Separation of interference pulses from physiological pulses in a pressure signal

• US 10,314,965 B2
• Filed: 09/08/2014
• Issued: 06/11/2019
• Est. Priority Date: 09/09/2013
• Status: Active Grant

• Current Assignee: Gambro Lundia AB (Baxter International Inc.)
• Original Assignee: Gambro Lundia AB (Baxter International Inc.)
• Inventors: Holmer, Mattias, Olde, Bo, Solem, Kristian, Sornmo, Leif
• Primary Examiner(s): Seven, Evren
• Application Number:
  US14/917,099
• Publication Number:
  US 20160206804A1
• Time in Patent Office: 1,737 Days
• Field of Search: None
• CPC Class Codes: A61B 5/02108 from analysis of pulse wave characteristics
• CPC Class Codes: A61B 5/4836 Diagnosis combined with treatment in closed-loop systems or methods A61B5/0036 takes precedence
• CPC Class Codes: A61B 5/7217 of noise originating from a therapeutic or surgical apparatus, e.g. from a pacemaker
• CPC Class Codes: A61B 5/7235 Details of waveform analysis A61B5/349 takes precedence
• CPC Class Codes: A61M 1/3656 Monitoring patency or flow at connection sites; Detecting disconnections
• CPC Class Codes: A61M 2205/3331 Pressure; Flow
• CPC Class Codes: A61M 2230/30 Blood pressure A61M2230/04 takes precedence

Abstract

A filtering device receives a signal from a pressure sensor in an extracorporeal fluid circuit connected to a subject and processes the signal to separate physiological pulses, e.g. from the subject'"'"'s heart, from interference pulses, e.g. from a pump in the fluid circuit. The device repeatedly (iteratively) processes a signal segment by alternately subtracting (S3) a template signal from the signal segment, and applying a refinement processing (S6) to the resulting difference signal to generate a new template signal. By proper selection (S2) of the initial template signal, consecutive difference signals will alternately approximate the sequence of interference pulses in the signal segment and the sequence of physiological pulses in the signal segment. The refinement processing (S6) aims at alternately cleaning up unwanted residuals from interference pulses and physiological pulses, respectively, in the respective difference signal, so as to improve the accuracy of the template signal between the subtractions.

Claims

1. A device for processing a pressure signal obtained from a pressure sensor in an extracorporeal fluid circuit, said device comprising:

an input for receiving the pressure signal from the pressure sensor; and

a signal processor connected to the input and being configured to;

extract, from the pressure signal, a signal segment that comprises a sequence of interference pulses originating from an interference generator associated with the extracorporeal fluid circuit, and a sequence of physiological pulses originating from a physiological pulse generator in a subject which is connected to the extracorporeal fluid circuit;

process the signal segment for separation of the interference pulses from the physiological pulses by;

a) subtracting at least one initial template signal from the signal segment to generate a first difference signal that represents the sequence of physiological pulses and residuals of the interference pulses;

b) processing the first difference signal to generate a first template signal in which the residuals of the interference pulses are suppressed in relation to the sequence of physiological pulses;

c) subtracting at least the first template signal from the signal segment to generate a second difference signal that represents the sequence of interference pulses and residuals of the physiological pulses; and

d) processing the second difference signal to generate a second template signal in which the residuals of the physiological pulses are suppressed in relation to the sequence of interference pulses; and

evaluating a property of the extracorporeal fluid circuit using the second template signal.

2. The device of claim 1, wherein the signal processor is configured to, subsequent to the steps a)-d), process the signal segment for separation of the interference pulses from the physiological pulses by:

e) subtracting at least the second template signal from the signal segment to generate the first difference signal; and

repeating the steps b)-e) in at least one iteration.

3. The device of claim 2, wherein the signal processor is configured to repeatedly execute steps b)-e) until a predefined convergence criterion is fulfilled or until a predefined time limit is exceeded.

