Method of assessing blood volume using photoelectric plethysmography

• US 8,251,912 B2
• Filed: 01/02/2004
• Issued: 08/28/2012
• Est. Priority Date: 03/12/2003
• Status: Active Grant

• Current Assignee: Adam J. Shelley, David G. Silverman, Kirk H. Shelley
• Original Assignee: Yale University
• Inventors: Shelley, Kirk H., Silverman, David G., Shelley, Adam J., Stout, Robert G.
• Primary Examiner(s): Natnithithadha, Navin
• Application Number:
  US10/548,518
• Publication Number:
  US 20070032732A1
• Time in Patent Office: 3,161 Days
• Field of Search: 600529-543, 600/595, 600/587, 600/481, 600483-485, 600500-507
• US Class Current: 600/484
• CPC Class Codes: A61B 5/0059 using light, e.g. diagnosis by transillumination, diascopy, fluorescence A61B5/0093, A61B5/1455, A61B5/02416 and A61B5/0261 take precedence
• 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 5/02416 using photoplethysmograph signals, e.g. generated by infrared radiation A61B5/14552 takes precedence
• CPC Class Codes: A61B 5/026 Measuring blood flow A61B3/1233, A61B3/1241 take precedence
• CPC Class Codes: A61B 5/1455 using optical sensors, e.g. spectral photometrical oximeters
• CPC Class Codes: A61B 5/14551 for measuring blood gases
• CPC Class Codes: A61B 5/7282 Event detection, e.g. detecting unique waveforms indicative of a medical condition A61B5/4094, A61B5/4818, A61B5/349, A61B5/0823 take precedence
• CPC Class Codes: A61B 5/7405 using sound
• CPC Class Codes: A61B 5/742 using visual displays A61B5/339 takes precedence
• CPC Class Codes: A61B 5/746 Alarms related to a physiological condition, e.g. details of setting alarm thresholds or avoiding false alarms alarms per se G08B
• CPC Class Codes: G16H 10/40 for data related to laboratory analysis, e.g. patient specimen analysis
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: Y02A 90/10 Information and communication technologies [ICT] supporting adaptation to climate change, e.g. for weather forecasting or climate simulation

Abstract

A method and system for assessing blood volume within a subject includes generating a cardiovascular waveform representing physiological characteristics of a subject and determining blood volume of the subject by analyzing the cardiovascular waveform. The step of analyzing includes generating a first trace of the per heart-beat maximums of the cardiovascular waveform, which is representative of the systolic pressure upon the cardiovascular signal, generating a second trace of the per heart-beat minimums of the cardiovascular waveform, which is representative of the diastolic pressure upon the cardiovascular signal, and comparing the respective first trace and the second trace to generate an estimate of relative blood volume within the subject. In accordance with an alternate method of analyzing harmonic analysis is applied to the cardiovascular waveform, extracting a frequency signal created by ventilation and applying the extracted frequency signal in determining blood volume of the subject.

Claims

1. A method for assessing changes in blood volume within a subject, the method comprising:

generating a cardiovascular waveform representing physiological characteristics of a subject;

detecting changes in blood volume of the subject by analyzing the cardiovascular waveform using a processor, wherein the analyzing of the cardiovascular waveform includes;

applying harmonic analysis to the cardiovascular waveform;

extracting a signal created by ventilation; and

analyzing changes in signal strength of the extracted signal to detect changes in blood volume of the subject.

2. The method according to claim 1, wherein the cardiovascular waveform is a photoplethysmograph waveform.

3. The method according to claim 1, wherein the harmonic analysis includes Fourier analysis.

4. The method according to claim 1, wherein the harmonic analysis includes joint time-frequency analysis.

5. The method according to claim 1, wherein the harmonic analysis includes a short-time Fourier transformation.

6. The method according to claim 1, wherein the extraction of the signal is achieved using a peak detection algorithm.

7. The method according to claim 6, wherein the peak detection algorithm is applied in the frequency range of ventilation.

8. The method according to claim 1, wherein the cardiovascular waveform is generated using a photoplethysmographic device.

9. The method according to claim 1, wherein one or more oscillations of the cardiovascular waveform are representative of ventilatory related fluctuation.

10. The method according to claim 1, wherein the determining the changes in blood volume includes monitoring a signal in a respiratory frequency range to ascertain changes in a venous component of blood volume.

11. The method according to claim 1, wherein the determining the changes in blood volume includes monitoring side bands surrounding a signal in a cardiac frequency range to ascertain changes in the arterial component of the blood volume.

12. The method according to claim 1, wherein ventilation of the subject is synchronized with a metronome.

13. A method for facilitating detection of physiological changes of a subject, the method comprising:

analyzing a cardiovascular waveform representing physiological characteristics of a subject using a processor, wherein the analyzing of the cardiovascular waveform includes;

identifying a first component of the cardiovascular waveform reflective of a cardiovascular impact of respiration; and

analyzing a characteristic of the first component reflective of amplitude variations of the first component, wherein the amplitude variations are indicative of changes in blood volume of the subject.

