U.S. patent application number 15/729178 was filed with the patent office on 2018-06-07 for opticoustic sensor.
The applicant listed for this patent is MASIMO CORPORATION. Invention is credited to Massi Joe E. Kiani.
Application Number | 20180153446 15/729178 |
Document ID | / |
Family ID | 55301201 |
Filed Date | 2018-06-07 |
United States Patent
Application |
20180153446 |
Kind Code |
A1 |
Kiani; Massi Joe E. |
June 7, 2018 |
OPTICOUSTIC SENSOR
Abstract
A physiological sensor has an optic assembly, an acoustic
assembly and an attachment assembly. The optic assembly has an
optic transducer that is activated so as to transmit a plurality of
wavelengths of light into a tissue site and to detect the light
after attenuation by pulsatile blood flow within the tissue site.
The acoustic assembly has an acoustic transducer activated so as to
respond to vibrations at the surface of the tissue site. The
attachment assembly affixes the optic assembly and acoustic
assembly to the tissue site, such as along one side of a person's
neck or the forehead. A sensor cable extends from the attachment
assembly so as to transmit an optic transducer signal and an
acoustic transducer signal to a monitor for calculation of
physiological parameters.
Inventors: |
Kiani; Massi Joe E.; (Laguna
Niguel, CA) |
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Applicant: |
Name |
City |
State |
Country |
Type |
MASIMO CORPORATION |
Irvine |
CA |
US |
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|
Family ID: |
55301201 |
Appl. No.: |
15/729178 |
Filed: |
October 10, 2017 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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14928484 |
Oct 30, 2015 |
9782110 |
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15729178 |
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13152259 |
Jun 2, 2011 |
9326712 |
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14928484 |
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61350673 |
Jun 2, 2010 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 5/14552 20130101;
A61B 5/0205 20130101; A61B 5/68335 20170801; A61B 5/02427 20130101;
A61B 5/6814 20130101; A61B 5/08 20130101; A61B 5/0261 20130101;
A61B 5/6823 20130101; A61B 5/6815 20130101; A61B 8/06 20130101;
A61B 5/6822 20130101; A61B 5/1455 20130101; A61B 5/0816
20130101 |
International
Class: |
A61B 5/1455 20060101
A61B005/1455; A61B 5/0205 20060101 A61B005/0205; A61B 5/026
20060101 A61B005/026; A61B 5/024 20060101 A61B005/024; A61B 5/08
20060101 A61B005/08; A61B 5/00 20060101 A61B005/00; A61B 8/06
20060101 A61B008/06 |
Claims
1-19. (canceled)
20. A physiological sensor assembly comprising: an acoustic sensor
configured to attach to a neck of a patient; an optical sensor
configured to attach to an ear of the patient on a same side of the
neck as the acoustic sensor; and an anchor configured to secure a
first cable, a second cable, and a third cable, wherein the first
cable is configured to connect the acoustic sensor to the third
cable and the second cable is configured to connect the optical
sensor to third cable.
21. The physiological sensor of claim 20, wherein the third cable
is configured to connect with a physiological monitor.
22. The physiological sensor of claim 20, wherein the first and the
second cables are shorter in length than the third cable.
23. The physiological sensor of claim 20, wherein the acoustic
sensor is configured to detect tracheal airflow sound.
24. The physiological sensor of claim 20, wherein the optical
sensor is configured to detect blood flow in concha tissues.
25. The physiological sensor of claim 20, wherein the acoustic
sensor further comprises an attachment assembly configured to house
a piezoelectric element.
26. The physiological sensor of claim 25, wherein the attachment
assembly comprises an elongated body including a bottom side and a
top side, the bottom side comprising an adhesive of skin
attachment.
27. The physiological sensor of claim 26, wherein the elongated
body is flexible.
28. The physiological sensor of claim 27, wherein the piezoelectric
element is positioned at a center of the elongated body.
29. The physiological sensor of claim 28, wherein a center portion
of the elongated body is shorter in length than an end portion of
the elongated body.
30. A physiological sensor assembly comprising: an acoustic sensor
configured to attach to a neck of a patient; an optical sensor
configured to attach to an ear of the patient on a side of the neck
opposite to the acoustic sensor; and an anchor configured to secure
a first cable, a second cable, and a third cable, wherein the first
cable is configured to connect the acoustic sensor to the third
cable and the second cable is configured to connect the optical
sensor to third cable.
31. The physiological sensor of claim 30, wherein the third cable
is configured to connect with a physiological monitor.
32. The physiological sensor of claim 30, wherein the anchor is
positioned on the side of the neck opposite to the acoustic
sensor.
33. The physiological sensor of claim 30, wherein the acoustic
sensor is configured to detect tracheal airflow sound.
34. The physiological sensor of claim 20, wherein the optical
sensor is configured to detect blood flow in concha tissues.
35. The physiological sensor of claim 30, wherein the acoustic
sensor further comprises an attachment assembly configured to house
a piezoelectric element.
36. The physiological sensor of claim 35, wherein the attachment
assembly comprises an elongated body including a bottom side and a
top side, the bottom side comprising an adhesive of skin
attachment.
37. The physiological sensor of claim 36, wherein the elongated
body is flexible.
38. The physiological sensor of claim 37, wherein the piezoelectric
element is positioned at a center of the elongated body.
39. The physiological sensor of claim 38, wherein a center portion
of the elongated body is shorter in length than an end portion of
the elongated body.
