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| United States Patent | 5309916 |
| Link to this page | http://www.wikipatents.com/5309916.html |
| Inventor(s) | Hatschek; Rudolf A. (Fribourg, CH) |
| Abstract | A device for measuring blood pressure includes a sensor arrangement which
is releasably attached to the exterior of a body and which is electrically
conductively connected with electronic circuit. The sensor arrangement and
the circuit are configured to determine, in at least one measuring region
of the body, a valve which is a measure for a variable that changes
periodically over time in the rhythm of the pulse beat and which is
correlated with the blood pressure. This variable may, for example, be the
flow velocity and/or flow quantity and/or the volume of the arterial blood
and/or a cross-sectional dimension and/or the flow cross section area of
an arterial blood vessel. The sensor and circuit further determine a value
which is a measure for the pulse wave velocity. By linking the two values
together and including at least one calibration value, at least one value
that is characteristic for of the blood pressure (preferably including at
least the systolic blood. pressure) can be determined. The device makes it
possible to measure the blood pressure of a person at least
quasi-continuously with relatively little bother for the person. |
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Title Information  |
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Drawing from US Patent 5309916 |
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Blood pressure measuring device and method |
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| Publication Date |
May 10, 1994 |
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| Filing Date |
July 16, 1991 |
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| Priority Data |
Jul 18, 1990[CH]2390/90 |
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Title Information  |
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References  |
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U.S. References |
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| | Reference | Relevancy | Comments | Reference | Relevancy | Comments | 5111817 Clark 600/323 May,1992 |      Your vote accepted [0 after 0 votes] | | 5099852 Meister 600/485 Mar,1992 |      Your vote accepted [0 after 0 votes] | | 4984567 Kageyama 600/438 Jan,1991 |      Your vote accepted [0 after 0 votes] | | 4873987 Djordjevich 600/485 Oct,1989 |      Your vote accepted [0 after 0 votes] | | 4807638 Sramek 600/485 Feb,1989 |      Your vote accepted [0 after 0 votes] | | 4703758 Omura 600/485 Nov,1987 |      Your vote accepted [0 after 0 votes] | | 4370985 Takeichi 600/440 Feb,1983 |      Your vote accepted [0 after 0 votes] | | 4357944 Mauser 600/453 Nov,1982 |      Your vote accepted [0 after 0 votes] | | 4296754 Hennig 600/507 Oct,1981 |      Your vote accepted [0 after 0 votes] | | 4562843 Djordjevich 600/485 Dec,1969 |      Your vote accepted [0 after 0 votes] | | 5111826 Nasiff 600/485 Dec,1969 |      Your vote accepted [0 after 0 votes] | | | | | |
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Market Review  |
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Technical Review  |
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Claims  |
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What is claimed is:
1. A device for measuring blood pressure of a living body having a pulse
beat with a rhythm and producing a pulse wave propagating with a pulse
wave velocity, comprising:
sensor means for generating sensor data when the sensor means is attached
to the living body; and
electronic circuit means for determining the blood pressure of the living
body from the sensor data, the electronic circuit means including
first means, responsive to the sensor data, for determining a measurement
value which is a measure for a first variable that can assume a plurality
of first variable values, the first variable changing over time in the
rhythm of the pulse beat and being correlated with at least one of the
blood pressure and a change in the blood pressure,
second means, responsive to the sensor data, for determining another
measurement value which is a measure for a second variable that can assume
a plurality of second variable values, the second variable being
correlated with at least one of the pulse wave velocity and a change in
the pulse wave velocity,
third means for receiving calibration data during a calibration procedure
and for storing at least one constant determined by the calibration data,
fourth means for determining a function value on the basis of the
measurement value for the first variable and the measurement value for the
second variable; and
fifth means for using the function value and said at least one constant to
determine a value for the blood pressure.
2. A device according to claim 1, wherein the first variable is selected
from the group consisting of the momentary flow velocity of blood through
at least one artery in a measuring region, a change in the flow velocity
of blood through at least one artery in the measuring region, the blood
flow quantity through at least one artery in the metering region, the
volume of the blood in at least one artery in the measuring region, a
cross-sectional dimension of at least one artery in the measuring region,
and the cross section area of at least one artery in the measuring region,
as they occur in synchronism with the pulse beat.
