WO2013005320A1 - 血圧低下予測装置 - Google Patents
血圧低下予測装置 Download PDFInfo
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- WO2013005320A1 WO2013005320A1 PCT/JP2011/065503 JP2011065503W WO2013005320A1 WO 2013005320 A1 WO2013005320 A1 WO 2013005320A1 JP 2011065503 W JP2011065503 W JP 2011065503W WO 2013005320 A1 WO2013005320 A1 WO 2013005320A1
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- risk level
- blood flow
- blood pressure
- pulse rate
- risk
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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
- A61B5/02—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
- A61B5/021—Measuring pressure in heart or blood vessels
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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
- A61B5/02—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
- A61B5/021—Measuring pressure in heart or blood vessels
- A61B5/02108—Measuring pressure in heart or blood vessels from analysis of pulse wave characteristics
- A61B5/02116—Measuring pressure in heart or blood vessels from analysis of pulse wave characteristics of pulse wave amplitude
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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
- A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
- A61B5/7271—Specific aspects of physiological measurement analysis
- A61B5/7275—Determining trends in physiological measurement data; Predicting development of a medical condition based on physiological measurements, e.g. determining a risk factor
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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
- A61B5/02—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
-
- 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
- A61B5/026—Measuring blood flow
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
- A61M1/16—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
- A61M1/3621—Extra-corporeal blood circuits
- A61M1/3639—Blood pressure control, pressure transducers specially adapted therefor
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2230/00—Measuring parameters of the user
- A61M2230/30—Blood pressure
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- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
- G16H50/30—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for calculating health indices; for individual health risk assessment
Definitions
- the present invention relates to a technical field of a blood pressure decrease prediction device that predicts a blood pressure decrease in a living body.
- Patent Documents 1 and 2 propose a technique for quickly determining a decrease in blood pressure of a patient during artificial dialysis.
- Patent Document 1 discloses a technique of predicting a change in blood pressure by weighted evaluation of blood pressure change-related information and controlling the rate of water removal in artificial dialysis based on the prediction result.
- an abnormality determination value for determining a decrease in blood pressure as abnormal is set to be smaller than other time zones.
- the present invention has been made in view of the above-described problems, for example, and provides, for example, a blood pressure decrease prediction device that can predict a decrease in blood pressure of a living body at an early stage and with high accuracy, while placing little burden on the living body. Is an issue.
- the blood pressure decrease prediction device of the present invention is a blood pressure decrease prediction device that predicts blood pressure decrease in a living body, and a pulse rate calculation unit that calculates the pulse rate of the living body, and the blood flow rate of the living body
- a blood flow rate calculation unit that calculates a risk level
- a risk level determination unit that determines a risk level indicating a risk of blood pressure reduction based on fluctuations in at least one of the calculated pulse rate and the calculated blood flow rate
- the determined risk level And a risk level high determination unit that determines that the risk level is high.
- the blood pressure decrease prediction device is a blood pressure decrease prediction device that predicts a blood pressure decrease of a living body, and a pulse rate calculation unit that calculates the pulse rate of the living body;
- a blood flow rate calculation unit that calculates a blood flow rate, and a risk level determination that determines a risk level indicating a risk that the blood pressure decrease occurs based on at least one variation of the calculated pulse rate and the calculated blood flow rate And the calculated pulse rate and / or the calculated blood flow volume during a predetermined period exceeds a threshold determined according to the determined risk level, the blood pressure decrease occurs
- a risk level high determination unit that determines that the risk to be performed is in a risk level high state that is higher than the determined risk level.
- the pulse rate calculation unit first calculates the biological pulse rate, and the blood flow rate calculation unit calculates the biological blood flow rate.
- the pulse rate calculating unit and the blood flow rate calculating unit may calculate the pulse rate and the blood flow rate using separate measuring devices, or may calculate the pulse rate and the blood flow rate using the same measuring device.
- an electrocardiograph can be used to calculate the pulse rate
- a blood flow meter can be used to obtain the blood flow.
- a blood flow waveform of a living body that is a subject or a patient is input from a laser blood flow meter using a laser Doppler flowmetry method, for example.
- the pulse rate and blood flow rate of the living body are calculated by the pulse rate calculation unit and the blood flow rate calculation unit, respectively.
- the pulse rate calculation unit typically calculates the frequency corresponding to the pulse wave of the blood flow waveform (that is, the reciprocal of the cycle) as the pulse rate.
- the blood flow rate calculation unit typically calculates an average value of a blood flow waveform for a predetermined time as a blood flow rate.
