JP7444913B2 - パルスオキシメータおよびその作動方法 - Google Patents
パルスオキシメータおよびその作動方法 Download PDFInfo
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- A61B5/00—Measuring for diagnostic purposes; Identification of persons
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- 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
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Description
酸素供給の別のインジケータは、酸素の分圧(PaO2)である。しかし、現在のところ、非侵襲的にPaO2を測定する信頼できる方法が存在しない。侵襲的なPaO2測定は、高価なセンサーを必要としており、かつ、患者の健康を害する可能性のある重篤な副作用を引き起こすと知られている。
本開示に添付の特許請求の範囲によって定義されるが、説明される様々な実施形態の態様は、本開示の範囲を限定しない。
の追跡をすることは、困難です。生の信号を厳密に表示すること又は生の信号を変換することでさえ、不正確な読み取り、又は不当なアラーム状態につながる可能性がある。処理基板222の処理は、通常、限定された期間の異常から真に変化する状態を検出するのに役立つ。次いで、ホスト機器223は、機器マネージャ228からの指示に基づいて、1又は2以上の生理学的パラメータを表示することができ、ケア提供者は、測定値(reading)の信頼性をより確信することができる。
酸素分子が、血液と接触するとき、酸素分子の大部分は、赤色血液細胞中のヘモグロビンに結合され、かつ、わずかな部分は、血液血漿中に直接溶解される。これらの処理の両方は、酸素の分圧によって駆動される。肺では、酸素は、肺細胞を横切って、次いで、肺の毛細血管内の赤血球膜に拡散する。酸素分子が、ヘモグロビンの分子に直面すると、鉄原子とグロビン鎖に結合された窒素原子との間にそれ自信を押し込む(wedge)。これは、タンパク質内の適当な位置にヘム基を保持するのに役立ちます。その4つのヘム基を有するヘモグロビンの1つの分子は、二原子酸素O2の4分子を結合することが可能です。オキシヘモグロビンと呼ばれるヘム基にロードされた酸素の色素は、鮮紅色である。これは、通常、動脈血の色である。血漿中及び赤血球中の周囲における溶存酸素からの圧力は、結合部位の酸素を維持するのに役立つ。
以下の酸素含有量の式は、特定のヘモグロビン濃度(tHb)で指定された血液中に存在する酸素の量と、酸素の分圧(PaO2)に関連する。
・単位時間当たりに臓器によって取り込まれるマーカー物質の量
・臓器に供給する動脈血におけるマーカー物質の濃度
・臓器を離れる静脈血におけるマーカー物質の濃度
である。
パルスオキシメトリは、動脈の酸素飽和度を非侵襲的に測定するための技術として1972年にAyogi博士によって発明された。Ayogi博士は、測定部位における局所血流を反映する心拍に同期した信号を見ることによって組織、骨及び軟骨吸収から、動脈吸収を単離することができた。この信号は、フォトプレチスモグラフィと呼ばれ、高通過フィルタ(high-pass filter)の使用によって単離することができる。血管床を介して動脈の酸素飽和度と光吸収との間の予測可能な関係を利用することにより、動脈血酸素飽和度(SpaO2)は、非侵襲的に計算されてもよい。動脈からの計算を示すために、SaO2に小さいpを追加することに留意すべきである。二つの異なる光源、赤色(R)=660 nm及び赤外線(IR) =910 nmの使用し、パルスオキシメーターは、図3Cに示される典型的なパルスオキシメーター検量曲線を介して比率=R (AC/DC) / IR (AC/DC)をヘモグロビン酸素飽和度に関連付けることによって、酸素飽和度を非侵襲的に計算することができることが示されている。この比率を(R/IR)比として参照する。
102 患者モニター
104 ケーブル
106 センサー
108 ディスプレイ
110 制御ボタン
112 スピーカー
216 エミッタ
218 患者監視部位
220 検出器
222 処理基板
224 センサーインターフェース
226 プロセッサ
228 機器マネージャ
230 メモリ
