This application is based upon and claims the benefit of priority from prior Japanese patent application No. 2014-009623, filed on Jan. 22, 2014, the entire contents of which are incorporated herein by reference.
The presently disclosed subject matter relates to a system for invasively measuring the blood pressure value of the subject.
There are invasive blood pressure measuring methods in which a catheter or the like is inserted into the blood vessel of the subject to continuously measure the time varying blood pressure (for example, see JP-A-4-269938). The pressure generated in the blood vessel is converted to an electrical signal by a transducer which is connected to the catheter via a monitoring line. A sphygmomanometer displays the blood pressure value and waveform corresponding to the electrical signal, to a medical person or the like.
In an invasive blood pressure measurement, it is necessary to perform a process called “zero point calibration” for setting a reference value of the measurement. The zero point calibration is performed in the following manner. The transducer is placed in a reference point. When a pressure acting on the transducer is made zero (when the catheter is opened to the atmosphere), the electrical signal indicative of the blood pressure value is set to have a measurement reference value (for example, 0 V).
The zero point calibration is performed each time the subject is changed. Even during a measurement on the same subject, however, the measurement reference value is caused to vary (drift) by various causes. The largest variation cause is that the position relationship (relative altitude) of the blood pressure measurement position and the transducer is changed by a postural change of the subject or the like. When the measurement reference value varies, the blood pressure measurement is not correctly conducted, and therefore the zero point calibration must be again performed. In the zero point calibration, a three-way stopcock to which the transducer is connected must be opened to the atmosphere. A large burden is imposed to both the subject and the medical person by performing the zero point calibration each time the posture of the subject is changed.
The presently disclosed subject matter may provide a blood pressure measuring system in which the burden which is imposed to the subject and a medical person is reduced in an invasive blood pressure measurement.
The blood pressure measuring system may comprise: a sphygmomanometer which is configured to invasively measure a blood pressure value of a subject; a calibrating section which is configured to calibrate a measurement reference value of the blood pressure value; a first atmospheric pressure sensor which is adapted to be attached to the subject; a second atmospheric pressure sensor which is fixed to a predetermined position; a difference acquiring section which is configured to acquire a difference between a first atmospheric pressure value detected by the first atmospheric pressure sensor, and a second atmospheric pressure value detected by the second atmospheric pressure sensor; and a determining section which, based on the difference, is configured to determine whether a calibration of the measurement reference value is necessary or not.
When the determining section determines that the calibration is necessary, the calibrating section may automatically calibrate the measurement reference value.
The blood pressure measuring system may further comprise: a notifying section which, when the determining section determines that the calibration is necessary, is configured to output an alarm.
The blood pressure measuring system may further comprise: a temperature sensor which is disposed in adjacent to at least one of the first atmospheric pressure sensor and the second atmospheric pressure sensor. Based on the difference and a temperature detected by the temperature sensor, the determining section may determine whether the calibration is necessary or not.
The first atmospheric pressure sensor may be adapted to be attached to a chest of the subject.
The determining section may determine that the calibration of the measurement reference value is necessary when a value of the difference between the first and second atmospheric pressure values is varied at a degree which is larger than a predetermined value.
The calibrating section may store a relationship between a correction amount of the measurement reference value and a value of the difference between the first and second atmospheric pressure values.
An embodiment of the presently disclosed subject matter will be described in detail with reference to the accompanying drawing.
The blood pressure measuring system 1 includes a sphygmomanometer 10. The sphygmomanometer 10 invasively measures the blood pressure value of the subject 2.
The illustrated embodiment shows the case where the arterial blood pressure is measured. A catheter (arterial needle) 21 is inserted into the radial artery of the subject 2. In the case where the venous blood pressure is measured, a Swan-Ganz catheter may be used. A transducer 22 is fixed at the level of the heart (the level corresponding to a half of the chest depth) of the subject 2. The catheter 21 and the transducer 22 are connected to each other through a monitoring line 23.
The monitoring line 23 includes a first tube 23a, a second tube 23b, a third tube 23c, a three-way stopcock 23d, and an infusion bottle 23e. The first tube 23a connects the catheter 21 to the three-way stopcock 23d. The second tube 23b connects the transducer 22 to the three-way stopcock 23d. The third tube 23c connects the infusion bottle 23e to the three-way stopcock 23d. The infusion bottle 23e stores a physiological saline solution containing heparin. When the three-way stopcock 23d is opened in all the directions, the first tube 23a, the second tube 23b, and the third tube 23c are filled with the physiological saline solution containing heparin.