- the risk level determination unit indicates the risk of a decrease in blood pressure in the living body (that is, the possibility that a decrease in blood pressure will occur) based on fluctuations in at least one of the calculated pulse rate and blood flow. Risk level is determined.
- the risk level determination unit determines the risk level by referring to a predetermined risk level determination table in which, for example, a combination of fluctuations in pulse rate and blood flow rate is associated with a risk level.
- the risk level determination unit may determine the risk level using one of the calculated pulse rate and blood flow, or may determine the risk level using both the calculated pulse rate and blood flow. Also good. However, compared to the case where the risk level is determined using either one of the calculated pulse rate or blood flow, the case where the risk level is determined using both the calculated pulse rate and blood flow, The risk level can be determined with higher accuracy.
- the risk level determination unit determines that the risk level is “low” when, for example, the pulse rate is increasing or the blood flow volume is decreasing, and the pulse rate becomes constant after the increase.
- the risk level is determined to be “medium” when the blood flow rate becomes constant after the decrease, and when either the pulse rate or the blood flow rate becomes constant after the decrease and further decreases, the risk level becomes “ It is determined to be “high”.
- a risk level determination part determines a risk level using the risk level determination table etc. in which the value of the risk level was stored so as to respond
- the risk level determination unit may determine the risk level using other parameters (for example, pulse wave amplitude, etc.) in addition to the pulse rate and blood flow volume.
- blood pressure is determined by the product of cardiac output and peripheral vascular resistance.
- Cardiac output is the amount of blood that is pumped (ie, pumped out) from the heart in one minute, and changes according to the heart rate that changes depending on the function of the autonomic nervous system (sympathetic / parasympathetic nervous system). To do.
- the cardiac output is determined by the product of a single cardiac output and a heart rate that are output from the heart in a single heartbeat.
- blood pressure is determined by the product of heart rate, stroke output and peripheral vascular resistance.
- Pulheral vascular resistance refers to difficulty in blood flow in peripheral arteries, and changes depending on the action of the autonomic nervous system (particularly the sympathetic nervous system).
- the living body When the living body is a healthy person, the living body usually adjusts the heart rate and peripheral vascular resistance in order to maintain blood pressure. In other words, when the blood pressure is about to drop, the living body maintains the blood pressure by adjusting the heart rate and peripheral vascular resistance. Therefore, the heart rate and peripheral vascular resistance often change before the blood pressure rapidly decreases.
- the risk level determination unit determines the risk level of blood pressure reduction in the living body based on the fluctuation of at least one of the calculated pulse rate and blood flow.
- the pulse rate corresponds to the heart rate
- the blood flow volume often varies according to the variation of the peripheral vascular resistance. Therefore, according to the risk level determination unit, it is possible to appropriately determine the risk level indicating the risk of blood pressure reduction based on the fluctuation of at least one of the pulse rate and the blood flow rate.
- the risk level high determination unit determines whether or not the risk level is high. Specifically, the risk level high determination unit, when the fluctuation range in the predetermined period of at least one of the calculated pulse rate and the calculated blood flow exceeds a threshold determined according to the determined risk level. It is determined that the risk level is higher than the determined risk level.
- the “predetermined period” is a period set for detecting fluctuations in the pulse rate and blood flow in a relatively short period, and the risk level determination unit detects fluctuations in the pulse rate and blood flow. It is set shorter than the period to do.
- the “threshold value determined according to the determined risk level” is a threshold value determined according to the level of the risk level determined by the risk level determination unit, and is determined as a lower value as the risk level is higher. The In other words, the higher the risk level determined by the risk level determination unit, the easier it is to determine that the risk level is high.
- the risk level high determination unit may determine whether or not the risk level is high using either one of the calculated pulse rate and blood flow volume, and calculates both the calculated pulse rate and blood flow volume. It may be used to determine whether the risk level is high. However, compared to the case where it is determined whether or not the risk level is high using either one of the calculated pulse rate or blood flow volume, the risk level high using both the calculated pulse rate and blood flow volume. In the case of determining whether or not the state is the state, it is possible to determine whether or not the risk level is in the high state with higher accuracy.
- the risk level determination unit determines whether the risk level is high using the calculated blood flow rate Also good.
- the risk level high determination unit determines whether the risk level is high using the calculated pulse rate. May be.
- the risk level of blood pressure decrease is considered to increase, but the degree of the increase was determined by the risk level determination unit It has been found that it corresponds to the risk level. For example, when the pulse rate and the blood flow rate fluctuate rapidly in a short period in a state where the risk level is relatively high, the risk level for lowering blood pressure rises relatively large. On the other hand, when the pulse rate and the blood flow volume fluctuate rapidly in a short period in a state where the risk level is relatively low, the risk level for lowering blood pressure rises relatively small.
