Fiber optic interferometric vital sign monitor for use in magnetic resonance imaging, confined care facilities and in-hospital

• US 20030095263A1
• Filed: 11/19/2002
• Published: 05/22/2003
• Est. Priority Date: 02/08/2000
• Status: Active Grant

• Current Assignee: Tamiras Per Pte Ltd LLC (Intellectual Ventures LLC)
• Original Assignee: Deepak Varshneya
• Inventors: Maida, John L. Jr., Jeffers, Larry A., Varshneya, Deepak
• Granted Patent: US 6,816,266 B2
• Time in Patent Office: Days
• US Class Current: 356/477
• CPC Class Codes: A61B 2503/06 Children, e.g. for attention deficit diagnosis
• CPC Class Codes: A61B 2562/0266 Optical strain gauges
• CPC Class Codes: A61B 5/002 Monitoring the patient using a local or closed circuit, e.g. in a room or building A61B5/0017 takes precedence
• CPC Class Codes: A61B 5/0205 Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
• CPC Class Codes: A61B 5/024 Detecting, measuring or recording pulse rate or heart rate A61B5/0205, A61B5/021 take precedence
• CPC Class Codes: A61B 5/11 Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb for measuring pulse A61B5/02 ;A61B5/1038 takes precedence; motion detection to correct for motion artifacts in physiological signals A61B5/721
• CPC Class Codes: A61B 5/113 occurring during breathing
• CPC Class Codes: A61B 5/14551 for measuring blood gases
• CPC Class Codes: A61B 5/318 Heart-related electrical modalities, e.g. electrocardiography [ECG]
• CPC Class Codes: A61B 5/412 Detecting or monitoring sepsis
• CPC Class Codes: A61B 5/4818 Sleep apnoea
• CPC Class Codes: A61B 5/6805 Vests
• CPC Class Codes: A61B 5/6887 mounted on external non-worn devices, e.g. non-medical devices
• CPC Class Codes: A61B 5/6892 Mats

Abstract

A fiber optic monitor that utilizes optical phase interferometry to monitor a patient'"'"'s vital signs such as respiration, cardiac activity, blood pressure and body'"'"'s physical movement. The monitor, which is non-invasive, comprises an optical fiber interferometer that includes an optical fiber proximately situated to the patient so that time varying acousto-mechanical signals from the patient are coupled into the optical fiber. Responsive thereto, the interferometer generates a time-varying optical intensity resulting from the interference of optical signals, which are detected at a photo-detector. A signal processor coupled to the optical detector provides one or more processed output signals indicative of the vital functions. The monitor system has broad applicability, from routine monitoring of infants at home to detection of apnea, arrhythmia, blood pressure and trauma. The system can be implemented in embodiments ranging from a low cost in-home monitor for infants to a high end product for in hospital use. The monitor can be integrated with other sensors such as an EKG, a video or still camera, an oxygen sensor, a carbon dioxide sensor, temperature sensor or a microphone to get additional required information depending on the application. When integrated and combined with EKG information, the monitor provides ballisto-mechanical information of the heart for early diagnosis of cardiac conditions or prediction of events or for correcting corrupted EKG signals due to time varying magnetic and electric fields. In some embodiments of the monitor, the system can be made portable so that the patient can walk around while still being continuously monitored for vital signs. Another suitable design measures blood pressure continuously and non-invasively by containing the fiber optic sensor in a cuff that wraps around an arterial wall of the patient. The fiber optic monitor may be designed for use in a variety of settings including an operating room, a recovery room, an intensive care unit, a magnetic resonance imaging laboratory, a computerized tomography scan laboratory and an elderly care facility.

Claims

1. A method of detecting vital signs of a patient exposed to nuclear magnetic resonance imaging, comprising:

providing optical fiber proximate to a patient exposed to a nuclear magnetic resonance imaging environment, said optical fiber comprising a first optical path and a second optical path;

coupling optical radiation into an input of said first optical path and an input of said second optical path;

coupling acousto-mechanical signals indicative of vital signs generated by said patient into said optical fiber to modulate a physical parameter of said optical fiber responsive to said acousto-mechanical signals;

creating interference of optical radiation emitted from an output of said first optical path and an output of said second optical path;

detecting time variations of said interference and providing a time-varying electrical signal responsive thereto; and

signal processing said time-varying electrical signal to provide one or more output signals indicative of said vital signs.

2. The method of claim 1 comprising providing said one or more output signals indicative of said vital signs during administration of anesthesia to said patient while exposed to the nuclear magnetic resonance imaging environment.

