DE3910749A1 - Method and device for the non-invasive monitoring of physiological parameters - Google Patents
Method and device for the non-invasive monitoring of physiological parametersInfo
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- DE3910749A1 DE3910749A1 DE19893910749 DE3910749A DE3910749A1 DE 3910749 A1 DE3910749 A1 DE 3910749A1 DE 19893910749 DE19893910749 DE 19893910749 DE 3910749 A DE3910749 A DE 3910749A DE 3910749 A1 DE3910749 A1 DE 3910749A1
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- 238000012544 monitoring process Methods 0.000 title claims abstract description 16
- 238000005259 measurement Methods 0.000 claims abstract description 24
- 238000002496 oximetry Methods 0.000 claims abstract description 7
- QVGXLLKOCUKJST-UHFFFAOYSA-N atomic oxygen Chemical compound [O] QVGXLLKOCUKJST-UHFFFAOYSA-N 0.000 claims description 11
- 229910052760 oxygen Inorganic materials 0.000 claims description 11
- 239000001301 oxygen Substances 0.000 claims description 11
- 210000000613 ear canal Anatomy 0.000 claims description 8
- 230000005693 optoelectronics Effects 0.000 claims description 6
- 238000012545 processing Methods 0.000 claims description 5
- 238000002106 pulse oximetry Methods 0.000 claims description 4
- 238000009532 heart rate measurement Methods 0.000 claims description 3
- 238000001514 detection method Methods 0.000 claims 4
- 238000001208 nuclear magnetic resonance pulse sequence Methods 0.000 claims 2
- 238000000691 measurement method Methods 0.000 abstract description 3
- 238000009529 body temperature measurement Methods 0.000 abstract 1
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- 102000001554 Hemoglobins Human genes 0.000 description 3
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- 230000036760 body temperature Effects 0.000 description 3
- XUIMIQQOPSSXEZ-UHFFFAOYSA-N Silicon Chemical compound [Si] XUIMIQQOPSSXEZ-UHFFFAOYSA-N 0.000 description 2
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- 108010064719 Oxyhemoglobins Proteins 0.000 description 1
- 230000037005 anaesthesia Effects 0.000 description 1
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
- A61B5/6801—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be attached to or worn on the body surface
- A61B5/6813—Specially adapted to be attached to a specific body part
- A61B5/6814—Head
- A61B5/6815—Ear
- A61B5/6817—Ear canal
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/024—Detecting, measuring or recording pulse rate or heart rate
- A61B5/02416—Detecting, measuring or recording pulse rate or heart rate using photoplethysmograph signals, e.g. generated by infrared radiation
- A61B5/02427—Details of sensor
- A61B5/02433—Details of sensor for infrared radiation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/145—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue
- A61B5/1455—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue using optical sensors, e.g. spectral photometrical oximeters
- A61B5/14551—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue using optical sensors, e.g. spectral photometrical oximeters for measuring blood gases
- A61B5/14552—Details of sensors specially adapted therefor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
- A61B5/7203—Signal processing specially adapted for physiological signals or for diagnostic purposes for noise prevention, reduction or removal
- A61B5/7207—Signal processing specially adapted for physiological signals or for diagnostic purposes for noise prevention, reduction or removal of noise induced by motion artifacts
Abstract
Description
Die Erfindung betrifft ein Verfahren und eine Vorrichtung zur nichtinvasiven Überwachung physiologischer Meßgrößen mittels wenigstens eines am oder über eine Körperhöhle im Körper eines Lebewesens anzubringenden oder zu fixierenden Meßaufnehmers.The invention relates to a method and a device for non-invasive monitoring of physiological parameters by means of at least one on or over a body cavity in the Body of a living being to be attached or fixed Sensor.