- the risk level is determined only by the risk level determination unit by determining whether or not the risk level is in a high state by using the fluctuation in either one of the calculated pulse rate and blood flow for a predetermined period. Compared with the case, it is possible to predict the risk of blood pressure reduction with high accuracy.
- the risk level determined by the risk level determination unit or the risk level high state determined by the risk level high determination unit is externally displayed as a color, number, character, sentence, figure, symbol, sound, or the like.
- the risk level and the risk level high state are not simply output as described above, but may be used for control of other connected devices.
- the risk of blood pressure or lower can be suitably reduced by controlling the operation of the dialysis machine based on the risk level and the high level of the risk level. It becomes.
- another device such as a dialysis device is connected, it is also possible to output a risk level and a risk level high state reflecting information of the other device. For example, if a signal for calculating a pulse rate and a blood flow value which are parameters for determining a risk level is received, but dialysis is not actually performed, dialysis is not performed from a dialysis machine. It is also possible to perform control such that the risk level and the risk level high state are not output after receiving the information.
- the pulse rate and the blood flow are calculated based on the blood flow waveform input from the laser blood flow meter, for example, compared with the case where the blood pressure is measured using a cuff or an electrode, for example.
- the pulse rate and the blood flow are calculated based on the blood flow waveform input from the laser blood flow meter, for example, compared with the case where the blood pressure is measured using a cuff or an electrode, for example.
- the blood pressure decrease prediction apparatus of the present embodiment it is possible to predict a decrease in blood pressure of a living body at an early stage and with high accuracy without placing a burden on the living body.
- the risk level high determination unit determines whether the fluctuation range of any one of the calculated pulse rate and the calculated blood flow volume is the determined risk level. Compared with the case where the threshold value determined according to the above is exceeded, the fluctuation range of both the calculated pulse rate and the calculated blood flow rate exceeds the threshold value determined according to the determined risk level. It is determined that the risk level is in a high state where the risk of blood pressure reduction is high.
- risk level high A state when the fluctuation range of any one of the calculated pulse rate and the calculated blood flow exceeds a threshold value determined according to the determined risk level, the risk of blood pressure reduction is in a high risk level state. Among these, it is determined that the state is relatively low (hereinafter referred to as “risk level high A state” as appropriate).
- risk level high B state if the fluctuation range of both the calculated pulse rate and the calculated blood flow exceeds the threshold determined according to the determined risk level, the risk of blood pressure drop is compared even in the high risk level state It is determined that the risk level is high (hereinafter referred to as “risk level high B state” as appropriate).
- the risk of blood pressure reduction is determined to be the risk level high A state or the risk level high B state depending on which parameter of the calculated pulse rate and the calculated blood flow volume exceeds the threshold value. By doing so, the risk of lowering blood pressure can be predicted with higher accuracy.
- the risk level determination unit determines a predetermined risk level in which at least one of the pulse rate and the blood flow is associated with the risk level.
- the risk level may be determined by referring to a table.
- the risk level determination unit determines the risk level indicating the risk of blood pressure reduction by referring to the predetermined risk level determination table.
- the risk level determination table is a predetermined reference table for determining a risk level in which at least one variation of the pulse rate and blood flow rate is associated with a risk level when the variation occurs and stored in advance. Look-up table).
- the risk level determination table stores the value of the risk level so as to correspond to the fluctuation value of at least one of the pulse rate and the blood flow rate. Specifically, the risk level determination table stores “low” as the risk level when the pulse rate is rising or when the blood flow rate is decreasing, and the pulse rate is constant after the rise. Is stored as the risk level corresponding to when the blood flow rate becomes constant after falling, and when either the pulse rate or blood flow rate becomes constant after falling and further falls “High” is stored as the corresponding risk level.
- the risk level determination table stores risk level values so as to correspond to combinations of fluctuations in the pulse rate and blood flow.
- “LV1” is stored as the risk level when the pulse rate increases and the blood flow rate is constant.
- “LV1” is stored as the risk level when the pulse rate is constant and the blood flow rate is decreasing.
- “LV2” indicating that the risk of lowering blood pressure is higher than “LV1” is stored.
- “LV3” indicating that the risk of blood pressure reduction is higher than “LV2” is stored.
- “LV3” is stored as the risk level when the pulse rate is increasing and the blood flow is constant after the decrease.
