Blood Pressure Measuring Method and Blood Pressure Manometer

• US 20070232939A1
• Filed: 09/24/2004
• Published: 10/04/2007
• Est. Priority Date: 09/26/2003
• Status: Active Grant

• Current Assignee: Beumer GmbH & Company KG
• Original Assignee: Beumer GmbH & Company KG
• Inventors: Forstner, Klaus
• Granted Patent: US 8,864,678 B2
• Time in Patent Office: Days
• US Class Current: 600/495
• CPC Class Codes: A61B 5/022 by applying pressure to close blood vessels, e.g. against the skin; Ophthalmodynamometers
• CPC Class Codes: A61B 5/02225 using the oscillometric method

Abstract

A blood pressure measuring method, according to which a pulse oscillogram of a patient is defined, the blood pressure is then determined from the pulse oscillogram and displayed. Reliable blood pressure values are obtained without additional cost to the user, by obtaining an evaluation criterion for the presence of haemodynamic stability from the individual pulse oscillogram, the determination of the blood pressure value or the determined blood pressure value being related to the criterion.

Claims

1. A blood pressure measuring method, wherein a pulse oscillogram (PO) of a patient is determined and used to detect a blood pressure which is displayed, the method comprising:

while determining the pulse oscillogram (PO), performing an analysis of a hemodynamic stability, wherein at least one of a hemodynamic parameter and at least one other physiological parameter which correlates with the hemodynamic parameter are evaluated with respect to chronological changes; and

obtaining assessment criteria for a presence of the hemodynamic stability from the analysis by which one of a determination of the blood pressure value and the determined blood pressure value is brought into a correlation to ascertain whether the blood pressure value was obtained during the hemodynamic stability, or that a corrected blood value is determined.

2. The method in accordance with claim 1, wherein a warning indication is generated by an evaluation criteria if there is a deviation from one of a preset and a predeterminable threshold criteria.

3. The method in accordance with claim 2, wherein the individual pulse oscillogram (PO) is subjected to an analysis regarding the hemodynamic stability.

4. The method in accordance with claim 3, wherein prior to obtaining the assessment criteria, influential values of at least one of artifacts and arrhythmia are suppressed.

5. The method in accordance with claim 4, wherein at least one of a pulse period progression (2.2), a pulse amplitude progression (3), and a pulse shape (6), is determined and analyzed from the pulse oscillogram (PO), and the assessment criteria from one of the pulse period progression (2.2), the pulse amplitude progression (3), the pulse shape (6), and a combined evaluation are formed from at least two items of base information.

6. The method in accordance with claim 5, wherein pulse period lengths of at least a starting range and an end range of the pulse oscillogram (PO) are compared with each other, and a deviation of the pulse period lengths of a starting range (T_initial) and an end range (T_terminal) is made a basis of the assessment criteria.

7. The method in accordance with claim 6, wherein a deviation of the lengths of the pulse period is calculated by the pulse oscillogram (PO) as a difference of lengths of the periods of the starting range and the end range as a function of a mean pulse period length of the pulse oscillogram.

8. The method in accordance with claim 5, wherein an entire progression of all pulse periods in regard to their chronological change is determined and used as a measure for the hemodynamic stability.

9. The method in accordance with claim 5, wherein an entire progression of pulse-specific systolic times in regard to changes over time is determined and used as a measure of the hemodynamic stability.

10. The method in accordance with claim 9, wherein an assessment of a constancy of the pulse period progression (2.2) is included when forming the assessment criteria.

11. The method in accordance with claim 10, wherein a rise (α

) in an ascending branch of one of an envelope and a rise (β

) in a descending branch, a plateau width (PL) around a maximum, or a combination of at least two ofthese characteristic values from the pulse amplitude progression (3) each is used as a characteristic value for forming the assessment criteria.

12. The method in accordance with claim 11, wherein as the assessment criteria for the hemodynamic stability the analysis of the pulse shape (6) includes a determination of at least one rise at least at one point of at least one of an ascending flank and a descending pulse flank, and a chronological change in the rise at the respective points or a ratio of the rises at least at two points of a pulse is checked for different pulses.

13. The method in accordance with claim 12, wherein for forming the assessment criteria, at least one of the pulse period progression (2.2), the pulse amplitude progression (PA) and the pulse shape (6) is weighted one of identically and differently depending on a markedness.

14. The method in accordance with claim 13, wherein at least one of a breathing frequency signal, an electrocardiogram signal and a skin impedance measurement signal each is determined and evaluted in regard to a chronological change during the individual blood pressure measurement.

