Non-invasive blood pressure monitor with improved performance

• US 7,678,059 B2
• Filed: 10/12/2005
• Issued: 03/16/2010
• Est. Priority Date: 10/12/2005
• Status: Active Grant

• Current Assignee: General Electric Company
• Original Assignee: General Electric Company
• Inventors: Hersh, Lawrence T., Kolluri, Sai, Friedman, Bruce A.
• Primary Examiner(s): Marmor, II; Charles A
• Assistant Examiner(s): JANG, CHRISTIAN YONGKYUN
• Application Number:
  US11/248,099
• Publication Number:
  US 20070106163A1
• Time in Patent Office: 1,616 Days
• Field of Search: 600/485, 600/493, 600/494, 600/496
• US Class Current: 600/485
• CPC Class Codes: A61B 5/02125 of pulse wave propagation time
• CPC Class Codes: A61B 5/02225 using the oscillometric method
• CPC Class Codes: A61B 5/02255 the pressure being controlled by plethysmographic signals, e.g. derived from optical sensors
• CPC Class Codes: A61B 5/0535 Impedance plethysmography for measuring blood flow A61B5/0295
• CPC Class Codes: A61B 5/145 Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissuemeasuring of blood pressure or blood flow A61B5/02; non-radiation detecting or locating of foreign bodies in blood A61B5/06
• CPC Class Codes: A61B 5/318 Heart-related electrical modalities, e.g. electrocardiography [ECG]

Abstract

A blood pressure measurement system that utilizes both a non-invasive blood pressure (NIBP) monitor having a blood pressure cuff and a continuous non-invasive blood pressure (CNIBP) monitor. During operation of the NIBP monitor, the blood pressure cuff is inflated to an initial inflation pressure greater than the systolic blood pressure for the patient being monitored. The CNIBP monitor calculates an estimated blood pressure that is supplied to the NIBP monitor. The NIBP monitor utilizes the continuous, estimated blood pressure to select a target inflation pressure for the blood pressure cuff. During operation of the NIBP monitor, the size of the pressure steps from the initial inflation pressure to a final pressure can be varied based upon the continuous blood pressure estimate from the NIBP monitor.

Claims

1. A method of monitoring blood pressure in a patient, the method comprising the steps of:

positioning a blood pressure cuff of a non-invasive blood pressure (NIBP) monitor on the patient;

providing a continuous, non-invasive blood pressure (CNIBP) monitor operable to continuously estimate the blood pressure of the patient and generate a continuous blood pressure estimate that includes at least an estimated systolic blood pressure;

calculating a target inflation pressure for the NIBP monitor based upon the continuous blood pressure estimate determined by the CNIBP monitor before inflation of the blood pressure cuff, wherein the target inflation pressure is the estimated systolic blood pressure plus an offset value, wherein the offset value is determined as a statistical function of the estimated systolic pressure over a pre-determined number of the previous beats;

inflating the blood pressure cuff to the target inflation pressure;

continuously decreasing the pressure in the blood pressure cuff while monitoring for oscillometric pulses in the blood pressure cuff in the NIBP monitor; and

calculating the systolic pressure, mean arterial pressure and diastolic pressure based upon the oscillometric pulses detected during deflation of the blood pressure cuff.

2. The method of claim 1 wherein the statistical function of the systolic pressure is the standard deviation.

3. The method of claim 1 wherein the inflation pressure in the blood pressure cuff is decreased from the target inflation pressure to a final pressure through a series of pressure steps, wherein the oscillometric pulses are monitored at each pressure step, wherein each pressure step represents a decrease in the in the cuff pressure.

4. A method of monitoring blood pressure in a patient, the method comprising the steps of:

providing a continuous, non-invasive blood pressure (CNIBP) monitor operable to continuously estimate the blood pressure of the patient and generate a continuous blood pressure estimate;

calculating a target inflation pressure based upon the continuous blood pressure estimate from the CNIBP monitor;

positioning a blood pressure cuff of a non-invasive blood pressure (NIBP) monitor on the patient;

inflating the blood pressure cuff to the target inflation pressure;

decreasing the pressure in the blood pressure cuff from the target inflation pressure to a final pressure through a series of pressure steps;

varying the size of the pressure steps within the series of pressure steps during deflation of the blood pressure cuff between the target inflation pressure and the final pressure, wherein the selection of the size of the pressure steps is based upon the continuous blood pressure estimate to optimize the deflation of the blood pressure cuff;

monitoring for oscillometric pulses in the blood pressure cuff at each pressure step; and

calculating the systolic pressure, mean arterial pressure and diastolic pressure based upon the oscillometric pulses detected during deflation of the blood pressure cuff.