- “LV4” As the risk level when the pulse rate is constant after the increase and the blood flow rate is constant after the decrease, “LV4” indicating that there is a higher risk of blood pressure reduction than “LV3” is stored. “LV5” is stored as a risk level when the pulse rate becomes constant after the rise and further falls, and the blood flow rate is constant after the decrease, indicating that the risk of lowering blood pressure is higher than “LV4”. Yes. “LV5” is stored as the risk level when the pulse rate is constant after the increase and the blood flow is constant after the decrease and further decreases. “LV6” indicating that the risk level is higher than “LV5” as the risk level when the pulse rate is constant and further decreased after the increase, and the blood flow is constant and further decreased after the decrease. Is stored.
- the risk level determination table may store risk level values so as to correspond to combinations of fluctuations in the pulse rate and blood flow rate and other parameters (for example, pulse wave amplitude).
- a risk level determination table can be created by estimating the risk of blood pressure lowering when fluctuations in pulse rate and blood flow occur in advance experimentally, empirically, or by simulation.
- the risk level determination unit sets the risk level to the matched combination.
- the risk level associated with is determined. If the calculated pulse rate and blood flow fluctuation value do not match either the pulse rate or blood flow fluctuation value stored in the risk level determination table, for example, the risk level is almost free of risk. Alternatively, it may be determined as “no” indicating extremely low.
- the risk level can be determined relatively easily and accurately by using the risk level determination table. Therefore, it is possible to predict a decrease in blood pressure of the living body more appropriately, and it is possible to more appropriately determine a risk level indicating a risk that a decrease in blood pressure occurs.
- the pulse rate calculation unit calculates the pulse rate of the living body based on a blood flow waveform indicating a change in blood flow of the living body over time, The blood flow rate calculation unit calculates the blood flow rate of the living body based on the blood flow waveform.
- each of the pulse rate and the blood flow rate of the living body is calculated from the blood flow waveform indicating the temporal change in the blood flow rate of the living body. That is, the pulse rate and blood flow rate of the living body are not calculated based on different parameters, but are calculated from the same parameters.
- the blood pressure decrease prediction apparatus further includes a pulse wave amplitude calculation unit that calculates the pulse wave amplitude of the living body, and the risk level determination unit calculates the calculated pulse rate and the calculated pulse rate.
- a risk level indicating a risk of the blood pressure decrease is determined based on the calculated fluctuation of the pulse wave amplitude.
- the risk level determination unit predicts a decrease in blood pressure in the living body based on the fluctuation in the calculated pulse wave amplitude in addition to the fluctuation in at least one of the calculated pulse rate and blood flow volume.
- the blood pressure drop in the living body can be predicted earlier and more appropriately.
- the risk level determination unit associates at least one of the pulse rate and the blood flow rate, and a combination of each variation of the pulse wave amplitude with the risk level.
- the risk level may be determined by referring to the predetermined risk level determination table.
- the risk level determination unit determines a risk level indicating a risk of blood pressure reduction by referring to a predetermined risk level determination table.
- the risk level determination table stores a risk level in which a combination of fluctuations in at least one of pulse rate and blood flow volume and fluctuations in pulse wave amplitude and a risk level when the combination occurs are stored in association with each other in advance. It is a predetermined reference table (lookup table) for determination.
- “LV1” is stored as the risk level when the pulse rate is constant, the pulse wave amplitude is reduced, and the blood flow is constant.
- “LV2” indicating that the risk of blood pressure drop is higher than “LV1” is stored.
- “LV2” is stored as the risk level when the pulse rate is constant, the pulse wave amplitude is decreasing, and the blood flow volume is decreasing.
- “LV3” indicating that the risk of blood pressure decrease is higher than “LV2”.
- LV4 indicating that the risk level is higher than “LV3” as the risk level when the pulse rate is constant after the pulse rate is increased, the pulse wave amplitude is decreased, and the blood flow volume is decreased. Is stored. “LV4” is stored as the risk level when the pulse rate is rising, the pulse wave amplitude is decreasing, and the blood flow is constant after the decrease. “LV5” indicates that the risk level is higher than “LV4” as the risk level when the pulse rate is constant after the increase, the pulse wave amplitude is decreased, and the blood flow is constant after the decrease. Is stored.
- the calculated combination of the pulse rate, the blood flow volume, and the fluctuation of the pulse wave amplitude matches any of the combination of the pulse rate, the blood flow volume, and the fluctuation of the pulse wave amplitude stored in the risk level determination table.
- the risk level is determined to be a risk level associated with the matched combination. If the calculated pulse rate, blood flow volume and pulse wave amplitude variation combination does not match any of the pulse rate, blood flow volume and pulse wave amplitude variation combinations stored in the risk level determination table, For example, the risk level may be determined as “none” indicating that there is almost no risk or very low risk.