Description
INCORPORATION BY REFERENCE TO ANY PRIORITY APPLICATIONS
[0001] This application is a continuation of U.S. application Ser.
No. 14/928,484, filed Oct. 30, 2015, claims priority benefit under
35 U.S.C. .sctn. 120 from, and is a continuation of U.S. patent
application Ser. No. 13/152,259, now U.S. Pat. No. 9,326,712, filed
Jun. 2, 2011, entitled Opticoustic Sensor, which claims priority
benefit under 35 U.S.C. .sctn. 119(e) from U.S. Provisional Patent
Application Ser. No. 61/350,673, filed Jun. 2, 2010, entitled
Opticoustic Sensor. Any and all applications for which a foreign or
domestic priority claim is identified above or in the Application
Data Sheet as filed with the present application are hereby
incorporated by reference under 37 CFR 1.57.
BACKGROUND
[0002] Various sensors may be applied to a person for measuring
physiological parameters indicative of health or wellness. As one
example, a pulse oximetry sensor generates a blood-volume
plethysmograph waveform from which oxygen saturation of arterial
blood and pulse rate may be determined, among other parameters. As
another example, an acoustic sensor may be used to detect airflow
sounds in the lungs, bronchia or trachea, which are indicative of
respiration rate.
SUMMARY
[0003] An optical-acoustic ("opticoustic") sensor integrates an
optic sensor for measuring blood flow parameters with an acoustic
sensor for measuring body-sound parameters. Such integration
increases the number of important physiological parameters
available from a single sensor site or proximate sensor sites.
Further, such integration allows improved measurements of
physiological parameters.
[0004] In an advantageous embodiment, an opticoustic sensor applied
to a neck site utilizes a piezo element to measure respiration rate
acoustically (RRa), such as from trachea airflow sounds, and LEDs
to measure respiration rate optically (RRo) from pulsatile blood
flow. Such opticoustic-derived respiration rate (Roa) based upon
both RRa and RRo provides a more accurate or more robust measure of
respiration rate RR than achievable from either acoustic or optical
sensors alone.
[0005] In an advantageous embodiment, a tissue-profile opticoustic
sensor has an array of optical elements for distinguishing tissue
depth. Applied to a neck site, the opticoustic sensor provides
RRoa, as described above, in addition to measurements of carotid
oxygen saturation (SpO.sub.2) and jugular (pulsatile) vein
SpO.sub.2 along with peripheral tissue SpO.sub.2. The difference
between carotid artery and jugular vein SpO.sub.2 advantageously
allows an indirect measure of brain oximetry parameters including
brain oxygen demand and metabolism.
[0006] In an advantageous embodiment, a tissue-profile opticoustic
sensor applied to a forehead site advantageously provides
respiration parameters based upon paranasal sinus ostium airflow,
turbulence and echoes and, further, cerebral oxygen saturation
based upon pulsatile flow in blood-perfused brain tissues at
various depths. Attached to a back or chest site, a tissue profile
opticoustic sensor provides respiration parameters based upon
turbulent airflow in the lungs and various airways along with
neonatal core oxygen saturation.
[0007] Problems also arise when multiple sensors are used
simultaneously for patient monitoring. Each sensor utilizes its own
cable and connector, and multiple sets of cables applied to
different patient sites tend to tangle and rub together. This can
cause electrical and acoustic noise, which affect the sensors and
lead to inaccurate readings for measured parameters. Further, a
patient tethered to a variety of cumbersome cables and connectors
that limit patient movement may experience discomfort. In addition,
it is inconvenient and time consuming for a caregiver to repeatedly
connect and disconnect multiple cable sets between sensors and
monitors.
[0008] In an advantageous embodiment, an integrated opticoustic
sensor provides respiration rate based upon trachea airflow sounds
and oxygen saturation and pulse rate based upon pulsatile blood
flow within perfused ear tissues. In particular, proximate neck and
ear site attachment embodiments measure oxygen saturation, pulse
rate and respiration rate among other blood parameters. In
addition, these major vital sign measurements can be taken with the
attachment-detachment ease and convenience of a single sensor and
with minimal patient discomfort.
BRIEF DESCRIPTION OF THE DRAWINGS
[0009] FIGS. 1A-B are illustrations of optical-acoustic
("opticoustic") sensor embodiments in communications with an
opticoustic monitoring platform;
[0010] FIG. 2 is an illustration of an opticoustic sensor
embodiment for measurements of acoustically-derived parameters at a
neck site and optically-derived parameters at a proximate ear
site;
[0011] FIGS. 3A-B are illustrations of an opticoustic sensor
embodiment for measuring acoustically-derived parameters at a neck
site and optically-derived parameters at a distal ear site;
[0012] FIGS. 4A-B are illustrations of an opticoustic sensor
embodiment for measuring acoustically-derived parameters and
optically-derived parameters at a single tissue site, such as a
neck or forehead;
[0013] FIGS. 5A-B are detailed top and bottom perspective views,
respectively, of an opticoustic sensor head;
[0014] FIGS. 6A-B are detailed top and bottom perspective views,
respectively, of a tissue-profile opticoustic sensor head;
[0015] FIGS. 7A-B are detailed top and bottom perspective views,
respectively, of a multiple-acoustic sensor head;
[0016] FIG. 8 is an illustration of an arrayed acoustic sensor
embodiment;
[0017] FIGS. 9A-B are detailed opticoustic sensor block diagrams;
and
[0018] FIG. 10 is a detailed opticoustic monitor block diagram.
