Method and system for assessing breathing effectiveness via assessment of the dynamic arterial pressure wave using the oscillometric measurement technique

• US 7,458,937 B2
• Filed: 01/11/2005
• Issued: 12/02/2008
• Est. Priority Date: 01/11/2005
• Status: Expired due to Fees

• Current Assignee: Coherence LLC
• Original Assignee: Coherence LLC
• Inventors: Elliott, Stephen Bennett
• Primary Examiner(s): Nasser, Robert L
• Application Number:
  US11/032,662
• Publication Number:
  US 20060155167A1
• Time in Patent Office: 1,421 Days
• Field of Search: None
• US Class Current: 600/485
• CPC Class Codes: A61B 5/021 Measuring pressure in heart or blood vessels A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/02225 using the oscillometric method
• CPC Class Codes: A61B 5/0816 Measuring devices for examining respiratory frequency measuring frequency of electric signals G01R23/00

Abstract

The present invention specifies a method and system for assessing breathing effectiveness via dynamic assessment of respiratory sinus arrhythmia and the consequent arterial pressure wave using the oscillometric measurement technique. Arterial pressure wave peak pressure, valley pressure, amplitude, and rate are characterized and displayed for diagnostic and remedial purposes. The dynamic change in respiratory sinus arrhythmia and resultant arterial pressure wave is visually presented in real time as user biofeedback. A respiratory sinus arrhythmia generator generates varying frequencies to which the user synchronizes their breathing cycle for purposes of increasing arterial pressure wave amplitude with a consequent increase in breathing depth and decrease in breathing frequency. An instructive method in the application of the present invention is also specified.

Claims

1. A method for assessing breathing optimality of a patient comprising:

measuring a varying breathing induced arterial pressure wave of a patient;

assessing optimality of a breathing process of the patient based on the measured arterial pressure wave; and

providing a characterization to the patient of the optimality of the patient'"'"'s breathing process based on the measured arterial pressure wave.

2. The method of claim 1 wherein measuring the varying breathing induced arterial pressure wave of the patient comprises measuring a varying pulse pressure of the patient via oscillometry.

3. The method of claim 1 wherein measuring the varying breathing induced arterial pressure wave of the patient comprises measuring one or more from the group consisting of a pulse pressure amplitude of the patient, pulse pressure periodicity of the patient, and coherence of the patient.

4. The method of claim 1 wherein measuring the varying breathing induced arterial pressure wave of the patient comprises measuring oscillometric characteristics of the arterial pressure wave of the patient over a measurement interval including multiple breathing cycles;

and

wherein assessing optimality of a breathing process of the patient based on the measured arterial pressure wave comprises assessing changes in the arterial pressure wave pressure of the patient over the measurement interval using the oscillometric characteristics.

5. The method of claim 1 wherein assessing the optimality of a breathing process of the patient is performed for an approximate 60 second period defining an arterial pressure wave assessment cycle and further comprises:

sustaining a pulse oscillation for the approximate 60 second period by gradually reducing a cuff pressure; and

measuring multiple arterial pressure wave cycles of the patient during the arterial pressure wave assessment cycle.

6. The method of claim 1 wherein measuring the varying breathing induced arterial pressure wave of the patient further comprises

detecting cardiac systole of the patient;

and

detecting pulse oscillations of the patient corresponding to the cardiac systole occurring at the peak of the breathing induced arterial pressure wave.

7. The method of claim 1 wherein measuring the varying breathing induced arterial pressure wave of the patient comprises:

measuring an oscillometric pulse oscillation amplitude of the patient; and

measuring an arterial pressure wave amplitude of the patient as a function of the measured oscillometric pulse oscillation amplitude of the patient, and

wherein providing a characterization to the patient of the optimality of the patient'"'"'s breathing process based on the measured arterial pressure wave comprises displaying the arterial pressure wave amplitude of the patient on a display for diagnostic and remedial purposes.

8. The method of claim 1 wherein measuring the varying breathing induced arterial pressure wave of the patient comprises:

measuring an oscillometric pulse oscillation periodicity of the patient; and

measuring an arterial pressure wave rate of the patient as a function of the oscillometric pulse oscillation periodicity, and

wherein providing a characterization to the patient of the optimality of the patient'"'"'s breathing process based on the measured arterial pressure wave comprises displaying the arterial pressure wave rate of the patient on a display for diagnostic and remedial purposes.

