Method for measuring central venous pressure or respiratory effort

• US 8,721,555 B2
• Filed: 02/18/2010
• Issued: 05/13/2014
• Est. Priority Date: 06/14/2006
• Status: Active Grant

• Current Assignee: Watermark Medical, Inc. (BioSerenity SAS)
• Original Assignee: Watermark Medical, Inc. (BioSerenity SAS)
• Inventors: Westbrook, Philip R., Levendowski, Daniel J., Zavora, Timothy, Popovic, Djordje, Cvetinovic, Milenko, Berka, Chris
• Primary Examiner(s): Mallari, Patricia
• Assistant Examiner(s): WESTON, TIFFANY C
• Application Number:
  US12/708,403
• Publication Number:
  US 20100145201A1
• Time in Patent Office: 1,545 Days
• Field of Search: 600/309, 600481-507, 600/561
• US Class Current: 600/485
• 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 5/021 Measuring pressure in heart or blood vessels A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/02125 of pulse wave propagation time
• CPC Class Codes: A61B 5/02416 using photoplethysmograph signals, e.g. generated by infrared radiation A61B5/14552 takes precedence
• CPC Class Codes: A61B 5/037 Measuring oesophageal pressure
• CPC Class Codes: A61B 5/0816 Measuring devices for examining respiratory frequency measuring frequency of electric signals G01R23/00
• CPC Class Codes: A61B 5/1073 Measuring volume, e.g. of limbs
• CPC Class Codes: A61B 5/1135 by monitoring thoracic expansion
• CPC Class Codes: A61B 5/14551 for measuring blood gases
• CPC Class Codes: A61B 5/412 Detecting or monitoring sepsis
• CPC Class Codes: A61B 5/4818 Sleep apnoea

Abstract

Photoplethysmography (PPG) is obtained using one red (e.g., 660 nm) and one infrared (e.g., 880 to 940 nm) light emitting diode with a single photo diode in combination with a pressure transducer thereby allowing both CVP and SpO2 to be measured simultaneously. The system also includes sensors capable of measuring position, angle and/or movement of the sensor or patient. Once the PPG signal is acquired, high pass adaptive and/or notch filtering can be used with one element of the filter from the red and infrared signals used to measure the arterial changes needed to compute SpO2 and the other element of the signal can be used to measure CVP changes.

Claims

1. A non-invasive system for measuring central venous pressure, the system comprising:

a photoplethysmography sensor and a pressure sensor adapted to be placed on a patient'"'"'s skin;

wherein the photoplethysmography sensor generates a photoplethysmography signal, and the pressure sensor generates a pressure signal which comprises an element for determining central venous pressure information

a motion sensor which generates a motion signal comprising an indication of one or more changes in a position of the patient; and

an acquisition signal processing quantification module in communication with the photoplethysmography sensor, the pressure sensor, and the motion sensor and configured to

filter the photoplethysmography signal, and

use the photoplethysmography signal, the pressure signal, and the motion signal to determine a measurement of respiration, the measurement of respiration relating to central venous pressure.

2. The system of claim 1, further comprising:

a position sensor which generates a position signal comprising a position of the patient'"'"'s body;

wherein the acquisition signal processing quantification module is in communication with the position sensor and is further configured to use the photoplethysmography signal, the motion signal, and the position signal to determine the measurement of respiration.

3. The system of claim 2 wherein the measurement of respiration comprises discrete central venous pressure information, the position signal comprises a position of the patient'"'"'s head, and the acquisition signal processing quantification module is further configured to use changes in the position of the patient'"'"'s head to extract the discrete central venous pressure information from the photoplethysmography signal.

4. The system of claim 2 wherein the acquisition signal processing quantification module is further configured to filter the photoplethysmography signal to extract effort arousal waves.

5. The system of claim 2 wherein the position signal comprises an indication of the position, angle and movement of the position sensor.

6. The system of claim 1, wherein the measurement of respiration comprises a measurement of central venous pressure.

7. The system of claim 6, further comprising an application in communication with the acquisition signal processing quantification module, wherein the application is configured to:

receive the measurement of central venous pressure; and

identify an apnea based on the measurement of central venous pressure.

8. The system of claim 7, wherein the application is further configured to generate a control signal for a positive airway pressure ventilation device based on the identified apnea.

9. The system of claim 7, wherein the identification of the apnea comprises discriminating between obstructive, central, and mixed apneas.

10. The system of claim 9, wherein the application is further configured to:

receive a measurement of airflow; and

use the measurement of central venous pressure and the measurement of airflow to discriminate between obstructive, central, and mixed apneas.

11. The system of claim 1, wherein the measurement of respiration comprises a composite measurement of central venous pressure, and the system further comprises a plurality of additional sensors which generate a plurality of intermediate signals comprising measurements of venous pulsation, wherein the acquisition of signal processing quantification module is in communication with the plurality of additional sensors and is further configured to use the photoplethysmography signal, the plurality of intermediate signals, and the motion signal to determine the composite measurement of central venous pressure.

12. The system of claim 11, wherein the acquisition signal processing quantification signal module is further configured to:

select one or more reference signals from among the photoplethysmography signal and the plurality of intermediate signals; and

use the one or more reference signals to remove artifacts from the composite measurement of central venous pressure.

13. A non-invasive system for measuring central venous pressure, the system comprising:

a photoplethysmography sensor and a pressure sensor adapted to be placed on a patient'"'"'s skin;

wherein the photoplethysmography sensor generates a photoplethysmography signal, and the pressure sensor generates a pressure signal which comprises an element for determining central venous pressure information;

a motion sensor which generates a motion signal comprising an indication of one or more changes in a position of the patient;

a position sensor which generates a position signal comprising one or more positions of the patient; and

an acquisition signal processing quantification module in communication with the photoplethysmography sensor and the motion sensor and configured to

filter the photoplethysmography signal, and

use the photoplethysmography signal, the pressure signal, and the motion signal to determine a measurement of respiration, the measurement of respiration relating to central venous pressure.

14. A non-invasive system for measuring central venous pressure, the system comprising:

a photoplethysmography sensor and a pressure sensor adapted to be placed on a patient'"'"'s skin;

wherein the photoplethysmography sensor generates a photoplethysmography signal, and the pressure sensor generates a pressure signal which comprises an element for determining central venous pressure information;

an accelerometer which generates one or more accelerometer signals comprising indications of the position, angle and movement of the patient; and

an acquisition signal processing quantification module in communication with the photoplethysmography sensor and the motion sensor and configured to

filter the photoplethysmography signal, and

use the photoplethysmography signal, the pressure signal, and the motion signal to determine a measurement of respiration, the measurement of respiration relating to central venous pressure.