- the risk level can be determined relatively easily and accurately by using the risk level determination table. Therefore, it is possible to predict a decrease in blood pressure of the living body more appropriately, and it is possible to more appropriately determine a risk level indicating a risk that a decrease in blood pressure occurs.
- the pulse rate calculation unit calculates the pulse rate of the living body based on a blood flow waveform indicating a change in blood flow of the living body over time, and the blood flow rate
- the calculation unit calculates the blood flow volume of the living body based on the blood flow waveform
- the pulse wave amplitude calculation unit calculates the pulse wave amplitude of the living body based on the blood flow waveform. Good.
- each of the pulse rate, blood flow volume, and pulse wave amplitude of the living body is calculated from the blood flow waveform indicating the change in the blood flow volume of the living body over time. That is, the pulse rate, blood flow rate, and pulse wave amplitude of the living body are not calculated based on mutually different parameters, but are calculated from the same parameters.
- the blood flow waveform obtained from a blood flow meter or the like there are three types of pulse rate, blood flow rate, and pulse wave amplitude of the living body used for determining the risk level and determining whether or not the risk level is in the high state. All parameters can be calculated. Therefore, it is possible to simplify the apparatus configuration and the calculation process of each parameter.
- the blood pressure reduction prediction apparatus further includes a first output unit that outputs the risk level determined by the risk level determination unit to the outside.
- the output unit outputs the risk level determined by the risk level determination unit to the outside, for example, as a color, number, character, sentence, figure, symbol, sound, or the like. Therefore, it is possible to notify the subject who is a subject or patient, or a related person such as a doctor or a nurse about the risk of blood pressure reduction. As a result, it is possible to reduce or prevent delaying treatment for a living body that is predicted to decrease in blood pressure (that is, it is possible to perform treatment early on a living body that is at risk of blood pressure reduction).
- the blood pressure reduction prediction apparatus further includes a second output unit that outputs the risk level high state determined by the risk level high determination unit to the outside.
- the output unit displays the determination result (that is, whether the risk level is high or not) by the risk level high determination unit as, for example, a color, a number, a character, a sentence, a figure, a symbol, or a sound. Output to the outside. Therefore, it is possible to notify the subject who is a subject or patient, or a related person such as a doctor or a nurse about the risk of blood pressure reduction. As a result, it is possible to reduce or prevent delaying treatment for a living body that is predicted to decrease in blood pressure (that is, it is possible to perform treatment early on a living body that is at risk of blood pressure reduction).
- FIG. 1 is a block diagram illustrating the configuration of the blood pressure decrease prediction apparatus according to the present embodiment.
- a blood pressure decrease prediction apparatus 100 is an apparatus for predicting a decrease in blood pressure of a living body 900 while the living body 900 as a patient is undergoing artificial dialysis by the dialysis apparatus 600.
- the blood pressure decrease prediction device 100 includes a pulse rate calculation unit 110, a blood flow rate calculation unit 120, a pulse wave amplitude calculation unit 130, a blood pressure decrease prediction unit 140 having a risk level determination unit 150 and a risk level high determination unit 160, And an output unit 170.
- the blood pressure decrease prediction device 100 is configured such that the blood flow waveform output from the blood flow waveform output device 800 is input.
- the blood flow waveform output device 800 is a laser blood flow meter using, for example, a laser Doppler flowmetry method, and outputs a blood flow waveform of the living body 900 (that is, a waveform signal indicating a change in blood flow over time).
- the pulse rate calculation unit 110, the blood flow rate calculation unit 120, and the pulse wave amplitude calculation unit 130 calculate the pulse rate, the blood flow rate, and the pulse wave amplitude of the living body 900 based on the blood flow waveform input from the blood flow waveform output device 800. Calculate each.
- the risk level determination unit 150 uses the pulse rate, blood flow rate, and pulse wave amplitude fluctuations of the living body 900 calculated by the pulse rate calculation unit 110, the blood flow rate calculation unit 120, and the pulse wave amplitude calculation unit 130, respectively. A risk level indicating a risk of a decrease in blood pressure of the living body 900 is determined.
- the risk level determination unit calculates fluctuations of the pulse rate, blood flow rate, and pulse wave amplitude of the living body 900 in a short period calculated by each of the pulse rate calculation unit 110, the blood flow rate calculation unit 120, and the pulse wave amplitude calculation unit 130. It is used to determine whether or not the risk level of the living body 900 being lowered is very high.