The transducer 22 outputs an electrical signal corresponding to the pressure in the blood vessel of the subject 2, the pressure being transmitted through the physiological saline solution containing heparin. The sphygmomanometer 10 displays the blood pressure value and waveform corresponding to the electrical signal, to the user such as a medical person.
The blood pressure measuring system 1 includes a calibrating section 11. The calibrating section 11 is configured so as to calibrate the measurement reference value of the blood pressure value measured by the sphygmomanometer 10. When the measurement of the blood pressure is to be started, an initial zero point calibration of the sphygmomanometer 10 is performed. Specifically, the catheter 21 is set to be opened to the atmosphere to make the pressure acting on the transducer 22 zero. In this state, the calibrating section 11 performs a calibration so that the electrical signal supplied to the sphygmomanometer 10 has a reference value (for example, 0 V).
The blood pressure measuring system 1 includes a first atmospheric pressure sensor 31. The first atmospheric pressure sensor 31 is configured so as to be attachable to the subject 2. The first atmospheric pressure sensor 31 detects an atmospheric pressure (first atmospheric pressure value) at the attached position, and outputs a signal corresponding to the first atmospheric pressure value.
The blood pressure measuring system 1 includes a second atmospheric pressure sensor 32. The second atmospheric pressure sensor 32 is fixed to a predetermined position. The second atmospheric pressure sensor 32 detects an atmospheric pressure (second atmospheric pressure value) at the predetermined position, and outputs a signal corresponding to the second atmospheric pressure value.
The blood pressure measuring system 1 includes a difference acquiring section 12. The difference acquiring section 12 is configured so as to acquire the difference between the first atmospheric pressure value detected by the first atmospheric pressure sensor 31, and the second atmospheric pressure value detected by the second atmospheric pressure sensor 32.
The blood pressure measuring system 1 includes a determining section 13. Based on the difference acquired by the difference acquiring section 12, the determining section determines whether a calibration of the measurement reference value of the sphygmomanometer 10 is necessary or not.
In the case where, at the start of the measurement, the value of the difference between the first atmospheric pressure value and the second atmospheric pressure value is varied at a degree which is larger than a predetermined value, for example, it is determined that a calibration is necessary. The predetermined value is set to a value of a degree by which the execution of a correct measurement of the blood pressure value is impeded. In other words, even in the case where a postural change of the subject 2 occurs, when the change of the difference value is smaller than the predetermined value, the determining section 13 does not determine that a calibration is necessary.
In the case where a single atmospheric pressure sensor is used, it is impossible to determine from only a detection value of the atmospheric pressure during a measurement whether a change of the detection value is caused by that of the atmospheric pressure, or by a postural change of the subject. According to the configuration of the embodiment, by contrast, the difference between the first atmospheric pressure value detected by the first atmospheric pressure sensor 31 which is attached to the subject 2, and the second atmospheric pressure value detected by the second atmospheric pressure sensor 32 which is positionally fixed is monitored, and hence it is possible to grasp only the variation of the measurement reference value caused by a postural change of the subject 2. Therefore, an appropriate response is possible. When the degree of the postural change is within the range where the blood pressure measurement is not impeded, it is possible to determine that the calibration is not necessary. Consequently, the opportunity to perform the zero point calibration involving an operation of opening the three-way stopcock 23d to the atmosphere can be reduced, and the burden which is imposed to the subject and the medical person in the invasive blood pressure measurement can be reduced.
The calibrating section 11 may be configured so as to execute a calibration of the measurement reference value through a dial or switch which can be manually operated by a user. As indicated by the broken line in
According to the configuration, the calibration of the measurement reference value is automated, and the necessity to perform the zero point calibration involving an operation of opening the three-way stopcock 23d to the atmosphere can be further suppressed. Therefore, the burden which is imposed to the subject and the medical person in the invasive blood pressure measurement can be further reduced.
As indicated by the broken lines in
According to the configuration, in the case where the calibration of the measurement reference value is to be manually performed, the necessity can be notified more surely to the medical person. In the case where the calibration of the measurement reference value is to be automatically performed by the calibrating section 11, the medical person can easily grasp the situation where the calibration process is performed (i.e., the system is not in the usual measuring state). Therefore, the burden which is imposed to the medical person in an invasive blood pressure measurement can be further reduced.
As indicated by the broken lines in
The measurement reference value of the sphygmomanometer 10 is varied also by a temperature change during a measurement.
The result of the detection by the temperature sensor 15 can suggest the possibility that the measurement reference value is varied by a temperature change. According to the configuration, based also on an ambient temperature change during a measurement, it is determined whether the calibration is necessary or not. Hence, it is possible to provide a more correct determination result. Therefore, the burden which is imposed to the subject and the medical person in the invasive blood pressure measurement can be further reduced.
