Artifact rejection using pulse quality values

• US 7,070,566 B2
• Filed: 03/13/2003
• Issued: 07/04/2006
• Est. Priority Date: 03/13/2003
• Status: Active Grant

• Current Assignee: GE Medical Systems Information Technologies Incorporated (General Electric Company)
• Original Assignee: GE Medical Systems Information Technologies Incorporated (General Electric Company)
• Inventors: Hersh, Lawrence T., Medero, Richard, Kolluri, Sai, Friedman, Bruce A.
• Primary Examiner(s): Nasser, Robert L.
• Application Number:
  US10/387,631
• Publication Number:
  US 20040181157A1
• Time in Patent Office: 1,209 Days
• Field of Search: None
• US Class Current: 600/494
• CPC Class Codes: A61B 5/02225 using the oscillometric method

Abstract

A method and system for making pulse rate and blood pressure determinations is disclosed. The method and system comprise collecting oscillometric blood pressure data from pulses, determining individual quality values for feature measurements of the pulses, obtaining an overall quality assessment based on the individual quality values, repeating the collecting step until overall quality level is satisfied, and determining blood pressure and pulse rate using the individual quality values.

Claims

1. A method of making pulse rate and blood pressure determinations comprising:

collecting oscillometric blood pressure data from pulses;

determining individual quality values for feature measurements of the pulses;

obtaining an overall quality assessment based on the individual quality values;

repeating the collecting step until the overall quality assessment satisfies a threshold; and

determining blood pressure and pulse rate based on the oscillometric blood pressure data.

2. The method of claim 1, wherein determining the individual quality values for feature measurements of the pulses comprises using information from pulse oscillations of the current determination as well as previous blood pressure determinations.

3. The method of claim 2, further comprising updating and storing the individual quality values for feature measurements, including at least one of the following measurements:

(a) amplitude, (b) pulse period, (c) time to peak, (d) slope, (e) systolic area, and (f) diastolic area.

4. The method of claim 3, wherein determining individual quality values for feature measurements of the pulses comprises using a pulse period quality function according to an equation having substantially the form:

PPQ(PP₁,PP₂)=100−

(|PP₂−

PP₁|×

100/PP₁)

where PP₁ is a first pulse period and PP₂ is a second subsequent pulse period.

5. The method of claim 3, wherein determining individual quality values for feature measurements of the pulses comprises using a peak match quality function according to an equation having substantially the form:

MPKQ(PK₁,PK₂)=100−

(|PK₂−

PK₁|−

3)×

200/(PK₁+PK₂)

where PK₁ is an amplitude of a first pulse and PK₂ is an amplitude of a second pulse.

6. The method of claim 3, wherein determining individual quality values for feature measurements of the pulses comprises using a slope quality function according to an equation having substantially the form:

SLPQ(SLP₁,SLP₂)=100−

(|SLP₂−

SLP₁|)×

200/(SLP₁+SLP₂)

where SLP₁ is a slope for a first complex and SLP₂ is a slope of a second complex.

7. The method of claim 3, wherein determining individual quality values for feature measurements of the pulses comprises using a time to peak quality function according to an equation having substantially the form:

T2PQ(T₁,T₂)=100−

(|T₂−

T₁|)×

200/(T₁+T₂)

where T₁ is a time to peak for a first complex and T₂ is a time to peak for a second complex.

8. The method of claim 3, wherein determining individual quality values for feature measurements of the pulses comprises using a last slope quality function according to an equation having substantially the form:

LSLPQ(SLP₁,LSLP₂)=Quality(SLP₁,LSLP₂)

where SLP₁ is a slope for a first complex and LSLP₂ is a slope of a second complex obtained from a previous pressure step in the determination.

9. The method of claim 3, wherein determining individual quality values for feature measurements of the pulses comprises using a last time to peak quality function according to an equation having substantially the form:

LT2PQ(T2P₁,LT2P₂)=Quality(T2P₁,LT2P₂)

where T2P₁ is a time to peak for a first complex and LT2P₂ is a time to peak for a second complex obtained from a previous pressure step in the determination.