3. A device according to claim 1, wherein the sensor means comprises means
for sending waves into a measuring region of the body including at least
one arterial blood vessel and for receiving waves scattered by blood in
the at least one arterial blood vessel, wherein the first variable is one
of the flow velocity of blood through the at least one arterial blood
vessel in the measuring region and the flow quantity of blood through the
at least one arterial blood vessel in the measuring region, and wherein
the first means comprises means for determining from the scattered waves a
measurement value for one of the flow velocity and flow quantity of blood
flowing through the at least one arterial blood vessel in the measuring
region.
4. A device according to claim 1, wherein the sensor means comprises means
for sending lightwaves into a measuring region of the body and for
converting scattered-back lightwaves into at least one electrical signal.
5. A device according to claim 4, wherein the means for sensing lightwaves
comprises at least one light source which generates lightwaves whose
wavelength is at least 700 nm and at most 1200 nm.
6. A device according to claim 1, wherein the sensor means comprises at
least one ultrasound transducer which sends ultrasonic waves into at least
one measuring region of the body and which converts scattered-back
ultrasonic waves into at least one electrical signal.
7. A device according to claim 1, wherein the sensor means comprises
electrodes, wherein the first variable is selected from the group
consisting of the volume of blood in at least one artery in a measuring
region, the blood flow quantity through at least one artery in the
measuring region, the cross-sectional area of at least one artery in the
measuring region, and the inner diameter of at least one artery in the
measuring region, and wherein the first means comprises means for
determining one of the electrical impedance, admittance, change in the
impedance over time, and change in the admittance over time in the
measuring region and for forming therefrom, as the measurement value for
the first variable, a value for one of the volume of blood in at least one
artery in the measuring region, the blood flow quantity through at least
one artery in the measuring region, the cross-sectional area of at least
one artery in the measurement region, and the inner diameter of at least
one artery in the measuring region.
8. A device according to claim 1, wherein the sensor means comprises at
least one ultrasound transducer for sending ultrasonic waves into at least
one measuring region of the body and which receives reflected ultrasonic
waves from at least one wall section of an artery, wherein the first
variable is selected from the group consisting of the diameter of the
artery, a change in the diameter of the artery, the cross-sectional area
of the artery, and a change in the cross-sectional area of the artery, and
wherein the first means comprises means for determining, as the
measurement value of the first variable, a value for one of the diameter
of the artery, the cross-sectional area of the artery, a change in the
diameter of the artery, and a change in the cross-sectional area of the
artery.
9. A device according to claim 1, wherein the sensor means comprises two
sensors for determining, in two measuring regions which are spaced from
one another along an artery, changes over time which occur periodically in
the rhythm of the pulse beat in the first variable, wherein the second
variable is the pulse wave velocity, and wherein the second means
comprises means for determining, from a time shift between the periodic
time changes in said first variable as determined by the two sensors, a
value for the pulse wave velocity as the measurement value of the second
variable.
10. A device according to claim 1, wherein the second variable is the pulse
wave velocity, and wherein the second means comprises means for
identifying a primary extreme occurring during a pulse period and
corresponding to the systolic blood pressure as well as an additional
extreme caused by interference between a pulse wave moving away from the
heart and a reflected pulse wave and to determine a time or phase shift
between the two extremes and to form therefrom a value constituting a
measure for the pulse wave velocity as the measurement value for the
second variable.
11. A device according to claim 1, wherein the sensor means is disposed at
a measuring location that is remote from the cardiac muscle of the living
body, wherein a graph of the first variable as a function of time has a
predetermined feature occurring during each pulse period, further
comprising additional sensor means for determining an electrical current
associated with the cardiac muscle, the electrical current associated with
the cardiac muscle changing over time and having a predetermined feature
occurring during each pulse period in the change over time, and wherein
the second means is responsive to the electrical current associated with
the cardiac muscle and comprises means for determining the measurement
value for the second variable on the basis of a time shaft between the
occurrence of the predetermined feature occurring during each pulse period
in the change over time of the electrical current associated with the
cardiac muscle and the predetermined feature occurring during each pulse
period in the graph of the variable as a function of time.
