Automatic blood pressure measuring device and method

• US 4,796,184 A
• Filed: 08/01/1986
• Issued: 01/03/1989
• Est. Priority Date: 08/01/1986
• Status: Expired due to Term

• Current Assignee: Cas Medical Systems Incorporated (Edwards Lifesciences Corporation)
• Original Assignee: Cas Medical Systems Incorporated (Edwards Lifesciences Corporation)
• Inventors: Bahr, Dennis E., Clark, Kenneth R., Post, Kendall E.
• Primary Examiner(s): Smith, Jerry
• Assistant Examiner(s): Meyer, Charles B.
• Application Number:
  US06/892,848
• Time in Patent Office: 886 Days
• Field of Search: 364/417, 364/416, 128/680, 128/681, 128/682, 128/685, 128/686
• US Class Current: 600/492
• 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

The device measures blood pressure automatically using the oscillometric technique. The device includes a pressure cuff which is automatically inflated to an initial pressure which is calculated to be above the subject'"'"'s systolic pressure. The cuff is then deflated stepwise in preset pressure increments while cuff pressure oscillations are sensed at each cuff pressure level and stored in a computer incorporated into the device. Cuff deflation is continued until the cuff pressure is below the subject'"'"'s diastolic pressure whereupon the cuff is automatically deflated. The computer then fits a calculated parabolic curve onto the greatest cuff pressure oscillation and onto a lesser oscillation on each side of the greatest oscillation. From the thusly derived curve, the computer determines the mean blood pressure, and the systolic and diastolic blood pressures.

Claims

1. A device for automatic determination of blood pressure values using a non-invasive oscillometric technique, said device comprising:

(a) a cuff means for girdling securement to a subject whose pressure is to be measured;

(b) pump means operably connected to said cuff means for inflating said cuff means to an initial pressure;

(c) valve means operably connected to said cuff means for venting air from aid cuff means to lower the pressure thereof;

(d) sensor means operably connected to said cuff means for sensing cuff pressure and oscillations in cuff pressure caused by arterial pulsations of the subject;

(e) memory means for storing cuff pressure data and cuff pressure oscillation data obtained from said sensor means; and

(f) computer means operably connected to said valve means, to said sensor means, and to said memory means, said computer means being operable to;

(i) actuate said valve means to periodically cause deflation of said cuff means in serial steps until a predetermined terminal cuff pressure step is reached;

(ii) record cuff pressure measurements at each pressure step;

(iii) record arterial cuff pressure oscillations at each pressure step;

(iv) collate each of said recorded cuff pressure measurements with the respective arterial cuff pressure oscillations and store said collated pressure measurements and pressure oscillations in said memory means;

(v) after said terminal cuff pressure step is reached, identify three stored arterial oscillation values, which include at least the greatest cuff pressure oscillation value and the next greatest oscillation values on each side of said greatest oscillation value, and their collated cuff pressure measurements;

(vi) fit a curve to said three oscillation values; and

(vii) calculate true means blood pressure from said curve.

2. The device of claim 1, wherein said curve is a parabolic curve produced by solving the equation

3. The device of claim 2 wherein said true mean blood pressure is calculated by solving the equation Pm=-0.5 B/A wherein Pm is the true mean blood pressure.

4. The device of claim 1 wherein said computer means is operable to fully deflate said cuff means when detected cuff pressure oscillations occurring subsequent to the maximum cuff pressure oscillations measured are equal to approximately 0.6 of the maximum cuff pressure oscillations measured.

5. The device of claim 1 wherein said computer means is operable to calculate systolic pressure as a function of the maximum oscillation described by said parabolic curve.

6. The device of claim 1 wherein said computer means is operable to calculate diastolic pressure as a function of the maximum oscillation described by said parabolic curve.

7. The device of claim 1 further comprising means forming an air flow restriction between said cuff means and said valve measn for controllling the rate of venting of said cuff means to adapt the device for neonatal use.