234 無線信号放送器
Claims (11)
- 患者の酸素飽和度を測定するように構成されたパルスオキシメータであって、前記酸素飽和度は、過飽和状態を含み、
赤色(R)と赤外(IR)の2つの波長の光を患者の組織に放射するように構成された1つまたは複数の発光器と、
前記患者の前記組織により減衰された後の検出された光に応答する信号を出力するように構成された1つまたは複数の検出器と、
前記信号を受信し、前記信号から比率=R(AC/DC)/IR(AC/DC)を決定するように構成された1つまたは複数の信号処理装置であって、前記比率は、前記2つの波長のうちの一方の検出された光と前記2つの波長のうちの他方の検出された光との比較であり、前記比率を酸素飽和度または過飽和度のいずれかに関連付けられるようにさらに構成され、前記過飽和状態は、酸素飽和度100%よりも多くの酸素が前記患者の血液中に存在することを示しており、前記比率が第1の閾値を下回る場合、前記比率は過飽和度に関連付けされ、前記比率が前記第1の閾値を上回る場合、比率は酸素飽和度に関連付けされる、1つまたは複数の信号処理装置と、
前記酸素飽和度または前記過飽和度のいずれかを表示するように構成されたディスプレイと、
を具備することを特徴とするパルスオキシメータ。 - 前記第1の閾値は、酸素飽和度100%に関連付けされる比率値に設定されることを特徴とする請求項1に記載のパルスオキシメータ。
- 前記比率が、ヘモグロビンキャリアが完全に飽和していないことを示す場合、前記比率は酸素飽和度に関連付けされ、前記比率が、前記ヘモグロビンキャリアが完全に飽和し、追加の酸素が血流に溶解していることを示す場合、前記比率は、過飽和度に関連付けされることを特徴とする請求項1に記載のパルスオキシメータ。
- 前記酸素飽和度は、1~100の範囲であり、前記過飽和度は、1~10の範囲であることを特徴とする請求項1に記載のパルスオキシメータ。
- 前記酸素飽和度は、前記過飽和度とは別に表示されることを特徴とする請求項1に記載のパルスオキシメータ。
- 前記過飽和度は、数値を含むことを特徴とする請求項1に記載のパルスオキシメータ。
- 過飽和状態での値を含む酸素飽和度を測定するパルスオキシメータの作動方法であって、
前記パルスオキシメータは、1つまたは複数の発光器と、光検出器と、信号処理装置と、表示装置と、を具備し、
前記1つまたは複数の発光器が、赤色(R)と赤外(IR)の2つの波長の光を放射するステップと、
前記光検出器が、組織により減衰された後の放射光を検出するステップと、
検出された前記放射光を代表する信号を前記信号処理装置に供給するステップと、
前記信号処理装置が、患者の過飽和状態の指標を決定する前記信号を処理するステップであって、前記過飽和状態は、酸素飽和度100%よりも多くの酸素が前記患者の血液中に存在することを示しており、前記過飽和状態の前記指標は、100%以下の酸素飽和度を決定するために使用可能な式を用いて決定される、ステップと、
前記表示装置が、前記過飽和状態の前記指標を表示するステップと、
を具備することを特徴とするパルスオキシメータの作動方法。 - 前記過飽和状態の前記指標は、前記2つの波長のうちの第1の波長と前記2つの波長のうちの第2の波長との計算に基づいて決定されることを特徴とする請求項7に記載の作動方法。
- 前記過飽和状態の前記指標は、酸素飽和度とは別に表示される指標であることを特徴とする請求項7に記載の作動方法。
- 前記過飽和状態の前記指標は、酸素飽和度とともに表示されることを特徴とする請求項7に記載の作動方法。
- 前記過飽和状態の前記指標は、数値を含むことを特徴とする請求項7に記載の作動方法。
Applications Claiming Priority (7)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US201261625599P | 2012-04-17 | 2012-04-17 | |
US61/625,599 | 2012-04-17 | ||
US201261703087P | 2012-09-19 | 2012-09-19 | |
US61/703,087 | 2012-09-19 | ||
US201261719866P | 2012-10-29 | 2012-10-29 | |
US61/719,866 | 2012-10-29 | ||
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