12. A device according to claim 1, wherein the first means comprises means
for determining a measurement value for the first variable repeatedly for
the same living body, wherein the second means comprises means for
determining a measurement value for the second variable repeatedly for the
same living body, wherein the fourth means comprises means for determining
function values repeatedly, and wherein the fifth means comprises means
for repeatedly using the function values and said at least one constant to
repeatedly determine at least one of the systolic and diastolic blood
pressure of the same living body.
13. A device according to claim 12, wherein the means for repeatedly using
function values and said at least one constant to repeatedly determine at
least one of the systolic and diastolic blood pressure of the body
comprises means for determining at least one of the systolic and diastolic
blood pressure at each heart beat of the body.
14. A device according to claim 1, wherein the calibration procedure is
conducted on the same living body and the calibration data comprises at
least one calibration blood pressure value measured during the calibration
procedure, and wherein the third means further comprises means for
determining the at least one constant from the at least one calibration
blood pressure value.
15. A device according to claim 1, wherein the calibration procedure is
conducted on the same living body, wherein the third means comprises means
for storing two constants determined by the calibration data, and wherein
the fifth means comprises means for multiplying one of the constants by
the function value to determine a product and for adding the other
constant to the product to determine the value for the blood pressure.
16. A device according to claim 1, wherein the fourth means comprises means
for storing a table that associates a function value to every pair of a
first variable value and a second variable value, and means for reading
from the table, for each pair of a first variable value and a second
variable value, an associated function value.
17. A device for measuring blood pressure of a living body having a pulse
beat with a rhythm and producing a pulse wave propagating with a pulse
wave velocity, comprising:
sensor means for generating sensor data when the sensor means is attached
to the living body; and
electronic circuit means for determining the blood pressure of the living
body from the sensor data, the electronic circuit means including
first means, responsive to the sensor data, for determining a measurement
value which is a measure for a first variable that can assume a plurality
of first variable values, the first variable changing over time in the
rhythm of the pulse beat and being correlated with at least one of the
blood pressure and a change in the blood pressure,
second means, responsive to the sensor data, for determining another
measurement value which is a measure for a second variable that can assume
a plurality of second variable values, the second variable being
correlated with at least one of the pulse wave velocity and a change in
the pulse wave velocity,
third means for receiving calibration data during a calibration procedure
and for storing at least one constant determined by the calibration data,
fourth means for storing a table which associates table values with
variable values, including at least the second variable values,
fifth means for selecting one of the table values on the basis of the
measurement value for the second variable to provide a selected table
value,
sixth means for multiplying the selected table value by one of the
measurement value for the first variable, a table value associated by the
table with the measurement value for the first variable, and a value
computed from the measurement value for the first variable by a
predetermined equation to provide a product value, and
seventh means for using the product value and said at least one constant to
determine a value for the blood pressure.
18. A device according to claim 17, wherein the first means comprises means
for determining a measurement value for the first variable repeatedly for
the same living body, wherein the second means comprises means for
determining a measurement value for the second variable repeatedly for the
same living body, wherein the fifth means comprises means for providing
selected table values repeatedly, wherein the sixth means comprises means
for providing product values repeatedly, and wherein the seventh means
comprises means for repeatedly determining a value for at least one of the
systolic and diastolic blood pressure for the same living body.
19. A device according to claim 17, wherein the calibration procedure is
conducted on the same living body and the calibration data comprises at
least one calibration blood pressure value measured during the calibration
procedure, and wherein the third means further comprises means for
determining the at least one constant from the at least one calibration
blood pressure value.
20. A device according to claim 17, wherein the calibration procedure is
conducted on the same living body and the third means comprises means for
storing two constants determined by the calibration data, and wherein the
seventh means comprises means for multiplying the product value by one of
the constants to obtain a resulting value and for adding the resulting
value to the other constant.
21. A device for measuring blood pressure of a living body having a pulse
beat with a rhythm and producing a pulse wave propagating with a pulse
wave velocity, comprising:
sensor means for generating sensor data when the sensor means is attached
to the living body; and
electronic circuit means for determining the blood pressure of the living
body from the sensor data, the electronic circuit means including
first means, responsive to the sensor data, for determining a measurement
value which is a measure for a first variable that changes over time in
the rhythm of the pulse beat and is correlated with at least one of the
blood pressure and a change in the blood pressure,
second means, responsive to the sensor data, for determining another
measurement value which is a measure for a second variable that is
correlated with at least one of the pulse wave velocity and a change in
the pulse wave velocity,
third means for receiving calibration data during a calibration procedure
and for storing at least one constant determined by the calibration data,
and
fourth means for computing a blood pressure value using an equation
expressing the blood pressure explicitly in dependence on the measurement
value for the first variable, the measurement value for the second
variable, and the at least one constant.