Für die Überwachung und Behandlung Schwerkranker sowie für die Überwachung von Patienten oder Probanden unter außerge wöhnlichen Bedingungen, z. B. während Narkose und Operation oder bei ergometrischen oder anderweitigen Streßuntersu chungen, ist die Überwachung von physiologischen Meßwerten unerläßlich. Hierbei werden nichtinvasive Meßmethoden be vorzugt, die keinen verletzenden oder risikoträchtigen Ein griff erfordern, um den Meßaufnehmer für die gewünschte Meßgröße an eine geeignete Stelle des Körpers zu bringen. Dies bedeutet im allgemeine, daß der Meßaufnehmer oder Sen sor zur nichtinvasiven Messung auf der Körperoberfläche an gebracht werden muß. Dabei wird der Meßaufnehmer gewissen Störungen ausgesetzt, die je nach Meßprinzip in Körperbewe gungen (Artefakten) oder Umgebungseinflüssen - Änderungen von Temperatur und Licht, Luftzug etc. - ihre Ursache ha ben.For the monitoring and treatment of the seriously ill and for the monitoring of patients or test subjects under unusual conditions, e.g. B. during anesthesia and surgery or ergometric or other stress tests, the monitoring of physiological measurements is essential. Here, non-invasive measuring methods are preferred, which do not require an injuring or risky intervention to bring the sensor for the desired measured variable to a suitable location on the body. This generally means that the sensor or sensor must be placed on the body surface for non-invasive measurement. The sensor is exposed to certain disturbances, which depending on the measuring principle in body movements (artifacts) or environmental influences - changes in temperature and light, drafts etc. - have their cause.
Eine nichtinvasive Meßmethode, die in letzter Zeit stark an Bedeutung gewonnen hat, ist die Oxymetrie, d. h. die photo elektrische Messung der arteriellen Sauerstoffsättigung im Blut. Die Sauerstoffsättigung als Verhältnis Oxyhämoglobin/ Gesamthämoglobin kann prinzipiell über optische Transmis sions- oder Reflexionsmessungen an mindestens zwei Licht wellenlängen bestimmt werden (vgl. Ullrich, G.: Physika lisch-Technisches zur Oxymetrie und Farbstoff-Injektionsme thode; HELLIGE-Mitteilungen für die Medizin, Heft 7 (1964), Seite 4 bis 16). Diese seit langem bekannte Methode krankte zunächst in ihrer nichtinvasiven, d. h. transkutanen An wendung daran, daß zwangsläufig stets auch Haut, Gewebe und venöses Blut mitgemessen wurden, so daß nur mittels um ständlicher Kalibrier- und Korrekturverfahren ein dem arte riellen Sättigungswert entsprechender Wert gefunden werden konnte. Durch Verwendung neuer optoelektronischer Bauele mente im Sensor und Anwendung elektronischer Auswertungsmetho den unter Einsatz von Mikrocomputern ist es in den letzten Jahren gelungen, auch die nichtinvasive Oxymetrie dadurch erheblich zu verbessern, daß die durch die Herztätigkeit erzeugte Pulsation des arteriellen Blutes, die sich natür lich im erhaltenen photoelektrischen Signal widerspiegelt, benutzt wird, um auf elektronischem Wege den arteriellen Anteil der für die Sauerstoffsättigung repräsentativen Meß signale zu isolieren (vgl. Yoshiya et al.: "Spectrophoto metric Monitoring of Arterial Oxygen Saturation in the Fin gertip", Med. Biol. Eng. Comput. 18 (1980), Seite 27 bis 32, insbesondere Figur 2). Hierdurch wird eine bessere nichtinvasive Messung der arteriellen Sauerstoffsättigung ermöglicht. Für diese Methode hat sich die Bezeichnung "Pulsoxymetrie" eingebürgert. Mit ihr wurde zwar die nicht invasive Oxymetrie verbessert, es konnten aber nicht alle Störeinflüsse ausgeschaltet werden. So ist es für eine einwandfreie Meßwertverarbeitung erforderlich, daß ein ausreichendes photo elektrisch erfaßbares Pulssignal vorliegt und daß dieses nicht durch Bewegungen oder Lichteinflüsse gestört ist.A non-invasive method of measurement that has been increasing recently Oximetry has gained importance. H. the photo electrical measurement of arterial oxygen saturation in the Blood. Oxygen saturation as the ratio oxyhemoglobin / Total hemoglobin can in principle be via optical transmis sions- or reflection measurements on at least two lights wavelengths are determined (see Ullrich, G .: Physika technical for oximetry and dye injection measurement method; HELLIGE-Mitteilungen für die Medizin, Issue 7 (1964), Pages 4 to 16). This long-known method fell ill initially in its non-invasive, i.e. H. transcutaneous an applied to the fact that skin, tissue and venous blood were measured, so that only by means of constant calibration and correction procedure according to the arte saturation value corresponding value can be found could. By using new optoelectronic components elements in the sensor and application of electronic evaluation methods the use of microcomputers is the last Years, also the non-invasive oximetry to significantly improve that through cardiac activity generated pulsation of arterial blood that is natural is reflected in the received photoelectric signal, is used to electronically monitor the arterial Proportion of the representative measurement for the oxygen saturation isolate signals (cf. Yoshiya et al .: "Spectrophoto metric monitoring of arterial oxygen saturation in the fin gertip ", Med. Biol. Eng. Comput. 18 (1980), pages 27 to 32, in particular Figure 2). This will make a better one non-invasive measurement of arterial oxygen saturation enables. For this method, there is a name "Pulse oximetry" naturalized. It was not with her Improved invasive oximetry, but not all Interference can be switched off. So it is for a flawless Measurement processing required that a sufficient photo electrically detectable pulse signal is present and that this is not disturbed by movements or light influences.
