesure de pression artérielle, dispositif de mesure de pression artérielle et procédé de conception associé
WO2016055356A1 (fr) * 2014-10-10 2016-04-14 Koninklijke Philips N.V. Dispositifs de surveillance non invasifs de la pression sanguine, procédés et programme informatique pour les exploiter
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CN111990982A (zh) * 2020-08-31 2020-11-27 中国计量科学研究院 血压采集装置、处理系统及血压采集方法
CN111990982B (zh) * 2020-08-31 2024-03-26 中国计量科学研究院 血压采集装置及处理系统

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