9. The method of claim 1 wherein measuring the varying breathing induced arterial pressure wave of the patient comprises:

measuring an oscillometric pulse oscillation amplitude of the patient;

measuring an actual variation in arterial pressure wave amplitude representative of changes in arterial pressure wave pressure of the patient as a function of changes in the oscillometric pulse oscillation amplitude of the patient; and

wherein providing a characterization to the patient of the optimality of the patient'"'"'s breathing process based on the measured arterial pressure wave comprises displaying the actual variation in arterial pressure wave amplitude for the patient for diagnostic and remedial purposes.

10. The method of claim 1 wherein measuring the varying breathing induced arterial pressure wave of the patient further comprises:

detecting cardiac diastole of the patient; and

detecting pulse oscillations of the patient corresponding to the cardiac diastole occurring at the valley of the breathing induced arterial pressure wave.

11. The method of claim 1 wherein providing a characterization to the patient of the optimality of the patient'"'"'s breathing process based on the measured arterial pressure wave comprises displaying measured values associated with the varying breathing induced arterial pressure wave on a display.

12. The method of claim 1 further comprising instructing the patient on a breathing cycle based on the characterization to the patient of the optimality of the patient'"'"'s breathing process based on the measured arterial pressure wave.

13. The method of claim 12 wherein instructing the patient on a breathing cycle based on the characterization to the patient of the optimality of the patient'"'"'s breathing process based on the measured arterial pressure wave comprises generating target breathing frequencies of 5, 6, 7, 8, 9, 10, 15, 20, and 30 breathing cycles per minute to instruct the patient on how to synchronize their breathing cycle with the target breathing frequency.

14. The method of claim 12 wherein instructing the patient on a breathing cycle based on the characterization to the patient of the optimality of the patient'"'"'s breathing process based on the measured arterial pressure wave comprises providing an audible chime to the patient that sounds at a peak of desired inhalation and at a peak of desired exhalation.

15. The method of claim 12 wherein instructing the patient on a breathing cycle based on the characterization to the patient of the optimality of the patient'"'"'s breathing process based on the measured arterial pressure wave comprises:

providing a target breathing frequency and an actual breathing frequency of the patient on a display; and

providing an output to the patient such that the target breathing frequency and actual breathing frequency of the patient are correlated to each other to facilitate the patient breathing in synchrony with the target breathing frequency to bring the actual breathing frequency of the patient into amplitude and time alignment with the target breathing frequency.

16. The method of claim 12 wherein instructing the patient on a breathing cycle based on the characterization to the patient of the optimality of the patient'"'"'s breathing process based on the measured arterial pressure wave comprises:

providing a target breathing reference to the patient; and

instructing the patient to breathe to increase an amplitude of the varying breathing induced arterial pressure wave of the patient to match an amplitude of the target breathing reference.

28. The system of claim 15 wherein the processing module is adapted to instruct the patient on a breathing cycle based on the characterization to the patient of the optimality of the patient'"'"'s breathing process based on the measured arterial pressure wave by being adapted to provide an audible chime to the patient that sounds at a peak of desired inhalation and at a peak of desired exhalation.

29. The system of claim 15 wherein the processing module is adapted to instruct the patient on a breathing cycle based on the characterization to the patient of the optimality of the patient'"'"'s breathing process based on the measured arterial pressure wave by being adapted to provide a target breathing induced arterial pressure wave amplitude and an actual breathing induced arterial pressure wave amplitude of the patient on a display;

and

is further adapted to provide an output to the patient such that the target breathing induced arterial pressure wave amplitude and actual breathing induced arterial pressure wave amplitude of the patient are correlated to each other to facilitate the patient breathing in synchrony with the target breathing frequency to bring the actual breathing induced arterial pressure wave of the patient into amplitude and time alignment with the target arterial pressure wave amplitude.

