Rapid non-invasive blood pressure measuring device

• US 6,027,452 A
• Filed: 06/26/1996
• Issued: 02/22/2000
• Est. Priority Date: 06/26/1996
• Status: Expired due to Term

• Current Assignee: Masimo Corporation
• Original Assignee: Vital Insite, Inc.
• Inventors: Sher, Mark Henry, Caro, Richard G., Flaherty, Bryan Patrick
• Primary Examiner(s): Nasser, Robert L.
• Application Number:
  US08/672,218
• Time in Patent Office: 1,336 Days
• Field of Search: 600/485, 600/493-6, 600/500-503, 600/561
• US Class Current: 600/485
• CPC Class Codes: A61B 5/02133 by using induced vibration of the blood vessel
• CPC Class Codes: A61B 5/022 by applying pressure to close blood vessels, e.g. against the skin; Ophthalmodynamometers

Abstract

A blood pressure can be obtained by supplying an external pressure to a portion of an artery. The external pressure is preferably between the systolic and diastolic pressure. An event which occurs at least once a cycle can then be identified. This event can be, for example, a peak in the arterial compliance that occurs at a transmural pressure approximately equal to zero. A pair of signals, one that is an arterial volume-indicating signal, and one that is an arterial pressure-indicating signal can be used to identify this event. Alternately, a small signal high-frequency exciter component can be placed upon the pressure or volume of the artery and detected to determine the time that the transmural pressure is equal to zero.

Claims

1. An apparatus comprising:

a device for applying external pressure to an artery, the external pressure being such that the artery experiences a range of transmural pressures within a cardiac cycle; and

a processor adapted to identify an event occurring at a transmural pressure in said range of transmural pressures, the event being associated with a first time, the arterial pressure at said first time not being a systolic or diastolic arterial pressure, the processor further adapted to determine the arterial pressure at a specific time.

2. The apparatus of claim 1, wherein the device varies the external pressure during the cardiac cycle less than the average difference between systolic and diastolic pressure.

3. The apparatus of claim 1, wherein the range in the transmural pressure is primarily due to arterial pressure variation.

4. The apparatus of claim 1, wherein the device applies the external pressure to an artery over a measurement period.

5. The apparatus of claim 4, wherein the device applies a substantially constant external pressure to the artery over the measurement period.

6. The apparatus of claim 5, wherein the substantially constant pressure-applying device comprises a cuff that contains a constant volume of a fluid during the measurement period.

7. The apparatus of claim 5, wherein the processor is adapted to determine said first time that the event occurs without requiring data from outside the measurement period.

8. The apparatus of claim 4, wherein the processor is adapted to determine said first time that the event occurs without requiring data from outside the measurement period.

9. The apparatus of claim 1, wherein the device applies an external pressure not equaling a systolic or diastolic arterial pressure over the cardiac cycle.

10. The apparatus of claim 1, wherein the processor is adapted to determine the arterial pressure at the first time.

11. The apparatus of claim 1, wherein specific time is not the first time.

12. The apparatus of claim 1, further comprising a detector to produce a pressure-indicative signal, wherein the processor is further adapted to calibrate the pressure-indicative signal using the arterial pressure at the specific time.

13. The apparatus of claim 12, wherein the detector is an arterial tonometer.

14. The apparatus of claim 12, wherein the detector is a pressure sensor of a vascular unloading system.

15. The apparatus of claim 1, wherein the processor is adapted to calibrate a pressure-indicative signal using the arterial pressure at the specific time.

16. The apparatus of claim 15, further comprising a pressure wave velocity measurement system to produce the pressure indicative signal.

17. The apparatus of claim 1, wherein the processor is adapted to identify a peak in arterial compliance.

18. The apparatus of claim 1, wherein the processor is adapted to identify the opening or closing of the artery.

19. The apparatus of claim 1, wherein the processor is adapted to identify a change in the viscoelastic properties of a portion of the body.

20. The apparatus of claim 1, wherein the processor is adapted to identify a change in the flow of blood through the artery.

21. The apparatus of claim 1, wherein the processor is adapted to identify an event occurring at a transmural pressure of about zero.

22. The apparatus of claim 1, further comprising a first detector electrically connected to the processor to produce a signal indicative of arterial pressure and a second detector electrically connected to the processor to produce a signal indicative of an arterial volume.

23. The apparatus of claim 22, wherein the processor is adapted to determine the first time of the event from the pressure-indicative signal and the volume-indicative signal.

24. The apparatus of claim 22, wherein the processor is adapted to evaluate volume-indicative values versus pressure-indicative values to help determine a time when the transmural pressure is equal to about zero.