- the output unit 170 outputs the risk level determined by the risk level determination unit 150 and the determination result of the risk level high determination unit 160 (that is, whether or not the risk level is high) to the monitor.
- the control unit 180 controls the operation of the dialysis apparatus 600 according to the risk level determined by the risk level determination unit 150 and the determination result of the risk level high determination unit 160.
- the control unit 180 is also configured to receive various information (for example, the operation status of the dialysis machine, various parameters during dialysis, etc.) from the dialysis machine 600.
- FIG. 2 is a graph for explaining an example of a method for calculating the pulse rate, the blood flow volume, and the pulse wave amplitude based on the blood flow waveform.
- FIG. 2 shows an example of a blood flow waveform output from the blood flow waveform output device 800.
- the pulse rate calculation unit 110 calculates the frequency of the waveform corresponding to the pulse wave in the blood flow waveform, that is, the reciprocal (1 / A) of the period A of the blood flow waveform as the pulse rate.
- the pulse rate may be calculated by using another calculation method such as fast Fourier transform.
- the blood flow rate calculation unit 120 calculates the average value B of the blood flow waveform at a predetermined time as the blood flow rate.
- the pulse wave amplitude calculation unit 130 calculates the amplitude C of the waveform corresponding to the pulse wave in the blood flow waveform as the pulse wave amplitude. Note that other calculation methods such as fast Fourier transform may be used as the pulse wave amplitude calculation method.
- the blood pressure decrease prediction apparatus 100 is configured to acquire three fluctuation parameters, ie, the pulse rate, the blood flow volume, and the pulse wave amplitude, from the blood flow waveform output from the blood flow waveform output apparatus 800.
- FIG. 3 is a flowchart showing the flow of the blood pressure decrease prediction process. It is.
- LV0 is first output by the output unit 170 (step S110). That is, the risk level determination unit 150 sets “LV0” indicating that there is almost no or very low risk of blood pressure reduction as an initial value for the blood pressure reduction risk level, and the output unit 170 sets the set blood pressure reduction risk. The level “LV0” is output.
- the pulse rate calculation unit 110 calculates the pulse rate HR, the blood flow rate BF, and the pulse wave amplitude PW based on the blood flow waveform.
- FIG. 4 is a flowchart showing the flow of processing in the pulse rate variation detection subroutine.
- FIG. 5 is a flowchart showing the flow of processing in the blood flow fluctuation detection subroutine.
- FIG. 6 is a flowchart showing the flow of processing in the pulse wave amplitude fluctuation detection subroutine.
- the fluctuations in the pulse rate HR, the blood flow rate BF, and the pulse wave amplitude PW are the following: It is detected by determining the indicated pulse wave amplitude fluctuation flag flPW.
- the pulse rate fluctuation flag flHR, the blood flow fluctuation flag flBF, and the pulse wave amplitude fluctuation flag flPW are “0” indicating no change, “1” indicating an increase, “ ⁇ 1” indicating a decrease, and constant after the increase, respectively.
- a value of “2” indicating the case of becoming “2” and “ ⁇ 2” indicating a case where it becomes constant after descending can be taken.
- step S21 when determining the pulse rate variation flag flHR, first, “0” is set as the initial value fl0HR of the pulse rate variation flag flHR. If the determination subroutine for the pulse rate variation flag flHR is not the first time, the value of the pulse rate variation flag flHR determined last time is set as the initial value fl0HR (step S21).
- the past average value HRpast and current value HRpre of the pulse rate HR are determined (step S22).
- the past average value HRpast is calculated as, for example, the past 5-minute average value. However, not only the average value but also one point such as a past maximum value may be used.
- the current value HRpre is calculated, for example, as an average value for the latest one minute.
- step S23 When the past average value HRpast and the current value HRpre are determined, the past average value HRpast and the current value HRpre are compared with each other (step S23).
- HR past> HR pre that is, when the pulse rate HR is decreasing
- HR past HR pre
- HR past ⁇ HR pre that is, when the pulse rate HR is increasing
- the process proceeds to step S26.
- the pulse rate variation flag flHR is set to “ ⁇ 2”. If the initial value fl0HR is “ ⁇ 2”, the pulse rate variation flag flHR is set to “ ⁇ 2”. If the initial value fl0HR is “ ⁇ 1 (2)”, the pulse rate variation flag flHR is set to “ ⁇ 2”. If the initial value fl0HR is “ ⁇ 1 ( ⁇ 2)”, the pulse rate variation flag flHR is set to “ ⁇ 2” (step S25).
- the pulse rate variation flag flHR is determined and output according to the case (step S27).
- the subroutine ends and returns to the main routine (ie, the process shown in FIG. 3).