22. A device according to claim 21, wherein the calibration procedure is
conducted on the same living body and the third means comprises means for
storing two constants determined by the calibration data, and wherein the
fourth means comprises means for computing a first function value from the
measurement value for the first variable, means for computing a second
function value from the measurement value for the second variable, means
for multiplying one of the constants by the first function value and by
the second function value to provide a product, and means for adding the
other constant by the product.
23. A method of determining the blood pressure of a living body using a
device which includes sensor means for generating sensor data and
electronic circuit means for determining the blood pressure of the living
body from the sensor data, the living body having a pulse beat with a
rhythm and producing a pulse wave propagating with a pulse wave velocity,
said method comprising the steps of:
(a) disposing the sensor means on the body at at least one measuring region
that includes at least one arterial blood vessel;
(b) using the electronic circuit means to repeatedly determine, in response
to the sensor data, a measurement value which is a measure for a first
variable that can assume a plurality of first variable values, the first
variable periodically changing over time in the rhythm of the pulse beat;
(c) using the electronic circuit means to repeatedly determine, in response
to the sensor data, another measurement value which is a measure for a
second variable that can assume a plurality of second variable values, the
second variable being the pulse wave velocity;
(d) measuring the blood pressure of the body during a calibration
procedure;
(e) storing, in the electronic circuit means, at least one constant
determined by the calibration procedure;
(f) using the electronic circuit means to repeatedly determine a function
value on the basis of the repeatedly-determined measurement value for the
first variable and the repeatedly-determined measurement value for the
second variable; and
(g) using the repeatedly-determined function value and the at least one
constant in the electronic circuit means to provide blood pressure values.
24. A method according to claim 23, wherein a table containing a plurality
of function values is stored in the electronic circuit means, the table
associating each function value with a first variable value and a second
variable value, and wherein step (f) comprises selecting one of the
function values contained in the table on the basis of the measurement
value for the first variable and the measurement value for the second
variable.
25. A method according to claim 23, wherein step (d) comprises the steps of
temporarily fastening a cuff defining a cavity to the body inflating and
deflating the cuff; measuring the pressure in the cavity; determining the
at least one calibration value; and removing the cuff. |
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Claims  |
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Description  |
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BACKGROUND OF THE INVENTION
The invention relates to a device and a method for measuring blood
pressure.
The device and the method serve to measure blood pressure, namely to
measure blood pressure in a non-invasive manner. The term "non-invasive"
here means that the measurement is performed without an instrument being
introduced into a blood vessel and is thus effected with sensor means
which are disposed completely outside of the living human, or possibly
animal body whose blood pressure is being measured.
At present, blood pressure is mostly measured by methods based on the
Riva-Rocci method. Prior art devices provided for such blood pressure
measurements include a deformable cuff. This cuff defines a cavity which
is connected with a compressed gas source, usually formed by a pump that
pumps air, an outlet and a pressure measuring device. Means are further
provided to be able to associate two values of this pressure when there is
a change in the pressure existing in the cuff--namely upon deflation of
the cuff--with the systolic and the diastolic pressure. The association
with the systolic and the diastolic pressure can here be made either on
the basis of Korotkoff sounds generated when the blood flows through an
artery or according to the oscillometric variant of the method. In more
recent prior art sphygmomanometers, the pressure measuring devices include
a measuring transducer that is connected with the cavity in the cuff for
converting the pressure into an electrical value, electronic circuit means
and a display member for the analog or digital display of the systolic and
diastolic blood pressure. Devices for determining the systolic and
diastolic blood pressure on the basis of the Korotkoff sounds additionally
include either a stethoscope or a microphone. Reference is here made, for
example, to German Laid-Open Patent Application 3,014,199 and the
corresponding U.S. Pat. No. 4,459,991. The pulsating flow of the blood is
able to excite vibrations in the gas present in the cuff, normally air. In
the devices provided for oscillometric measurements, the pressure
measuring transducer and the electronic circuit means are configured to
detect the fluctuations of the pressure in the cuff connected with the
above-mentioned vibrations.