8. A device for use in combination with a cuff for automatic determination of blood pressure values using a non-invasive oscillometric technique, said device comprising:

(a) a pump for inflating the cuff;

(b) a first valve for venting air stepwise from the cuff to lower pressure in the cuff to successively lower pressure plateaus;

(c) sensor means for sensing cuff pressure at each pressure plateau, and for sensing oscillations in cuff pressure caused by arterial pulsations at each pressure plateau;

(d) means for storing collated cuff pressure data and cuff pressure oscillation data obtained from said sensor means. said cuff pressure oscillation data including at least the greatest cuff pressure oscillation value, and the next greatest oscillation values on each side of said greatest oscillation value; and

(e) computer means operable to fit a parabolic curve onto said cuff pressure oscillation data and to calculate true mean blood pressure from said parabolic curve and the stored cuff pressure data.

9. The device of claim 8 wherein said computer means determines said parabolic curve by solving the equation:

space="preserve" listing-type="equation">Y=AP.sup.2 +BP+C

wherein Y is cuff pressure oscillation, P is the collated cuff pressure, and A, B and C are constants, said equation being solved for A, B and C with simultaneous equations using three stored cuff pressure oscillation measurements and their collated cuff pressure measurements.

10. The device of claim 9 wherein said computer means calculates true mean pressure by solving the equation:

space="preserve" listing-type="equation">Pm=-0.5 B/A

wherein Pm is true mean pressure.

11. The device of claim 10 further comprising display means operably connected to said computer means for displaying the calculated true mean pressure.

12. The device of claim 11 wherein said computer means calculates systolic and diastolic pressure from said parabolic curve as cuff pressure values corresponding to oscillation values on said parabolic curve occurring at an ascending oscillation equal to approximately 0.75 of the maximum oscillation which correlates with Pm and a descending oscillation equal to approximately 0.8 of said maximum oscillation.

13. A method of measuring blood pressure values, said method comprising the steps of:

(a) encircling a limb of a subject with an inflatable pressure cuff;

(b) inflating said pressure cuff to an initial pressure;

(c) incrementally deflating said pressure cuff through a series of desending pressure plateaus;

(d) maintaining constant pressure at each of said pressure plateaus while measuring and recording cuff pressure values and cuff pressure oscillation values at each pressure plateau;

(e) storing said measured cuff pressure values and cuff pressure oscillation values in collated fashion;

(f) repeating steps (c) (d) and (e) until a preset terminal cuff pressure plateau is reached;

(g) fitting a parabolic curve to stored oscillation values which include at least the greatest cuff pressure oscillation value and the next greatest oscillation values on each side of said greatest oscillation value; and

(h) calculating true mean pressure from said parabolic curve.

14. The method of claim 13 further comprising the steps of completely deflating said cuff when measured cuff pressure oscillation values occurring subsequent to a measured maximum cuff pressure oscillation value are less than or equal to about 0.6 of said measured maximum cuff pressure oscillation value.

15. The method of claim 13 wherein said parabolic curve is fitted onto a set of measured cuff pressure oscillations comprising the three greatest oscillations measured.

16. The method of claim 15 wherein the parabolic curve is derived from identifying constants A, B and C by solving equations:

space="preserve" listing-type="equation">Y.sub.1 =AP.sub.1.sup.2 +BP.sub.1 +C;

space="preserve" listing-type="equation">Y.sub.2 =AP.sub.2.sup.2 +BP.sub.2 +C; and

space="preserve" listing-type="equation">Y.sub.3 =AP.sub.3.sup.2 +BP.sub.3 +C

wherein Y₁ equals the maximum measured cuff pressure oscillation and P₁ equals its collated measured cuff pressure;

Y₂ equals the greatest measured cuff pressure oscillation occurring prior to Y₁ and P₂ equals its collated measured cuff pressure; and

Y₃ equals the greatest measured cuff pressure oscillation occurring subsequent to Y₁ and P₃ equals its collated measured cuff pressure.

17. The method of claim 16 wherein true mean blood pressure is derived from the equation:

space="preserve" listing-type="equation">Pm=-0.5 B/A

where P_m equals true mean blood pressure.