- step S31 when determining the blood flow fluctuation flag flBF, first, “0” is set as the initial value fl0BF of the blood flow fluctuation flag flBF. If the determination subroutine for the blood flow fluctuation flag flBF is not the first time, the value of the blood flow fluctuation flag flBF determined last time is set as the initial value fl0BF (step S31).
- the past average value BFpast and current value BFpre of the blood flow rate BF are determined (step S32).
- the past average value BFpast is calculated as, for example, the past 5-minute average value. However, not only the average value but also one point such as a past maximum value may be used.
- the current value BFpre is calculated as an average value for the latest one minute, for example.
- step S33 When the past average value BFpast and the current value BFpre are determined, the past average value BFpast and the current value BFpre are compared with each other (step S33).
- BFpast> BFpre that is, when the blood flow rate BF decreases
- the process proceeds to step S34.
- BFpast BFpre
- the process proceeds to step S35.
- BFpast ⁇ BFpre that is, when the blood flow BF increases
- the process proceeds to step S36.
- BFpast> BFpre that is, when the blood flow rate BF is decreased
- the blood flow rate fluctuation flag flBF is set to “ ⁇ 1 (2)”.
- the blood flow fluctuation flag flBF is set to “ ⁇ 1 ( ⁇ 2)”. In other cases, the blood flow fluctuation flag flBF is set to “ ⁇ 1” (step S34).
- BFpast BFpre (that is, when the blood flow rate BF has not changed)
- the blood flow rate fluctuation flag flBF is set to “2”. If the initial value fl0BF is “1 ( ⁇ 2)”, the blood flow fluctuation flag flBF is set to “2”. If the initial value fl0BF is “2”, the blood flow fluctuation flag flBF is set to “2”. If the initial value fl0BF is “1”, the blood flow fluctuation flag flBF is set to “2”. If the initial value fl0BF is “0”, the blood flow fluctuation flag flBF is set to “0”.
- the blood flow fluctuation flag flBF is set to “ ⁇ 2”. If the initial value fl0BF is “ ⁇ 2”, the blood flow fluctuation flag flBF is set to “ ⁇ 2”. If the initial value fl0BF is “ ⁇ 1 (2)”, the blood flow fluctuation flag flBF is set to “ ⁇ 2”. If the initial value fl0BF is “ ⁇ 1 ( ⁇ 2)”, the blood flow fluctuation flag flBF is set to “ ⁇ 2” (step S35).
- BFpast ⁇ BFpre that is, when the blood flow rate BF increases
- the blood flow rate fluctuation flag flBF is set to “1 (2)”.
- the blood flow fluctuation flag flBF is set to “1 ( ⁇ 2)”. In other cases, the blood flow rate fluctuation flag flBF is set to “1” (step S36).
- the blood flow rate fluctuation flag flBF is determined and output according to the case (step S37).
- the subroutine ends and returns to the main routine (that is, the process shown in FIG. 3).
- step S41 when determining the pulse wave amplitude fluctuation flag flPW, first, “0” is set as the initial value fl0PW of the pulse wave amplitude fluctuation flag flPW. If the determination subroutine for the pulse wave amplitude fluctuation flag flPW is not the first time, the value of the pulse wave amplitude fluctuation flag flPW determined last time is set as the initial value fl0PW (step S41).
- the past average value PWpast and current value PWpre of the pulse wave amplitude PW are determined (step S42).
- the past average value PWpast is calculated as, for example, the past five-minute average value. However, not only the average value but also one point such as a past maximum value may be used.
- the current value PWpre is calculated, for example, as an average value for the latest one minute.
- step S43 the past average value PWpast and the current value PWpre are compared with each other.
- PWpast> PWpre that is, if the pulse wave amplitude PW is decreasing
- PWpast PWpre
- PWpast PWpre
- PWpast PWpre
- PWpast PWpre
- the pulse wave amplitude fluctuation flag flPW is set to “0”. If the initial value fl0PW is “ ⁇ 1”, the pulse wave amplitude fluctuation flag flPW is set to “ ⁇ 2”. If the initial value fl0PW is “ ⁇ 2”, the pulse wave amplitude fluctuation flag flPW is set to “ ⁇ 2”. If the initial value fl0PW is “ ⁇ 1 (2)”, the pulse wave amplitude variation flag flPW is set to “ ⁇ 2”. If the initial value fl0PW is “ ⁇ 1 ( ⁇ 2)”, the pulse wave amplitude fluctuation flag flPW is set to “ ⁇ 2” (step S45).
- the pulse wave amplitude fluctuation flag flPW is determined and output according to the case (step S47).
