Monitoring the blood pressure of a patient

• US 10,271,751 B2
• Filed: 08/12/2009
• Issued: 04/30/2019
• Est. Priority Date: 08/19/2008
• Status: Active Grant

• Current Assignee: Koninklijke Philips Electronics N.V. (Koninklijke Philips N.V.)
• Original Assignee: Koninklijke Philips N.V.
• Inventors: Muhlsteff, Jens, Morren, Geert Guy Georges, Aubert, Xavier Louis Marie Antoine
• Primary Examiner(s): Agahi, Puya
• Application Number:
  US13/059,133
• Publication Number:
  US 20110144456A1
• Time in Patent Office: 3,548 Days
• Field of Search: 600301, 600481, 600490, 600500, 600504
• CPC Class Codes: A61B 5/02125 of pulse wave propagation time
• CPC Class Codes: A61B 5/022 by applying pressure to close blood vessels, e.g. against the skin; Ophthalmodynamometers
• CPC Class Codes: A61B 5/0285 Measuring or recording phase velocity of blood waves
• CPC Class Codes: A61B 5/0295 using plethysmography, i.e. measuring the variations in the volume of a body part as modified by the circulation of blood therethrough, e.g. impedance plethysmography
• CPC Class Codes: A61B 5/7285 for synchronising or triggering a physiological measurement or image acquisition with a physiological event or waveform, e.g. an ECG signal A61B6/5205, A61B6/541, A61B8/5207, A61B8/543 take precedence

Abstract

A method for monitoring the blood pressure of a patient, comprising the following steps: determining a pulse arrival time signal from the patient 2 based on the pulse wave velocity method; determining an accelerometer signal from the patient 2; and triggering an additional measure or deriving a blood pressure value, taking into account the pulse arrival time signal and a DC component of the accelerometer signal. In this way, a possibility for monitoring the blood pressure of a patient is provided with which false alarms and/or unnecessary additional cuff-based blood pressure measurements can be avoided.

Claims

1. A method for monitoring blood pressure of a patient, comprising the following steps:

(a) determining a pulse arrival time signal from the patient with a pulse wave velocity unit based on a pulse wave velocity method;

(b) determining an accelerometer signal from the patient with an accelerometer sensor after determining the pulse arrival time signal;

(c) detecting a DC component of the accelerometer signal indicative of a posture of the patient with a monitoring device;

(d) normalizing the pulse arrival time signal with a reference pulse arrival time value with the monitoring device by dividing the determined pulse arrival time signal by a reference pulse arrival time value to generate a normalized pulse arrival time signal;

(e) comparing a value of the normalized pulse arrival time signal with predefined upper and lower pulse arrival time threshold values with the monitoring device;

(f) determining if the value of the normalized pulse arrival time signal exceeds the upper reference threshold value or under-runs the lower reference threshold value with the monitoring device;

(g) checking for a change in the posture of the patient based on a change of the DC component of the accelerometer signal;

at least one of;

(h) repeating steps (a)-(g) when the value of the normalized pulse arrival time signal exceeds or under-runs the predefined pulse arrival time threshold values;

(i) in response to the normalized pulse arrival time signal exceeding or under-running the predefined pulse arrival time threshold values and the DC component change not being detected, at least one of;

controlling an alarm to generate an alarm signal; and

controlling a blood pressure cuff to measure the blood pressure of the patient, and

(j) in response to the normalized pulse arrival time signal exceeding or under-running the predefined pulse arrival time threshold values and the DC component change being detected, updating the reference pulse arrival time value; and

(k) deriving and displaying a blood pressure value with the monitoring device from the normalized pulse arrival time signal when the value of the normalized pulse arrival time signal does not exceed or under-run the predefined pulse arrival time threshold values.

2. The method according to claim 1, wherein the reference pulse arrival time threshold value is dependent on a heart rate.

3. The method according to claim 1, further including:

with the monitoring device, in response to the normalized pulse arrival time signal exceeding or under-running the pulse arrival time threshold values and the posture change being detected, controlling the blood pressure cuff to make a cuff-based measurement of the blood pressure value of the patient.

4. The method according to claim 1, further including, with the monitoring device, at least one of:

inputting the pulse arrival time signal and the DC component of the accelerometer signal into a look-up table which was pre-calibrated with blood pressure values to give the blood pressure value, the blood pressure value being based on the input pulse arrival time signal and the input DC component;

or

operating on the pulse arrival time signal and the DC component with an analytical correction function which was pre-calculated to provide a determination of the patient'"'"'s blood pressure corrected for an effect of posture.

5. The method according to claim 1, wherein the step of determining the pulse arrival time signal from the patient based on the pulse wave velocity-method comprises the steps of deriving an electrocardiogram signal from the patient, and deriving a pulse wave signal from the patient.

6. The method according to claim 5, wherein the step of deriving the pulse wave signal from the patient comprises the step of deriving a plethysmographic signal.

12. The method according to claim 1, further including:

attaching the accelerometer to a torso of the patient such that the DC component is indicative of an orientation of the torso relative to an axis of earth gravity.