For a measurement according to the Riva-Rocci method, the cuff is fastened
to a body segment--for example an upper arm or a finger--and is pumped up
until the pressure of the air present in its cavity is sufficient to
constrict the artery in the enclosed member. Then the cuff is slowly
deflated. In the variant involving the detection of the Korotkoff sounds
by means of a stethoscope or microphone, two values are detected and
identified for the pressure in the cuff cavity during deflation of the
cuff as the systolic blood pressure and the diastolic blood pressure,
respectively. The pressure existing in the cuff during the first
occurrence of Korotkoff sounds is associated with the systolic blood
pressure. The diastolic pressure is recognized by the fact that the actual
Korotkoff sounds disappear, with the sounds generated by the flowing blood
becoming lower and less distinct or disappearing altogether. In the
oscillometric variant of the method, the pressures of the air contained in
the cuff and corresponding to the systolic and diastolic blood pressures
are determined in that the fluctuations in the cuff pressure caused by the
pulsating flow of the blood begin to appear or disappear again.
For seriously ill or critical accident victims and/or patients just coming
out of surgery and in other cases it may be necessary or at least
desirable to measure the blood pressure of the respective patient over a
certain period of time--for example over several hours or
days--permanently and as continuously as possible. In practice, devices
are known for this purpose which operate according to the Riva-Rocci
method and in which the cuff can be inflated and deflated automatically in
cycles during operation, with the systolic and diastolic blood pressure
each being measured during the deflation. However, periodic pumping up and
subsequent deflating of the cuff and the interruption of blood circulation
connected therewith in the limb around which the cuff is placed is
unpleasant for the patient being examined and may even be damaging to his
health. Since an inflation/deflation cycle usually requires at least about
one minute and, moreover, short pauses should be introduced between
successive measurements to keep annoyance to the patient being examined at
a minimum, the Riva-Rocci method does not really permit truly continuous
blood pressure measurements.
The publication entitled "Possible Determinants of Pulse-Wave Velocity In
Vivo" by Masahiko Okada, in IEEE Transactions on Biomedical Engineering,
Volume 35, No. 5, May 1988, pages 357-361, discloses a
photoplethysmographic method for measuring pulse wave velocity that will
be discussed in greater detail below. The measurement is made at the
finger or toe tips with the use of light at a wavelength of 300 nm to 500
nm. This publication describes the correlation of the pulse wave velocity
with various other parameters and variables, one of which is the blood
pressure. According to this publication, a certain correlation was found
to exist between the pulse wave velocity and the systolic and diastolic
blood pressure. Such a relatively slight correlation, however, does not
permit a determination of the blood pressure. Since the pulse wave
velocity does not change periodically, it would also not be possible, in
particular, to determine the systolic and the diastolic blood pressure
from the pulse wave velocity. Moreover, the walls of the large arteries
and the tissue portions usually covering them toward the exterior are
practically impermeable to light of a wavelength of 300 nm to 500 nm. The
method disclosed in the publication by M. Okada is therefore suitable only
for measurements at thin-walled blood vessels near the surface, which are
correspondingly small and is not suitable for measurements at large,
correspondingly thick-walled blood vessels that may possibly be relatively
far removed from the surface of the body part being examined.
Several general characteristics relating to blood circulation will now be
discussed. The circulatory system includes arterial blood vessels -(that
is, arteries),-venous blood vessels, and capillaries that interconnect the
two types of vessels. The smallest arterial blood vessels or arteries,
that are connected directly with the capillaries, are called arterioles.
The arterial blood vessels have elastically deformable walls and are at
least in part provided with muscle fibers and/or enclosed by such muscle
fibers. These muscle fibers are able to compress the arteries and
particularly the arterioles to different degrees and thus influence their
elasticity, the flow resistance and the distribution of blood to the
various blood vessels. The heart pumps the blood in a pulsating
manner--that is, in surges--through the blood vessels. The blood flows
through the blood vessels at a flow velocity v that is a function of locus
as well as time. If, for the sake of simplification, it is initially
assumed that the blood vessels have rigid walls, changes in pressure in
the blood propagate at the speed of sound cs, whose second power or square
is defined by the following formula:
c.sub.s.sup.2 =k/.rho. (1)
where .rho. is the density of the blood and K the modulus of compression,
which is also called the volume elasticity modulus and is equal to the
reciprocal of compressibility, usually identified as .kappa..
