U.S. patent number 3,628,525 [Application Number 04/834,735] was granted by the patent office on 1971-12-21 for blood oxygenation and pulse rate monitoring apparatus.
This patent grant is currently assigned to American Optical Corporation. Invention is credited to David S. Ostrowski, Michael L. Polanyi.
United States Patent |
3,628,525 |
Polanyi , et al. |
December 21, 1971 |
BLOOD OXYGENATION AND PULSE RATE MONITORING APPARATUS
Abstract
An ear oximeter functioning as a transducer for monitoring blood
oxygen saturation and pulse rate comprising an ear clamp having a
pair of opposed jaws between which body tissue may be clamped for
transillumination by light emitted from one jaw into the clamped
tissue. Thermostatically controlled heating means arterializes the
transilluminated tissue and light emitter from the tissue is
monitored by a photoelectric light-intensity meter for indication
of percent oxygen in blood within the arterialized tissue.
Inventors: |
Polanyi; Michael L. (Webster,
MA), Ostrowski; David S. (Dudley, MA) |
Assignee: |
American Optical Corporation
(Southbridge, MA)
|
Family
ID: |
25267661 |
Appl.
No.: |
04/834,735 |
Filed: |
June 19, 1969 |
Current U.S.
Class: |
600/334; 356/41;
600/502 |
Current CPC
Class: |
A61B
5/02416 (20130101); A61B 5/6816 (20130101); A61B
5/02427 (20130101); A61B 5/1491 (20130101); A61B
5/14552 (20130101) |
Current International
Class: |
A61B
5/00 (20060101); A61B 5/024 (20060101); A61b
005/00 () |
Field of
Search: |
;128/2R,2L,2.1R,2.5F,2.5P,2.5R,2.5D ;356/39-41 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Kamm; William E.
Claims
We claim:
1. An oximeter device comprising:
a main supporting member;
a pair of parallel clamping jaws extending laterally from said
member, said jaws being movable at least one toward the other along
said member for clamping a section of body tissue between their
corresponding terminal ends;
light-emitting means in a first of said jaws of said pair adjacent
its terminal end and a light-receiving platen adjacent the terminal
of the second of said jaws between which said section of body
tissue is adapted to be received for said clamping thereof and is
adapted to be transilluminated by light emitted from said emitting
means;
an electrical heating element adjacent said platen for heating
same;
a thermistor in said platen;
temperature control means in electrical circuit with said heating
element and thermistor, said control means being responsive to
variations in electrical resistance of said thermistor for
maintaining the temperature of said platen and said section of
tissue substantially constant during said transillumination of the
tissue;
means adjacent said terminal end of said jaw for receiving light
transmitted through said tissue and;
light intensity measuring means operatively associated with said
light-receiving means for measuring the intensity of light received
thereby.
2. An oximeter device according to claim 1 wherein said
light-emitting means comprises one end of an elongated bundle of
light-conducting fibers having a source of light adjacent its
opposite end.
3. An oximeter device according to claim 1 wherein said
light-emitting means comprises at least one light-emitting
diode.
4. An oximeter device according to claim 1 wherein said thermistor
in said platen is positioned adjacent the surface thereof against
which said tissue is adapted to be clamped.
5. An oximeter device according to claim 1 wherein said movable jaw
is biased toward the other jaw of said pair thereof by spring means
whereby said tissue may be clamped nonsubjectively.
6. An oximeter device according to claim 5 including means for
releasably fixing said jaws against separation from a clamped
relationship with said section of body tissue.
7. An oximeter device according to claim 6 further including an
inflatable transparent membrane extending over said light-emitting
means and means through which an inflating medium may be directed
into said membrane to distend same.
8. An oximeter device according to claim 1 wherein said
light-receiving means comprises one end of an elongated bundle of
light-conducting fibers and said light-intensity measuring means
includes a photoelectric transducer system.
9. An oximeter device according to claim 1 wherein said
light-receiving means comprises at least one photoelectric detector
for converting light received thereby into electrical energy and
said light-intensity measuring means includes electrical energy
measuring and intensity indicating means electrically connected to
said detector.
10. An oximeter device according to claim 2 wherein portions of
said light-conducting fibers adjacent said one end of said bundle
are spaced a preselected radial distance away from the principal
axis of the bundle.
11. An oximeter device according to claim 10 wherein said portions
of said light-conducting fibers are disposed annularly about said
principal axis of said bundle.
12. An oximeter device according to claim 8 wherein portions of
said light-conducting fibers adjacent said one end of said bundle
are spaced a preselected radial distance away from the principal
axis of the bundle.
13. An oximeter device according to claim 13 wherein said portions
of said light-conducting fibers are disposed annularly about said
principal axis of said bundle.
Description
BACKGROUND OF THE INVENTION
1. Field of the Invention
Tissue oximeters with particular reference to improvements in means
for arterializing relevant portions of body tissue under
observation.