Der Erfindung liegt damit die Aufgabe zugrunde, die Bedin gungen der Signalerfassung bei der nichtinvasiven Überwa chung von physiologischen Meßgrößen grundsätzlich zu ver bessern.The invention is therefore based on the task, the Bedin signal acquisition during non-invasive monitoring principle of verifying physiological parameters improve.
Bei den hierfür durchgeführten Untersuchungen wurde überra schend festgestellt, daß im Ohrinneren, d. h. im Gehörgang, die Signale für photoelektrische Pulsmessung und Pulsoxyme trie sehr vorteilhaft und weitgehend störungsfrei erfaßt werden können.In the investigations carried out for this purpose, it was exceeded found schend that inside the ear, d. H. in the ear canal, the signals for photoelectric pulse measurement and pulse oxyme trie recorded very advantageous and largely trouble-free can be.
Dementsprechend ist das erfindungsgemäßen Verfahren zur nichtinvasiven Überwachung physiologischer Meßgrößen mit tels wenigstens eines am Körper eines Lebewesens anzubrin genden Meßaufnehmers dadurch gekennzeichnet, daß die Über wachung im Ohr mittels eines in den Gehörgang einzuführen den Meßaufnehmers erfolgt.Accordingly, the inventive method for non-invasive monitoring of physiological parameters with at least one on the body of a living being Genden transducer characterized in that the over to insert a watch into the ear by means of a the sensor.
Die zur Durchführung des Verfahrens geeignete Vorrichtung ist erfindungsgemäß dadurch gekennzeichnet, daß das Gehäuse des Meßaufnehmers als in den Gehörgang des Ohrs einzufüh render Stöpsel ausgeführt ist, in den wenigstens ein meß größenspezifisches Sensorelement eingebaut ist.The device suitable for carrying out the method is characterized in that the housing of the sensor than to be inserted into the ear canal render plug is executed in which at least one measure size-specific sensor element is installed.
Für das erfindungsgemäße Verfahren bzw. die Anwendung in der erfindungsgemäßen Vorrichtung ist es nicht erforder lich, daß photoelektrische Sender und Empfänger die Ohrwand berühren. Vielmehr hat sich gezeigt, daß sich das Ohrinne re, das bei der Messung zweckmäßigerweise nach außen mit einer plastischen Masse bekannter Art abgeschlossen wird, ähnlich einer Ulbricht′schen Kugel verhält, wobei das von dem durchbluteten Gewebe rückgestrahlte Licht integral er faßt wird.For the method according to the invention or the application in the device according to the invention is not required lich that photoelectric transmitter and receiver the ear wall touch. Rather, it has been shown that the inner ear re, which expediently with the measurement to the outside a plastic mass of known type is closed, behaves similar to an Ulbricht ball, with that of the light radiated back through the tissue is integral is caught.
Außer der angestrebten, weitgehend störungsfreien Erfassung des Meßsignals ergibt sich ein weiterer besonderer Vorteil der Erfindung daraus, daß der Meßaufnehmer den Probanden kaum mehr als ein Ohrhörer behindert.In addition to the desired, largely trouble-free recording of the measurement signal results in a further particular advantage the invention that the sensor the subject little more than an earphone.