5. The method of claim 4 wherein the CNIBP monitor continuously determines at least an estimate systolic blood pressure, an estimated diastolic blood pressure and an estimate mean arterial pressure, wherein the size of the steps decreases near the mean arterial pressure estimated by the CNIBP monitor.

6. The method of claim 5 wherein the size of the steps are increased between the estimated mean arterial pressure and the estimated diastolic pressure.

7. A method of enhancing the operation of a non-invasive blood pressure (NIBP) monitor having a blood pressure cuff selectively inflatable and deflatable to determine at least a systolic pressure, a mean arterial pressure and a diastolic pressure for a patient, the method comprising the steps of:

providing a continuous non-invasive blood pressure (CNIBP) monitoring system operable to continuously estimate the blood pressure of the patient and generate a continuous blood pressure estimate including at least an estimated systolic blood pressure;

calculating an initial target inflation pressure based upon the continuous blood pressure estimate, wherein the initial target inflation pressure is selected above the estimated systolic blood pressure;

inflating the blood pressure cuff of the NIBP monitor to the initial target inflation pressure, wherein the initial target inflation pressure is calculated based on the continuous blood pressure estimate before inflation of the blood pressure cuff;

deflating the blood pressure cuff from the initial target inflation pressure to a final pressure through a series of pressure steps that each represent a decrease in the inflation pressure in the blood pressure cuff;

varying the size of the pressure steps within the series of pressure steps during deflation of the blood pressure cuff from the initial target inflation pressure to the final pressure, wherein the size of each of the pressure steps of the decreasing pressure values of the blood pressure cuff are based upon the continuous blood pressure estimate;

monitoring for oscillometric pulses in the blood pressure cuff at each of the pressure steps as the blood pressure cuff is deflated from the initial target inflation pressure to the final pressure; and

calculating and displaying the systolic pressure, mean arterial pressure and diastolic pressure based upon the oscillometric pulses.

8. The method of claim 7 wherein the initial target inflation pressure is the estimated systolic blood pressure plus an offset value.

9. The method of claim 7 wherein the CNIBP monitor continuously determines at least an estimate systolic blood pressure, an estimated diastolic blood pressure and an estimate mean arterial pressure, wherein the size of the steps decreases near the mean arterial pressure estimated by the CNIBP monitor.

10. The method of claim 9 wherein the size of the steps are increased between the estimated mean arterial pressure and the estimated diastolic pressure.

11. A system for monitoring blood pressure in a patient, the system comprising:

a central processor;

a non-invasive blood pressure (NIBP) monitor including a pressure transducer coupled to the central processor and operable to detect oscillometric pulses from the patient and a blood pressure cuff positionable on the patient, the blood pressure cuff being coupled to a supply of pressurized air such that the blood pressure cuff can be selectively inflated and deflated by the central processor;

a continuous non-invasive blood pressure (CNIBP) monitor positionable on the patient to continuously estimate the blood pressure of the patient and generate a continuous blood pressure estimate including at least an estimated systolic blood pressure,

wherein in the central processor is operable to inflate the blood pressure cuff to a target pressure and deflate the blood pressure cuff from the target pressure to determine the blood pressure of the patient, wherein the central processor estimates the target pressure based upon the estimated systolic pressure,

wherein the central processor is operable to deflate the blood pressure cuff in a series of pressure steps from the target pressure to a final pressure, wherein the central processor varies the size of the pressure steps within the series of pressure steps during the deflation of the blood pressure cuff from the target pressure to the final pressure, wherein the size of each of the pressure steps is based upon the estimated blood pressure from the CNIBP monitor.

12. The system of claim 11 further comprising a display coupled to the central processor, wherein the central processor displays the detected blood pressure based on the information obtained from the pressure transducer.