Patent Application
20160089036
CROSS-REFERENCE TO RELATED APPLICATION(S)
The present application claims priority from Japanese Patent Application No. 2014-198149 filed on Sep. 29, 2014 and Japanese Patent Application No. 2015-175300 filed on Sep. 7, 2015, the entire content of which is incorporated herein by reference.
The presently disclosed subject matter relates to a sensor and a biological signal measuring system.
A blood refill time is one of indexes for observing a tissue perfusion of a subject. The blood refill time is used as a simple index for evaluating whether shock has occurred. The blood refill time is widely used in the field of emergency medicine for the purpose of determining necessity of transfusion, triage (evaluation of priority in a case where many persons are injured or sickened) or the like.
Generally, when measuring a blood refill time, a medical person applies pressure on a living tissue of a subject, such as a finger nail, and after the pressure is released, visually checks the color change of the nail or the skin. When the color returns to an original color within approximately two seconds, it is determined that the subject is in a normal condition. In this technique, however, because the living tissue is manually pressed and the change of the skin color is visually checked, it cannot provide quantitative results and an error easily occurs.
A related art blood refill time measurement uses a pulse oximeter (see, e.g., US2007/0282182A1). More specifically, light of a wavelength which can be absorbed by blood enters living tissue, and the intensity of light which transmits through the living tissue is measured by an optical sensor. In this case, when the living tissue is pressed by using an actuator, blood is evacuated from the living tissue of the pressed portion, and hence the intensity of the transmitted light is increased. When the pressure is released, the living tissue of the portion is filled with blood, and therefore the intensity of the transmitted light is decreased. The blood refill time is identified based on the time elapsed from the release of the pressure until the transmitted light intensity returns to the original level.
In order to perform a reproducible and quantitative measurement of the blood refill time, it is necessary to provide the same condition of applying pressure on living tissue. In the configuration where the living tissue is directly pressed by an actuator, however, it is difficult to always bring the actuator to contact the same portion of the living tissue. When the contacting position changes, the condition of applying pressure also changes, and therefore the reproducibility of measurement results is lowered.
The living tissue may compressed by using an air bag or the like. Depending on the material of the air bag, however, the light entering the living tissue, and the transmitted light (or reflected light) from the living tissue are affected, and the accuracy of measurement results may be lowered.
Illustrative aspects of the present invention provide a sensor and a biological signal measuring system configured to perform an accurate measurement of blood refill time.
According to an illustrative aspect of the present invention, a sensor is configured to measure a blood refill time of a living tissue of a subject. The sensor includes a pressure applying portion configured to apply pressure on the living tissue of the subject, a light emitter configured to emit light toward the living tissue of the subject, a light receiver configured to receive reflected light or transmitted light from the living tissue of the subject, a first light transmitting member made of a light transmitting material and having one end configured as a contact surface contacting the light emitter and another end forming a contact surface to contact the subject, a second light transmitting member made of a light transmitting material and having one end configured as a contact surface contacting the light receiver and another end forming the contact surface to contact the subject, and a light blocking member configured to block light between the light emitter and the light receiver.
According to another illustrative aspect of the present invention, a biological signal measuring system includes the sensor described above, and a biological signal measuring apparatus configured to calculate the blood refill time of the subject based on an amount of light received by the sensor.
Hereinafter, exemplary embodiments of the present invention will be described in detail with reference to the drawings.
The sensor 10 is used for measuring a blood refill time of a subject. The sensor 10 is configured to apply pressure on a living tissue (for example, an arm or a forehead) of the subject, emit light toward the living tissue, and receive reflected light or transmitted light from the living tissue. The sensor 10 sends a detection signal indicating the amount of light received from the living tissue to the biological signal measuring apparatus 20. The configuration of the sensor 10 will be described later with reference to
The biological signal measuring apparatus 20 includes a controller 21, an input section 22, and an output section 23. The controller 21 includes a pressure adjusting section 211 and a blood refill time measuring section 212.
The pressure adjusting section 211 adjusts the strength of pressure applied by the sensor 10 to the living tissue of the subject. Specifically, the pressure adjusting section 211 sends a control signal (hereinafter, a pressure control signal) to the sensor 10 to control the strength of pressure applied to the subject by the sensor 10. Generally, it is considered that the normal blood refill time is two seconds or less. Therefore, the pressure adjusting section 211 reduces the pressure so that the time period from the start of reduction of the pressure to the end of the application of pressure is shorter than two seconds (i.e., the time constant of the pressure reduction is equal to or less than two seconds).