Gemäß einer vorteilhaften Ausführungsform ist die stöpsel artige Vorrichtung so gestaltet, daß sich die als Sender und Empfänger dienenden optoelektronischen Bauelemente und/oder ein Temperatursensor im Ohr befinden. Gemäß einer an deren Ausführungsform können die optoelektronischen Bauele mente außerhalb des Ohrs, jedoch integral eingebettet in den Kopfabschnitt des stöpselartigen Körpers, angeordnet und über Lichtleiter mit dem Ohrinneren verbunden sein. Diese letzt genannte Ausführungsform läßt sich besonders schlank und damit auch für Kinder geeignet gestalten. Es ist an sich bekannt, daß die Körpertemperatur im Ohr gemessen werden kann. Besonders vorteilhaft ist es in Verbindung mit der Erfindung, wenn die Temperaturmeßeinrichtung mit den Ein richtungen für Pulsmessung und/oder Oxymetrie kombiniert werden. Es ergibt sich dann die Möglichkeit, mit einem ein zigen Meßaufnehmer die Pulsfrequenz, die Sauerstoffsätti gung im Blut und die Körpertemperatur zu erfassen, was bei spielsweise bei der peroperativen Überwachung von Patien ten, aber unter anderem auch bei ergometrischen Messungen, von Nutzen ist. Vorteilhaft ist hierbei auch, daß der Meß aufnehmer im Ohr in den allermeisten Fällen das Operations team nicht behindert, noch den Probanden der Ergometrie und dergleichen.According to an advantageous embodiment, the plug like device designed so that the transmitter and receiver serving optoelectronic components and / or a temperature sensor in the ear. According to one their embodiment can the optoelectronic components elements outside the ear, but embedded in the head portion of the plug-like body, arranged and over The light guide must be connected to the inside of the ear. This last one mentioned embodiment can be particularly slim and make it suitable for children. It is in itself known to measure body temperature in the ear can. It is particularly advantageous in connection with the Invention when the temperature measuring device with the one combined directions for pulse measurement and / or oximetry will. Then there is the possibility of using a Zigen sensor the pulse frequency, the oxygen saturation blood supply and body temperature to record what for example in the peroperative monitoring of patients but also with ergometric measurements, is useful. It is also advantageous that the measurement In most cases, the ear is used for operations team is not disabled, nor the subjects of ergometry and the like.
Zwei beispielsweise Ausführungsformen der Erfindung werden nachfolgend unter Bezug auf die Zeichnung mit weiteren vor teilhaften Einzelheiten der Erfindung erläutert. Es zeigen:Two example embodiments of the invention will be below with reference to the drawing with others explained partial details of the invention. Show it:
Fig. 1 eine Schnittdarstellung des menschlichen Ohrs, in das eine nichtinvasive Meßvorrichtung erfindungs gemäßer Art eingesetzt ist, und Fig. 1 is a sectional view of the human ear, in which a non-invasive measuring device according to the Invention is used, and
Fig. 2 eine entsprechende Schnittdarstellung des mensch lichen Ohrs, in dessen Gehörgang eine erfindungs gemäße Meßvorrichtung mit sehr schlanker Bauform eingesetzt ist. Fig. 2 is a corresponding sectional view of the human union ear, in the ear canal according to the Invention measuring device is used with a very slim design.
Die Schnittdarstellung der Fig. 1 und 2 des menschlichen Ohrs läßt den Schädelknochen 10 im Bereich des Ohrs mit dem außeren Gehörgang 12, Ohrmuschel 13, Trommelfell 11, eusta chischer Röhre 17, Bogengängen 14 des Gleichgewichtsorgans, den Gehörknöchelchen 18, der Schnecke 15 und dem Hörnerv 16 erkennen.The sectional view of FIGS. 1 and 2 of the human ear allows the cranial bone 10 in the area of the ear with the outer auditory canal 12 , pinna 13 , eardrum 11 , eusta chischer tube 17 , arches 14 of the balance organ, the auditory ossicles 18 , the snail 15 and the Detect auditory nerve 16 .