The attachment position of the first atmospheric pressure sensor 31 is not particularly limited as far as the difference acquiring section 12 can acquire the difference between the first and second atmospheric pressure values, and, based on the difference, the determining section 13 can determine whether the calibration is necessary or not. However, it is preferable that, as shown in
According to the configuration, the difference between the first and second atmospheric pressure values which is acquired by the difference acquiring section 12 further conforms to the spirit of the invention, and the correctness of the determination on the necessity/unnecessity of a calibration is enhanced. Therefore, the burden which is imposed to the subject and the medical person in the invasive blood pressure measurement can be further reduced.
The embodiment has been described in order to facilitate understanding of the invention, and is not intended to limit the invention. It is a matter of course that the invention may be changed or improved without departing the spirit thereof, and includes equivalent of the embodiment.
In the example shown in
It is not always required that the sphygmomanometer 10 is an independent apparatus. The sphygmomanometer may be provided as one function realized in a biological information monitoring apparatus which acquires and displays biological information such as an electrocardiogram.
According to an aspect of the presently disclosed subject matter, there is provided a blood pressure measuring system comprising: a sphygmomanometer which is configured to invasively measure a blood pressure value of a subject; a calibrating section which is configured to calibrate a measurement reference value of the blood pressure value; a first atmospheric pressure sensor which is adapted to be attached to the subject; a second atmospheric pressure sensor which is fixed to a predetermined position; a difference acquiring section which is configured to acquire a difference between a first atmospheric pressure value detected by the first atmospheric pressure sensor, and a second atmospheric pressure value detected by the second atmospheric pressure sensor; and a determining section which, based on the difference, is configured to determine whether a calibration of the measurement reference value is necessary or not. According to the configuration, the difference between the first atmospheric pressure value detected by the first atmospheric pressure sensor which is attached to the subject, and the second atmospheric pressure value detected by the second atmospheric pressure sensor which is positionally fixed is monitored. Therefore, it is possible to grasp only the variation of the measurement reference value caused by a postural change of the subject. Therefore, an appropriate response is possible.
When the degree of the postural change is within the range where the blood pressure measurement is not impeded, it is possible to determine that the calibration is not necessary. Consequently, the opportunity to perform the zero point calibration involving an operation of opening a three-way stopcock to the atmosphere can be reduced, and the burden which is imposed to the subject and a medical person in an invasive blood pressure measurement can be reduced.
When the determining section determines that the calibration is necessary, the calibrating section may automatically calibrate the measurement reference value. According to the configuration, the calibration of the measurement reference value is automated, and the necessity to perform the zero point calibration involving an operation of opening the three-way stopcock to the atmosphere can be further suppressed. Therefore, the burden which is imposed to the subject and a medical person in an invasive blood pressure measurement can be further reduced.
The blood pressure measuring system may further comprise: a notifying section which, when the determining section determines that the calibration is necessary, is configured to output an alarm. According to the configuration, in the case where the calibration of the measurement reference value is to be manually performed, the necessity can be notified more surely to a medical person. In the case where the calibration of the measurement reference value is to be automatically performed by the calibrating section, a medical person can easily grasp the situation where the calibration process is performed (i.e., the system is not in the usual measuring state). Therefore, the burden which is imposed to the medical person in an invasive blood pressure measurement can be further reduced.
The blood pressure measuring system may further comprise: a temperature sensor which is disposed in adjacent to at least one of the first atmospheric pressure sensor and the second atmospheric pressure sensor, and, based on the difference and a temperature detected by the temperature sensor, the determining section may determine whether the calibration is necessary or not. The measurement reference value of a sphygmomanometer is varied also by a temperature change during a measurement. According to the configuration, based also on an ambient temperature change during a measurement, it is determined whether the calibration is necessary or not. Hence, it is possible to provide a more correct determination result. Therefore, the burden which is imposed to the subject and a medical person in an invasive blood pressure measurement can be further reduced.
The first atmospheric pressure sensor may be adapted to be attached to a chest of the subject. According to the configuration, the difference between the first and second atmospheric pressure values which is acquired by the difference acquiring section further conforms to the spirit of the invention, and the correctness of the determination on the necessity/unnecessity of a calibration is enhanced. Therefore, the burden which is imposed to the subject and a medical person in an invasive blood pressure measurement can be further reduced.
Number | Date | Country | Kind |
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2014-009623 | Jan 2014 | JP | national |