The controller 21 controls the amount of light to be emitted from the sensor 10 and the timing of the light emission by using a control signal. The blood refill time measuring section 212 acquires the amount of light received by the sensor 10 in each of time periods (for example, before the start of the application of pressure, during the application of pressure, and after the end of the application of pressure). Then, the blood refill time measuring section 212 measures the blood refill time in accordance with a change in the amount of received light. The process of measuring the blood refill time will be described in detail with reference to the flowchart of
Firstly, the controller 21 starts emission and reception of light at a predetermined timing (for example, every 30 minutes) (S11). In this step, the pressure adjusting section 211 performs a control so as not to apply pressure on the living tissue. The blood refill time measuring section 212 measures the amount of received light before an application of pressure on the living tissue, from the sensor 10 (S12). After acquisition of the amount of received light before the application of pressure, the pressure adjusting section 211 starts to apply pressure on the living tissue (S13). The blood refill time measuring section 212 measures the amount of received light in the state of pressure being applied on the living tissue, from the sensor 10 (S14). After the application of pressure is sufficiently performed, the pressure adjusting section 211 releases the pressure on the living tissue (S15).
The blood refill time measuring section 212 computes or calculates the time elapsed from the timing when the pressure on the living tissue is released, until when the amount of received light attenuates to a value that is approximately equal to that before the application of pressure, as the blood refill time (S16). An example of a method of calculating the blood refill time is disclosed in JP2012-115640A.
The blood refill time may be calculated by using a change of the amount of received light after the application of pressure, without using the amount of received light before the application of pressure. That is, the blood refill time measuring section 212 may use any kind of algorithm in so far as the blood refill time can be identified by using a change of the amount of received light after the application of pressure on the living tissue.
Referring again to
The output section 23 outputs the blood refill time which is measured by the controller 21. For example, the output section 23 displays the blood refill time on a liquid crystal display disposed on the housing of the biological signal measuring apparatus 20. The outputting process by the output section 23 includes not only the display on the screen, but also a print output, writing into an electronic file, and the like.
The input section 22 and the output section 23 may be configured such that the display of information and the operation input can be simultaneously performed as in a touch panel.
Next, the configuration of the sensor 10 will be described with reference to
The sensor 10 includes a light emitter 11, a first light transmitting member 12, a light receiver 13, a second light transmitting member 14, and a light blocking member 15. A contact surface 16 contacts a surface of a living tissue of a subject.
The light emitter 11 emits light of a predetermined wavelength toward the living tissue of the subject (downward in
The first light transmitting member 12 is configured to guide the light emitted from the light emitter 11 toward the living tissue of the subject. That is, the first light transmitting member 12 is arranged such that one side (one end) of the first light transmitting member 12 provides a contact surface contacting the light emitter 11, and the other side (other end) of the first light transmitting member 12 provides a contact surface to contact the subject. The first light transmitting member 12 is made of a material having a high light transmission rate (light transmitting material), such as silicon rubber, elastomer, polyvinyl chloride, polycarbonate, ABS, polyurethane, plant fibers, or nylon. The light transmission rate of the first light transmitting member 12 is preferably about 30% to 100%.
The second light transmitting member 14 is configured to guide reflected light or transmitted light from the living tissue of the subject toward the light receiver 13. That is, the second light transmitting member 14 is arranged such that one side (one end) of the second light transmitting member 14 provides a contact surface contacting the light receiver 13, and the other side (other end) the second light transmitting member 14 provides a contact surface to contact the subject. The second light transmitting member 14 is made of a material having a high light transmission rate (light transmitting material), such as silicon rubber, elastomer, polyvinyl chloride, polycarbonate, ABS, polyurethane, plant fibers, or nylon. The light transmission rate of the second light transmitting member 14 is preferably about 30% to 100%.
The light receiver 13 receives reflected light or transmitted light from the living tissue of the subject. The light receiver 13 sends a light reception signal corresponding to the amount of received light (intensity of the received light), to the biological signal measuring apparatus 20. The light receiver 13 produces the light reception signal by a light receiving device provided therein. An example of the light receiving device is a photodiode.
The light blocking member 15 is disposed between the light emitter 11 and the light receiver 13, and has a low light transmission rate. In other words, the light blocking member 15 has a lower light transmission rate (second light transmission rate) than the light transmission rate (first light transmission rate) of the first light transmitting member 12 and the second light transmitting member 14. The light blocking member 15 is configured to block light so that the light emitted from the light emitter 11 is not directly received by the light receiver 13. The light blocking member 15 is made of, for example, silicon rubber to which pigment is added, elastomer, polyvinyl chloride, polycarbonate, ABS, polyurethane, plant fibers, or neoprene. The light transmission rate of the light blocking member 15 is preferably about 0% to 30%.