In die Ohröffnung ist bis in den Innenraum des Gehörgangs 12 reichend ein stöpselartiger Körper eines Meßaufnehmers 5 eingesetzt, der in der Ohröffnung durch eine einmal zu ver wendende plastische Masse 4 gegen äußere Störeinflüsse ab dichtend fixiert und gehalten ist. Am distalen, also von einer Signalabführleitung 6, die zu einer elektronischen Signalverarbeitung führt, entfernten Ende ist am oder im Körper des Meßaufnehmers 5 ein Temperatursensor 3, bei spielsweise ein Thermistor, fixiert, über den in an sich bekannter Weise die Körpertemperatur erfaßt werden kann.In the ear opening extending into the interior of the ear canal 12 a plug-like body of a sensor 5 is used, which is fixed and held in the ear opening by a plastic mass 4 to be used against external interference from sealing. At the distal end, ie from a signal discharge line 6 , which leads to electronic signal processing, the temperature sensor 3, for example a thermistor, is fixed on or in the body of the sensor 5 , via which the body temperature can be detected in a manner known per se.
Bei der Ausführungsform nach Fig. 1 sind im Bereich einer Außenwandfläche des Körpers des Meßaufnehmers 5 ein photo elektrisches Empfängerelement 1, vorzugsweise eine Sili ziumdiode, eingelassen. In etwa gleicher axialer Entfernung vom distalen Ende des Körpers des Meßaufnehmers 5 ist ein oder sind vorzugsweise zwei photoelektrische Senderele ment(e) 2 angebracht, die von der elektronischen Signalver arbeitung aus vorzugsweise pulsweise oder im Dauerstrich zur Abgabe von Licht erregt werden können, das gegen die Innenwand des Gehörgangs 12 gestrahlt wird. Als Senderele mente kommen in erster Linie lichtemittierende Dioden, die sich besonders für Pulsbetrieb eignen, in Frage und bei der bevorzugten Betriebsart einen hohen Wirkungsgrad zeigen. Im Falle von zwei Senderelementen strahlen diese vorteilhaf terweise in unterschiedlichen Spektralbereichen, z. B. bei 660 nm (rot) und bei 940 nm (infrarot), so daß sowohl Puls frequenzmessungen als auch gleichzeitig oder nachfolgend oxymetrische Messungen durchgeführt werden können.In the embodiment according to FIG. 1, a photoelectric receiver element 1 , preferably a silicon diode, is let in in the region of an outer wall surface of the body of the measuring sensor 5 . At about the same axial distance from the distal end of the body of the sensor 5 , one or preferably two photoelectric Senderele element (s) 2 is attached, which can be excited by the electronic signal processing preferably in pulses or in continuous wave to emit light against the inner wall of the auditory canal 12 is blasted. As transmitter elements come primarily light-emitting diodes, which are particularly suitable for pulsed operation, and in the preferred operating mode show a high degree of efficiency. In the case of two transmitter elements, these radiate advantageously in different spectral ranges, e.g. B. at 660 nm (red) and 940 nm (infrared), so that both pulse frequency measurements and simultaneously or subsequently oximetric measurements can be carried out.
Das bei der Pulsoxymetrie angewandte Meßprinzip ist prinzi piell bekannt; es wird nur beispielshalber auf den oben er wähnten Aufsatz G. Ullrich, HELLIGE Mitteilungen für die Medizin, Nr. 7, Oktober 1964 hingewiesen. Die Messung be ruht auf der unterschiedlichen Absorption des Lichts durch mit Sauerstoff angereichertem Hämoglobin (HbO2) bzw. Hämo globin (reduziert; Hb) bei verschiedenen Lichtwellenlängen unter zusätzlicher Berücksichtigung der Absorption in Haut und Gewebe. Dabei erzeugt der Meßaufnehmer Licht bestimmter Wellenlängen (z. B. wie erwähnt 660 nm bzw. 940 nm), das nach Durchgang durch das Gewebe auf das Empfängerelement 1 (Photozelle, z. B. Siliziumdiode) fällt und dort in ein elektrisches Signal umgewandelt wird. Im über die Leitung 6 angeschlossenen Gerät wird dieses Signal aufgebreitet, an gezeigt und ausgewertet, beispielsweise hinsichtlich der Sauerstoffsättigung des arteriellen Bluts. Dabei kann mit tels eines Mikroprozessors bei On-Line-Verrechnung berück sichtigt werden, daß das Lambert-Beer′sche Gesetz beim Blut nicht streng gilt und z. B. gespeicherte Korrekturwerte zu berücksichtigen sind.The measuring principle used in pulse oximetry is known in principle; reference is made only to the above-mentioned article G. Ullrich, HELLIGE Mitteilungen für die Medizin, No. 7, October 1964, by way of example. The measurement is based on the different absorption of light by oxygen-enriched hemoglobin (HbO 2 ) or hemoglobin (reduced; Hb) at different light wavelengths with additional consideration of the absorption in skin and tissue. The sensor generates light of certain wavelengths (e.g. 660 nm or 940 nm as mentioned) which, after passing through the tissue, falls on the receiver element 1 (photocell, e.g. silicon diode) and is converted there into an electrical signal . In the device connected via line 6 , this signal is spread out, displayed and evaluated, for example with regard to the oxygen saturation of the arterial blood. It can be taken into account with means of a microprocessor in on-line accounting that the Lambert-Beer law does not apply strictly to the blood and z. B. saved correction values have to be considered.
