Physiological-signal-analysis device for measuring a blood pressure and method

• US 6,746,403 B2
• Filed: 03/01/2002
• Issued: 06/08/2004
• Est. Priority Date: 10/04/2000
• Status: Expired due to Term

• 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
• Primary Examiner(s): Hindenburg, Max F.
• Assistant Examiner(s): Mallari, Patricia C.
• Application Number:
  US09/683,911
• Publication Number:
  US 20020082507A1
• Time in Patent Office: 830 Days
• Field of Search: 600/300-301, 600/485-507, 600/508, 600/509
• 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 5/02416 using photoplethysmograph signals, e.g. generated by infrared radiation A61B5/14552 takes precedence
• CPC Class Codes: A61B 5/318 Heart-related electrical modalities, e.g. electrocardiography [ECG]
• CPC Class Codes: A61B 5/33 specially adapted for cooperation with other devices

Abstract

A physiological-signal-analysis device for determining a blood pressure value of a patient and a method of operating the device. The device includes a cuff attachable to an extremity of the patient, a pneumatic system connected to the cuff that supplies a fluid to the cuff, a pressure transducer that measures the pressure signal having pressure oscillations, and a control unit connected to the pneumatic system and the pressure transducer. The control unit is operable to acquire a first oscillation having a first fiducial point, acquire a second oscillation having a second fiducial point, calculate a time interval representing a time from the first fiducial point to the second fiducial point, decide against selecting the second oscillation when the time interval is not a substantial integral multiple of a nominal oscillation period, and calculate a blood pressure value based on selected oscillations.

Claims

1. A method of determining whether an oscillation of a pressure signal acquired from a patient satisfies one or more criteria, the method comprising the acts of:

acquiring a first oscillation having a first fiducial point;

acquiring a second oscillation having a second fiducial point;

calculating a time interval representing a time from the first fiducial point to the second fiducial point; and

determining whether the time interval is an integral multiple of a nominal.

2. A method as set forth in claim 1 wherein the nominal time interval is an average oscillation period.

3. A method as set forth in claim 1 wherein the first fiducial point is the starting point of the first oscillation, and wherein the second fiducial point is the starting point of the second oscillation.

4. A method as set forth in claim 1 wherein the first fiducial point is the maximum slope point of the first oscillation, and wherein the second fiducial point is the maximum slope point of the second oscillation.

5. A method as set forth in claim 1 wherein the first fiducial point is the maximum amplitude point of the first oscillation, and wherein the second fiducial point is the maximum amplitude point of the second oscillation.

6. A method as set forth in claim 1 wherein the act of determining whether the time interval is an integral multiple of a nominal time interval includes determining whether the time interval is within a time interval range.

7. A method as set forth in claim 1 wherein the act of determining whether the time interval is an integral multiple of a nominal time interval includes the acts of setting a variable (N), and determining whether the interval divided by (N) is within a time interval range.

8. A method as set forth in claim 7 wherein the act of determining whether the interval divided by (N) is within a time interval range includes the acts of multiplying the nominal time interval by a first factor to calculate a high value, multiplying the nominal time interval by a second factor to calculate a low value, and determining whether the interval divided by (N) is between the high and low values.

9. A method as set forth in claim 1 wherein the second oscillation has an amplitude, and wherein the method further comprises the act of determining whether the amplitude is within an amplitude range.

10. A method as set forth in claim 9 wherein the amplitude range is a range around an amplitude of the first oscillation.

11. A method as set forth in claim 1 wherein the second oscillation has a slope during a specified interval, and wherein the method further comprises the act of determining whether the slope is within a slope range.

12. A method as set forth in claim 11 wherein the slope range is a range around a slope of the first oscillation.

13. A method as set forth in claim 1 wherein the second oscillation has a time-to-peak interval, the time-to-peak interval representing a time from a starting point of the second oscillation and a point when a maximum amplitude of the second oscillation occurs, and wherein the method further comprises the act of determining whether the time-to-peak interval is within a time-to-peak interval range.

14. A method as set forth in claim 13 wherein the time-to-peak interval range is a range around a time-to-peak interval of the first oscillation.

15. A method as set forth in claim 1 and further comprising the acts of:

applying a pressure to a patient'"'"'s extremity; and

acquiring the first and second oscillations at a same pressure.

16. A method as set forth in claim 1 and further comprising the acts of:

applying a first pressure to a patient'"'"'s extremity;

wherein the act of acquiring the first oscillation occurs when the first pressure is applied to a patient'"'"'s extremity;

applying a second pressure to a patient'"'"'s extremity, the second pressure being less than the first pressure; and

wherein the act of acquiring the second oscillation occurs when the second pressure is applied to the patient'"'"'s extremity.