14. The method of claim 13, wherein the first component of the cardiovascular waveform is a systolic component reflective of a cardiovascular impact of respiration on per cardiac-cycle maximums of the cardiovascular waveform.

15. The method of claim 13, wherein the first component of the cardiovascular waveform is a diastolic component reflective of a cardiovascular impact of respiration on per cardiac-cycle minimums of the cardiovascular waveform.

16. The method of claim 13, wherein the first component of the cardiovascular waveform is reflective of a cardiovascular impact of respiration on per heart-beat dicrotic notches of the cardiovascular waveform.

17. The method of claim 13, wherein the first component of the cardiovascular waveform is an arterial component reflective of a cardiovascular impact of respiration on an amplitude of a cardiac-signal component of the cardiovascular waveform, wherein the amplitude variations of the arterial component are indicative of changes in arterial blood volume of the subject.

18. The method of claim 13, wherein the first component of the cardiovascular waveform is a venous component reflective of a cardiovascular impact of respiration on a baseline of a cardiac-signal component of the cardiovascular waveform, wherein the amplitude variations of the venous component are indicative of changes in venous blood volume of the subject.

19. The method of claim 13, wherein the cardiovascular waveform is analyzed in at least one of (i) the time domain, (ii) the frequency domain and (iii) the joint time-frequency domain.

20. The method of claim 13, wherein the analyzed characteristic is reflective of at least one of (i) changes in per respiratory-cycle maximums of the first component in the time domain, (ii) changes in per respiratory-cycle minimums of the first component in the time domain, and (iii) changes in a difference between corresponding per respiratory-cycle maximums and per respiratory-cycle minimums of the first component in the time domain;

and (iv) changes in a signal strength of the first component in the frequency domain.

21. The method of claim 13, wherein the cardiovascular waveform is analyzed using harmonic analysis to identify the first component of the cardiovascular waveform.

22. The method of claim 21, wherein the identifying the first component of the cardiovascular waveform is achieved using a peak detection algorithm on the cardiovascular waveform applied in the frequency domain.

23. The method of claim 21, wherein the first component of the cardiovascular waveform is an arterial component reflective of a cardiovascular impact of respiration on an amplitude of a cardiac-signal component of the cardiovascular waveform, wherein the amplitude variations of the arterial component are identified based on side bands surrounding a primary cardiac signal component in the cardiac frequency range, and wherein the amplitude variations of the arterial component are indicative of changes in arterial blood volume of the subject.

24. The method of claim 21, wherein the first component of the cardiovascular waveform is a venous component reflective of a cardiovascular impact of respiration on a baseline of a cardiac-signal component of the cardiovascular waveform, wherein the venous component is identified in the respiratory frequency range, and wherein the amplitude variations of the venous component are indicative of changes in venous blood volume of the subject.

25. The method of claim 13, wherein the first component is normalized based on an amplitude of a cardiac signal component of the cardiovascular waveform.

26. The method of claim 13, wherein the analyzing the characteristic of the first component of the cardiovascular waveform includes calculating an index responsive to the amplitude variations of the first component, wherein index variations are indicative of physiological changes in the subject.

27. The method of claim 13, further comprising monitoring fluid responsiveness of the subject based on the analysis of the characteristic of the first component.

28. The method of claim 13, further comprising detecting hypovolemia based on the analysis of the characteristic of the first component.

29. The method of claim 13, further comprising detecting dehydration based on the analysis of the characteristic of the first component.

30. The method of claim 13, wherein subject respiration is synchronized with a metronome.

31. The method of claim 13, wherein airway pressure is at least one of (i) actively controlled and (ii) standardized.

32. The method of claim 13, wherein the first component is normalized based on one of (i) respiratory oscillations and (ii) airway pressure.

33. A system for assessing changes in blood volume within a subject, the system comprising:

a probe adapted for generating a cardiovascular waveform of a subject; and

a processor configured for analyzing the cardiovascular waveform to determine changes in blood volume of the subject, wherein the analyzing of the cardiovascular waveform includes;

applying harmonic analysis to the cardiovascular waveform;

extracting a signal created by ventilation; and

applying the extracted signal in determining the changes in blood volume of the subject, wherein the applying the extracted signal includes monitoring changes in a signal strength of the extracted signal in the frequency domain.

34. The system according to claim 33, wherein the probe is photoplethysmographic device and the cardiovascular waveform is a photoplethysmograph waveform.

35. The system according to claim 33, wherein the harmonic analysis includes Fourier analysis.

36. The system according to claim 33, wherein the harmonic analysis includes joint time-frequency analysis.

37. The system according to claim 36, wherein the harmonic analysis includes a short-time Fourier transformation.

38. The system according to claim 33, wherein the extraction of the signal is achieved using a peak detection algorithm.

39. The system according to claim 38, wherein the peak detection algorithm is applied in the frequency range of ventilation.