25. The apparatus of claim 22, wherein the first detector comprises a tonometer.

26. The apparatus of claim 22, wherein the first detector comprises an apparatus to measure the velocity of a pressure wave in the artery.

27. The apparatus of claim 22, wherein the second detector comprises a plethysmograph.

28. The apparatus of claim 22, wherein the second detector comprises a pressure transducer on a cuff used to supply the external pressure.

29. The apparatus of claim 1, wherein the processor is adapted to sample signals of external physiological indications.

30. The apparatus of claim 1, further comprising a detector to produce a volume-indicative signal, wherein the processor is further adapted to compare the volume-indicative signal measured with two different external pressures to determine a blood pressure at a time.

31. The apparatus of claim 30, wherein the processor is further adapted to compare the volume-indicative signals at two different time periods, the one of the time periods being such that an external pressure between the systolic and diastolic is applied to sections of the artery.

32. The apparatus of claim 1, further comprising a detector used to detect a signal indicative of the arterial closing or opening.

33. An apparatus comprising:

a device for applying external pressure to an artery, the external pressure being such that the artery experiences a range of transmural pressures within a cardiac cycle;

a processor adapted to identify an event occurring at a transmural pressure in said range of transmural pressures, the event being associated with a first time, the processor further adapted to determine the arterial pressure at a specific time; and

an exciter to induce an oscillating component having a frequency greater than the pulsatile frequencies.

34. The apparatus of claim 33, wherein the exciter induces an oscillating component onto the arterial pressure.

35. The apparatus of claim 33, further comprising a detector to produce a signal indicative of arterial volume.

36. The apparatus of claim 35, further comprising a filter to filter the signal indicative of arterial volume.

37. The apparatus of claim 33, further comprising a detector to produce a signal indicative of arterial pressure.

38. The apparatus of claim 33, further comprising means to put the oscillatory component onto the arterial volume.

39. The apparatus of claim 38, wherein the external pressure-applying means is a cuff for applying external pressure to a section of an artery, the cuff having a chamber adapted to contain a fluid, the oscillatory component means comprising means to produce an oscillation in volume of the fluid of the cuff.

40. A method of determining arterial pressure, comprising:

applying an external pressure to an artery, the external pressure being such that the artery experiences a range of transmural pressures within a cardiac cycle;

identifying an event occurring at a transmural pressure in said range of transmural pressures, the event being associated with a first time, the arterial pressure at said first time not being a systolic or diastolic arterial pressure; and

determining the arterial pressure at a specific time.

41. The method of claim 40, wherein the external pressure varies during the cardiac cycle less than the average difference between systolic and diastolic pressure.

42. The method of claim 40, wherein the range in the transmural pressures is primarily due to arterial pressure variation.

43. The method of claim 40, wherein the external pressure is applied to the artery over a measurement period.

44. The method of claim 43, wherein said first time that the event occurs is determined without requiring data from outside the measurement period.

45. The method of claim 43, wherein the device applies a substantially constant external pressure to the artery over the measurement period.

46. The method of claim 45, wherein the substantially constant pressure-applying device comprises a cuff that contains a constant volume of a fluid during the measurement period.

47. The method of claim 40, wherein the external pressure is not equal to a systolic or diastolic arterial pressure over the cardiac cycle.

48. The method of claim 40, wherein the arterial pressure is determined at the first time.

49. The method of claim 40, wherein specific time is not the first time.

50. The method of claim 40, further comprising producing a pressure-indicative signal, and calibrating the pressure-indicative signal using the arterial pressure.

51. The method of claim 50, wherein the pressure-indicative signal is produced with an arterial tonometer.

52. The method of claim 50, wherein the pressure-indicative signal is produced with a pressure sensor of a vascular unloading system.

53. The method of claim 40, further comprising calibrating a pressure-indicative signal using the arterial pressure.

54. The method of claim 53, wherein the pressure-indicative signal is produced by a pressure wave velocity measurement system.

55. The method of claim 40, further comprising identifying a peak in arterial compliance.

56. The method of claim 40, further comprising identifying the opening or closing of the artery.

57. The method of claim 40, further comprising identifying a change in the viscoelastic properties of a portion of the body.

58. The method of claim 40, further comprising identifying a change in the flow of blood through the artery.

59. The method of claim 40, further comprising identifying an event occurring at a transmural pressure of about zero.

60. The method of claim 40, further comprising producing a signal indicative of arterial pressure and producing a signal indicative of an arterial volume.

61. The method of claim 60, wherein the first time of the event is determined from the pressure-indicative signal and the volume-indicative signal.