Da bei der Oxymetrie Signalverhältnisse (Durchlässigkeit des Gewebes, Reflexion) bei den verschiedenen Wellenlängen bestimmt werden, ist die quantitative Verteilung des von den beiden Senderelementen 2 ausgehenden Lichts von sekun därem Interesse. Das von den beiden Senderelementen in das Gewebe des Gehörgangs abgestrahlte Licht gelangt nach Streuvorgängen, verbunden mit Absorption in den die eigent liche Information enthaltenden Erythrozyten auf den auf der diametral gegenüberliegenden Mantelfläche des Sensors ange ordneten Empfänger 1.Since signal ratios (permeability of the tissue, reflection) are determined at the different wavelengths in the oximetry, the quantitative distribution of the light emanating from the two transmitter elements 2 is of secondary interest. The light emitted by the two transmitter elements into the tissue of the ear canal arrives after scattering processes, combined with absorption in the erythrocytes containing the actual information, onto the receiver 1 arranged on the diametrically opposite lateral surface of the sensor.
Bei der Messung werden die rote und die infrarote Leucht diode der Senderelemente 2 zyklisch aufeinanderfolgend ein- und ausgeschaltet, beispielsweise mit einer Folgefrequenz von 400 Hz oder mehr. Die dadurch im Empfängerelement aus gelösten Ströme werden während der einzelnen Phasen ge trennt erfaßt. Der Strom während einer auf die beiden Ein schaltphasen folgenden Dunkelphase ermöglicht die Beurtei lung der Umgebungshelligkeit. Die Taktfrequenz kann prinzi piell beliebig gewählt werden, sollte jedoch für eine gün stige Signalverarbeitung einen möglichst großen Abstand von der höchstmöglichen Pulsfrequenz aufweisen. Weiterhin ist es zweckmäßig, im Hinblick auf eine Störunterdrückung eine Taktfrequenz mit einem ganzen Vielfachen der Netzfrequenz zu wählen; z. B. eine Taktfrequenz von 480 Hz, wenn das Meßgerät für den Anschluß an ein 60 Hz-Netz bestimmt ist.During the measurement, the red and infrared LEDs of the transmitter elements 2 are cyclically switched on and off successively, for example with a repetition frequency of 400 Hz or more. The currents thereby triggered in the receiver element are detected separately during the individual phases. The current during a dark phase following the two switch-on phases enables the ambient brightness to be assessed. In principle, the clock frequency can be chosen arbitrarily, but should have the greatest possible distance from the highest possible pulse frequency for signal processing. Furthermore, it is expedient to choose a clock frequency with a whole multiple of the network frequency with regard to interference suppression; e.g. B. a clock frequency of 480 Hz if the measuring device is intended for connection to a 60 Hz network.
Gleichzeitig oder phasenverschoben zur oxymetrischen Mes sung läßt sich der Puls photoelektrisch messen, da sich die Blutfüllung im Takte des Arterienpulses ändert und damit auch das durchgelassene und rückgestreute Licht.Simultaneously or out of phase with the oximetric measurement solution, the pulse can be measured photoelectrically since the Blood filling changes in time with the arterial pulse and thus also the transmitted and backscattered light.
Für das Temperaturmeßelement 3 kommen außer Thermistoren auch Thermoelemente oder bestimmte Dioden in Frage.In addition to thermistors, thermocouples or certain diodes are also suitable for the temperature measuring element 3 .
