Method and apparatus for in vivo blood constituent analysis

• US 5,782,756 A
• Filed: 09/19/1996
• Issued: 07/21/1998
• Est. Priority Date: 09/19/1996
• Status: Expired due to Term

• Current Assignee: Nellcor Puritan Bennett Incorporated (Medtronic Plc)
• Original Assignee: Nellcor Puritan Bennett Incorporated (Medtronic Plc)
• Inventors: Mannheimer, Paul D.
• Primary Examiner(s): Bahr, Jennifer
• Assistant Examiner(s): WINAKUR, ERIC FRANK
• Application Number:
  US08/715,848
• Time in Patent Office: 670 Days
• Field of Search: 128/633, 128/664, 128/665, 128/666, 356/41, 600/322, 600/323, 600/326, 600/328, 600/330, 600/336, 600/473, 600/476, 600/479
• US Class Current: 600/322
• CPC Class Codes: A61B 5/14542 for measuring blood gases A61B5/14551 takes precedence
• CPC Class Codes: A61B 5/1464 specially adapted for foetal tissue
• CPC Class Codes: A61B 5/6852 Catheters

Abstract

The present invention utilizes at least three wavelengths of electromagnetic radiation for determining a blood constituent, such as arterial oxygen saturation, in a patient. The detected radiation scattered by the tissue of the patient is analyzed in a manner that compensates for variations in the detected radiation caused by differences in the scattering of the radiation at different wavelengths. In particular, a result is determined which is equivalent to the sum of a first blood constituent estimate using a first pair of the detected signals, and the difference between the first blood constituent estimate and a second blood constituent estimate, using a different pair of wavelengths, with the difference being multiplied by a multiplicative factor.

Claims

1. A method for determining a blood constituent comprising the steps of:

emitting electromagnetic radiation of at least three wavelengths toward a patient;

detecting a portion of the electromagnetic radiation scattered by the tissue of said patient for each of said at least three wavelengths and generating at least three signals indicative thereof;

determining a blood constituent result from a combination of said at least three signals, said result being equivalent to the sum of (1) a first blood constituent estimate determined using a first set of at least two of said signals and (2) a multiplicative factor multiplied by a difference between said first blood constituent estimate and a second blood constituent estimate, said second blood constituent estimate being determined using a second set of a different combination of at least two of said signals.

2. The method of claim 1 wherein said result is determined utilizing a formula of the form M=M(1)+k·

M(1)-M(2)!^p, wherein M(1) is determined utilizing a set of signals comprising at least 2 wavelengths and M(2) is determined utilizing a different set of signals comprising at least 2 wavelengths that are not all equal to the first set, k is a multiplicative factor and p is a exponential factor.

3. The method of claim 1 wherein said result is determined utilizing a formula of the form M=aR₁ +bR₂ +c, wherein R₁ is determined utilizing a set of signals comprising at least 2 wavelengths and R₂ is determined utilizing a different set of signals comprising at least 2 wavelengths that are not all equal to the first set, and a, b, and c are constants.

4. The method of claim 1 wherein said result is determined utilizing a formula of the form M=(1/m₃) (am₁ +bm₂)+c, where m₁, m₂, and m₃ are signal modulation amplitudes emanating from a cardiac pulse determined at 3 different wavelengths, and a, b, and c are constants.

5. The method of claim 1 wherein said result is determined utilizing a formula of the form M=m₃ (a/m₁ +b/m₂)+c, where m₁, m₂, and m₃ are signal modulation amplitudes emanating from a cardiac pulse determined at 3 different wavelengths, and a, b, and c are constants.

6. The method of claim 1 wherein said result is determined utilizing a formula of the form M=M(1)+f(Δ

), wherein f is a polynomial function, Δ

is the difference between two blood constituent estimates from different wavelength combinations and M(1) is determined utilizing a set of signals comprising at least 2 wavelengths.

