Apparatus and method for measuring blood pressure

• US 4,427,013 A
• Filed: 06/08/1983
• Issued: 01/24/1984
• Est. Priority Date: 01/29/1981
• Status: Expired due to Fees

• Current Assignee: C.R. Bard, Inc. (Becton, Dickinson & Co)
• Original Assignee: C.R. Bard, Inc. (Becton, Dickinson & Co)
• Inventors: Beveridge, Robert W., Nunn, Donald E.
• Primary Examiner(s): Kamm, William
• Assistant Examiner(s): Shein, Mitchell J.
• Application Number:
  US06/502,151
• Time in Patent Office: 230 Days
• Field of Search: 128/680, 128/681, 128/682, 128/670
• US Class Current: 600/494
• CPC Class Codes: A61B 5/02225 using the oscillometric method

Abstract

A blood pressure measuring device is disclosed which uses an inflatable cuff to apply external pressure to a patient'"'"'s body member. The device detects and measures amplitude of pressure oscillations induced in the cuff by blood flow in the body member as the cuff pressure is decreased in steps from a magnitude above the expected systolic pressure to a magnitude below the expected diastolic blood pressure. The means arterial blood pressure is measured at the step at which the pressure oscillations reach a maximum. Systolic blood pressure is determined by making a first linear approximation to a plurality of amplitude measurements occurring below the expected systolic pressure and making a second linear approximation to a plurality of points occurring above the expected systolic pressure. The systolic pressure is calculated by setting the two approximations equal. Diastolic blood pressure is determined by detecting the cuff pressure which results in an equivalent oscillation magnitude to that determined for the systolic pressure.

Claims

1. A non-invasive method for measuring systolic blood pressure in a body member, including the steps of:

A. occluding blood flow in said body member by applying a variable and measurable external pressure to said member;

B. varying said pressure between a magnitude whereat said blood flow is substantially occluded and a magnitude whereat said blood flow is substantially unoccluded;

C. measuring, at a plurality of pressure values, the peak-to-peak oscillation magnitude of oscillations in said external pressure caused by blood flow pulses in said body member;

D. storing a plurality of readings, each of said readings consisting of a pressure value and a corresponding oscillation magnitude, said stored readings forming a curve when plotted against each other;

E. determining an expected value of said systolic blood pressure; and

F. determining a selected pressure at or near said expected value at which the rate of change of the magnitude of said oscillations with respect to changes in said applied pressure undergoes a change.

2. A method according to claim 1 wherein step E comprises the steps of:

E'"'"'. determining the maximum of said stored oscillation magnitudes; and

E". determining said expected systolic pressure to occur at a pressure at which the corresponding oscillation magnitude is one-half said maximum oscillation magnitude.

3. A method according to claim 2 further comprising the steps of:

G. forming a linear approximation to said curve for pressure values near but greater than said expected systolic blood pressure value;

H. forming a linear approximation to said curve for pressure values near but less than said systolic blood pressure value; and

I. selecting the pressure value at which both of said linear approximations yield the same oscillation magnitude.

4. A method according to claim 3 further comprising the steps of:

J. determining the oscillation magnitude corresponding to said selected pressure; and

K. determining an additional value of said pressure having a corresponding oscillation magnitude equal to said magnitude determined in step J, whereby said diastolic pressure is calculated.

5. Apparatus for measuring systolic blood pressure in a body member comprising:

means for applying a variable and measurable external pressure to said member to occlude blood flow in said body member;

means for varying said pressure between a magnitude whereat said blood flow is substantially unoccluded and a magnitude whereat said blood flow is substantially unoccluded;

means for measuring the peak-to-peak oscillation magnitude at a plurality of pressure values;

means for storing a plurality of readings, each of said readings consisting of a pressure value and a corresponding oscillation magnitude, said stored readings forming a curve when plotted;

means for determining an expected value of said systolic blood pressure;

means for determining the maximum pressure at which the rate of change of the magnitude of said oscillations with respect to changes in said applied pressure undergoes a change about said expected value.

6. Apparatus according to claim 5 further comprising:

means responsive to said maximum pressure and responsive to said output for determining the oscillation magnitude corresponding to said maximum pressure; and

means responsive to values of said pressure and responsive said output for determining an additional value of said pressure having a corresponding oscillation magnitude equal to the output of said last-mentioned means whereby said diastolic pressure is calculated.