17. A system for assessing breathing optimality of a patient comprising:

a display module for providing information to a patient;

an oscillometric pulse detector adapted to determine an oscillometric pulse of the patient; and

a processing module adapted to;

measure a varying breathing induced arterial pressure wave of the patient based upon the oscillometric pulse;

assess optimality of a breathing process of the patient based on the measured arterial pressure wave; and

provide a characterization to the patient of the optimality of the patient'"'"'s breathing process based on the measured arterial pressure wave.

18. The system of claim 17 wherein the processing module is adapted to measure the varying breathing induced arterial pressure wave of the patient based upon the oscillometric pulse by being adapted to measure a varying pulse pressure of the patient based upon the oscillometric pulse.

19. The system of claim 17 wherein the processing module is further adapted to measure the varying breathing induced arterial pressure wave of the patient based upon the oscillometric pulse by one of the group consisting of a pulse pressure amplitude of the patient, a pulse pressure periodicity, and a coherence of the patient.

20. The system of claim 17 wherein the processing module is further adapted to

measure the varying breathing induced arterial pressure wave of the patient based upon the oscillometric pulse by being adapted to measure oscillometric characteristics of the varying breathing induced arterial pressure wave over a measurement interval including multiple breathing cycles and

assessing pressure changes in the varying breathing induced arterial pressure wave over the measurement interval using the oscillometric characteristics.

21. The system of claim 17 wherein the processing module is further adapted to assess optimality of a breathing process of the patient based on the measured arterial pressure wave by being adapted to:

sustain a pulse oscillation for an approximate 60 second period defining an arterial pressure wave assessment cycle by gradually reducing cuff pressure; and

measure multiple arterial pressure wave cycles during the arterial pressure wave assessment cycle.

22. The system of claim 17 wherein the processing module is further adapted to measure the varying breathing induced arterial pressure wave of the patient based upon the oscillometric pulse by being adapted to detect cardiac systole and to detect pulse oscillations corresponding to the cardiac systole of the patient occurring at the peak of the breathing induced arterial pressure wave.

23. The system of claim 17 wherein the processing module is further adapted to measure a varying breathing induced arterial pressure wave of the patient based upon the oscillometric pulse by being adapted to:

measure an oscillometric pulse oscillation amplitude based upon the oscillometric pulse of the patient;

measure an arterial pressure wave amplitude as a function of the oscillometric pulse oscillation amplitude; and

wherein the processing module is further adapted to display the arterial pressure wave amplitude of the patient for diagnostic and remedial purposes on the display module.

24. The system of claim 17 wherein the processing module is further adapted to measure a varying breathing induced arterial pressure wave of the patient based upon the oscillometric pulse by being adapted to:

measure an oscillometric pulse oscillation periodicity based upon the oscillometric pulse;

measure an arterial pressure wave rate as a function of the oscillometric pulse oscillation periodicity; and

wherein the processing module is further adapted to display the arterial pressure wave rate of the patient for diagnostic and remedial purposes on the display module.

25. The system of claim 17 wherein the processing module is further adapted to measure a varying breathing induced arterial pressure wave of the patient based upon the oscillometric pulse by being adapted to:

measure an oscillometric pulse oscillation amplitude based upon the oscillometric pulse;

measure an actual breathing induced amplitude variation representative of changes in arterial pressure wave pressure as a function of changes in the oscillometric pulse oscillation amplitude; and

wherein the processing module is further adapted to display the actual breathing induced amplitude variation of the patient for diagnostic and remedial purposes on the display module.

26. The system of claim 17 wherein the processing module is further adapted to instruct the patient on a breathing cycle based on the characterization to the patient of the optimality of the patient'"'"'s breathing process based on the measured arterial pressure wave.

27. The system of claim 26 wherein the processing module is adapted to instruct the patient on a breathing cycle based on the characterization to the patient of the optimality of the patients breathing process based on the measured arterial pressure wave by being adapted to provide a target breathing reference to the patient;

and

instructing the patient to breathe to increase an amplitude of the varying breathing induced arterial pressure wave of the patient to match an amplitude of the target breathing reference.

30. The system of claim 17 wherein the processing module is adapted to measure the varying breathing induced arterial pressure wave of the patient by being adapted to:

detect cardiac diastole of the patient; and

detect pulse oscillations of the patient corresponding to the cardiac diastole occurring at the valley of the breathing induced arterial pressure wave.