In the example of
The light blocking member 15 may also function as a pressure applying portion configured to apply pressure on the living tissue of the subject, as in the later described examples. For example, the light blocking member 15 may be a bag of a cuff or the like. Pressure may be applied to the living tissue of the subject by a detachable belt or the like (pressure applying portion) through the sensor 10, as will be described later with reference to
Advantages of the configuration described above and shown in
The light receiver 13 directly receives light (reflected light or transmitted light) from the living tissue of the subject, through the second light transmitting member 14 which is made a light transmitting material. Therefore, the light receiver 13 can perform a light receiving process which is affected by nothing other than the living tissue.
The light blocking member 15 is disposed between the light emitter 11 and the light receiver 13. Therefore, the light receiver 13 can avoid being directly affected by the light emission of the light emitter 11.
These functions (“a sufficient amount of light can enter the living tissue,” “light from the living tissue can be directly received,” and “the light receiver 13 is not directly affected by the light emission of the light emitter 11”) allow the sensor 10 to correctly acquire only a change in the amount of light caused by the living tissue of the subject.
Hereinafter, specific examples of the above-described configuration (
According to an exemplary embodiment of the present invention, the sensor 10 is provided in a form of a so-called cuff.
A configuration of the cuff 30 will be described in detail with reference to
Referring again to
The blood pressure calculator 213 calculates the blood pressure of the subject based on the displacement of the oscillation signal. The blood pressure calculator 213 is configured to performs a non-invasive blood pressure measurement by linear inflation method. The non-invasive blood pressure measurement by linear inflation method may be implemented by, for example, a system similar to that disclosed in JP2012-40088A or Nihon Kohden's website “Bedside Monitor BSM-1700 series—Life Scope PT”, accessible as of Sep. 22, 2014 at www.nihonkohden.co.jp/iryo/products/monitor/01_bedside/bsm1700.html.
Following is a brief description of a linear inflation non-invasive blood pressure measurement performed by the blood pressure calculator 213. The pressure adjusting section 211 raises the cuff pressure to a first set value. The blood pressure calculator 213 identifies the systolic blood pressure and the diastolic blood pressure by using the oscillation signal which is varied in accordance with the pressure rise. In the case where both the identified systolic and diastolic blood pressures are normal values, the pressure adjusting section 211 terminates the pressure rise of the cuff 30, and immediately releases the cuff pressure. In the case where at least one of the systolic blood pressure and diastolic blood pressure which are identified by the blood pressure calculator 213 is an abnormal value, by contrast, the pressure adjusting section 211 raises the cuff pressure to a second set value, and then lowers the pressure. The blood pressure calculator 213 identifies the blood pressure based on a change of the oscillation signal during the falling. As for the details of the linear inflation method, see, e.g., FIGS. 2 and 3 of JP2012-40088A.
In parallel with the measurement of the blood pressure, the biological signal measuring apparatus 20 measures also the blood refill time. Firstly, the cuff 30 measures the amount of light received from the living tissue before the rise of the cuff pressure (corresponding to S12 of
As described above, the biological signal measuring apparatus 20 is configured to calculate the blood refill time of the subject based on the amount of received light acquired by the cuff 30 (i.e., by the sensor 10), and to calculate the blood pressure of the subject based on the pressure change acquired by the cuff 30 (i.e., by the sensor 10). The biological signal measuring apparatus 20 may be configured to always calculate the blood refill time and the blood pressure, or may perform calculation (measurement of only the blood refill time, measurement of only the blood pressure, or measurement of the blood refill time and the blood pressure) in accordance with a mode setting by a user (e.g., setting by an operation of a button). With the configuration that allows the mode setting, a measurement that is required in accordance with the condition of the subject can be performed, and the measurement time can be shortened by not performing an unnecessary measurement.
It is preferable that at least one of the timing of measuring the blood pressure and the timing of measuring the blood refill time be set optionally by the user. That is, only the timing of measuring the blood pressure, only the timing of measuring the blood refill time, or both of the timing of measuring the blood pressure and the timing of measuring the blood refill time may be set. For example, the user may perform setting so that the blood pressure is measured every 30 minutes, and the blood refill time is measured every one hour. The biological signal measuring system 1 automatically controls measurements of parameters in accordance with the setting.