40. The system according to claim 33, wherein the determining the changes in blood volume includes monitoring a signal in a respiratory frequency range to ascertain changes in a venous component of blood volume.

41. The system according to claim 33, wherein the determining the changes in blood volume includes monitoring side bands surrounding a signal in a cardiac frequency range to ascertain changes in the arterial component of the blood volume.

42. The system according to claim 33, wherein ventilation of the subject is synchronized with a metronome.

43. A system for facilitating detection of physiological changes of a subject, the system comprising:

a probe adapted for generating a cardiovascular waveform representing physiological characteristics of a subject; and

a processor configured for analyzing the cardiovascular waveform, wherein the analyzing the cardiovascular waveform includes identifying a first component of the cardiovascular waveform reflective of a cardiovascular impact of respiration, and analyzing a characteristic of the first component reflective of amplitude variations of the first component, wherein the amplitude variations are indicative of changes in blood volume of the subject.

44. The system of claim 43, wherein the first component of the cardiovascular waveform is a systolic component reflective of a cardiovascular impact of respiration on per cardiac-cycle maximums of the cardiovascular waveform.

45. The system of claim 43, wherein the first component of the cardiovascular waveform is a diastolic component reflective of a cardiovascular impact of respiration on per cardiac-cycle minimums of the cardiovascular waveform.

46. The system of claim 43, wherein the first component of the cardiovascular waveform is reflective of a cardiovascular impact of respiration on per heart-beat dicrotic notches of the cardiovascular waveform.

47. The system of claim 43, wherein the first component of the cardiovascular waveform is an arterial component reflective of a cardiovascular impact of respiration on an amplitude of a cardiac-signal component of the cardiovascular waveform, wherein the amplitude variations of the arterial component are indicative of changes in arterial blood volume of the subject.

48. The system of claim 43, wherein the first component of the cardiovascular waveform is a venous component reflective of a cardiovascular impact of respiration on a baseline of a cardiac-signal component of the cardiovascular waveform, wherein the amplitude variations of the venous component are indicative of changes in venous blood volume of the subject.

49. The system of claim 43, wherein the cardiovascular waveform is analyzed in at least one of (i) the time domain, (ii) the frequency domain and (iii) the joint time-frequency domain.

50. The system of claim 43, wherein the analyzed characteristic is reflective of at least one of (i) changes in per respiratory-cycle maximums of the first component in the time domain, (ii) changes in per respiratory-cycle minimums of the first component in the time domain, and (iii) changes in a difference between corresponding per respiratory-cycle maximums and per respiratory-cycle minimums of the first component in the time domain;

and (iv) changes in a signal strength of the first component in the frequency domain.

51. The system of claim 43, wherein the cardiovascular waveform is analyzed using harmonic analysis to identify the first component of the cardiovascular waveform.

52. The system of claim 51, wherein the identifying the first component of the cardiovascular waveform is achieved using a peak detection algorithm on the cardiovascular waveform applied in the frequency domain.

53. The system of claim 51, wherein the first component of the cardiovascular waveform is an arterial component reflective of a cardiovascular impact of respiration on an amplitude of a cardiac-signal component of the cardiovascular waveform, wherein the amplitude variations of the arterial component are identified based on side bands surrounding a primary cardiac signal component in the cardiac frequency range, and wherein the amplitude variations of the arterial component are indicative of changes in arterial blood volume of the subject.

54. The system of claim 51, wherein the first component of the cardiovascular waveform is a venous component reflective of a cardiovascular impact of respiration on a baseline of a cardiac-signal component of the cardiovascular waveform, wherein the venous component is identified in the respiratory frequency range, and wherein the amplitude variations of the venous component are indicative of changes in venous blood volume of the subject.

55. The system of claim 43, wherein the first component is normalized based on an amplitude of a cardiac signal component of the cardiovascular waveform.

56. The system of claim 43, wherein the analyzing the characteristic of the first component of the cardiovascular waveform includes calculating an index responsive to the amplitude variations of the first component, wherein index variations are indicative of physiological changes in the subject.

57. The system of claim 43, wherein the analyzing the cardiovascular waveform further includes monitoring fluid responsiveness of the subject based on the analysis of the characteristic of the first component.

58. The system of claim 43, wherein the analyzing the cardiovascular waveform further includes detecting hypovolemia based on the analysis of the characteristic of the first component.

59. The system of claim 43, wherein the analyzing the cardiovascular waveform further includes detecting dehydration based on the analysis of the characteristic of the first component.

60. The system of claim 43, further comprising a metronome adapted for synchronizing subject respiration.

61. The system of claim 43, further comprising an airway pressure control adapted for at least one of (i) actively controlling airway pressure and (ii) standardizing airway pressure.

62. The system of claim 43, wherein the first component is normalized based on one of (i) respiratory oscillations and (ii) airway pressure.