7. The method of any one of claims 1-6 wherein said blood constituent is arterial oxygen saturation.

8. The method of claim 1 wherein said multiplicative factor is a function of at least one of said blood constituent estimates.

9. The method of claim 1 wherein said result is determined utilizing said three signals in a bivariate formula, having two variables, said variables being said first and second blood constituent estimates.

10. A method for determining a blood constituent comprising the steps of:

emitting electromagnetic radiation of at least three wavelengths toward a patient;

detecting a portion of the electromagnetic radiation scattered by the tissue of said patient for each of said at least three wavelengths and generating at least three signals indicative thereof;

determining a blood constituent result utilizing at least one coefficient chosen to compensate for variations in detected radiation paths through said patient of said electromagnetic radiation for at least two of said wavelengths.

11. The method of claim 10 further comprising the step of multiplexing said three wavelengths in said emitting step.

12. The method of claim 11 wherein said multiplexing is time multiplexing.

13. The method of claim 11 wherein said multiplexing is frequency multiplexing.

14. A method for determining a blood constituent comprising the steps of:

emitting electromagnetic radiation of at least three wavelengths toward a patient;

detecting a portion of the electromagnetic radiation scattered by the tissue of said patient for each of said at least three wavelengths and generating at least three signals indicative thereof;

determining a blood constituent result utilizing said at least three signals; and

wherein said at least three wavelengths are chosen so that

(1) first and second groups of said wavelengths have sufficient sensitivity to changes in said blood constituent so that a ratio of detected values varies by more than double between 0 and 100 percent of said blood constituent, and

(2) said first and second groups of wavelengths have different penetrations into said patient with sufficient overlap to provide correlated errors in blood constituent calculations using said first and second groups of wavelengths.

15. The method of claim 14 wherein said wavelengths are chosen from among the groupings set forth in Table 1 herein.

16. The method of claim 14 wherein said wavelengths include at least one wavelength between 625-800 nm, and at least one wavelength between 775-1000 nm.

17. The method of claim 14 wherein said wavelengths include at least two wavelengths between 650-750 nm, and at least one wavelength between 775-1000 nm.

18. The method of claim 14 wherein said wavelengths are separated by at least 10 nm.

19. The method of claim 14 wherein said wavelengths are separated by at least 30 nm.

20. The method of claim 14 wherein said blood constituent is arterial oxygen saturation.

21. The method of claim 14 further comprising the step of multiplexing said three wavelengths in said emitting step.

22. The method of claim 14 further comprising the step of selecting, based on an encoded value from a sensor, coefficients for use in calculating said blood constituent.

23. An apparatus for determining a blood constituent comprising:

at least one emitter configured to emit electromagnetic radiation of at least three wavelengths toward a patient;

a detector configured to detect a portion of the electromagnetic radiation scattered by the tissue of said patient for each of said at least three wavelengths and generating at least three signals indicative thereof;

means for determining a blood constituent result from a combination of said at least three signals, said result being equivalent to the sum of (1) a first blood constituent estimate determined using a first set of at least two of said signals and (2) a multiplicative factor multiplied by a difference between said first blood constituent estimate and a second blood constituent estimate, said second blood constituent estimate being determined using a second set of a different combination of at least two of said signals.

24. The apparatus of claim 23 wherein said result is determined utilizing a formula of the form M=M(1)+k·

M(1)-M(2)!^p, wherein M(1) is determined utilizing a set of signals comprising at least 2 wavelengths and M(2) is determined utilizing a different set of signals comprising at least 2 wavelengths that are not all equal to the first set, k is a multiplicative factor and p is a exponential factor.

25. The apparatus of claim 24 wherein said result is determined utilizing a formula of the form M=m₃ (a/m₁ +b/m₂)+c, where m₁, m₂, and m₃ are signal modulation amplitudes emanating from a cardiac pulse determined at 3 different wavelengths, and a, b, and c are constants.