17. A method of determining whether an oscillation of a blood pressure signal satisfies a criteria, the method comprising the acts of:

acquiring an electrocardiogram (ECG) signal having a first beat and a second beat;

identifying a first fiducial point on the first ECG beat and a second fiducial point on the second ECG beat;

acquiring a blood pressure signal having a first oscillation related to the first ECG beat and a second oscillation related to the second ECG beat;

calculating a time interval between the first fiducial point and the second fiducial point;

determining whether the time interval is an integral multiple of a nominal time interval; and

rejecting the second oscillation for use in blood pressure calculations if the time interval is not an integral multiple of a nominal time interval.

18. A method as set forth in claim 17 and further comprising the acts of:

classifying at least one of the first ECG beat and the second ECG beat; and

adjusting the nominal time interval when at least one of the first ECG beat and the second ECG beat is an abnormal beat.

19. A method as set forth in claim 17 wherein the act of determining whether the time interval is an integral multiple of a nominal time interval includes determining whether the time interval is within a time interval range.

20. A method as set forth in claim 17 wherein the act of determining whether the time interval is an integral multiple of a nominal time interval includes the acts of setting a variable (N) and determining whether the interval divided by (N) is within a time interval range.

21. A method as set forth in claim 20 wherein the act of determining whether the interval divided by (N) is within a time interval range includes the acts of multiplying the nominal time interval by a first factor to calculate a high value, multiplying the nominal oscillation period by a second factor to calculate a low value, and determining whether the interval divided by (N) is between the high and low values.

22. A method of rejecting an artifact in a blood pressure signal, the method comprising the acts of:

acquiring an electrocardiogram (ECG) signal having an ECG beat;

identifying a QRS fiducial point on the ECG beat;

acquiring a blood pressure signal having an oscillation related to the ECG beat;

identifying a beginning-of-oscillation fiducial point on the oscillation;

calculating a QRS-to-oscillation interval between the QRS fiducial point and the beginning-of-oscillation fiducial point;

determining whether the oscillation is an artifact based on the QRS-to-oscillation interval; and

rejecting the oscillation for use in blood pressure calculations if the oscillation is an artifact.

23. A physiological-signal-analysis device for determining a blood pressure value of a patient, the device comprising:

a cuff attachable to an extremity of a patient;

a pneumatic system connected to the cuff that supplies a fluid to the cuff;

a pressure transducer that captures a pressure signal having a pressure oscillation; and

a control unit connected to the pneumatic system and the pressure transducer, the control unit being operable to

acquire a first oscillation having a first fiducial point,

acquire a second oscillation having a second fiducial point,

calculate a time interval representing a time from the first fiducial point to the second fiducial point,

decide against selecting the second oscillation when the time interval is not a an integral multiple of a nominal oscillation period, and

calculate the blood pressure value based upon selected oscillations.

24. A device as set forth in claim 23 wherein the first fiducial point is the baseline of the first oscillation, and the second fiducial point is the baseline of the second oscillation.

25. A device as set forth in claim 23 wherein the first fiducial point is the maximum slope point of the first oscillation, and the second fiducial point is the maximum slope point of the second oscillation.

26. A method as set forth in claim 23 wherein the first fiducial point is the maximum amplitude point of the first oscillation, and the second fiducial point is the maximum amplitude point of the second oscillation.

27. A device as set forth in claim 23 wherein the second oscillation has a maximum amplitude, and wherein the control unit is further operable to decide against selecting the second oscillation when the maximum amplitude is not within a maximum amplitude range.

28. A device as set forth in claim 23 wherein the second oscillation has a slope, and wherein the control unit is further operable to decide against selecting the second oscillation when the slope is not within a slope range.

29. A device as set forth in claim 23 wherein the second oscillation has a time-to-peak interval, the time-to-peak interval representing a time from a starting point of the second oscillation and a point when a maximum amplitude of the second oscillation occurs, and wherein the control unit is further operable to decide against selecting the second oscillation when the time-to-peak interval is not within a time-to-peak interval range.

30. A device as set forth in claim 23 wherein the control system is further operable to control the pneumatic system such that the cuff applies varying pressure steps to the patient, wherein the first and second oscillations occur at the same pressure step.

31. A device as set forth in claim 23 wherein the control system is further operable to control the pneumatic system such that the cuff applies varying pressure steps to the patient, and wherein the first oscillation occurs at a first pressure step and the second oscillation occurs at a pressure different than the first pressure step.