3. The method of claim 1 wherein said vital signs comprise at least one of heart and respiration rates.

4. The method of claim 1 wherein said acousto-mechanical signals correspond to myocardial sounds selected from the group consisting of S1, S2, S3 and S4 myocardial sounds and combinations thereof.

5. The method of claim 1 further comprising monitoring heart electrical activities using an electrocardiogram.

6. The method of claim 1 comprising providing an electrocardiogram waveform based on output signals from an electrocardiogram used on said patient exposed to the nuclear magnetic resonance imaging environment, and correlating said one or more output signals indicative of said vital signs and said output signals from said electrocardiogram effective to supplement or correct said electrocardiogram waveform.

7. The method of claim 1 comprising providing an electrocardiogram waveform based on output signals from an electrocardiogram used on said patient exposed to the nuclear magnetic resonance imaging environment, correlating said one or more output signals indicative of said vital signs and said output signals from said electrocardiogram effective to supplement or correct said electrocardiogram waveform, and using said corrected electrocardiogram waveform to improve electrocardiogram reliability in detecting heart condition information comprising at least one of rate, rhythm, axis, hypertrophy and infarction.

8. The method of claim 1 further comprising monitoring heart sounds using a listening or recording device.

9. The method of claim 1 further comprising measuring said vital signs using a technique selected from the group consisting of pulse Oximetry, respiration measurements using capnograph or end-tidal volume CO₂, blood pressure measurement, body temperature measurement, and combinations thereof.

10. The method of claim 1 comprising a mattress pad or a jacket that contains said optical fiber.

11. The method of claim 1 wherein a first optical fiber comprises said first optical path and a second optical fiber comprises said second optical path.

12. The method of claim 1 wherein a single optical fiber comprises both said first optical path and said second optical path.

13. A method of detecting vital signs of a patient, comprising:

providing optical fiber proximate to a patient comprising a first optical path and a second optical path;

coupling optical radiation into an input of said first optical path and an input of said second optical path;

coupling acousto-mechanical signals indicative of vital signs generated by said patient into said optical fiber to modulate a physical parameter of said optical fiber responsive to said acousto-mechanical signals;

creating interference of optical radiation emitted from an output of said first optical path and an output of said second optical path;

detecting time variations of said interference and providing a time-varying electrical signal responsive thereto; and

signal processing said time-varying electrical signal to provide one or more output signals indicative of said vital signs.

14. The method of claim 13 wherein a first optical fiber comprises said first optical path and a second optical fiber comprises said second optical path.

15. The method of claim 13 wherein a single optical fiber comprises both said first optical path and said second optical path.

16. A fiber optic monitor for detecting vital signs in a patient comprising:

optical fiber comprising a first optical path and a second optical path, said optical fiber being adapted to be situated proximate to a patient so that acousto-mechanical signals generated by said patient are coupled into said optical fiber effective to modulate a physical parameter of said optical fiber responsive to said acousto-mechanical signals;

optrodes for affixing at least a portion of said optical fiber to the patient;

an optical source coupled to supply optical radiation into an input of said first optical path and an input of said second optical path;

an optical system for creating optical interference from the optical radiation emitted from an output of said first optical path and an output of said second optical path;

a photo-detector arranged to sense an optical signal provided by time variations in said interference, said photo-detector providing a raw electrical signal responsive thereto;

a signal processor coupled to said photo-detector to process said raw electrical signal to provide one or more processed output signals indicative of vital signs of the patient; and

an output system that communicates said one or more output signals.

17. The fiber optic monitor of claim 16 wherein said output signals are indicative of vital signs selected from the group consisting of heart rate, respiration, movement and combinations thereof.

18. The fiber optic monitor of claim 16 further comprising electrodes of electrocardiogram equipment adapted for use as a group with said optrodes of said fiber optic monitor.

19. A method of detecting vital signs of patient in a confined care facility in which the patient is confined to a bed or room during treatment or monitoring, comprising:

providing optical fiber proximate to the patient comprising a first optical path and a second optical path;

coupling optical radiation into an input of said first optical path and an input of said second optical path,

coupling acousto-mechanical signals indicative of vital signs generated by said patient into said optical fiber to modulate a physical parameter of said optical fiber responsive to said acousto-mechanical signals;

creating interference of optical radiation emitted from an output of said first optical path and an output of said second optical path;

detecting time variations of said interference and providing a time-varying electrical signal responsive thereto;

signal processing said time-varying electrical signal to provide one or more output signals indicative of said vital signs; and

communicating said output signals in a manner selected from the group consisting of;

     1) as a local numerical or graphical readout near the patient,

     2) over at least one of fiber optic lines, phone lines, power lines, local area network lines, and TV cable lines to a central monitoring station to produce a numerical or graphical readout, and the combination of

     1) and

     2).