26. The apparatus of claim 23 wherein said result is determined utilizing a formula of the form M=aR₁ +bR₂ +c, wherein R₁ is determined utilizing a set of signals comprising at least 2 wavelengths and R₂ is determined utilizing a different set of signals comprising at least 2 wavelengths that are not all equal to the first set, and a, b, and c are constants.

27. The apparatus of claim 23 wherein said result is determined utilizing a formula of the form M=(1/m₃) (am₁ +bm₂)+c, where m₁, m₂, and m₃ are signal modulation amplitudes emanating from a cardiac pulse determined at 3 different wavelengths, and a, b, and c are constants.

28. The apparatus of claim 23 wherein said result is determined utilizing a formula of the form M=M(1)+f(Δ

), wherein f is a polynomial function, Δ

is the difference between two M estimates from different waveform combinations, and M(1) is determined utilizing a set of signals comprising at least 2 wavelengths.

29. The apparatus of any of claims 23-28 wherein said blood constituent is arterial oxygen saturation.

30. The apparatus of claim 23 wherein said multiplicative factor is a function of at least one of said blood constituent estimates.

31. The apparatus of claim 23 wherein said result is determined utilizing a bivariate formula, having three wavelengths and two variables, said variables being said first and second blood constituent estimates.

35. The apparatus of claim 23 wherein said blood constituent is arterial oxygen saturation.

32. An apparatus for determining a blood constituent comprising:

means for emitting electromagnetic radiation of at least three wavelengths toward a patient;

means for detecting a portion of the electromagnetic radiation scattered by the tissue of said patient for each of said at least three wavelengths and generating at least three signals indicative thereof;

means for determining a blood constituent result utilizing at least one coefficient chosen to compensate for variations in detected radiation paths through said patient of said electromagnetic radiation for at least two of said wavelengths.

33. The apparatus of claim 32 further means for emitting and detecting comprise a sensor, and further comprising means for biasing said sensor against a fetus.

34. The apparatus of claim 32 further comprising means for multiplexing said three wavelengths in said means for emitting.

36. An apparatus for determining a blood constituent comprising:

means for emitting electromagnetic radiation of at least three wavelengths toward a patient;

means for detecting a portion of the electromagnetic radiation scattered by the tissue of said patient for each of said at least three wavelengths and generating at least three signals indicative thereof;

means for determining a blood constituent result utilizing said at least three signals; and

wherein said at least three wavelengths are chosen so that

(1) first and second groups of said wavelengths have sufficient sensitivity to changes in said blood constituent so that a ratio of detected values varies by more than double between 0 and 100 percent of said blood constituent, and

(2) said first and second pairs of wavelengths have different penetrations of said patient with sufficient overlap to provide correlated errors in blood constituent calculations using said first and second groups of wavelengths.

37. The apparatus of claim 36 wherein said wavelengths are chosen from among the groupings set forth in Table 1 herein.

38. The apparatus of claim 36 wherein said wavelengths include at least one wavelength between 625-800 nm, and at least one wavelength between 775-1000 nm.

39. The apparatus of claim 36 wherein said wavelengths are separated by at least 10 nm.

40. The apparatus of claim 36 wherein said wavelengths are separated by at least 30 nm.

41. The apparatus of claim 36 wherein said blood constituent is arterial oxygen saturation.

42. An oximeter processor comprising:

means for receiving, as an input, signals corresponding to a portion of electromagnetic radiation scattered by the tissue of a patient for each of at least three wavelengths of electromagnetic radiation directed toward a patient; and

means for determining a blood constituent result from a combination of said at least three signals, said result being equivalent to the sum of (1) a first blood constituent estimate determined using a first set of at least two of said signals and (2) a multiplicative factor multiplied by a difference between said first blood constituent estimate and a second blood constituent estimate, said second blood constituent estimate being determined using a second set of a different combination of at least two of said signals.