DETAILED DESCRIPTION
[0019] FIGS. 1A-B illustrate a patient monitoring system 100 having
a monitor 1000 in communications with optical-acoustic
("opticoustic") sensor embodiments 200, 400. As shown in FIG. 1A,
an opticoustic sensor 200 attaches to a neck site so as to detect
tracheal airflow sounds and an proximate ear site on a person so as
to detect optical changes due to pulsatile flow in blood-perfused
concha tissues, as described in detail with respect to FIGS. 2-3,
below. An integrated sensor cable 240 links the sensor 200 to a
patient cable 110, and the patient cable 110 links the sensor cable
240 to the monitor 1000, allowing communications between the sensor
200 and monitor 1000, as described in detail with respect to FIG.
9A, below. The monitor 1000 processes the opticoustic sensor
signals so as to calculate optically-derived blood parameters from
the optic head 210, such as pulse rate (PR) and oxygen saturation
(SpO.sub.2), to name a few, and acoustically-derived parameters
from the acoustic head 220, such as respiration rate (RR), as
described in detail with respect to FIG. 10, below.
[0020] As shown in FIG. 1B, in another embodiment, an opticoustic
sensor 400 attaches to a single tissue site, such as a neck,
forehead, chest or back, to name a few, so as to generate
acoustic-based and optic-based sensor signals, as described in
detail with respect to FIGS. 4-5, below. An integrated sensor cable
440 links the sensor 400 to a monitor 1000 (FIG. 1A) via a patient
cable 110 (FIG. 1A), as described in detail with respect to FIG.
98, below. The monitor 1000 processes the opticoustic sensor
signals so as to calculate acoustically-derived and
optically-derived parameters from the integrated opticoustic sensor
head 500, as described in detail with respect to FIG. 10,
below.
[0021] In an advantageous embodiment, an opticoustic sensor 200
(FIG. 1A), 400 (FIG. 1B) utilizes a piezo element to measure
respiration rate acoustically (RRa), such as from trachea airflow
sounds, and LEDs to measure respiration rate optically (RRo) from
pulsatile blood flow. Such opticoustic-derived respiration rate
(Roa) based upon both RRa and RRo provides a more accurate or more
robust measure of respiration rate RR than achievable from either
acoustic or optical sensors alone. Optically-derived respiration
rate RRo is described in U.S. patent application Ser. No.
13/076,423 titled Plethysmographic Respiration Processor filed Mar.
30, 2011, assigned to Masimo Corporation, Irvine, Calif. ("Masimo")
and incorporated by reference herein.
[0022] Although capable of simultaneous optic and acoustic
measurements at a single site, the opticoustic sensor 400 may also
be advantageously used for optic measurements at one site and
acoustic measurements at another site. For example, respiration
rate may be monitored with the sensor head 500 attached to a neck
site and cerebral oximetry may be monitored with the sensor head
500 attached to a forehead site.
[0023] Although described above with respect to respiration rate
measurements, an opticoustic sensor 200, 400 may provide
acoustic-based parameters based upon any of various body sounds
monitored at a variety of tissue sites, with applications ranging
from cardiac function analysis and diagnosis to acoustic
rhinometry. Likewise, optic-based parameters may be based on blood
flow monitored at a variety of tissue sites.
[0024] FIG. 2 illustrates an opticoustic sensor embodiment 200
providing respiration rate based upon trachea airflow sounds in
addition to oxygen saturation and pulse rate measurements based
upon pulsatile blood flow in ear tissues. The opticoustic sensor
200 has an acoustic head 220 configured for a neck site 7 and an
optic head 210 configured for an ear concha site 5 proximate to the
neck site 7, i.e. on the same side of the head as the neck site 7.
Advantageously, the proximate ear site 5 and neck site 7 allows the
sensor to be applied and removed with the ease and convenience of a
single site sensor. An optic head cable 212 interconnects the optic
head 210 to a sensor cable 240. An acoustic head cable 222
interconnects the acoustic head 220 to the sensor cable 240. An
anchor 230 attaches to the patient's neck so as to stabilize the
cables 212, 222, 240 and prevent rubbing and movement that might
generate mechanical and/or electrical noise, which interferes with
the sensor signal. Advantageously, the two sensor heads 210, 220
provide complementary physiological measurements, with the acoustic
head 220 providing respiration rate based upon trachea airflow
sounds and the optic head 210 providing oxygen saturation and pulse
rate measurements, among others, based upon pulsatile blood flow in
perfused ear (concha) tissues. The sensor cable 240 communicates
between the opticoustic sensor 200 and a patient monitor 1000 (FIG.
1A) via a sensor cable connector 250. The opticoustic sensor output
can be processed by a single monitoring platform sharing common
signal processing hardware, as described with respect to FIG. 10,
below.
[0025] As shown in FIG. 2, one embodiment of the optic head 210 is
a "Y"-clip having a base, a pair of curved clips extending from the
base, an emitter assembly extending from one clip end and a
detector assembly extending from another clip end. The clips are
tubular so as to accommodate wires from the emitter/detector
assemblies, which extend from apertures in the base. Each assembly
has a pad, a molded lens and a lid, which accommodate either an
emitter subassembly or a detector subassembly. The Y-clip flexes so
as to slide over the ear periphery and onto either side of the
concha. The Y-clip, so placed, can transmit multiple wavelength
light into the concha tissue and detect that light after
attenuation by pulsatile blood flow within the concha tissue. Ear
sensor embodiments are described in U.S. patent application Ser.