2. Description Of The Prior Art
The determination of oxygen saturation of the circulating blood
without extracting a sample of the blood can be accomplished by
transilluminating the pinna of the ear, or another suitable portion
of the body, and measuring the light transmitted at a wavelength of
about 650 .mu. against a reference wavelength of about 805 m.mu..
The ear oximeter, in general, is a well-known instrument and is
described in U.S. Pat. No. 2,706,927.
In this manner of measuring oxygen saturation, it is common to heat
the skin in the area under observation so as to dilate arterioles
with the intent of increasing the blood flow to the point where
very little deoxygenation occurs in the capillaries so that the
measurement becomes essentially that of arterial oxygen saturation
which in most instances is of greater clinical value than a
measurement of oxygen saturation in venus blood.
Heretofore, a small incandescent lamp has been used both for
illumination and for heating of the skin. However, when the blood
circulation is abundant, heat from a lamp is quickly dissipated and
the skin may not become sufficiently heated for arterialization. On
the other hand, when circulation is poor and little or no
dissipation of heat occurs, serious discomfort or harm to the
patient may result from excessive heating by the lamp.
It has also been determined that in cases where the optical path
length of light in an ear oximeter is varied according to the
thickness of ear tissue being transilluminated, difficulty in
obtaining absolute measurements of blood oxygen saturation is
encountered.
The aforesaid drawbacks in prior art ear oximetry and others which
may become apparent hereinafter are overcome by the present
invention which is directed more particularly to a system wherein a
fixed optical path length of light is used to transilluminate
portions of bodies under test and heating is kept within a narrow
range of a temperature which is comfortable and harmless to the
patient, yet optimum in effecting arterialization.
SUMMARY OF THE INVENTION
The optimum in arterialization without discomfort or harm to the
patient and the corollary of greater accuracy and dependability of
oxygen saturation measurements performed according to principles of
this invention are accomplished by directing cold light to the
portion of tissue under observation and heating that portion with a
heating pad kept within a narrow range of temperature (e.g.
41.degree. C.) which is optimum for arterialization of the
skin.
The term "cold light" as used herein is intended to include any
light which is rendered substantially unaccompanied by appreciable
amounts of heat such as light emitted from fiber optic conductors,
or light-emitting diodes which, when directed upon tissue under
observation will produce minimal heating of the tissue.
The present invention features a system having a fixed path length
of light into which portions of the body (e.g. the ear) may be
positioned for transillumination whereby measurements of blood
oxygen saturation obtained by such means are substantially
independent of thickness of the body under test. Furthermore,
greater precision in the measurement of blood oxygen saturation is
accomplished by directing light into the transilluminated portion
of the body specimen from points equally radially spaced a few
millimeters from the axis along which light from the specimen is
received for analysis. Also, an arrangement for receiving light
from the transilluminated specimen at points equally radially
spaced from the axis of a bundle of light rays directed into the
specimen will produce similar results.
Details of this invention will become more fully understood by
reference to the following description and the accompanying
drawing.
DESCRIPTION OF THE DRAWING
FIG. 1 is a diagrammatic illustration of a system and apparatus for
performing oximetry and pulse rate monitoring according to
principles of this invention; and
FIG. 2 is an enlarged cross-sectional view of the apparatus shown
in FIG. 1 wherein portions thereof pertinent to the present
inventive concept are shown in greater detail and modifications
thereof are shown with dot-dash outline; and
FIG. 3 is a view taken along line 3--3 of FIG. 2 looking in the
direction of the arrows.
DESCRIPTION OF THE PREFERRED EMBODIMENT
In FIG. 1 of the drawing there is illustrated an oxygen saturation
and pulse rate monitoring system 10 incorporating an ear oximeter
12 functioning as a transducer in the system. Amounts of oxygen in
blood flowing through an ear 14 and/or changing amounts of blood
present in the ear are converted by oximeter 12 into corresponding
variations in intensity of particular wavelengths of light caused
to pass through the pinna of the ear.
System 10 further includes a remote light source 16, at least one
elongated fiber optical light pipe 18 for receiving and conducting
light from source 16 to ear 14 and a number of bandpass filters 20
adapted to be selectively interposed between light source 16 and
end 22 of light pipe 18 for filtering all but selected wavelengths
of light caused to enter light pipe 18. Filters 20 are
conventionally so preselected as to have one transmissive to
substantially only light of a wavelength of 650 m.mu., another
transmissive to substantially only light of a wavelength of 805
.mu. and a third transmissive to substantially only light of a
wavelength of 910 m.mu.; the latter wavelength being used for dye
dilution testing wherein 910 m.mu. light is readily absorbed by
dyes commonly used in dye dilution testing.
With light of a preselected wavelength (e.g. 650 m.mu. ) directed
into ear 14, a measurement of the amount of such light transmitted
through the ear, which is a function of oxygen saturation, is made
by directing the light into a measuring and indication
photoelectric system represented by block 24 in FIG. 1.