4. The device of claim 3, wherein the predefined convergence criterion is defined to detect a predefined suppression of the residuals of the physiological pulses in the second difference signal or the second template signal, or to detect a predefined suppression of the residuals of the interference pulses in the first difference signal or the first template signal.

5. The device of claim 1, wherein the signal processor is further configured, in step b), to:

identify a set of predefined first cycles of the physiological pulses in the first difference signal, determine a first signal profile for each of the predefined first cycles, and generate the first template signal by tiling the first signal profiles such that the timing of the first signal profiles in the first template signal matches the timing of the set of predefined first cycles in the first difference signal.

6. The device of claim 5, wherein the signal processor is further configured, in step b), to:

identify a respective reference time point for each of the predefined first cycles in the first difference signal, and generate the first template signal by tiling and time-scaling the first signal profiles with respect the reference time points.

7. The device of claim 5, wherein the signal processor is further configured, in step b), to:

determine a length of the respective predefined first cycle in the first difference signal; and

select the first signal profile among at least two candidate profiles based on the length of the respective predefined first cycle.

8. The device of claim 5, wherein the signal processor is further configured, in step b), to determine the first signal profile by at least one of:

retrieving the first signal profile from an electronic memory associated with the device, wherein the first signal profile is fixed and pre-defined, or generated and stored in the electronic memory by the signal processor during processing of a preceding signal segment in the pressure signal;

generating the first signal profile as a function of the predefined first cycles in the first difference signal;

generating the first signal profile by processing the pressure signal while the interference generator is intermittently disabled; and

generating the first signal profile by processing a further pressure signal acquired from a further pressure sensor in the extracorporeal fluid circuit.

9. The device of claim 1, wherein the signal processor is further configured, in step d), to:

identify a set of predefined second cycles in the second difference signal;

determine a second signal profile for each of the predefined second cycles; and

generate the second template signal by tiling the second signal profiles such that the timing of the second signal profiles in the second template signal matches the timing of the set of predefined second cycles in the second difference signal.

10. The device of claim 9, wherein the signal processor is further configured, in step d), to:

identify a respective reference time point for each of the predefined second cycles in the second difference signal, and generate the second template signal by tiling and time-scaling the second signal profiles with respect to the reference time points.

11. The device of claim 9, wherein the signal processor is further configured, in step d), to determine the second signal profile by one of:

retrieving the second signal profile from an electronic memory associated with the device, wherein the second signal profile is fixed and pre-defined, or generated and stored in the electronic memory by the signal processor during processing of a preceding signal segment in the pressure signal;

retrieving the second signal profile from the electronic memory based on an operating condition of the extracorporeal fluid circuit, wherein a plurality of second signal profiles are stored in the electronic memory in association with different operating conditions;

generating the second signal profile as a function of the predefined second cycles in the second difference signal;

mapping the predefined second cycles in the second difference signal to corresponding subsets of the signal segment, and generating the second signal profile as a function of the corresponding subsets; and

generating the second signal profile by processing a further pressure signal acquired from a further pressure sensor in the extracorporeal fluid circuit.

12. The device of claim 1, wherein the signal processor is further configured, in step d), to:

determine a current operating condition of the interference generator; and

generate the second template signal as a combination of sinusoids at a plurality of harmonic frequencies associated with the current operating condition.

13. The device of claim 1, wherein the signal processor is further configured, in step a), to:

acquire said at least one initial template signal as an initial estimate of the shape, the magnitude and the timing of the interference pulses in the signal segment.

14. The device of claim 1, wherein the signal processor is further configured, in step a), to acquire said at least one initial template signal by one of:

determining a current operating condition of the interference generator, determining an initial signal profile for predefined second cycles in the signal segment, and generating said at least one initial template signal by tiling the initial signal profiles such that the timing of the initial signal profiles in said at least one initial template signal corresponds to the current operating condition;

determining a current operating condition of the interference generator, and generating said at least one initial template signal as a combination of sinusoids at a plurality of harmonic frequencies associated with the current operating condition; and

retrieving said at least one initial template signal from an electronic memory associated with the device, wherein said at least one initial template signal is generated and stored in the electronic memory by the signal processor during processing of a preceding signal segment in the pressure signal, preferably as a function of at least one of the second difference signal, the second template signal, and the second signal profile generated during the processing of the preceding signal segment.