Bei der Ausführungsform nach Fig. 2 ist der Körper des Meß aufnehmers 5 in seinem vorderen, in den Gehörgang 12 einzu schiebenden Bereich sehr schlank ausgebildet, so daß sich diese Ausführungsform insbesondere auch für Messungen an Kindern und Kleinkindern eignet. Das Empfängerelement 1′ ist in diesem Fall im verbreiterten Kopf 7 des stöpselarti gen Körpers untergebracht, ebenso das oder die photoelek trischen Senderelement(e) 2′. Empfänger 1′ und Sender 2′ sind mit der Meßstelle 1 bzw. 2 am distalen, im Gehörgang inneren liegenden Bereich des Körpers des Meßaufnehmers 5 über Lichtleiter 1′′ und 2′′ verbunden. Als geeignete Licht leiter kommen solche aus Glas oder aus Kunststoff, z. B. die von der Firma DUPONT unter dem Warenzeichen CROFON® vertriebenen Lichtleitermaterialien in Frage. Wichtig für die Auswahl der Lichtleiter 1′′, 2′′ ist die noch hinreichen de Lichtleitfähigkeit im Infrarotbereich, da, wie erwähnt, mindestens eine der benutzten Lichtwellenlängen im Infra rotbereich, beispielsweise bei 940 nm, liegt. Für eine Er höhung der Meßempfindlichkeit kann es auch vorteilhaft sein, eine Lichtwellenlänge von 810 nm zu benutzen, die dem isosbestischen Punkt des Bluts entspricht, bei dem die Ab sorption unabhängig ist von der Sauerstoffsättigung.In the embodiment of FIG. 2, the body of the transducer 5 is very slim in its front area to be inserted into the auditory canal 12 , so that this embodiment is particularly suitable for measurements on children and young children. The receiver element 1 ' is in this case housed in the widened head 7 of the stöpselarti gene body, as well as the or the photoelectric transmitter element (s) 2 '. Receiver 1 'and transmitter 2 ' are connected to the measuring point 1 and 2 at the distal, inner region of the body of the measuring sensor 5 via the light guide 1 '' and 2 ''. Suitable light conductors come from glass or plastic, for. For example, the light guide materials sold by DUPONT under the trademark CROFON® are questionable. Important for the selection of the light guide 1 '', 2 '' is the still sufficient light conductivity in the infrared range, since, as mentioned, at least one of the light wavelengths used in the infrared range, for example at 940 nm. For an increase in measuring sensitivity, it may also be advantageous to use a light wavelength of 810 nm, which corresponds to the isosbestic point of the blood, at which the absorption is independent of the oxygen saturation.
Mit der Erfindung wurden ein Verfahren und eine Vorrichtung zur weitgehend störungsfreien Erfassung und nichtinvasiven Überwachung physiologischer Meßgrößen, insbesondere des Pulses, der Sauerstoffversorgung des arteriellen Bluts und der Temperatur, geschaffen. Die Vorrichtung läßt sich im Gehörgang eines Probanden leicht und rasch installieren mit einem Minimum an Beeinträchtigung bei der Verfahrensdurch führung.With the invention, a method and an apparatus for largely trouble-free recording and non-invasive Monitoring of physiological parameters, especially the Pulse, the supply of oxygen to the arterial blood and the temperature. The device can be in Install a subject's ear canal easily and quickly with a minimum of procedural interference guide.
Das der Erfindung zugrunde liegende Verfahren kann einer seits im medizinischen Bereich, insbesondere in der Inten sivmedizin bei der Dauerüberwachung von Patienten, aber auch in gewerblichen Bereichen, etwa bei der ergometrischen Betreuung und Überwachung von Sportlern und Fliegern, vor teilhaft angewendet werden.The method on which the invention is based can be one partly in the medical field, especially in the interior active medicine in the continuous monitoring of patients, however also in commercial areas, such as ergometric Supervision and monitoring of athletes and aviators, before be applied in part.
Claims (14)
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DE19893910749 DE3910749A1 (en) | 1989-04-03 | 1989-04-03 | Method and device for the non-invasive monitoring of physiological parameters |
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DE19893910749 DE3910749A1 (en) | 1989-04-03 | 1989-04-03 | Method and device for the non-invasive monitoring of physiological parameters |
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US10966662B2 (en) | 2016-07-08 | 2021-04-06 | Valencell, Inc. | Motion-dependent averaging for physiological metric estimating systems and methods |
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