In reality, however, the arterial blood vessels do not have rigid walls
but--as already mentioned--elastically deformable walls. During each blood
surge caused by one cardiac cycle and the pulse-like pressure increase
connected therewith, the arterial blood vessels are distended. These
distensions propagate along the arterial blood vessels. The velocity at
which the change in pressure caused by a cardiac cycle or blood surge
propagates along an arterial blood vessel under the influence of its wall
elasticity, is the already mentioned pulse wave velocity c.sub.pw.
According to the book by Ludwig Prandtl, entitled "Furer durch die
Stromungs-lehre" [Fluid Mechanics Guide], published by Verlag Friedr.
Vieweg & Sohn, Braunschweig, 1965, the second power or square of the
propagation velocity of pressure changes in tubes having elastically
distensible walls, and thus at least approximately also the second power
or square of the pulse wave velocity, neglecting flexural vibrations, is
given by the following equation:
##EQU1##
where E is the modulus of elasticity of the blood vessel wall, s is the
thickness of the blood vessel wall and d is the interior diameter of the
blood vessel.
According to the above-cited publication by M. Okada, the square of the
pulse wave velocity is given by the following equation:
##EQU2##
By inserting c.sub.s in Equation (2), it can be demonstrated that Equation
(3) is derived from Equation (2) if, for the sake of simplicity, the
second product in the parenthetical expression in Equation (2) is omitted.
The flow velocity of the blood is--as already mentioned--a function of
locus as well as time. Its maximum value in an arterial blood vessel and
particularly in a large artery of a grown human being is at most about 0.5
m/s and normally a little less. According to Equations (2) and (3), the
pulse wave velocity is dependent upon the ratio of the wall thickness to
the diameter of the arteries. Since this ratio increases from the heart
toward the capillaries and since the pulse wave velocity additionally is a
function of the modulus of elasticity and of the tension in the muscle
fibers belonging to the respective blood vessel, the pulse wave velocity
changes along the arterial blood vessels and is also dependent upon the
state of the human beings or animals examined. In the arteries, the pulse
wave velocity is typically about 4 m/s to 5 m/s. The speed of sound in
water, which is known to be the major component of blood, lies in an order
of magnitude of 1500 m/s. The pulse wave velocity c.sub.pw is thus
significantly greater, namely at least or approximately 10 times greater,
than the flow velocity v, and the speed of sound c.sub.s, in turn, is very
much greater than the pulse wave velocity.
The blood pressure developing in a certain blood vessel depends on the
pumping output of the heart, on the flow resistance of the blood vessel,
on the momentary quantity flowing through, on the elasticity of the blood
vessel wall and on the viscosity of the blood.
SUMMARY OF THE INVENTION
The object of the invention is to provide a device and a method for
non-invasively measuring blood pressure, with the device and method
avoiding the drawbacks of the prior art devices and methods discussed
above. More particularly, the object of the invention is to make it
possible to monitor the blood pressure of a human being or possibly an
animal essentially continuously without having to alternatingly inflate
and deflate a cuff, while nevertheless attaining good measuring accuracy.
It has been found that the blood pressure can be determined relatively
accurately by obtaining two different value, a first one of the volume
being a variable that changes continuously in at least one measuring
region periodically over time in the rhythm of the pulse beat and/or its
change as a function of the pulse, while the other or, second value is a
value which provides a measure for the pulse wave velocity and/or its
change. By using at least one calibration value determined according to
the above-described Riva-Rocci method and linking the two values together,
it is possible to form at least one value which is a measure for a
characteristic blood pressure value and/or its change, with it being
possible to measure and display, for example, at least the systolic
pressure and, for example, also the diastolic and/or the average blood
pressure.
The device includes sensor means which comprise, for example, at least one
sensor that is releasably fastened to a body part, with it being possible
to employ two identical or two different sensors. At least the sensor or
each sensor serving to measure the first, periodically changing value is
preferably attached to an arm or possibly a leg. The device preferably
further includes a display and monitoring unit constituted by one or
several such devices and including at least part of the electronic circuit
means of the device.
