Body-worn system for measuring continuous non-invasive blood pressure (cNIBP)

• US 8,740,802 B2
• Filed: 12/30/2009
• Issued: 06/03/2014
• Est. Priority Date: 06/12/2007
• Status: Active Grant

• Current Assignee: Sotera Wireless Incorporated
• Original Assignee: Sotera Wireless Incorporated
• Inventors: Banet, Matt, Dhillon, Marshal, McCombie, Devin
• Primary Examiner(s): Natnithithadha, Navin
• Assistant Examiner(s): WEARE, MEREDITH H
• Application Number:
  US12/650,389
• Publication Number:
  US 20100160796A1
• Time in Patent Office: 1,616 Days
• Field of Search: 600481-507
• US Class Current: 600/485
• CPC Class Codes: A61B 5/0022 Monitoring a patient using a global network, e.g. telephone networks, internet
• CPC Class Codes: A61B 5/02125 of pulse wave propagation time
• CPC Class Codes: A61B 5/02133 by using induced vibration of the blood vessel
• CPC Class Codes: A61B 5/0225 the pressure being controlled by electric signals, e.g. derived from Korotkoff sounds
• CPC Class Codes: A61B 5/02416 using photoplethysmograph signals, e.g. generated by infrared radiation A61B5/14552 takes precedence
• CPC Class Codes: A61B 5/0295 using plethysmography, i.e. measuring the variations in the volume of a body part as modified by the circulation of blood therethrough, e.g. impedance plethysmography
• CPC Class Codes: A61B 5/1118 Determining activity level
• CPC Class Codes: A61B 5/14551 for measuring blood gases
• CPC Class Codes: A61B 5/318 Heart-related electrical modalities, e.g. electrocardiography [ECG]
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle
• CPC Class Codes: A61B 5/6824 Arm or wrist
• CPC Class Codes: A61B 5/721 using a separate sensor to detect motion or using motion information derived from signals other than the physiological signal to be measured
• CPC Class Codes: A61B 5/7239 using differentiation including higher order derivatives
• CPC Class Codes: A61B 5/742 using visual displays A61B5/339 takes precedence

Abstract

The present invention provides a technique for continuous measurement of blood pressure based on pulse transit time and which does not require any external calibration. This technique, referred to herein as the ‘Composite Method’, is carried out with a body-worn monitor that measures blood pressure and other vital signs, and wirelessly transmits them to a remote monitor. A network of body-worn sensors, typically placed on the patient'"'"'s right arm and chest, connect to the body-worn monitor and measure time-dependent ECG, PPG, accelerometer, and pressure waveforms. The disposable sensors can include a cuff that features an inflatable bladder coupled to a pressure sensor, three or more electrical sensors (e.g. electrodes), three or more accelerometers, a temperature sensor, and an optical sensor (e.g., a light source and photodiode) attached to the patient'"'"'s thumb.

Claims

1. A system for measuring a blood pressure value from a patient, comprising:

(a) a first sensor configured to generate a first time-dependent waveform indicative of one or more contractile properties of the patient'"'"'s heart;

(b) a second sensor configured to generate a second time-dependent waveform indicative of one or more contractile properties of the patient'"'"'s heart;

(c) a third sensor comprising an inflatable cuff configured to attach to the patient'"'"'s arm, a pneumatic system configured to inflate and deflate the inflatable cuff, a pressure sensor, an analog-to-digital converter, a first microprocessor, a first serial transceiver, and a battery, the third sensor configured to generate a third time-dependent waveform indicative of pressure measured by the pressure sensor during inflation of the cuff, wherein heartbeat-induced pulses are indicated in the third time dependent waveform by variations in the measured pressure; and

(d) a processing component configured to be worn on the patient'"'"'s body and comprising a second microprocessor and a second serial transceiver, the processing component programmed to;

(i) communicate through a cable worn on the patient'"'"'s body with a third microprocessor and third serial transceiver comprised by the first sensor to receive a digitized version of the first time-dependent waveform;

(ii) communicate with the first microprocessor and first serial transceiver comprised by the third sensor to receive a digitized version of the third time-dependent waveform;

(iii) calculate a pulse transit time (PTT) calculated using a time difference between time-dependent features in digitized versions of the first and second time-dependent waveforms;

(iv) receive the third time-dependent waveform and calculate therefrom systolic_index (SYS_index), diastolic_index (DIA_index), and mean arterial blood pressure_index (MAP_index) calibration values and a patient-specific slope value (m) relating pulse transit time to mean arterial blood pressure, the calibration values determined from a digitized version of the third time-dependent waveform; and

(v) calculate systolic and diastolic ratios (R_SYS and R_DIA) according to the following equations;

R_SYS=SYS_index/MAP_index

R_DIA=DIA_index/MAP_index; and

calculate continuous systolic, diastolic, and mean arterial blood pressures from the pulse transit time, the calibration values, the systolic and diastolic ratios, and the patient-specific slope value.

2. The system of claim 1, wherein the first sensor is an ECG sensor.

3. The system of claim 2, wherein the first time-dependent waveform is an ECG waveform.

4. The system of claim 2, wherein the second sensor is an optical sensor.

5. The system of claim 4, wherein the second time-dependent waveform is a PPG waveform.

6. The system of claim 5, wherein the optical sensor is configured to be worn around the patient'"'"'s finger.

7. The system of claim 6, wherein the optical sensor is configured to be worn around the patient'"'"'s thumb.

8. The system of claim 5, wherein the time difference between time-dependent features in digitized versions of the first and second time-dependent waveforms is a time separating a QRS complex in the ECG waveform and an onset point of the PPG waveform.

9. The system of claim 5, wherein the second sensor comprises a first LED operating in the red spectral range, and a second LED operating in the infrared spectral range.

10. The system of claim 9, wherein the second sensor is configured to generate a first PPG waveform using radiation from the first LED operating in the red spectral range, and a second PPG waveform using radiation from the second LED operating in the infrared spectral range.

11. The system of claim 10, wherein the processing component is further configured to calculate a SpO2 value from the first and second PPG waveforms.

12. The system of claim 1, wherein the cable comprises no more than 5 conductors.

13. The system of claim 12, wherein the cable is terminated with a connector, and the processing component comprises an input port comprising a group of conductors configured to match conductors in the cable, the input port configured so that the connector can be inserted into and detached therefrom.

14. The system of claim 1, wherein the third sensor is configured to be worn near the patient'"'"'s bicep.

15. The system of claim 1, wherein the processing component is configured to be worn near the patient'"'"'s wrist.