10. The method of claim 3, wherein determining individual quality values for feature measurements of the pulses comprises using an envelope quality function according to an equation having substantially the form:

QNORM(X₁,X₂)=100−

(|X₂−

X₁|)×

100/(X₁)

QADJ1(X₁,X₂)=100−

(|X₂−

2×

X₁|)×

100/(2×

X₁)

QADJ2(X₁,X₂)=100−

(|X₂−

0.875×

X₁|)×

100/(0.875×

X₁)

QADJ3(X₁,X₂)=100−

(|X₂−

1.125×

X₁|)×

100/(1.125×

X₁)

where X₁ is a complex size from a first complex obtained during a present determination and X₂ is a complex size obtained from using a previous curve fit to predict complex size.

11. The method of claim 10, wherein the envelope quality function is determined according to the following statements when cuff pressure is above systolic value:

If X₁≦

X₂, THEN ENVQ(X₁,X₂)=QNORM(X₁,X₂)

If X₂<

X₁≦

2×

X₂, THEN ENVQ(X₁,X₂)=100

If X₁>

2×

X₂, THEN ENVQ(X₁,X₂)=QADJ1(X₁,X₂)

where X₁ is a complex size from a first complex obtained during a present determination and X₂ is a complex size obtained from using a previous curve fit to predict complex size.

12. The method of claim 10, wherein the envelope quality function is determined according to the following statements when cuff pressure approximates MAP value:

If X₁≦

0.5×

X₂, THEN ENVQ(X₁,X₂)=1

If X₁≧

2×

X₂, THEN ENVQ(X₁,X₂)=1

If 0.5×

X₂<

X₁≦

0.875×

X₂, THEN ENVQ(X₁,X₂)=QADJ2(X₁,X₂)

If 0.875×

X₂<

X₁<

2×

X₂, THEN ENVQ(X₁,X₂)=QADJ3(X₁,X₂)

where X₁ is a complex size from a first complex obtained during a present determination and X₂ is a complex size obtained from using a previous curve fit to predict complex size.

13. The method of claim 10, wherein the envelope quality function is determined according to the following statements when cuff pressure is not above systolic and not near MAP:

If X₁≦

0.5×

X₂, THEN ENVQ(X₁,X₂)=1

If X₁≧

2×

X₂, THEN ENVQ(X₁,X₂)=1

If 0.5×

X₂<

X₁<

2×

X₂, THEN ENVQ(X₁,X₂)=QNORM(X₁,X₂)

where X₁ is a complex size from a first complex obtained during a present determination and X₂ is a complex size obtained from using a previous curve fit to predict complex size.

14. The method of claim 3, wherein obtaining the overall quality assessment based on the individual quality values comprises using an equation having substantially the form:

Q(MPJQ,SLPQ,PPQ,ENVQ)=[(MPKQ×

SLPQ)/100×

T2PQ]/50+[(PPQ+ENVQ)/2])/3

where Q(MPJQ, SLPQ, PPQ, ENVQ) is an overall quality value, MPKQ is a peak match quality value, SLPQ is a slope quality value, PPQ is a pulse period quality value, and ENVQ is an envelope quality value.

15. The method of claim 1, wherein determining individual quality values for feature measurements of the pulses comprises using a QRS to Peak function according to an equation having substantially the form:

QRS2P(EM₁,EM₂)=100−

(|EM₂−

EM₁|)×

100/EM₁

where EM₁ is a time period from R-wave in the ECG QRS complex to the peak of the oscillometric pulse (e.g., T -QRS to peak in FIG. 4F), and EM₂ is a time period between the same points from a subsequent pulse.

16. The method of claim 1, wherein determining individual quality values for feature measurements of the pulses comprises using a QRS to start function according to an equation having substantially the form:

QRS2F(EM₁,EM₂)=100−

(|EM₂−

EM₁|)×

100/EM₁

where EM₁ is a time period from R-wave in the ECG QRS complex to the start of the oscillometric pulse (e.g., T−

QRS to start in FIG. 4F), and EM₂ is a time period between the same points from a subsequent pulse.

17. The method of claim 1, further comprising rejecting pulses with individual quality values that do not meet threshold limits.

18. A method of making pulse rate and blood pressure determinations comprising:

processing oscillometric waveform data by passing a cuff pressure signal through at least one filter;

evaluating whether the oscillometric waveform data satisfies matching criteria including determining individual quality values for feature measurements of pulses, obtaining an overall quality assessment based on the individual quality values, and collecting data until a predetermined overall quality limit is satisfied; and

determining blood pressure and pulse rate based on the oscillometric waveform data.