7. An apparatus for monitoring blood pressure of a patient, comprising:

a blood pressure cuff;

an alarm unit in communication with the blood pressure cuff;

a pulse wave velocity unit comprising an ECG sensor and an optical sensor adapted to generate a plethysmographic signal from the patient, the pulse wave velocity unit configured to determine a first measure including a pulse arrival time signal from the patient based on a pulse wave velocity method;

an accelerometer configured to be attached to a torso of the patient and to determine a second measure including an accelerometer signal from the patient, the accelerometer signal including a component which is indicative of an orientation of the accelerometer and the patient torso with respect to an earth gravity axis; and

a monitoring device wirelessly connected with the ECG sensor, the optical sensor, and the accelerometer, the monitoring device configured to adjust the pulse arrival time signal based on the orientation of the accelerometer and the patient torso and at least one of;

trigger the pulse wave velocity unit to again determine the first measure and the accelerometer to again determine the second measure;

derive a blood pressure value, based on the pulse arrival time signal;

divide the measured pulse arrival time signal by a reference pulse arrival time value to generate a normalized pulse arrival time signal;

compare the normalized pulse arrival time signal with upper and lower threshold values of a threshold;

detect a change in a DC component of the accelerometer signal;

in response to the normalized pulse arrival time signal being outside of the upper and lower threshold values of the threshold and the DC component change not being detected;

control the blood pressure cuff to measure the blood pressure of the patient; and

control the alarm unit to generate an alarm signal in response to the blood pressure measured by the blood pressure cuff is outside of the upper and lower values of a predefined alarm threshold; and

in response to the normalized pulse arrival time signal being outside of the upper and lower threshold values of the threshold and the DC component change being detected, update the reference pulse arrival time value.

8. The apparatus according to claim 7, further including:

a display which displays the blood pressure value.

9. The apparatus according to claim 7, wherein the monitoring device is further configured to operate on the pulse arrival time signal and the DC component with an analytical correction function which was pre-calibrated to provide a determination of the patient'"'"'s blood pressure corrected for an effect of posture.

10. The apparatus according to claim 7, wherein the monitoring device is further configured to input the pulse arrival time signal and the DC component of the accelerometer signal into a look-up table which was pre-calibrated with blood pressure values to give the blood pressure value, the blood pressure value being based on the input pulse arrival time signal and the input DC component.

11. The apparatus according to claim 7, wherein the pulse wave velocity unit comprises an electrocardiogram sensor and a plethysmograph.

17. The apparatus according to claim 7, wherein the normalized pulse arrival time signal is outside of a first threshold when the normalized pulse arrival time signal exceeds the upper threshold value or when the normalized pulse arrival time signal under-runs the lower threshold value.

20. The apparatus according to claim 7, wherein the monitoring device is further configured to derive a blood pressure value from the normalized pulse arrival time signal and the DC component of the accelerometer signal when the value of the normalized pulse arrival time signal does not exceed or under-run the reference pulse arrival time threshold value.

13. A method for monitoring blood pressure of a patient, comprising:

with an electrocardiogram sensor and a plethysmograph, sensing blood flow of the patient and generating a pulse arrival time signal;

with an accelerometer attached to the patient, generating an accelerometer signal indicative of patient motion;

with a monitoring device,

comparing the pulse arrival time signal normalized by being divided by a reference pulse arrival time value with upper and lower threshold values of a threshold and repeating the sensing and generating until the normalized pulse arrival time signal is outside of the upper and lower threshold values of the threshold;

detecting a change in a DC component of the accelerometer signal;

in response to the normalized pulse arrival time signal being outside of the upper and lower threshold values of the threshold and the DC component change not being detected, at least one of;

controlling an alarm to generate an alarm signal; and

controlling a blood pressure cuff to measure the blood pressure of the patient, and

in response to the normalized pulse arrival time signal being outside of the upper and lower threshold values of the threshold and the DC component change being detected, updating the reference pulse arrival time value.

14. The method of claim 13, further including with the monitoring device:

inputting the pulse arrival time signal and the DC component of the accelerometer signal into a look-up table which was pre-calibrated with blood pressure values to give a blood pressure value based on the input pulse arrival time signal and the input DC component.

15. The method according to claim 13, further including with the monitoring device:

operating on the pulse arrival time signal and the DC component with an analytical correction function which was pre-calibrated to provide a determination of the patient'"'"'s blood pressure corrected for an effect of posture.

18. The method according to claim 13, wherein the normalized pulse arrival time signal is outside of a first threshold when the normalized pulse arrival time signal exceeds the upper threshold value or when the normalized pulse arrival time signal under-runs the lower threshold value.

16. A method for monitoring blood pressure of a patient, comprising:

with an electrocardiogram sensor and a plethysmograph, sensing blood flow of the patient and generating a pulse arrival time signal;

with an accelerometer attached to the patient, generating an accelerometer signal indicative of patient motion;

with a monitoring device, one of;

inputting the pulse arrival time signal and the DC component of the accelerometer signal into a look-up table which was pre-calibrated with blood pressure values to give a blood pressure value based on the input pulse arrival time signal and the input DC component; and

operating on the pulse arrival time signal and the DC component with an analytical correction function which was pre-calibrated to provide a determination of the patient'"'"'s blood pressure corrected for an effect of posture;

comparing the pulse arrival time signal normalized by being divided by a reference pulse arrival time value with upper and lower threshold values of a threshold;

detecting a change in a DC component of the accelerometer signal;

in response to the normalized pulse arrival time signal exceeding or under-running the upper and lower threshold values of the threshold and the DC component change not being detected, at least one of;

controlling an alarm to generate an alarm signal; and

controlling a blood pressure cuff to measure the blood pressure of the patient, and

in response to the normalized pulse arrival time signal exceeding or under-running the upper and lower threshold values of the threshold and the DC component change being detected, updating the reference pulse arrival time value.

19. The method according to claim 16, wherein the threshold includes a first threshold with the upper threshold value and the lower threshold value, the normalized pulse arrival time signal being outside of the first threshold when the normalized pulse arrival time signal exceeds the upper threshold value or when the normalized pulse arrival time signal under-runs the lower threshold value.