32. A device as set forth in claim 23 wherein the control unit includes a processor, and a memory having one or more software modules.

33. A device as set forth in claim 23 wherein the device further comprises a plurality of electrodes, and wherein the controller is further operable to acquire an electrocardiogram (ECG) having beats, and to classify the beats.

34. A device as set forth in claim 23 wherein the control unit deciding against selecting the second oscillation when the time interval is not an integral multiple of a nominal oscillation period includes the control unit determining whether the time interval is within a time interval range.

35. A device as set forth in claim 23 wherein the control unit deciding against selecting the second oscillation when the time interval is not an integral multiple of a nominal oscillation period includes the control unit setting a variable (N) and the control unit determining whether the interval divided by (N) is within a time interval range.

36. A device as set forth in claim wherein the control unit determining whether the interval divided by (N) is within a time interval range includes the control unit multiplying the nominal oscillation period by a first factor to calculate a high value, the control unit multiplying the nominal oscillation period by a second factor to calculate a low value, and the control unit determining whether the interval divided by (N) is between the high and low values.

37. A computer program embodied by a computer readable medium capable of being executed by a computer, the computer program capable of causing the computer to operate a physiological-signal-analysis device, the device including a cuff, a pneumatic system, a pressure transducer, and a control unit, the computer program comprising:

a pneumatic control module for controlling the operation of the pneumatic system; and

an analysis module for analyzing input from the pressure transducer and for calculating a blood pressure, the analysis module including instructions that are implemented for

acquiring a first oscillation having a first fiducial point;

acquiring a second oscillation having a second fiducial point;

calculating a time interval representing a time from the first fiducial point to the second fiducial point; and

determining whether the time interval is close to an integral multiple of a nominal time interval.

38. A computer program as set forth in claim 37 wherein the second oscillation has an amplitude, and wherein the analysis module further includes instructions for determining whether the amplitude is within an amplitude range.

39. A computer program as set forth in claim 37 wherein the second oscillation has a slope during a specified interval, and wherein the analysis module further includes instructions for determining whether the slope is within a slope ranges.

40. A computer program as set forth in claim 37 wherein the second oscillation has a time-to-peak interval, the time-to-peak interval representing a time from a starting point of the second oscillation and a point when a maximum amplitude of the second oscillation occurs, and wherein the analysis module further includes instructions for determining whether the time-to-peak interval is within a time-to-peak interval range.

41. A computer program as set forth in claim 37 wherein the instructions for determining whether the time interval is close to an integral multiple of a nominal time interval includes instructions for determining whether the time interval is within a time interval range.

42. A computer program as set forth in claim 37 wherein the instructions for determining whether the time interval is close to an integral multiple of a nominal oscillation period includes instructions for setting a variable (N), dividing the time interval by (N) to create a sub-interval, and determining whether the sub-interval is within a time interval range.

43. A computer program as set forth in claim 42 wherein the instructions for determining whether the sub-interval is within a time interval range includes instructions for multiplying the nominal oscillation period by a first factor to calculate a high value, multiplying the nominal oscillation period by a second factor to calculate a low value, and determining whether the sub-interval is between the high and low values.

44. A method of determining whether an oscillation of a blood pressure signal satisfies a criteria, the method comprising the acts of:

acquiring a first electrocardiogram (ECG) beat having a first fiducial point;

acquiring a first oscillation having a relationship to the first ECG beat;

acquiring a second ECG beat having a second fiducial point;

acquiring a second oscillation having a relationship to the second ECG beat;

calculating a time interval representing a time from the first fiducial point to the second fiducial point;

determining whether the time interval is close to an integral multiple of a nominal time interval; and

deciding against selecting the second pressure oscillation when the time interval is not a an integral multiple of a nominal time interval.

45. A method as set forth in claim 44 wherein the second oscillation includes a maximum amplitude, and wherein the method further comprises the act of determining whether the maximum amplitude is within a maximum amplitude range when the time interval is close to an integral multiple of a nominal time interval.

46. A method as set forth in claim 44 wherein the second oscillation includes a slope, and wherein the method further comprises the act of determining whether the slope is within a slope range when the time interval is close to an integral multiple of a nominal time interval.

47. A method as set forth in claim 44 wherein the second oscillation includes a time-to-peak interval, the time-to-peak interval representing a time from a starting point of the second oscillation and a point when a maximum amplitude of the second oscillation occurs, and wherein the method further comprises the act of determining whether the time-to-peak interval is within a time-to-peak interval range when the first time interval is close to an integral multiple of a nominal time interval.