20. The method of claim 19 wherein said vital signs include heart rate and respiration, comprising communicating an alarm if said output signals are outside of predetermined boundaries of said vital signs.

21. The method of claim 19 further comprising monitoring a location of said patient within the facility by transmitting an identification short range radio frequency signal from said patient to a radio frequency receiver, and transmitting an output of said radio frequency signal from said radio frequency receiver over at least one of fiber optic lines, phone lines, power lines, local area network lines, and TV cable lines, to a central monitoring station.

22. The method of claim 19 wherein said vital signs include heart rate and respiration, comprising communicating an alarm under conditions selected from the group consisting of:

1) breath rate is faster or slower than a preset threshold value of the breath rate,

2) heart rate is faster or slower than a preset threshold value of the heart rate,

3) no breath or heart rate signal is available because the patient has left the bed and not returned to the bedroom after a preset time duration has elapsed;

4) no breath or heart rate signal is available because the patient has left the bed and has not moved from a particular location after a preset time duration has elapsed, and combinations of

     1) through

     4).

23. The method of claim 19 comprising containing said optical fiber in one of a mattress pad and jacket vest operated by batteries.

24. A fiber optic monitor for detecting vital signs in a patient, comprising:

optical fiber comprising a first optical path and a second optical path, said optical fiber being adapted to be situated proximate to a patient so that acousto-mechanical signals generated by said patient are coupled into said optical fiber effective to modulate a physical parameter of said optical fiber responsive to said acousto-mechanical signals;

a casing containing at least a portion of said optical fiber and being adapted to be affixed to the patient, said casing being one of a cuff and a patch;

an optical source coupled to supply optical radiation into an input of said first optical path and an input of said second optical path;

an optical system for creating interference from the optical radiation emitted from an output of said first optical path and an output of said second optical path;

a photo-detector arranged to sense an optical signal provided by time variations in said interference, said photo-detector providing a raw electrical signal responsive thereto;

a signal processor coupled to said photo-detector to process said raw electrical signal to provide one or more processed output signals indicative of vital signs of the patient; and

an output system that communicates said one or more output signals.

25. The fiber optic monitor of claim 24 wherein said casing is at least one cuff that is adapted to extend around a body part of said patient selected from the group consisting of an arm, a leg, a wrist, an ankle, a finger and combinations thereof.

26. The fiber optic monitor of claim 24 wherein said casing is a cuff that comprises a fabric body and a hook and loop fastener connected to said fabric body for fastening said cuff to said patient.

27. The fiber optic monitor of claim 24 comprising periodically calibrating said fiber optic monitor with a standard blood pressure measurement.

28. The fiber optic monitor of claim 24 comprising periodically calibrating said fiber optic monitor with a standard blood pressure measurement obtained from a sphygmomanometer.

29. The fiber optic monitor of claim 24 comprising means for periodically calibrating said fiber optic monitor with a standard blood pressure measurement by either manually or automatically periodically storing the standard measurement in a processor, and means for using said stored measurement to automatically adjust the calibration of said processed output signals from said fiber optic monitor corresponding to a blood pressure reading.

30. A fiber optic monitor for detecting vital signs in a patient, comprising:

optical fiber comprising a first optical path and a second optical path, said optical fiber being adapted to be situated proximate to a patient so that acousto-mechanical signals generated by said patient are coupled into said optical fiber effective to modulate a physical parameter of said optical fiber responsive to said acousto-mechanical signals;

an optical source coupled to supply optical radiation into an input of said first optical path and an input of said second optical path;

an optical system for creating interference from the optical radiation emitted from an output of said first optical path and an output of said second optical path;

a photo-detector arranged to sense an optical signal provided by time variations in said interference, said photo-detector providing a raw electrical signal responsive thereto;

a signal processor coupled to said photo-detector to process said raw electrical signal to provide one or more processed output signals indicative of vital signs of the patient; and

an output system that communicates said one or more output signals.

31. The fiber optic monitor of claim 30 wherein said fiber optic monitor comprises a Sagnac interferometer configuration.

32. The fiber optic monitor of claim 30 wherein said fiber optic monitor comprises a Mach-Zehnder interferometer configuration.

33. The fiber optic monitor of claim 30 wherein said fiber optic monitor comprises a Fabry-Perot interferometer configuration.