Fiber optic light pipe 26, FIGS. 1 and 2, receives light
transmitted through ear 14 and conducts the same to the measuring
and indicating means 24. The measuring and indicating means 24 is
calibrated to measure oxygen saturation independently to tissue
pigmentation by rendering the portion of ear 14 under observation
temporarily bloodless. An inflatable diaphragm 18, FIGS. 1 and 2,
is provided for this purpose. Compressed air directed through
conduit 30 inflates diaphragm 28 whereby the adjacent portion of
ear 14 is squeezed against a fixed platen 32 stopping the
circulation of blood in the area between diaphragm 28 and platen
32. Those interested in further details of blood monitoring systems
such as that thus far described may refer to U.S. Pat. Nos.
3,068,739; 2,706,927 and 3,412,729.
In connection with the matter of supplying cold light to body
tissue (e.g. ear 14) under observation, it should be understood
that the arrangement of lamp 16, filters 20 and light pipe 18 may
be replaced by light-emitting diodes having peak emission
wavelengths corresponding to the wavelengths of light transmitted
by band-pass filters 20. Such diodes, also referred to as "visible
diodes" are well known to the artisan and readily commercially
available. In this instance, light-emitting diodes 19a, shown in
dot-dash outline (FIG. 2) would be located behind diaphragm 28 at a
position corresponding to or near the location of the emitting end
19 of the full line of illustration of light pipe 18. In this
latter case, light pipe 18 would be omitted. Diaphragm 28 is
transparent to light emitted from light pipe 18 and, accordingly,
would be similarly transmissive to light emitted by diodes 19a. It
is also pointed out that photoelectric detectors having the same
general appearance as diodes 19a may be positioned adjacent to
platen 32 (e.g. in the vicinity of the light-receiving end 27 of
light pipe 26) in which case light pipe 26 would be replaced by
electrical connections extending from such photoelectric detectors
to the measuring and indicating means 24.
Preferably, either the light-emitting end 19 or the light-receiving
end 27 of light pipes 18 and 26 respectively are formed with
corresponding ends of fibers of the particular bundle thereof
arranged annularly about the axis A-A(FIG. 1) of the light path
through ear 14 as illustrated in FIG. 3. This arrangement of fibers
has been found to produce greater precision in the measurement of
blood oxygen saturation. Alternatively, either one or the other of
the light-emitting and light-receiving ends 19 and 27 respectively
may have corresponding ends of their fibers similarly spaced from
each other in two or more groups respectively disposed at
approximately equal distances from each other (e.g. 4 millimeters)
from the axis A-A of the light path through ear 14.
With the light transmitted through ear 14 being of a temperature
substantially below that of incandescence, ear 14 is heated to
arterialize the portion thereof under observation by heating coil
34 (FIG. 2) which heats platen 32, keeping ear 14 to within a
narrow range of optimum temperature for arterialization of about
41.degree. C.
Heating coil 34 is operated by proportional temperature controller
36 (FIG. 1) which includes thermistor 38 located in platen 32
adjacent the surface thereof contacted by the portion of ear 14
under observation. Electrical leads 40 connect heating coil 34 and
thermistor 38 to controller 36 which, in turn, is connected to a
suitable source of current SC.
Platen 32 and diaphragm 28 are supported by jaws 42 and 44
respectively of oximeter 12. Jaw 42 is slidable toward and away
from jaw 44 along a supporting hollow post 46 to which jaw 44 is
fixed by clamp nut 48. Jaw 42, accordingly, may be moved away from
jaw 44 sufficiently to permit insertion of ear 44 between platen 32
and diaphragm 28. Release of jaw 42 will automatically
nonsubjectively clamp ear 14 in oximeter 12 with an optimum holding
force normally permitting free circulation of blood through the
ear. Spring 50 provides the nonsubjective holding force. Clam nut
52, when tightened, prevents accidental displacement of oximeter 12
during use and prevents displacement of jaw 42 when diaphragm 28 is
inflated to render the portion of ear 14 under observation
bloodless.
Jaw 42, in its movement toward and away from jaw 44, is guided by
pin 54 fixed in support 56 which, in turn, is fixed to post 46. Pin
54 thus maintains platen 32 and diaphragm 28 in aligned
relationship with each other at all times. Light pipe 26 having its
end 27 fixed in support 56 at a given distance from the
light-emitting end or ends 19 of one or more light-emitting light
pipes 18, established the above-mentioned fixed optical path length
of light into which portions of body tissue of varying thickness
may be placed by adjustment of jaw 42 relative to jaw 44
independently of support 56.
In its application as a pulse monitor, system 10 measures
variations in amounts of transmitted light resulting from changing
amounts of blood perfusing ear 14 due to pulsatile characteristics
of the blood flow. The controlled heating of ear 14 to the optimum
temperature of about 41.degree. C. increases the normal pulsatile
flow by a factor of approximately three with a corresponding
increase in intensity of light transmitted through the ear.
With the ear being held continuously within a narrow range of
optimum temperature the monitoring of pulsatile characteristics in
the ear with the aforesaid increase in light intensities provides
an accurate indication of actual pulse rate, even in cases of poor
peripheral circulation.
* * * * *