Advantages of the cuff 30 and biological signal measuring system 1 of the embodiment will be described. In the fingertip to which a pulse oximeter or the like is to be attached, sometimes, the blood flow is caused not to correctly reflect the operation of the central circulation, by an influence of the temperature of the nervous system. By contrast, the blood flow in a portion such as the upper arm or the lower limb is less affected by the temperature and the activity of the nervous system, as compared to the fingertip. The cuff 30 has a usual cuff shape (
In order to measure the blood refill time, gas (mainly air) is sent into the cuff 30, the cuff 30 compresses the living tissue, and then the pressure is released by discharging the gas. This operation is substantially the same as that of the cuff in non-invasive blood pressure measurement. Therefore, the biological signal measuring apparatus 20 can perform the non-invasive blood pressure measurement in addition to the measurement of the blood refill time. With a single application of pressure on the living tissue and a release of the pressure, the two parameters can be measured, and therefore the burden on the subject can be reduced. The single biological signal measuring apparatus 20 can measure the two parameters, and therefore cost reduction and miniaturization of the apparatus can be realized.
The biological signal measuring apparatus 20 may be configured to perform a linear inflation non-invasive blood pressure measurement as disclosed in JP2012-40088A (FIG. 7). In accordance with the setting by the user, the blood pressure and the blood refill time may be measured at the same timing. In this case, when the systolic blood pressure and the diastolic blood pressure can be correctly measured during the pressure rise to the first set value, the pressure rise is immediately ended, and the pressure fall is started. According to the configuration, the biological signal measuring apparatus 20 can measure the blood pressure in a time period which is shorter than that in the case of the usual blood pressure measuring system (the system in which the cuff pressure is firstly raised to a sufficiently high pressure, and, while then lowering the cuff pressure, the oscillation signal is acquired). The biological signal measuring apparatus 20 starts the measurement of the blood refill time at the timing when the pressure lowering is started. Since the pressure raising time can be made short, the biological signal measuring apparatus 20 can end also the measurement of the blood refill time in a short time period.
It is a matter of course that a configuration may be possible where, while measuring the blood refill time, the blood pressure is calculated by using the usual blood pressure measuring system (the system in which the cuff pressure is firstly raised to a sufficiently high pressure, and, while then lowering the cuff pressure, the oscillation signal is acquired).
By allowing the user to set the timing of measuring the blood pressure and the timing of measuring the blood refill time, the blood pressure and the blood refill time can be automatically acquired without performing starting operations on buttons and the like each time. By associating the timing of measuring the blood pressure with the timing of measuring the blood refill time (e.g., when the blood pressure is measured every 30 minutes, the blood refill time is measured every 30 minutes or every one hour), the two parameters can be simultaneously measured in a single step of performing the pressure raising and falling on the living tissue, so that the burden on the subject can be reduced.
In the above-described configuration, both of the blood pressure and the blood refill time are measured in accordance with the pressure control performed on the cuff 30. However, the invention is not limited to this. Of course, the cuff 30 and the biological signal measuring apparatus 20 may be configured as a single-function apparatus which is used only for measuring the blood refill time.
It is preferable that the energy for applying pressure on the living tissue to measure the blood refill time be minimized. Therefore, the biological signal measuring apparatus 20 detects the pulsation of the cuff pressure in the process of pressurizing, and calculates the maximal blood pressure from the pulsation in a technique similar to that disclosed in JP2012-40088A. Preferably, then, the biological signal measuring apparatus 20 may end the pressure rise at the timing when the cuff pressure becomes higher than the maximal blood pressure, immediately start the pressure fall, and begin the measurement of the blood refill time. In this case, the time period of the pressure rise and pressure required for measuring the blood refill time can be reduced to the minimum necessary level. Therefore, the blood refill time can be measured without imposing excessive pressure on a subject with low blood pressure.
Next, another exemplary embodiment of the present invention will be described. In this exemplary embodiment, the sensor 10 (
As shown in
The light emitter 11 in the embodiment emits light of a plurality of wavelengths. For example, the light emitter 11 includes a light emitting device which emits red light having a wavelength of about 660 nm, and another light emitting device which emits infrared light having a wavelength of about 940 nm. The light receiver 13 receives reflected or transmitted light of the wavelengths (660 nm and 940 nm). The light receiver 13 sends information on amounts of received light of the respective wavelengths to the biological signal measuring apparatus 20.