34. The fiber optic monitor of claim 30 comprising a first reflector at a first end of a single said optical fiber and a second reflector spaced from said first reflector at a second end of said single optical fiber, said first reflector and said second reflector being disposed in said first optical path and said second optical path of said single optical fiber and said photodetector and said optical source being disposed at said first end of said single optical fiber.

35. The fiber optic monitor of claim 30 comprising a first reflector at a first end of a single said optical fiber and a second reflector spaced from said first reflector at a second end of said single optical fiber, said first reflector and said second reflector being disposed in said first optical path and said second optical path of said single optical fiber and said photodetector and said optical source being disposed at said first end of said single optical fiber, wherein said first reflector comprises a Fiber Bragg Grating.

36. The fiber optic monitor of claim 30 comprising a first reflector at a first end of a single said optical fiber and a second reflector spaced from said first reflector at a second end of said single optical fiber, said first reflector and said second reflector being disposed in said first optical path and said second optical path of said single optical fiber and said photodetector and said optical source being disposed at said first end of said single optical fiber, wherein said first reflector comprises a Fiber Bragg Grating and said second reflector comprises one of a Faraday Rotation Mirror and a Fiber Bragg Grating.

37. The fiber optic monitor of claim 30 wherein said fiber optic monitor comprises a Michelson interferometer configuration.

38. A method of detecting vital functions of a patient, comprising:

providing optical fiber comprising a first optical path and a second optical path, said optical fiber being proximate to a patient located in an area selected from the group consisting of an operating room, a recovery room, an intensive care unit, a magnetic resonance imaging laboratory, a computerized tomography scan laboratory, an elderly care facility and combinations thereof;

coupling optical radiation into an input of said first optical path and an input of said second optical path;

coupling acousto-mechanical signals indicative of vital signs generated by said patient into said optical fiber to modulate a physical parameter of said optical fiber responsive to said acousto-mechanical signals;

creating interference of optical radiation emitted from an output of said first optical path and an output of said second optical path;

detecting time variations of said interference and providing a time-varying electrical signal responsive thereto; and

signal processing said time-varying electrical signal to provide one or more output signals indicative of said vital signs.

39. The method of claim 38 comprising communicating said output signals in a manner selected from the group consisting of:

1) as a local numerical or graphical readout near the patient,

     2) over at least one of fiber optic lines, phone lines, power lines, local area network lines, and TV cable lines to produce a numerical or graphical readout at a central monitoring station, and the combination of

     1) and

     2).

40. The method of claim 38 further comprising measuring said vital signs using a technique selected from the group consisting of electrocardiogram, electroencephalogram, pulse oximetry, respiration measurement using capnograph or end-tidal volume CO₂, blood pressure measurement, body temperature measurement, and combinations thereof.

41. The method of claim 38 comprising containing at least a portion of said optical fiber with a casing comprising one of a cuff and a patch and affixing said casing to the body of said patient.

42. The method of claim 38 wherein said vital signs include at least one of blood pressure, heart rate and respiration.

43. The method of claim 38 wherein said vital signs include at least one of blood pressure, heart rate and respiration, comprising communicating an alarm under conditions selected from the group consisting of:

1) breath rate is faster or slower than a preset threshold value of the breath rate,

2) heart rate is faster or slower than a preset threshold value of the heart rate,

3) blood pressure is higher or lower than a preset threshold value of the blood pressure.

44. A method of detecting blood pressure of a patient, comprising:

providing optical fiber comprising a first optical path and a second optical path, said optical fiber being contained by a cuff;

wrapping said cuff around a body part of the patient;

applying pressure to said cuff effective to cause said optical fiber to contact the body part;

coupling optical radiation into an input of said first optical path and an input of said second optical path;

coupling acousto-mechanical signals indicative of blood pressure generated by said patient into said optical fiber to modulate a physical parameter of said optical fiber responsive to said acousto-mechanical signals;

creating interference of optical radiation emitted from an output of said first optical path and an output of said second optical path;

detecting time variations of said interference and providing a time-varying electrical signal responsive thereto; and

signal processing said time-varying electrical signal to provide one or more output signals indicative of said blood pressure.

45. The method of claim 44 further comprising coupling acousto-mechanical signals indicative of heart rate generated by said patient into said optical fiber to modulate a physical parameter of said optical fiber responsive to said acousto-mechanical signals;

wherein said signal processing of said time-varying electrical signal provides one or more output signals indicative of said heart rate, while providing said output signals indicative of said blood pressure.