No. 12/706,711, titled Ear Sensor, filed Feb. 16, 2010, assigned to
Masimo and incorporated by reference herein.
[0026] In an embodiment, the Y-clip emitter includes both a red
light emitting diode (LED) and an infrared (IR) LED. The detector
is a photodiode that responds to both the red and infrared emitted
light so as to generate an output signal to the monitor. The LEDs
emit light into the ear concha. The photodiode is positioned
opposite the emitters so as to detect the LED emitted light after
attenuation by the blood-perfused concha tissue. The emitter and
detector have pinouts to the connector 250, which provides sensor
communication with the monitor. The monitor determines oxygen
saturation by computing the differential absorption by arterial
blood of the two wavelengths of emitted light, as is well-known in
the art. Although described above with respect to a Y-clip attached
to an ear concha site, the optic head 210 may comprise any of a
variety of transmission-mode or reflectance-mode sensors attached
to various ear tissue sites, such as an ear lobe or an ear canal,
as described in U.S. patent application Ser. No. 12/706,711, cited
above.
[0027] Also shown in FIG. 2, one embodiment of the acoustic head
220 is an attachment assembly configured to hold a sensor assembly
in contact with a neck site 7. The attachment assembly has lateral
extensions symmetrically placed about a sensor assembly, which has
a piezoelectric membrane mounted in a support frame. The
piezoelectric membrane moves on the frame in response to acoustic
vibrations, thereby generating electrical signals indicative of the
bodily sounds of the patient. An acoustic coupler generally
envelops the other sensor elements and improves the coupling
between the neck skin and the piezoelectric membrane. Acoustic
sensor embodiments, including embodiments of attachment
subassemblies and piezoelectric transducer subassemblies thereof,
are described in U.S. patent application Ser. No. 12/643,939 titled
Acoustic Sensor Assembly, filed Dec. 21, 2009 and U.S. patent
application Ser. No. 12/904,789 titled Acoustic Respiratory
Monitoring Systems and Methods, filed Oct. 14, 2010, both patent
applications assigned to Masimo and both incorporated by reference
herein.
[0028] FIGS. 3A-B illustrate an opticoustic sensor embodiment 300
providing respiration rate based upon trachea airflow sounds in
addition to oxygen saturation and pulse rate measurements based
upon pulsatile blood flow in ear tissues. The opticoustic sensor
300 has an acoustic head 320 configured for a neck site 7 (FIG. 3A)
and an optic head 310 configured for an ear concha site 9 (FIG. 38)
distal to the neck site 7 (FIG. 3A), i.e. on the opposite side of
the head. The opticoustic sensor 300 has an optic head 310
configured for an ear concha site 9 and an acoustic head 320
configured for a neck site 7. Advantageously, the neck site 7 and
distal ear site 9 removes the optic head cable 312 and the sensor
cable 340 from proximity to the acoustic head 320, eliminating any
potential for movement of these cables 312, 340 from creating
acoustic noise that could interfere with the acoustic head 320. An
optic head cable 312 interconnects the optic head 310 to a sensor
cable 340. An acoustic head cable 322 routes behind a patient neck
so as to interconnect the acoustic head 320 to the sensor cable
340. An anchor 330 attaches to the patient's neck so as to
stabilize the optical and acoustic head cables 312, 322 and the
interconnecting sensor cable 340. The sensor cable 340 communicates
between the opticoustic sensor 300 and a patient monitor 1000 (FIG.
1A) via a sensor cable connector 350. The opticoustic sensor output
can be processed by a single monitoring platform sharing common
signal processing hardware, as described with respect to FIG. 10,
below.
[0029] FIGS. 4A-B illustrate an opticoustic sensor embodiment 400
providing respiration-related parameters based upon airflow sounds
in addition to pulsatile blood flow-related parameters, such as
pulse rate and oxygen saturation. The opticoustic sensor 400 has a
sensor head 500, a sensor cable 440, a cable anchor 430 and a
sensor cable connector 450. The sensor head 500 advantageously
integrates both an optic assembly and an acoustic assembly into an
integrated adhesive media that can be quickly and easily applied to
a neck site 7 or a forehead site 3, to name a few, so as to measure
a wide range of physiological parameters. The sensor cable 440
communicates sensor signals and monitor control signals between the
sensor head 500 and the sensor connector 450. The sensor connector
450 mates with a patient cable 110 (FIG. 1A) or directly with a
patient monitor 1000 (FIG. 1A). The optic and acoustic assemblies
are described in further detail with respect to FIGS. 5-6,
below.
[0030] FIGS. 5A-B illustrates a sensor head 500 for an opticoustic
sensor embodiment 400 (FIGS. 4A-B). The sensor head 500 has
acoustic 510, optic 530, interconnect 540 and attachment 550
assemblies. The acoustic assembly 510 has an acoustic coupler 512
and a piezoelectric subassembly 514. The acoustic coupler 512
generally envelops or at least partially covers some or all of the
piezoelectric subassembly 512. The piezoelectric subassembly 512
includes a piezoelectric element and a support frame (not visible).
The piezoelectric membrane is configured to move on the frame in
response to acoustic vibrations, thereby generating electrical
signals indicative of the bodily sounds of the patient. The
acoustic coupler 512 advantageously improves the coupling between
the acoustic signal measured at the patient's skin and the
piezoelectric element. The acoustic coupler 512 includes a contact
portion 516, which is brought into contact with the skin of the
patient. As an example, at a neck site the acoustic assembly is
responsive to tracheal air flow sounds that can yield a patient's
respiration rate.