The mentioned first value which changes over time in synchronism with the
pulse beat and also in synchronism with the blood pressure--that is, in
the same rhythm as the blood pressure--is correlated with the blood
pressure by way of a physical linkage, but must be formed, of course,
differently from the blood pressure and not directly by the blood pressure
itself or by a change in the blood pressure. The sensor means and the
electronic circuit means may be configured to determine and display in the
form of an electrical signal as the first value, a value that is a measure
for the momentary value of the flow velocity and/or its change in
synchronism with the pulse beat and/or the flow quantity and/or the volume
of the blood in a measuring region and/or a cross-sectional dimension
and/or the area of the passage cross section of at least one arterial
blood vessel. Since the blood vessels and particularly the arteries
normally have an approximately circular cross section, the mentioned or
determined cross-sectional dimension may be formed at least in
approximation by the interior or exterior diameter or by an average
diameter of the blood vessel. In this connection, it should also be noted
that the variables mentioned for the first value are closely linked with
one another. If the quantity of the flow is measured in volume units per
unit time, the flow quantity is equal to the product of the average flow
velocity averaged over the cross-sectional area times the area of the flow
passage cross section of the blood vessel.
The device may, for example, be configured to detect the flow velocity
and/or the flow quantity as the first value in that lightwaves--namely
monochromatic coherent lightwaves--or ultrasonic waves are directed into a
body part to be examined and lightwaves or ultrasonic waves, respectively,
that are scattered by the blood or--more precisely--by the blood cells are
detected. The light or ultrasonic radiation may here be pulsed. In these
methods which are based on the scattering of light or ultrasound,
components of the flow velocity or flow quantity that are directed at a
right angle and/or parallel to the direction of incidence of the light or
ultrasound can be detected as desired. Various types of such measuring
methods based on the scattering of light or ultrasound are known. If light
is employed, the measurements may be effected, for example, with the aid
of photon correlation, light beating spectroscopy, speckle interferometry
or the Doppler effect. In this connection, reference is made, for example,
to the publication by E. R. Pike, entitled "Laser Doppler Anemometry, a
Comparative Study of the Measurement of Motion by Light Scattering", in
"The Engineering Uses of Coherent Optics", "Proceedings and Edited
Discussion of a Conference Held at the University of Strathclyde,
Glasgow," Apr. 8-11, 1975, Cambridge University Press, pages 431-457.
If ultrasound is employed, the measurements may be done in similar ways,
namely, for example, with the aid of time domain correlation, an
interference speckle pattern and/or a Fourier transformation or the
Doppler effect. A few such measuring methods are described, for example,
in the following articles published in "Proceedings zum IEEE Ultrasonics
Symposium" [Proceedings of the IEEE Ultrasonics Symposium] 1990, Volume 3:
M. R. Sturgill, R. H. Love, B. K. Herres, "An Improved Blood Velocity
Estimator Optimized For Real-Time Ultrasound Flow Applications", pages
1467-1471; H. F. Routh, T. L. Pusateri, D. D. Waters, "Preliminary Study
Into High Velocity Transverse Blood Flow Measurement", pages 1523-1526;
and T. Tamura, R. S. C. Cobbold, K. W. Johnston, "Determination of 2-D
Velocity Vectors Using Color Doppler Ultrasound", pages 1537-1540.
Reference is also made to the publication by L. N. Bohs, G. E. Trahey,
entitled "A novel Method For Angle Independent Ultrasonic Imaging of Blood
Flow and Tissue Motion", in IEEE Transactions on Biomedical Engineering,
Volume 38, No. 3, 1991, pages 280-286.
Regarding the various methods based on lightwaves or ultrasonic waves, it
should also be noted that these methods are sometimes identified somewhat
non-uniformly by the various authors and equipment manufacturers. For
example, methods in which a flow velocity is measured that occurs at a
right angle to the direction of the radiation are sometimes included in
the Doppler effect methods although, strictly speaking and in the
classical sense, the Doppler effect is understood to mean the generation
of a frequency shift by a velocity component that is parallel to the
direction of propagation of the waves in a wave radiation source.
If a determination of the flow velocity and/or flow quantity by means of
light is provided, the device may include one or a plurality of light
sources and one or a plurality of light receivers. The or each sensor may
then include, for example, at least one optoelectronic transducer serving
as a light source, for example a laser light emitting diode, and at least
one optoelectronic transducer serving as a light receive | | |