62. The method of claim 61, further comprising evaluating volume-indicative values versus pressure-indicative values to help determine a time when the transmural pressure is equal to about zero.

63. The method of claim 60, wherein the pressure-indicative signal is produced by a tonometer.

64. The method of claim 60, wherein the pressure-indicative signal is produced by an apparatus to measure the velocity of a pressure wave in the artery.

65. The method of claim 60, wherein the volume-indicative signal is produced by a plethysmograph.

66. The method of claim 60, wherein the volume-indicative signal is produced by a pressure transducer on a cuff used to supply the external pressure.

67. The method of claim 40, further comprising sampling signals of external physiological indications.

68. The method of claim 40, further comprising producing a volume-indicative signal, and comparing the volume-indicative signal measured with two different external pressures to determine a blood pressure at a time.

69. The method of claim 68, further comprising comparing the volume-indicative signals at two different time periods, the one of the time periods being such that an external pressure between the systolic and diastolic is applied to a section of the artery.

70. The method of claim 40, further comprising a detecting a signal indicative of the arterial closing or opening.

71. A method of determining arterial pressure, comprising:

applying an external pressure to an artery, the external pressure being such that the artery experiences a range of transmural pressures within a cardiac cycle;

inducing an oscillating component having a frequency greater than the pulsatile frequencies;

identifying an event occurring at a transmural pressure in said range of transmural pressures, the event being associated with a first time; and

determining the arterial pressure at a specific time.

72. The method of claim 71, wherein the oscillating component is induced onto the arterial pressure.

73. The method of claim 72, further comprising producing a signal indicative of arterial volume.

74. The method of claim 73, further comprising filtering the signal indicative of arterial volume.

75. The method of claim 71, further comprising producing a signal indicative of arterial pressure.

76. The method of claim 71, further comprising imposing the oscillatory component onto the arterial volume.

77. The method of claim 76, wherein the external pressure-applying step is done with a cuff for applying external pressure to a section of an artery, the cuff having a chamber adapter to contain a fluid, further comprising oscillating the volume of the fluid of the cuff.

78. An apparatus comprising:

a device for applying external pressure to an artery, the external pressure being such that the artery experiences a range of transmural pressures within a cardiac cycle, the device applying a substantially constant external pressure to the artery over the measurement period; and

a processor adapted to identify an event occurring at a transmural pressure in said range of transmural pressures, the event being associated with a first time, the processor further adapted to determine the arterial pressure at a specific time, wherein the processor is adapted to determine said first time that the event occurs without requiring data from outside the measurement period.

79. The apparatus of claim 78, wherein the substantially constant pressure-applying device comprises a cuff that contains a constant volume of a fluid during the measurement period.

80. The apparatus of claim 78, wherein the device applies an external pressure not equaling a systolic or diastolic arterial pressure over the measurement period.

81. The apparatus of claim 78, wherein the processor is adapted to identify a peak in arterial compliance.

82. The apparatus of claim 78, wherein the processor is adapted to identify an event occurring at a transmural pressure of about zero.

83. A method of determining arterial pressure comprising:

applying an external pressure to an artery, the external pressure being such that the artery experiences a range of transmural pressures within a cardiac cycle, a substantially constant external pressure being applied over a measurement period;

identifying an event occurring at a transmural pressure in said range of transmural pressures, the event being associated with a first time; and

determining the arterial pressure at a specific time without requiring data from outside the measurement period.

84. The method of claim 83, wherein the substantially constant pressure-applying device comprises a cuff that contains a constant volume of a fluid during the measurement period.

85. The method of claim 83, wherein the external pressure is not equal to a systolic or diastolic arterial pressure over the measurement period.

86. The method of claim 83, further comprising identifying a peak in arterial compliance.

87. The method of claim 83, further comprising identifying an event occurring at a transmural pressure of about zero.

88. An apparatus comprising:

a device for applying external pressure to an artery, the external pressure being such that the artery experiences a range of transmural pressures within a cardiac cycle; and

a processor adapted to identify an event occurring at a transmural pressure in said range of transmural pressures, the event being associated with a first time, the processor further adapted to determine the arterial pressure at a specific time, the processor being adapted to determine the arterial pressure at the specific time without requiring data from outside the cardiac cycle.

89. A method of determining arterial pressure, comprising:

applying an external pressure to an artery, the external pressure being such that the artery experiences a range of transmural pressures within a cardiac cycle;

identifying an event occurring at a transmural pressure in said range of transmural pressures, the event being associated with a first time; and

determining the arterial pressure at a specific time without requiring data from outside the cardiac cycle.