[0031] As shown in FIG. 5B, the optic assembly 530 has an emitter
subassembly 532 and a detector subassembly 534. The emitter
subassembly 532 includes multiple light emitting diodes and/or
laser diodes (collectively "LEDs") that emit narrow bandwidth light
centered on at least two discrete wavelengths in the red and IR
spectrums. The LEDs may be mounted on the attachment assembly 550
or mounted remotely, such in the sensor cable connector 450 (FIGS.
4A-B) or the monitor 1000 (FIG. 1A). If mounted remotely, light
output from the LEDs may be transported via optical fibers to the
emitter subassembly 532. The detector subassembly 534 includes at
least one photodiode detector and has a response bandwidth that
includes all of the emitter subassembly 532 bandwidths. In an
embodiment, the emitter subassembly 532 includes an addressable,
monolithic LED array that is mechanically mounted and electrically
interconnected in an encapsulated cavity of a ceramic substrate. In
an embodiment, the detector subassembly 534 includes a monolithic
Si photodiode or a combination of a monolithic Si photodiode and a
monolithic lnGaAs photodiode mechanically mounted and electrically
interconnected in an encapsulated and electromagnetically shielded
cavity of a ceramic substrate. The optical assembly 530 is
configured so that light transmitted from the emitter 532 passes
into patient tissue and is reflected back to the detector 534 after
attenuation by pulsatile blood flow in the tissue.
[0032] Further shown in FIG. 5B, the acoustic assembly 510 and
optic assembly 530 communicate with the sensor cable 440 via the
interconnect assembly 540. In an embodiment, the interconnect
assembly 540 is a flex circuit having multiple conductors that is
adhesively bonded to the attachment assembly 550. The interconnect
assembly 540 has a solder pad 542 or other interconnect to
interface with the sensor cable 440, and the attachment assembly
550 has a molded strain relief 558 for the sensor cable 440. In an
embodiment, the attachment assembly 550 is a generally elongated,
planar member having a top side 551, a bottom side 552, a first
wing 554, a center 555 and a second wing 556. A button 559
mechanically couples the acoustic assembly 510 to the attachment
assembly center 555 so that the acoustic assembly 510 extends from
the bottom side 552.
[0033] Also shown in FIG. 5B, the optic assembly 530 is disposed on
the attachment assembly bottom side 552 at the first wing 554. In
other embodiments, the optic assembly 530 is disposed on the second
wing 556 or both wings 554, 556. The interconnect assembly 540
routes along the bottom side 552 (as shown) or otherwise within
and/or upon the attachment assembly 550 so as interconnect the
acoustic 510 and optical 530 assemblies. The sensor cable 440
extends from one end of the interconnect 540 and attachment
assemblies 550 to a sensor connector 450 (FIGS. 4A-8) at an
opposite end so as to provide communications between the sensor 500
and a monitor 1000 (FIG. 1A), as described in further detail with
respect to FIG. 9B, below. In an embodiment, the wings 554, 556
have an adhesive along the bottom side 552 so as to secure the
acoustic 510 and optic 530 assemblies to a patient's skin, such as
at a neck site 7 (FIG. 4A). A removable backing can be provided
with the adhesive to protect the adhesive surface prior to affixing
to a patient's skin. In other embodiments, the attachment assembly
550 has a circular or rounded shape, which advantageously allows
uniform adhesion of the sensor head 500 to a measurement site. In a
resposable embodiment, the attachment assembly 550 or portions
thereof are removably attachable/detachable to the acoustic
assembly 510, the optic assembly 530 or both and disposed. The
acoustic 510 and/or optic 530 assemblies are reusable
accordingly.
[0034] FIGS. 6A-8 illustrates a tissue-profile sensor head 600
having acoustic 610, optic 630, interconnect 640 and attachment 650
assemblies and a sensor cable 670. The acoustic assembly 610 is as
described above with respect to 510 (FIGS. 5A-B). The optic
assembly 630 has an emitter subassembly 632 and multiple detector
subassemblies 635-637. The emitter subassembly 632 and each of the
detector subassemblies 635-637 are as described above with respect
532, 534 (FIG. 5B).
[0035] Advantageously, the optic assembly 630 is configured so that
light transmitted from the emitter subassembly 632 passes into
patient tissue and is reflected back to the detector subassemblies
635-637 after attenuation by pulsatile blood flow. Further, the
tissue-attenuated light detected varies according to tissue depth
and the spacing between the emitter subassembly 632 and a
particular one of the detector subassemblies 635-637. Accordingly,
the multiple detector subassemblies advantageously provide a tissue
profile of SpO.sub.2 versus depth. Specifically, simultaneous
SpO.sub.2 measurements are made at various tissue depths so as to
distinguish blood-perfused surface tissue measurements from deeper
tissues, veins and arteries.
[0036] As shown in FIGS. 6A-B, the acoustic assembly 610 and optic
assembly 630 communicate with the sensor cable 670 via the
interconnect assembly 640. In an embodiment, the interconnect
assembly 640 is a flex circuit having multiple conductors that is
adhesively bonded to the attachment assembly 650. The interconnect
assembly 640 has a solder pad 642 or other interconnect to
interface with the sensor cable 670, and the attachment assembly
650 has a molded strain relief 658 for the sensor cable 670. In an
embodiment, the attachment assembly 650 is a generally elongated,
planar member having a top side 651, a bottom side 652, a first
wing 654, a center 655 and a second wing 656. A button 659
mechanically couples the acoustic assembly 610 to the attachment
assembly center 655 so that the acoustic assembly 610 extends from
the bottom side 652.