15. The device of claim 12, wherein the signal processor is further configured to determine the current operating condition of the interference generator by processing one of the signal segment, the first difference signal, the second difference signal, or a reference signal that represents the operation of the interference generator.

16. The device of claim 5, wherein each predefined first cycle is predefined to comprise a given number of physiological pulses.

17. The device of claim 9, wherein each predefined second cycle is predefined to comprise a given number of interference pulses.

18. The device of claim 9, wherein the interference generator includes a peristaltic pump comprising a rotor with at least one roller, and wherein each predefined second cycle pulse is predefined to correspond to a full revolution of the rotor.

19. The device of claim 1, wherein the signal processor is configured to extract the signal segment such that the signal segment comprises at least 2, and preferably at least 10, physiological pulses, and at least 2, and preferably at least 10, interference pulses.

27. The device of claim 1, which is further configured to process a reference signal obtained from a reference sensor associated with the interference generator, and wherein the signal processor is configured to use information from the reference signal to separate the interference pulses from the physiological pulses.

20. A method of processing a pressure signal obtained from a pressure sensor in an extracorporeal fluid circuit, said method comprising:

extracting, from the pressure signal, a signal segment that comprises a sequence of interference pulses originating from an interference generator associated with the extracorporeal fluid circuit, and a sequence of physiological pulses originating from a physiological pulse generator in a subject which is connected to the extracorporeal fluid circuit;

subtracting at least one initial template signal from the signal segment to generate a first difference signal that represents the sequence of physiological pulses and residuals of the interference pulses;

processing the first difference signal to generate a first template signal in which the residuals of the interference pulses are suppressed in relation to the sequence of physiological pulses;

subtracting at least the first template signal from the signal segment to generate a second difference signal that represents the sequence of interference pulses and residuals of the physiological pulses;

processing the second difference signal to generate a second template signal in which the residuals of the physiological pulses are suppressed in relation to the sequence of interference pulses; and

evaluating a property of the extracorporeal fluid circuit using the second template signal.

21. A non-transitory computer-readable medium comprising computer instructions which, when executed by a processor, cause the processor to perform the method of claim 20.

28. The method of claim 20, which further includes processing a reference signal obtained from a reference sensor associated with the interference generator, and using information from the reference signal to separate the interference pulses from the physiological pulses.

22. A device for processing a pressure signal obtained from a pressure sensor in an extracorporeal fluid circuit, said device comprising:

segmentation means configured to receive the pressure signal and extract, from the pressure signal, a signal segment that comprises a sequence of interference pulses originating from an interference generator associated with the extracorporeal fluid circuit, and a sequence of physiological pulses originating from a physiological pulse generator in a subject which is connected to the extracorporeal fluid circuit;

first subtraction means configured to subtract at least one initial template signal from the signal segment to generate a first difference signal that represents the sequence of physiological pulses and residuals of the interference pulses;

first refinement means configured to process the first difference signal to generate a first template signal in which the residuals of the interference pulses are suppressed in relation to the sequence of physiological pulses;

second subtraction means configured to subtract at least the first template signal from the signal segment to generate a second difference signal that represents the sequence of interference pulses and residuals of the physiological pulses;

second refinement means configured to process the second difference signal to generate a second template signal in which the residuals of the physiological pulses are suppressed in relation to the sequence of interference pulses; and

evaluation means configured to evaluate a property of the extracorporeal fluid circuit using the second template signal.

29. The device of claim 22, which is further configured to process a reference signal obtained from a reference sensor associated with the interference generator, and use information from the reference signal to separate the interference pulses from the physiological pulses.