19. The method of claim 18, wherein the evaluating step further comprises updating and storing the individual quality values during a current determination.

20. The method of claim 19, wherein determining the individual quality values for feature measurements of the pulses comprises using information from pulse oscillations of the current determination as well as previous blood pressure determinations.

21. The method of claim 18, wherein the evaluating step further comprises updating and storing the individual quality values for feature measurements including at least one of the following measurements:

(a) amplitude, (b) pulse period, (c) time to peak, (d) slope, (e) systolic area, and (f) diastolic area.

22. The method of claim 18, wherein the evaluating step further comprises rejecting pulses with individual quality values that do not satisfy threshold limits.

23. The method of claim 18, wherein the processing step comprises passing a cuff pressure signal through a low-pass filter for eliminating noise from the signal, thereby creating low-pass filter data.

24. The method of claim 23, further comprising passing the signal through a band-pass filter for locating at least one principal time point in the signal.

25. The method of claim 24, further comprising transferring the time of at least one principal time point of the band-pass filter to the low-pass filter data to help identify and estimate features of that low-pass filtered signal.

26. The method of claim 18, further comprising processing an ECG signal.

27. The method of claim 26, further comprising using the ECG signal in evaluating the oscillometric blood pressure data.

28. An apparatus for measuring blood pressure and pulse rate comprising:

an inflatable cuff;

a pressurizing apparatus coupled to the cuff for selectively applying pressure by inflating or deflating the cuff;

a cuff pressure sensor coupled to the cuff for sensing cuff pressure and blood pressure oscillations;

a programmed control device configured to control the pressure cuff and pressurizing apparatus, collect oscillometric blood pressure data from pulses, determine individual quality values for feature measurements of the pulses, obtain an overall quality assessment based on the individual quality values, continue to collect data until the overall quality assessment satisfies a threshold, and determine blood pressure and pulse rate based on the oscillometric blood pressure data.

29. The apparatus of claim 28, wherein the programmed control device is configured to determine the individual quality values for feature measurements of the pulses based on information from pulse samples of the current determination as well as previous blood pressure determinations.

30. The apparatus of claim 29, wherein the programmed control device is configured to determine the individual quality values for feature measurements including at least one of the following measurements:

(a) amplitude, (b) pulse period, (c) time to peak, (d) slope, (e) systolic area, and (t) diastolic area.

31. The apparatus of claim 30, wherein the programmed control device is configured to reject pulses with individual quality values that do not satisfy threshold limits.

32. The apparatus of claim 28, wherein the programmed control device is further configured to process an ECG signal to evaluate the oscillometric blood pressure data.

33. The apparatus of claim 28, wherein the programmed control device is further configured to pass a cuff pressure signal through a low-pass filter to eliminate noise from the signal and thereby create low-pass filter data, and pass the signal through a band-pass filter for locating at least one principal time point in the signal.

34. The apparatus of claim 33, wherein the programmed control device is further configured to translate at least one key point in time to the low-pass filter data, and to measure and store for one or more complexes at least one of the following feature measurements:

(a) amplitude, (b) pulse period, (c) time to peak, (d) slope, (e) systolic area, and (f) diastolic area.

35. A system for making pulse rate and blood pressure determinations comprising:

means for collecting oscillometric blood pressure data from pulses;

means for determining individual quality values for feature measurements of the pulses;

means for obtaining an overall quality assessment based on function that weights the individual quality values;

means for collecting data until the overall quality assessment satisfies a threshold; and

means for determining blood pressure and pulse rate based on the oscillometric blood pressure data.

36. A computer program system comprising:

a computer useable medium having computer logic for enabling at least one processor in a computer system to make pulse rate and blood pressure determinations;

means for processing oscillometric blood pressure data by passing a cuff pressure signal through at least one filter;

means for evaluating whether the oscillometric blood pressure data meets matching criteria including determining associated individual quality values for feature measurements of the pulses, obtaining an overall quality assessment based on the individual quality values, and collecting data until a predetermined overall quality limit is met; and

means for determining blood pressure and pulse rate based on the oscillometric blood pressure data.