[0037] Also shown in FIGS. 6A-B, the optic assembly 630 is disposed
on the attachment assembly bottom side 652 along the first wing 654
and second wing 656. The interconnect assembly 640 routes along the
bottom side 652 (as shown) or otherwise within and/or upon the
attachment assembly 650 so as interconnect the acoustic 610 and
optical 630 assemblies. The sensor cable 670 extends from one end
642 of the interconnect assembly 640 and the attachment assembly
650 to a sensor connector 450 (FIGS. 4A-B) at an opposite end so as
to provide communications between the sensor 600 and a monitor 1000
(FIG. 1A). The attachment assembly 650 is as described in detail
above with respect to 550 (FIGS. 5A-B).
[0038] An advantageous application of a tissue-profile sensor head
600 is placement on a neck site 7 (FIG. 4A) so as to measure
respiration parameters based upon tracheal airflow sounds, such as
respiration rate, and so as to measure blood-related parameters
based upon pulsatile blood flow within peripheral (surface)
tissues, within the common carotid artery (CCA) and/or the jugular
vein (JV), such as pulse rate and SpO.sub.2. The CCA and JV are
close to the neck skin surface and large in size, so as to
facilitate optical reflectance measurements. Further, the CCA and
JV supply and extract most of the blood to and from the brain and
can therefore yield information regarding cerebral oxygen demand
and corresponding metabolic rate parameters.
[0039] In a further advantageous embodiment of a tissue-profile
sensor head 600, the acoustic assembly 610 and, in particular, the
piezoelectric transducer subassembly or subassemblies thereof is
configured to generate an active pulse into the tissue site so as
to measure venous oxygen saturation (SpvO.sub.2) and other blood
constituents of the peripheral neck tissues. The use of an active
pulse for blood constituent measurements is described in U.S. Pat.
No. 5,638,816 titled Active Pulse Blood Constituent Monitoring,
filed Jun. 7, 1995; and U.S. Pat. No. 6,334,065 titled Stereo Pulse
Oximeter, filed May 27, 1999, both patents assigned to Masimo and
both incorporated by reference herein. Transmitting acoustic
vibrations into a tissue measurement site with an acoustic sensor
and, in particular, the piezoelectric acoustic sensing element
thereof by applying a relatively high voltage driver to the
piezoelectric element is describe in U.S. patent application Ser.
No. 12/904,789 titled Acoustic Respiratory Monitoring Systems and
Methods, cited above.
[0040] In a particularly advantageous embodiment, an opticoustic
sensor such as a tissue-profile sensor head 600 described above,
when placed on the neck, has one or more acoustic sensor assemblies
for measuring respiration rate acoustically (RRa) and one or more
optical sensor assemblies for measuring respiration rate optically
(RRo) so as to provide a more accurate measure of respiration rate;
and the same optical sensor assemblies for measuring carotid artery
SpO.sub.2, jugular vein SpO.sub.2, and peripheral tissue SpO.sub.2;
and a combination of the same acoustic and optical sensor
assemblies for measuring peripheral tissue venous oxygen saturation
SpvO.sub.2. Similar advantageous combined use of the acoustic and
optical sensor assemblies of an opticoustic sensor may be obtained
by attaching the tissue-profile sensor head 600, singularly or in
multiple combinations of sensor heads, on various tissue sites of
the body.
[0041] Another advantageous application of a tissue-profile sensor
head 600 is placement on a forehead site 3 (FIG. 4B) so as to
provide respiration parameters based upon paranasal sinus ostium
airflow, turbulence and echoes and, further, cerebral oxygen
saturation based upon pulsatile flow in blood-perfused brain
tissues at various depths. Attached to a back or chest site, a
tissue profile sensor head 600 provides respiration parameters
based upon turbulent airflow in the lungs and various airways along
with neonatal core oxygen saturation.
[0042] In addition, a dual-head sensor, such as described with
respect to FIG. 8, below, allows placement of one sensor head 600
at a neck site 7 (FIG. 4A) and another sensor head 600 at a
forehead site 3 (FIG. 4B) so as to provide simultaneous oxygen
saturation measurements of the CCA, brain tissue at various depths
and the JV. Such simultaneous measurements provide an overall
functional analysis of cerebral oxygen supply and metabolism along
with a comprehensive diagnostic tool for cerebral injury and
disease.
[0043] FIGS. 7A-B illustrate a multiple-acoustic sensor head 700
having a first acoustic assembly 710, a second acoustic assembly
720, an interconnect assembly 740, attachment assembly 750 and a
sensor cable 770. Each acoustic assembly 710, 720 has an acoustic
coupler 712 and a piezoelectric subassembly 714 including contact
portions 716, 726 as described with respect to FIGS. 5A-B, above.
The acoustic assemblies 710, 720 communicate with the sensor cable
770 via the interconnect assembly 740. In an embodiment, the
interconnect assembly 740 is a flex circuit having multiple
conductors that is adhesively bonded to the attachment assembly
750. The interconnect assembly 740 has a solder pad 742 or other
interconnect so as to interface with the sensor cable 770, and the
attachment assembly 750 has a molded strain relief 758 for the
sensor cable 770. The attachment assembly 750 is a generally
elongated, planar member having a top side 751, a bottom side 752,
a first wing 754, a center 755 and a second wing 756. Buttons 759
mechanically couple the acoustic assemblies 710, 720 to the
attachment assembly center 755 so that the acoustic assemblies 710,
720 extend from the bottom side 752. In an embodiment, the sensor
head 700 may have an optical assembly such as described with
respect to FIGS. 5A-B or FIGS. 6A-B, above.