23. A device for processing a pressure signal obtained from a pressure sensor in an extracorporeal fluid circuit, said device comprising:

an input for receiving the pressure signal from the pressure sensor; and

a signal processor connected to the input and being configured to;

extract, from the pressure signal, a signal segment that comprises a sequence of interference pulses originating from an interference generator associated with the extracorporeal fluid circuit, and a sequence of physiological pulses originating from a physiological pulse generator in a subject which is connected to the extracorporeal fluid circuit;

process the signal segment for separation of the interference pulses from the physiological pulses by;

a) subtracting at least one initial template signal from the signal segment to generate a first difference signal that represents the sequence of interference pulses and residuals of the physiological pulses,

b) processing the first difference signal to generate a first template signal in which the residuals of the physiological pulses are suppressed in relation to the sequence of interference pulses,

c) subtracting at least the first template signal from the signal segment to generate a second difference signal that represents the sequence of physiological pulses and residuals of the interference pulses, and

d) processing the second difference signal to generate a second template signal in which the residuals of the interference pulses are suppressed in relation to the sequence of physiological pulses; and

evaluate a cardiovascular property of the subject using the second template signal.

30. The device of claim 23, which is further configured to process a reference signal obtained from a reference sensor associated with the interference generator, and wherein the signal processor is configured to use information from the reference signal to separate the interference pulses from the physiological pulses.

24. A method of processing a pressure signal obtained from a pressure sensor in an extracorporeal fluid circuit, said method comprising:

extracting, from the pressure signal, a signal segment that comprises a sequence of interference pulses originating from an interference generator associated with the extracorporeal fluid circuit, and a sequence of physiological pulses originating from a physiological pulse generator in a subject which is connected to the extracorporeal fluid circuit;

subtracting at least one initial template signal from the signal segment to generate a first difference signal that represents the sequence of interference pulses and residuals of the physiological pulses;

processing the first difference signal to generate a first template signal in which the residuals of the physiological pulses are suppressed in relation to the sequence of interference pulses;

subtracting at least the first template signal from the signal segment to generate a second difference signal that represents the sequence of physiological pulses and residuals of the interference pulses;

processing the second difference signal to generate a second template signal in which the residuals of the interference pulses are suppressed in relation to the sequence of physiological pulses; and

evaluating a cardiovascular property of the subject using the second template signal.

25. A non-transitory computer-readable medium comprising computer instructions which, when executed by a processor, cause the processor to perform the method of claim 24.

31. The method of claim 24, which further includes processing a reference signal obtained from a reference sensor associated with the interference generator, and using information from the reference signal to separate the interference pulses from the physiological pulses.

26. A device for processing a pressure signal obtained from a pressure sensor in an extracorporeal fluid circuit, said device comprising:

segmentation means configured to receive the pressure signal and extract, from the pressure signal, a signal segment that comprises a sequence of interference pulses originating from an interference generator associated with the extracorporeal fluid circuit and a sequence of physiological pulses originating from a physiological pulse generator in a subject which is connected to the extracorporeal fluid circuit;

first subtraction means configured to subtract at least one initial template signal from the signal segment to generate a first difference signal that represents the sequence of interference pulses and residuals of the physiological pulses;

first refinement means configured to process the first difference signal to generate a first template signal in which the residuals of the physiological pulses are suppressed in relation to the sequence of interference pulses;

second subtraction means configured to subtract at least the first template signal from the signal segment to generate a second difference signal that represents the sequence of physiological pulses and residuals of the interference pulses;

second refinement means configured to process the second difference signal to generate a second template signal in which the residuals of the interference pulses are suppressed in relation to the sequence of physiological pulses; and

evaluation means configured to evaluate a cardiovascular property of the subject using the second template signal.

32. The device of claim 26, which is further configured to process a reference signal obtained from a reference sensor associated with the interference generator, and use information from the reference signal to separate the interference pulses from the physiological pulses.