Method and system for cuff pressure reversions

• US 7,186,218 B2
• Filed: 02/27/2003
• Issued: 03/06/2007
• Est. Priority Date: 02/27/2003
• 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): Marmon, II; Charles A
• Assistant Examiner(s): Natnithithadha; Navin
• Application Number:
  US10/375,409
• Publication Number:
  US 20040171943A1
• Time in Patent Office: 1,468 Days
• Field of Search: 600490-499, 600/481, 600/485
• US Class Current: 600/496
• CPC Class Codes: A61B 5/02225 using the oscillometric method
• CPC Class Codes: A61B 5/0225 the pressure being controlled by electric signals, e.g. derived from Korotkoff sounds
• CPC Class Codes: A61B 5/7207 of noise induced by motion artifacts

Abstract

A method and system for determining when to make a reversion to smaller cuff pressure steps during an oscillometric blood pressure measurement is disclosed. The method and system comprise comparing conformance of oscillometric envelope blood pressure data with previous blood pressure data, including measuring a shift between the oscillometric envelope blood pressure data and an oscillometric envelope derived from the previous blood pressure data. In addition, the method and system include making a reversion decision based on whether the shift exceeds an allowable threshold. Once a reversion decision is made a subsequent decision may be made as to the need for increasing the cuff pressure level.

Claims

1. A method of determining when to make a reversion to smaller cuff pressure steps during an oscillometric blood pressure measurement, comprising:

comparing conformance of oscillometric envelope blood pressure data with previous blood pressure data, including measuring a shift between the oscillometric envelope blood pressure data and an oscillometric envelope derived from the previous blood pressure data;

and making a reversion decision based on whether the shift exceeds an allowable threshold.

2. The method of claim 1, wherein making a reversion decision further includes evaluating whether the shift has been consistently present in the oscillometric envelope blood pressure data.

3. The method of claim 2, wherein making a reversion decision further includes evaluating whether the shift is positive or negative.

4. The method of claim 3, wherein making a reversion decision further includes evaluating whether a lowest complex size on a diastolic side of the oscillometric envelope blood pressure data exceeds an allowable threshold.

5. The method of claim 4, wherein the allowable threshold is about 50% of a maximum complex size in the oscillometric envelope blood pressure data.

6. The method of claim 1, further comprising:

evaluating whether oscillometric envelope amplitudes exceed an allowable tolerance from the previous blood pressure data; and

making a reversion decision based on whether the oscillometric envelope amplitudes exceed the allowable tolerance.

7. The method of claim 6, wherein making a reversion decision further includes evaluating whether the oscillometric envelope amplitudes have consistently exceeded the allowable tolerance.

8. The method of claim 1, further comprising evaluating whether an oscillometric envelope acquisition process has been completed, and wherein making a reversion decision further includes determining whether the envelope acquisition process has been completed.

9. The method of claim 8, further comprising evaluating whether a sufficient number of oscillometric envelope data points have been obtained from cuff pressure steps on systolic and diastolic sides of the oscillometric envelope blood pressure data.

10. The method of claim 8, wherein making a reversion decision further includes evaluating whether a lowest complex size on a diastolic side of the oscillometric envelope blood pressure data exceeds an allowable threshold in order to decide whether a cuff pressure change should be made.

11. The method of claim 10, wherein the allowable threshold is about 50% of a maximum complex size in the oscillometric envelope blood pressure data.

12. The method of claim 1, wherein measuring the shift includes using an envelope curve fit technique.

13. The method of claim 12, wherein the envelope curve fit technique includes use of the following equation:

Ai=Ae<sup>−

((Pi−

B)2/C)</sup>=f(Pi,A,B,C)

where A, B and C are parameters that set amplitude, mean and spread of a previous blood pressure envelope, Ai is oscillation amplitude of a specific envelope data point, and Pi is cuff pressure of a specific envelope data point.

14. The method of claim 1, wherein measuring the shift includes an estimation of a blood pressure shift.

15. The method of claim 14, wherein measuring the shift includes estimating a blood pressure shift according to the following equation:

Bnew−

B=Pi±

√

{square root over ((C ln(A/Ai))}−

B

where A, B and C are parameters that set amplitude, mean and spread of a previous blood pressure envelope, Ai is oscillation amplitude of a specific envelope data point in a current blood pressure determination, and Pi is cuff pressure of a specific envelope data point in a current blood pressure determination.

16. The method of claim 1, wherein the allowable threshold is determined using a threshold calculation.

17. The method of claim 16, wherein the threshold calculation includes the use of the following equation:

|(Ai−

f(Pi,A,B,C))/f(Pi,A,B,C)|

where A, B and C are parameters that set amplitude, mean and spread of a previous blood pressure envelope, Ai is oscillation amplitude of a specific envelope data point in a current determination, and where Pi is cuff pressure of a specific envelope data point in the current determination.

18. An apparatus for measuring blood pressure 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; and

a programmed control device configured to;

control the pressure cuff and pressurizing apparatus;

compare conformance of oscillometric envelope blood pressure data with previous blood pressure data, including measuring a shift between the oscillometric envelope blood pressure data and an oscillometric envelope derived from the previous blood pressure data; and

make a reversion decision based on whether the shift exceeds an allowable threshold.

19. The apparatus of claim 18, wherein the programmed control device is further configured to:

evaluate whether oscillometric envelope amplitudes exceed an allowable tolerance from the previous blood pressure data; and

make a reversion decision based on whether the oscillometric envelope amplitudes exceed the allowable tolerance.

20. The apparatus of claim 19, wherein the programmed control device is further configured to:

evaluate whether an oscillometric envelope acquisition process has been completed; and

make a reversion decision based on whether the envelope acquisition process has been completed.

21. A system for determining when to make a reversion to smaller cuff pressure steps during oscillometric envelope blood pressure determinations comprising:

means for comparing conformance of oscillometric envelope blood pressure data with previous blood pressure data, including measuring a shift between the oscillometric envelope blood pressure data and an oscillometric envelope derived from the previous blood pressure data; and

means for making a reversion decision based on whether the shift exceeds an allowable threshold.

22. A computer program product comprising:

computer useable medium having computer logic for enabling at least one processor in a computer system to determine when to make a reversion to smaller cuff pressure steps during oscillometric envelope blood pressure determinations;

means for comparing conformance of oscillometric envelope blood pressure data with previous blood pressure data, including measuring a shift between the oscillometric envelope blood pressure data and an oscillometric envelope derived from the previous blood pressure data; and

means of making a reversion decision based on whether the shift exceeds an allowable threshold.