[0044] In an advantageous embodiment, one of the acoustic
assemblies 710, 720 is optimized for measuring pulse rate and heart
sounds from the heart and the other one of the acoustic assemblies
710, 720 is optimized for separately measuring turbulent air sounds
from the lungs and various airways. Heart sounds typically range in
frequency from about 15 Hz-400 Hz and are relatively narrow band.
By contrast, lung sounds typically range from about 600 Hz-2000 Hz
and resemble broadband white-noise. Accordingly, in one embodiment,
one of the piezo circuits 982 (FIG. 9B) of the acoustic assemblies
710, 720 is optimized for heart sounds and the other one of the
piezo circuits 982 (FIG. 9B) is optimized for lung sounds.
[0045] An opticoustic sensor head 700 may be applied singly to a
neck site, as described with respect to FIG. 18, above, or to other
sites including the chest or back. Further, multiple identical
sensor heads 700 may be used in combination with a common cable in
an arrayed sensor head embodiment, as described with respect to
FIG. 8, below
[0046] FIG. 8 illustrates an arrayed acoustic sensor 800 embodiment
that advantageously accesses the spatial information contained in
thoracic sounds. The arrayed acoustic sensor 800 has two or more
multiple-acoustic sensor heads 700, head cables 770, a cable
junction 830, a sensor cable 840 and a sensor connector 850. Each
of the sensor heads 700 have multiple acoustic transducers, as
described with respect to FIGS. 7A-B, above. The arrayed acoustic
sensor 800 is responsive to both the direction and timing of body
sounds. Such a configuration allows a continuous visualization of
breath sound information during a complete breathing cycle, details
regarding breath sound timing between the different lung locations
and a quantification of the regional distribution of breath sounds.
Although described with respect to FIGS. 7A-8, above, as having two
acoustic transducers in each sensor head 700, an arrayed acoustic
sensor 800 may have three or more acoustic transducers in each
sensor head. Further, there may be three or more sensor heads 700
merged via the cable junction 830 into the sensor cable 840. In
addition, two or more heads may be merged onto a single attachment
assembly having sufficient size for both rows and columns of
acoustic transducers. The merged assembly shares a single sensor
cable 840, which eliminates the sensor junction 830. The arrayed
acoustic sensor 800 may be attached at various neck, chest and back
sites. Further, multiple arrayed opticoustic sensors 800 may be
attached at multiple sites, such as chest, neck and back areas, and
routed to a single monitor for analysis.
[0047] FIG. 9A illustrates an opticoustic sensor 200 embodiment
according to FIGS. 2-3 having an optic head 210 (FIG. 2) and an
acoustic head 220 (FIG. 2). The optic head 210 (FIG. 2) has LED
emitters 910 attached on one side of an ear concha site 5 and at
least one detector 920 attached on the opposite side of the concha
site 5. In an embodiment, the emitters 910 emit light 901 having at
least one red wavelength and at least one IR wavelength, so as to
determine a ratio of oxyhemoglobin and deoxygemoglobin in the
pulsatile blood perfused tissues of the concha. In other
embodiments, the emitters 910 generate light having more than two
discrete wavelengths so as to resolve other hemoglobin components.
Emitter drivers in the monitor 1000 (FIG. 10) activate the emitters
910 via drive lines 1001 in the sensor cables 110 (FIGS. 1A-B). The
detector 920 generates a current responsive to the intensity of the
received light 902 from the emitters 910 after attenuation by the
pulsatile blood perfused concha tissue 5. One or more detector
lines 1002 in the sensor cables 110 (FIGS. 1A-B) transmit the
detector current to the monitor 1000 (FIG. 10) for signal
conditioning and processing, as described with respect to FIG. 10,
below.
[0048] Also shown in FIG. 9A, the acoustic head 220 (FIG. 2) has an
acoustic sensor 930 attached to a neck site 7. The acoustic sensor
930 has a power interface 1003, a piezo circuit 932 and a
piezoelectric element 934. The piezoelectric element 934 senses
vibrations and generates a voltage in response to the vibrations,
as described with respect to the various sensor embodiments, above.
The signal generated by the piezoelectric element 934 is
communicated to the piezo circuit 932, described immediately below,
and transmits the signal 1004 to the monitor 1000 (FIG. 10) for
signal conditioning and processing.
[0049] The piezo circuit 932 decouples the power supply and
performs preliminary signal conditioning. In an embodiment, the
piezo circuit 932 includes clamping diodes to provide electrostatic
discharge (ESD) protection and a mid-level voltage DC offset for
the piezoelectric signal to ride on, to be superimposed on or to be
added to. The piezo circuit 932 may also have a high pass filter to
eliminate unwanted low frequencies such as below about 100 Hz for
breath sound applications, and an op amp to provide gain to the
piezoelectric signal. The piezo circuit 932 may also have a low
pass filter on the output of the op amp to filter out unwanted high
frequencies. In an embodiment, a high pass filter is also provided
on the output in addition to or instead of the low pass filter. The
piezo circuit 932 may also provide impedance compensation to the
piezoelectric element 934, such as a series/parallel combination
used to control the signal level strength and frequency of interest
that is input to the op amp. In one embodiment, the impedance
compensation is used to minimize the variation of the piezoelectric
element output. The impedance compensation can be constructed of
any combination of resistive, capacitive and inductive elements,
such as RC or RLC circuits.