15. The method in accordance with claim 14, wherein a breathing frequency signal is obtained from one of the analysis of the pulse oscillogram and by an additional sensor arrangement.

16. The method in accordance with claim 15, wherein a diagnosis of the hemodynamic instability is an automated correction of the error effects.

17. A sphygmomanometer for executing the method in accordance with claim 1, having an inflatable cuff and an evaluating device which can be arranged thereon or connected to it, with a unit (1) creating the pulse oscillogram (PO), a blood pressure determination device and a display device, comprising the evaluating unit having an assessment arrangement embodied so that assessment criteria for the presence of hemodynamic stability are formed with it during the determination of the individual pulse oscillogram (PO), and the display device has an indicator of the hemodynamic instability.

18. The sphygmomanometer in accordance with claim 17, wherein the assessment arrangement is designed for detecting at least one of a pulse period progression (2.2), a pulse amplitude progression (3), pulse forms (6) from the pulse oscillogram (PO), a formation of the assessment criteria from the pulse period progression (2.2), a pulse amplitude progression (3), and a pulse form change.

19. The sphygmomanometer in accordance with claim 18, wherein that the assessment arrangement detects at least one secondary physiological parameter correlating with a change of hemodynamics which relates to at least one of a breathing frequency signal, an electrocardiogram signal and a skin impedance signal.

20. The sphygmomanometer in accordance with claim 17, wherein the assessment arrangement detects at least one secondary physiological parameter correlating with a change of hemodynamics which relates to at least one of a breathing frequency signal, an electrocardiogram signal and a skin impedance signal.

21. The method in accordance with claim 1, wherein the individual pulse oscillogram (PO) is subjected to an analysis regarding the hemodynamic stability.

22. The method in accordance with claim 1, wherein prior to obtaining the assessment criteria, influential values of at least one of artifacts and arrhythmia are suppressed.

23. The method in accordance with claim 3, wherein at least one of a pulse period progression (2.2), a pulse amplitude progression (3), and a pulse shape (6) is determined and analyzed from the pulse oscillogram (PO), and the assessment criteria from one of the pulse period progression (2.2), the pulse amplitude progression (3), the pulse shape (6), and a combined evaluation are formed from at least two items of base information.

24. The method in accordance with claim 23, wherein pulse period lengths of at least a starting range and an end range of the pulse oscillogram (PO) are compared with each other, and a deviation of the pulse period lengths of a starting range (T_initial) and an end range (T_terminal) is made a basis of the assessment criteria.

25. The method in accordance with claim 23, wherein a deviation of the lengths of the pulse period is calculated by the pulse oscillogram (PO) as a difference of lengths of the periods of the starting range and the end range as a function of a mean pulse period length of the pulse oscillogram.

26. The method in accordance with claim 23, wherein an entire progression of all pulse periods in regard to their chronological change is determined and used as a measure for the hemodynamic stability.

27. The method in accordance with claim 23, wherein an entire progression of pulse-specific systolic times in regard to changes over time is determined and used as a measure of the hemodynamic stability.

28. The method in accordance with claim 5, wherein an assessment of a constancy of the pulse period progression (2.2) is included when forming the assessment criteria.

29. The method in accordance with claim 5, wherein a rise (α

) in an ascending branch of one of an envelope and a rise (β

) in a descending branch, a plateau width (PL) around a maximum, or a combination of at least two of these characteristic values from the pulse amplitude progression (3) each is used as a characteristic value for forming the assessment criteria.

30. The method in accordance with claim 5, wherein as the assessment criteria for the hemodynamic stability the analysis of the pulse shape (6) includes a determination of at least one rise at least at one point of at least one of an ascending flank and a descending pulse flank, and a chronological change in the rise at the respective points or a ratio of the rises at least at two points of a pulse is checked for different pulses.

31. The method in accordance with claim 5, wherein for forming the assessment criteria, at least one of the pulse period progression (2.2), the pulse amplitude progression (PA) and the pulse shape (6) is weighted one of identically and differently depending on a markedness.

32. The method in accordance with claim 1, wherein at least one of a breathing frequency signal, an electrocardiogram signal and a skin impedance measurement signal each is determined and evaluated in regard to a chronological change during the individual blood pressure measurement.

33. The method in accordance with claim 32, wherein a breathing frequency signal is obtained from one of the analysis of the pulse oscillogram and by an additional sensor arrangement.

34. The method in accordance with claim 1, wherein a diagnosis of the hemodynamic instability is an automated correction of the error effects.