7. A non-invasive method for quantitatively determining one of the systolic blood pressure and the diastolic blood pressure for use with blood pressure measuring apparatus including means for applying a variable external pressure to an artery and means responsive to pulsatile waves occurring in a partially-occluded artery for detecting variations in said externally applied pressure, said method comprising the steps of:

A. imposing on said artery a time-varying external pressure extending over a pressure range including pressure equal to the expected systolic and diastolic blood pressures;

B. determining the peak amplitude of each pulsatile wave detected by said detecting means and determining the maximum of said peak amplitudes;

C. determining an expected systolic and an expected diastolic pressure to occur at pressures whereat the corresponding peak amplitude is one-half said maximum peak amplitude;

D. at a region of the external pressure range which includes one of the expected diastolic and systolic pressures determining a first rate of change with respect to said external pressure of the peak amplitudes of at least two waves occurring at external pressures near but in excess of said one expected pressure;

E. at said region, determining a second rate of change with respect to said external pressure of the peak amplitudes of at least two waves occurring at external pressures near but less than said one pressure; and

F. quantitatively establishing said one pressure equal to that external pressure at which said first rate of change changes to said second rate of change.

8. A method according to claim 7 further comprising the steps of:

G. determining the peak amplitude corresponding to said one pressure; and

H. determining an additional value of said pressure having a corresponding peak amplitude equal to said peak amplitude determined in step G, whereby said other of said systolic and diastolic pressures is calculated.

9. A non-invasive method according to claim 7 wherein step B comprises the steps of:

B'"'"'. determining and storing the peak amplitude of each pulsatile wave detected by said detecting means as said external pressure varies between a magnitude greater than said expected systolic blood pressure and a magnitude lower than said expected systolic pressure and storing the the corresponding pressure value;

B". determining from said stored peak amplitudes the maximum of said peak amplitudes.

10. A non-invasive method according to claim 9 wherein step D comprises the step of:

D'"'"'. determining from said stored peak amplitude values a first rate of change with respect to said external pressure of two or more successive and adjacent waves occurring at respective external pressure levels near but in excess of said one expected pressure;

and step E comprises the step of

E.'"'"' determining from said stored peak amplitude values a second rate of change with respect to said external pressure of the peak amplitudes of two or more successive and adjacent waves occurring at respective external pressure levels near but less than said one expected pressure.

11. A non-invasive method according to claim 10 wherein step D comprises the step of:

D'"'"'. determining from said stored amplitude values a first rate of change with respect to said external pressure of the peak amplitudes of three successive and adjacent waves occurring at respective external pressure levels near but in excess of the expected systolic pressure;

and step E comprises the step of

E.'"'"' determining from said stored peak amplitude values a second rate of change with respect to said external pressure of the peak amplitudes of three successive and adjacent waves occurring at respective external pressure levels near but less than the expected systolic pressure.

12. A non-invasive method for measuring systolic blood pressure in a body member, including the steps of:

A. occluding blood flow in said body member by applying a variable and measurable external pressure to said member;

B. varying said pressure between a magnitude whereat said blood flow is substantially occluded and a magnitude whereat said blood flow is substantially unoccluded;

C. monitoring the peak-to-peak magnitude of oscillations in said pressure produced by blood flow pulses in said body member;

D. storing a plurality of readings, each of said readings consisting of a pressure value and a corresponding oscillation magnitude, said stored readings, when plotted, forming a curve with at least one slope inflection point corresponding to the desired systolic blood pressure;

E. determining an expected value of said systolic blood pressure;

F. forming an approximation to said curve for pressure values near but greater than said expected systolic blood pressure value;

G. forming an approximation to said curve for pressure values near but less than said expected systolic blood pressure value; and

H. determining the pressure value corresponding to said inflection point by selecting the pressure value at which both of said approximations yield the same oscillation magnitude to be the calculated value of said systolic pressure.

13. A method according to claim 12 wherein step E comprises the further steps of:

E'"'"'. determining the maximum of said oscillation magnitudes; and

E". calculating the expected systolic pressure to occur at a pressure whereat the corresponding oscillation magnitude is one half said maximum oscillation magnitude.

14. A method according to claim 12 wherein the approximation in step F is a linear approximation.

15. A method according to claim 12 wherein the approximation in step G is a linear approximation.