Apparatuses and methods for a noninvasive measurement of physiological parameters

• US 6,228,033 B1
• Filed: 11/15/1999
• Issued: 05/08/2001
• Est. Priority Date: 05/14/1997
• Status: Expired due to Fees

• Current Assignee: Ants Aher, Heiki Silem, Jurgen Lamp, Tiit Koobi
• Original Assignee: Ants Aher, Heiki Silem, Jurgen Lamp, Tiit Koobi
• Inventors: Aher, Ants, Lamp, Jurgen, Koobi, Tiit
• Primary Examiner(s): O'Connor, Cary
• Assistant Examiner(s): CARTER, RYAN CHRISTOPHER
• Application Number:
  US09/423,879
• Time in Patent Office: 540 Days
• Field of Search: 600/481, 600/483-488, 600/490, 600/500, 600/504-506, 600/513, 600/529, 600/531-538, 600/547
• US Class Current: 600/483
• CPC Class Codes: A61B 5/02007 Evaluating blood vessel condition, e.g. elasticity, compliance
• CPC Class Codes: A61B 5/0205 Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
• CPC Class Codes: A61B 5/0245 by using sensing means generating electric signals, i.e. ECG signals
• CPC Class Codes: A61B 5/029 Measuring or recording blood output from the heart, e.g. minute volume A61B8/065 takes precedence
• CPC Class Codes: A61B 5/0295 using plethysmography, i.e. measuring the variations in the volume of a body part as modified by the circulation of blood therethrough, e.g. impedance plethysmography
• CPC Class Codes: A61B 5/0537 Measuring body composition by impedance, e.g. tissue hydration or fat content
• CPC Class Codes: A61B 5/087 Measuring breath flow
• CPC Class Codes: A61B 5/412 Detecting or monitoring sepsis
• CPC Class Codes: A61B 5/4869 Determining body composition

Abstract

The present invention relates to apparatuses and methods for measuring three important physiological systems, circulation, breathing, and body water compartments. More specifically, the present invention relates to apparatuses and methods for a continuous simultaneous/synchronized and noninvasive measurement of heart pump function, elastic properties of the vascular system, systemic vascular resistance, breathing capacity, and body water compartments through the combined use of bioimpedance and continuous blood pressure measurement techniques (5, 6) and, optionally, spirometry (7) and/or plethysmography.

Claims

1. An apparatus for a simultaneous/synchronized noninvasive measurement of cardiorespiratory and related parameters comprising

a bioimpedance measuring means (5) connectable to the body of the patient for injecting a current to a first outer body segment and sensing the voltage in the first and second inner body segments for generating output signals (53, 54, 55, 56, 57), characterized in that the apparatus further comprises

a pressure sensoring means (6) for the measurement of blood pressure, said sensoring means being connected to the bioimpedance measuring means (5) for generating a blood pressure output signal,

a respiratory flow sensor (7) for measuring the patient'"'"'s respiration continuously, said respiratory flow sensor being connected to the bioimpedance measuring means (5) for generating a respiratory flow output signal, and

a calculating means (83) for calculating cardiorespiratory and related parameters using said output signals.

2. The apparatus of claim 1, characterized in that the bioimpedance measuring means comprises

a current source having a high-frequency current output;

means (31, 32) for injecting the output of said current source into the first outer segment of the patient to cause current flow in said first and second inner segments;

first sensing means (11, 12, 11′

, 12′

) for sensing a voltage caused by said current flow through the first inner segment of the patient, said voltage having a magnitude that varies in accordance with changes in electrical impedance of first outer body segment caused by the flow of blood in the first and second body segment during each cardiac cycle;

second sensing means (21, 22) for sensing a voltage caused by said current flow through the second inner segment of the patient, said voltage having a magnitude that varies in accordance with changes in electrical impedance of first outer body segment caused by the flow of blood in the second body segment during each cardiac cycle; and

an electronic circuit connected to said first and second sensing means, said electronic circuit receiving said voltage sensed by said sensing means and generating output signals having a magnitude that changes in accordance with the flow of blood in the first segment during each cardiac cycle.

3. The apparatus of claim 1, characterized in that said calculating means further comprises a computational circuit block (83) that is responsive to said output signals from said bioimpedance measuring means.

4. The apparatus of claim 1, characterized in that the apparatus further comprises input means (81) connected to said computational circuit block for providing data thereto.

5. The apparatus of claim 1, characterized in that the apparatus further comprises a display device (85) connected to said calculating means (83), said display device displaying the calculated data.

6. A method for continuously, simultaneously/synchronously noninvasively measuring cardiorespiratory and related parameters in a patient by

electrically connecting a bioimpedance device to the distal parts of the arms and legs of a patient through a first set of electrodes comprising at least one current injecting electrode for a leg and one for an arm and at least one voltage sensing electrode for a leg and one for an arm,

injecting a first high-frequency constant alternating current via the current injecting electrode(s) and sensing the pulsatile voltage variations in the whole body generated by the electrical impedance of the tissues and the fluids in the whole body and obtaining electrocardiographic signals (ECG) from the heart and, alternating with said first current,

injecting high-frequency constant alternating currents of predetermined different fixed frequencies via said current injecting electrode(s) and sensing different voltages caused by the different high-frequency currents in the body, and

electrically connecting the bioimpedance device to different body segments of the patient through a second set of electrodes comprising at least one pair of sensing electrodes for sensing the pulsatile voltage changes in said segments caused by said first injected current in body segments,

characterized in that the method further comprises the steps of

electrically connecting a pressure sensor to a suitable location on the patient for measuring the blood pressure,

electrically connecting a respiratory flow sensor to the patient'"'"'s mouth/nose for measuring the patient'"'"'s respiration continuously, and thereafter

amplifying and digitizing the voltages sensed by said first sensing electrodes, the voltage changes sensed by said second sensing electrodes and the signals obtained from the pressure sensor and the respiratory flow sensor,

transmitting the digitized data to a computational circuit block for calculating the desired cardiorespiratory and related parameters, and

displaying the calculated data on a display with the on-line processed measurement results.

7. A method of claim 6, characterized in that the method further comprises a step of performing a conventional plethysmographic measurement in the extremities of the patient.

8. A method of claim 6, characterized in that the cardiorespiratory and related parameters to be calculated are the stroke volume, the stroke index, the heart rate, the cardiac output, the pulse wave velocity, the arterial compliance, stroke volume distribution index, the breathing frequency and amplitude, and the body water compartments and optionally, where the blood pressure sensor is used calculating the systolic arterial pressure, the diastolic arterial pressure, the mean arterial pressure, the systemic vascular resistance index, the left cardiac work, the left cardiac work index, and the arterial compliance.

9. A method of claim 7, characterized in that the cardiorespiratory and related parameters to be calculated are the stroke volume, the stroke index, the heart rate, the cardiac output, the pulse wave velocity, the arterial compliance, stroke volume distribution index, the breathing frequency and amplitude, and the body water compartments and optionally, where the blood pressure sensor is used calculating the systolic arterial pressure, the diastolic arterial pressure, the mean arterial pressure, the systemic vascular resistance index, the left cardiac work, the left cardiac work index and the arterial compliance.