The band sensor 40 has inside a bag 41. When gas is sent into the bag 41, the bag is inflated, and, in the inflated condition, applies pressure on the living tissue of the subject. The air is sent into the bag 41 through a tube which is not shown, from the biological signal measuring apparatus 20. The band sensor 40 may be configured by, for example, attaching the bag 41, the light emitter 11, the light receiver 13, and the like to a member such as a band. The member functions as the light blocking member 15 in
The band sensor 40 may operate as an SpO2 sensor and also as a sensor for measuring the blood refill time. The user operates the input section 22 to designate the measurement mode (an SpO2 measurement mode, a blood refill time measurement mode, or a mode of measurement of the both parameters). When the SpO2 measurement mode is selected, the light receiver 13 detects the amounts of received light of the two wavelengths, and a pulse wave, and sends the result of the detection to the biological signal measuring apparatus 20. When the blood refill time measurement mode is selected, the band sensor 40 detects the amounts of received light before and after the application of pressure in a manner similar to the example of the cuff 30, and sends the result of the detection to the biological signal measuring apparatus 20.
Next, the biological signal measuring apparatus 20 which is to be connected to the band sensor 40 will be described with reference to
The SpO2 calculator 214 measures the arterial oxygen saturation (Spo2) based on the pule wave and amounts of received light of the wavelengths (the red light and the infrared light) which are detected by the band sensor 40. A calculation of the arterial oxygen saturation by the SpO2 calculator 214 is the same as the calculation using a pulse oximeter (see, e.g., JP6-30915A).
The blood refill time measuring section 212 performs the process shown in
Although, in the above, the configuration where the light emitter 11 emits light of two wavelengths has been described, the invention is not limited to this. A configuration where light of three or more wavelengths is emitted may be employed.
Advantages of the band sensor 40 and biological signal measuring apparatus 20 of the embodiment will be described. Since the band sensor 40 has the configuration where an expandable band is used, the sensor can be attached to various locations on a subject. Therefore, like the example of the cuff, it is useful also in the case where the subject is a child or the like, and can measure the blood refill time to which the condition of the central circulation is reflected.
In the above-described configuration, the light emitter 11 emits light of two or more wavelengths, and the light receiver 13 receives light. The configuration is identical with that of a usual pulse oximeter, and therefore the blood refill time and the arterial oxygen saturation can be measured by using one identical apparatus.
Next, a modified example of the band sensor 40 will be described with reference to
When gas (mainly air) is sent into the bag 41, pressure is applied on the living tissue at a location where the thin-film sheet 42 is held. The methods of measuring the blood refill time and the SpO2 may be the same as the methods described above.
Also in the configuration (
While the configuration of
According to another exemplary embodiment of the present invention, the contact surface 16 of the sensor 10 may have adhesiveness, so that the sensor 10 is attached to a subject by the contact surface 16 adhered to the subject.
The contact surface 16 of the patch sensor 50 is provided by an adhesive material which can be adhered to the subject. Specifically, the contact surface 16 may be formed by a adhesive agent which is known as a medical adhesive agent. More specifically, an acrylic-based adhesive agent, a rubber-based adhesive agent, a silicone-based adhesive agent, a vinyl ether-based adhesive agent, and the like may be used as it is or mixed with each other.
Similarly with the case of
The biological signal measuring apparatus 20 causes gas (mainly air) to be flown into a bag 51 through a tube 52, thereby performing pressure rise and fall on the living tissue. The bag 51 functions as the light blocking member 15 in
Advantages of the patch sensor 50 and biological signal measuring system 1 of the embodiment will be described. The patch sensor 50 can be easily pasted to the subject by using a usual adhesive member (acrylic-based adhesive agent or the like). Moreover, the patch sensor 50 can be attached to various locations on the subject. Therefore, the blood refill time can be measured irrespective of situations such as injury or sickness, clothing, or the like of the subject. Like to the example of the cuff, it is useful also in a case where the subject is a child or the like, and can measure the blood refill time to which the condition of the central circulation is reflected.
While the present invention has been described with reference to certain exemplary embodiments thereof, the scope of the present invention is not limited to the exemplary embodiments described above, and it will be understood by those skilled in the art that various changes and modifications may be made therein without departing from the scope of the present invention as defined by the appended claims.
For example, the cuff 30 of
| Number | Date | Country | Kind |
|---|---|---|---|
| 2014-198149 | Sep 2014 | JP | national |
| 2015-175300 | Sep 2015 | JP | national |