43. The monitor of claim 42 wherein said result is determined utilizing a formula of the form M=M(1)+f(Δ

) wherein f is a polynomial function and Δ

is the difference between two blood constituent estimates from different waveform combinations.

44. The monitor of claim 42 wherein said blood constituent is arterial oxygen saturation.

45. An oximeter processor comprising:

means for receiving as an input signals corresponding to a portion of electromagnetic radiation scattered by the tissue of a patient for each of at least three wavelengths of electromagnetic radiation directed toward a patient; and

means for determining a blood constituent result utilizing at least one coefficient chosen to compensate for variations in path lengths through said patient of said electromagnetic radiation for at least two of said wavelengths.

46. The monitor of claim 45 wherein said blood constituent is arterial oxygen saturation.

47. A software program product comprising:

a memory having a program stored thereon, said program being usable by a processing device, said program being configured to

receive, as an input, signals corresponding to a portion of the electromagnetic radiation scattered by the tissue of a patient for each of at least three wavelengths of electromagnetic radiation directed toward a patient; and

determine a blood constituent result from a combination of said signals, said result being equivalent to the sum of (1) a first blood constituent estimate determined using a first set of at least two of said signals and (2) a multiplicative factor multiplied by a difference between said first blood constituent estimate and a second blood constituent estimate, said second blood constituent estimate being determined using a second set of a different combination of at least two of said signals.

48. The product of claim 47 wherein said result is determined utilizing a formula of the form M=M(1)+k·

M(1) -M(2)!^p, wherein M(1) is determined utilizing a set of signals comprising at least 2 wavelengths and M(2) is determined utilizing a different set of signals comprising at least 2 wavelengths that are not all equal to the first set, k is a multiplicative factor and p is a exponential factor.

49. The product of claim 47 wherein said result is determined utilizing a formula of the form M=aR₁ +bR₂ +c, wherein R₁ is determined utilizing a set of signals comprising at least 2 wavelengths and R₂ is determined utilizing a different set of signals comprising at least 2 wavelengths that are not all equal to the first set, and a, b, and c are constants.

50. The product of claim 47 wherein said result is determined utilizing a formula of the form M=(1/m₃) (am₁ +bm₂)+c, where m₁, m₂, and m₃ are signal modulation amplitudes emanating from a cardiac pulse determined at 3 different wavelengths, and a, b, and c are constants.

51. The product of claim 47 wherein said result is determined utilizing a formula of the form M=m₃ (a/m₁ +b/m₂)+c, where m₁, m₂, and m₃ are signal modulation amplitudes emanating from a cardiac pulse determined at 3 different wavelengths, and a, b, and c are constants.

52. The product of claim 47 wherein said result is determined utilizing a formula of the form M=M (1)+f(Δ

), wherein f is a polynomial function, Δ

is the difference between two M estimates from different waveform combinations, and M(1) is determined utilizing a set of signals comprising at least 2 wavelengths.

53. The product of any of claims 47-52 wherein said blood constituent is arterial oxygen saturation.

54. The product of claim 47 wherein said multiplicative factor is a function of at least one of said blood constituent estimates.

55. The product of claim 47 wherein said result is determined utilizing a bivariate formula, having three wavelengths and two variables, said variables being said first and second blood constituent estimates.

56. A software program product comprising:

a memory having a program stored thereon, said program being usable by a processing device, said program being configured to

receive as an input signals corresponding to a portion of the electromagnetic radiation scattered by the tissue of a patient for each of at least three wavelengths of electromagnetic radiation directed toward a patient; and

determine a blood constituent result utilizing at least one coefficient chosen to compensate for variations in path lengths through said patient of said electromagnetic radiation for at least two of said wavelengths.

57. The product of claim 56 further comprising means for multiplexing said three wavelengths in said means for emitting.

58. The product of claim 56 wherein said blood constituent is arterial oxygen saturation.