[0050] FIG. 9B illustrates an opticoustic sensor 400 embodiment
according to FIGS. 4-5 having an integrated sensor with both optic
and acoustic assemblies that attach along a neck site 7, as but one
example. The optic assembly has LED emitters 960 and at least one
detector 970 spaced apart at a predetermined distance. In an
embodiment, the LEDs 960 emit light 906 having at least one red
wavelength and at least one IR wavelength, so as to determine a
ratio of oxyhemoglobin and deoxygemoglobin in pulsatile blood
perfused tissue. In other embodiments, the LEDs 960 generate light
having more than two discrete wavelengths so as to resolve other
hemoglobin components. Emitter drivers in the monitor 1000 (FIG.
10) activate the emitters 960 via drive lines 1001 in the sensor
and patient cables. The detector 970 generates a current responsive
to the intensity of the received light 907 from the emitters 960
after reflection/attenuation by pulsatile blood perfused tissue.
One or more detector lines 1002 transmit the detector current to
the monitor 1000 (FIG. 10) for signal conditioning and processing,
as described with respect to FIG. 10, below. Also shown in FIG. 9B,
the acoustic assembly has an acoustic sensor 980 attached to, as
but one example, a neck site 7. The acoustic sensor 980 has a power
interface 1003, a piezo circuit 982 and a piezoelectric element
984, as described above with respect to FIG. 9A.
[0051] In multiple acoustic transducer embodiments, the piezo
circuit 982 for one transducer is optimized for pulse and heart
sounds and the piezo circuit 982 for another transducer is
optimized for lung sounds. In an embodiment, a piezo circuit filter
is relatively broadband and has a relatively high center frequency
for lung/breath sounds and is relatively narrow band with a
relatively low center frequency for pulse and heart sounds. In a
particularly advantageous embodiment, acoustic-derived pulse and
heart sounds are used to verify an optically-derived pulse rate as
well as characteristics of plethysmograph waveforms.
[0052] FIG. 10 illustrates a monitor 1000 for driving and
processing signals from an opticoustic sensor 200, 400 (FIGS.
9A-B). The monitor 1000 includes an optical front-end 1052, an
acoustic front-end 1056, an analog-to-digital (A/D) converter 1053,
a digital signal processor (DSP) 1058, emitter drivers 1054 and
digital-to-analog (D/A) converters 1055. In general, the D/A
converters 1055 and drivers 1054 convert digital control signals
into analog drive signals 1001 capable of activating the emitters
910, 960 (FIGS. 9A-B) via a sensor cable 1030. The optical
front-end 1052 and A/D converter 1053 transform composite analog
intensity signal(s) from light sensitive detector(s) received via
the sensor cable 1030 into digital data input to the DSP 1058. The
acoustic front-end 1056 and A/D converter 1053 transform analog
acoustic signals from a piezoelectric element into digital data
input to the DSP 1058. The A/D converter 1053 is shown as having a
two-channel analog input and a multiplexed digital output to the
DSP 1058. In another embodiment, each front-end 1052, 1056
communicates with a dedicated single channel ND converter
generating two independent digital outputs to the DSP 1058.
[0053] According to an embodiment, the DSP 1058 comprises a
processing device based on the Super Harvard Architecture
("SHARC"), such as those commercially available from Analog
Devices. However, the DSP 1058 can comprise a wide variety of data
and/or signal processors capable of executing programs 1059 for
determining physiological parameters from input data.
[0054] Also shown in FIG. 10, an instrument manager 1082
communicates with the DSP 1058 to receive physiological parameter
information derived by the DSP firmware 1059. One or more I/O
devices 1084 have communications 1083 with the instrument manager
1082 including displays, alarms, user I/O and instrument
communication ports. The alarms may be audible or visual indicators
or both. The user I/O may be, as examples, keypads, touch screens,
pointing devices or voice recognition devices, to name a few. The
displays may be indicators, numerics or graphics for displaying one
or more of various physiological parameters 1086. The instrument
manager 1082 may also be capable of storing or displaying
historical or trending data related to one or more of the measured
values or combinations of the measured values. A patient monitor is
disclosed in U.S. application Ser. No. 11/367,033, filed on Mar. 1,
2006, titled Noninvasive Multi-Parameter Patient Monitor, which is
assigned to Masimo and incorporated by reference herein.
[0055] In various embodiments, the monitor 1000 may be one or more
processor boards installed within and communicating with a host
instrument. Generally, a processor board incorporates the front-end
1052, 1056, drivers 1054, converters 1053, 1055 and DSP 1058.
Accordingly, the processor board derives physiological parameters
and communicates values for those parameters to the host
instrument. Correspondingly, the host instrument incorporates the
instrument manager 1082 and I/O devices 1084. A processor board may
also have one or more microcontrollers (not shown) for board
management, including, for example, communications of calculated
parameter data and the like to the host instrument.
[0056] An opticoustic sensor has been disclosed in detail in
connection with various embodiments. These embodiments are
disclosed by way of examples only and are not to limit the scope of
the claims that follow. One of ordinary skill in art will
appreciate many variations and modifications.
* * * * *