Surgery – Diagnostic testing – Cardiovascular
Reexamination Certificate
2000-02-07
2002-07-02
Nasser, Robert L. (Department: 3736)
Surgery
Diagnostic testing
Cardiovascular
C600S497000, C600S500000
Reexamination Certificate
active
06413224
ABSTRACT:
BACKGROUND OF THE INVENTION
1. Field of the Invention
The present invention relates to the improvements of a blood pressure measuring apparatus which measures a blood pressure value of a living subject such as a patient.
2. Related Art Statement
There is known an automatic blood pressure (BP) measuring apparatus which carries out BP measurements on a patient, accumulatively stores a measured BP value or values obtained in each BP measurement, and provides a graphic representation of the stored BP values arranged in the order of measurement. An example of the BP measuring apparatus is disclosed in Non-Examined Japanese Patent Application laid open under Publication No. 5(1993)-137698. The BP apparatus enables the patient to easily recognize the time change of the measured BP values and correctly judge whether he or she is in a healthy condition. When the patient feels tight in the chest, such a light attack may, however, be transient, so that the patient may fail to recognize that he or she possibly has a serious heart disease. Even if the patient may reach the recognition and consult a doctor, then the patient may no longer have any subjective symptom and may appear to the doctor to have no medical problem. In this case, the doctor may make a diagnosis based on insufficient examination data, e.g., BP values only. If the prior BP apparatus is used to obtain the BP values of the patient, however, the BP apparatus provides only the measured BP values of the patient, or only the time change of the measured BP values. With those data, the patient may suspect that he or she may have hypertension, but the patient cannot make a self-diagnosis, or the doctor cannot make a medical diagnosis, that he or she may have a heart disease. If the patient continues his or her life without receiving any medical treatments, he or she might be brought into a serious condition.
There is also known an automatic BP measuring apparatus which has a BP measuring device for automatically measuring a BP value or values of a living body, and a BP-value storing device for accumulatively storing the BP values measured by the BP measuring device from the living body. The BP measuring apparatus outputs the BP values accumulatively stored in the BP-value storing device, each time a new BP value or values of the subject is/are measured by the BP measuring device. Thus, the living body can easily recognize the time change of his or her BP values and effectively utilize the BP values for his or her health control. However, in the case where the BP values output from the BP apparatus do not fall within a normal BP range and care should be taken of the living body, just the marshalling of figures would give only a weak visual impression to the living body. Even if the living body may recognize his or her blood pressure abnormality, he or she is likely to forget it. While it is possible to output a pictorial image together with the BP values to give a stronger visual impression to the living body, it needs much time and effort to prepare the pictorial image or images. Moreover, in the case where a doctor gives a blood pressure-treating medicine to a patient after having made a diagnosis based on measured BP values, it may be somewhat cumbersome for the doctor to explain the directions for use of the medicine, the objects of administration of the same, and other necessary items.
Next, there is known an arm belt which is, either manually or using a winding device, wound around an upper arm of a living body or subject and which has an inflatable bag to which a pressurized air is supplied to press the arteries of the arm and measure a BP value or values of the subject. The supplying of the air to the bag is effected after the belt is wound around subject's arm, and the measurement of BP values is carried out while the air pressure of the bag is changed. It is preferred that the belt be wound around the arm such that three fingers can be inserted between the skin of the arm and the inside surface of the belt. However, since the upper arm of the subject around which the arm belt is wound is easily deformable, a certain level of skill is needed for winding the belt wound the arm with a preferable pressing force and measuring a BP value or values of the subject with accuracy. Hence, there has been used a winding device which automatically winds an arm belt around an upper arm of a living subject. The automatic winding device has a cylindrical arm receiver in which the belt taking. a cylindrical shape is provided, and has a drive device such as a motor for tightening the belt. After the subject inserts his or her arm into the belt inside the receiver through one end of the receiver, the drive device is operated to tighten the belt and thereby reduce the inside diameter of the cylindrical belt. Thus, the arm belt is automatically wound around the subject's upper arm. When a BP measurement is carried out using the automatic winding device, it is required that the arteries of the upper arm of the subject be uniformly pressed by the arm belt. To this end, generally, an elbow rest is provided outside the other end of the arm receiver, and the subject inserts his or her arm such that the elbow of the arm rests on the rest. The diameter of the belt is reduced when the subject is taking such a posture that the upper arm is not in contact with the inner wall of the above-mentioned one end of the receiver. That is, it is preferred that the longitudinal axis line of the upper arm of the subject be kept substantially parallel to the central axis line of the cylindrical arm receiver. However, ordering the subject to change his or her natural posture to the above-mentioned posture may result in forcing the subject to take an unnatural posture, depending upon the conformation of his or her body. This problem is exaggerated in particular for patients or aged persons who are not so free to change their postures. In the latter cases, the accuracy of BP measurements may be lowered.
There is known a BP monitor apparatus which monitors the blood pressure of a living subject. The BP monitor apparatus includes an automatic BP measuring device including an inflatable cuff adapted to be wound around a body portion of the subject. The automatic BP measuring device is iteratively started to measure a BP value or values of the subject. Thus, the BP monitor apparatus carries out BP measurements periodically, i.e., at a prescribed measurement period. However, if the measurement period is prescribed at so short a period to improve the reliability of the BP monitoring, the frequency of pressing of the subject's body portion with the cuff is increased so that the subject feels a heavy burden. In this situation, there has been proposed a BP monitor apparatus which increases the pressure of an inflatable cuff wound around a body portion of a living subject, up to a prescribed target pressure value, detects a pulse wave as a pressure oscillation produced in the cuff, and continuously estimates a BP value or values based on a magnitude or magnitudes of each of successive heartbeat-synchronous pulses of the pulse wave. Examples of this BP monitor apparatus are disclosed in Non-Examined Japanese Patent Applications No. 61(1986)-103432 and No. 60(1985)-241422. In the latter case, however, if the target pressure is prescribed at as low as possible a value to reduce the burden to the subject, it might be difficult to detect the change of respective amplitudes of successive pulses of the pulse wave corresponding to the change of BP values of the subject. That is, the reliability of the BP monitoring is lowered. The pulse amplitudes detected from the cuff set on people having normal blood pressure change with the cuff pressure so as to have an envelope indicated at solid line in
FIG. 29
, whereas the pulse amplitudes obtained from people having low blood pressure change with the cuff pressure so as to have an envelope indicated at broken line. Since the amount of change of the pulse amplitudes with respect to the amount of change of the BP values of a s
Ogura Toshihiko
Oka Toru
Colin Corporation
Nasser Robert L.
Oliff & Berridg,e PLC
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