- the subroutine ends and returns to the main routine (that is, the process shown in FIG. 3).
- the pulse rate variation flag flHR, the blood flow rate variation flag flBF, and the pulse wave amplitude variation flag flPW are output by the subroutine described above, the pulse rate variation flag flHR, the blood flow rate variation flag flBF, and the pulse wave amplitude variation The value of the flag flPW is compared with a preset variation pattern table.
- FIG. 7 is a conceptual diagram conceptually showing an example of a variation pattern table relating to the pulse rate.
- FIG. 8 is a conceptual diagram conceptually showing an example of a variation pattern table related to blood flow.
- FIG. 9 is a conceptual diagram conceptually illustrating an example of a variation pattern table regarding a combination of a pulse rate and a blood flow rate.
- FIG. 10 is a conceptual diagram conceptually showing an example of a variation pattern table related to the pulse rate, blood flow volume, and pulse wave amplitude.
- FIG. 11 is a flowchart showing the flow of the risk level high determination process.
- the values of the pulse rate fluctuation flag flHR, the blood flow rate fluctuation flag flBF, and the pulse wave amplitude fluctuation flag flPW are at least the values of the pulse rate fluctuation flag flHR and the blood flow rate fluctuation flag flBF without using all three. Even if only one of them is used, the risk of lowering blood pressure can be predicted with appropriate accuracy.
- the blood pressure reduction is used as the blood pressure reduction risk level when the pulse rate fluctuation flag flHR is “0” and the blood flow fluctuation flag flBF is “0”.
- “LV0” indicating that there is almost no risk or very low is stored.
- “LV1” indicating that the risk of lowering blood pressure is higher than “LV0” as the blood pressure reduction risk level when the pulse rate fluctuation flag flHR is “1” and the blood flow fluctuation flag flBF is “0”. Is stored.
- LV1 indicating that the risk of blood pressure reduction is higher than “LV0” as the blood pressure reduction risk level when the pulse rate fluctuation flag flHR is “0” and the blood flow fluctuation flag flBF is “ ⁇ 1”.
- LV2 indicating that the risk of blood pressure reduction is higher than “LV1” as the blood pressure reduction risk level when the pulse rate fluctuation flag flHR is “1” and the blood flow fluctuation flag flBF is “ ⁇ 1”.
- LV3 indicating that the risk of blood pressure reduction is higher than “LV2” as the blood pressure reduction risk level when the pulse rate fluctuation flag flHR is “2” and the blood flow fluctuation flag flBF is “ ⁇ 1”. Is stored.
- LV3 indicating that the risk of blood pressure reduction is higher than “LV2” as the blood pressure reduction risk level when the pulse rate fluctuation flag flHR is “1” and the blood flow fluctuation flag flBF is “ ⁇ 2”.
- LV4 indicating that the risk of blood pressure reduction is higher than “LV3” as the blood pressure reduction risk level when the pulse rate fluctuation flag flHR is “2” and the blood flow fluctuation flag flBF is “ ⁇ 2”. Is stored.
- the pulse rate fluctuation flag flHR is “ ⁇ 1 (2)” and the blood flow rate fluctuation flag flBF is “ ⁇ 2”
- the risk of lowering blood pressure is higher than “LV4” as the blood pressure reduction risk level.
- LV5 is stored.
- the pulse rate fluctuation flag flHR is “0”
- the pulse wave amplitude fluctuation flag flPW is “0”
- the blood flow fluctuation flag flBF is set.
- the blood pressure reduction risk level in the case of “0”, “LV0” indicating that there is almost no risk of blood pressure reduction or extremely low is stored.
- the pulse rate fluctuation flag flHR is “0”
- the pulse wave amplitude fluctuation flag flPW is “ ⁇ 1”
- the blood flow fluctuation flag flBF is “0”
- the blood pressure lowering risk level is higher than “LV0”.
- LV1 indicating that there is a high risk of blood pressure reduction is stored.
- the pulse rate fluctuation flag flHR is “1”
- the pulse wave amplitude fluctuation flag flPW is “ ⁇ 1”
- the blood flow fluctuation flag flBF is “0”
- the blood pressure lowering risk level is higher than “LV1”.
- “LV2” indicating that there is a high risk of blood pressure reduction is stored.
- the pulse wave amplitude fluctuation flag flPW is “ ⁇ 1”
- the blood flow fluctuation flag flBF is “ ⁇ 1”
- “LV2” indicating that there is a high risk of blood pressure reduction is stored. From “LV2”, the blood pressure reduction risk level when the pulse rate fluctuation flag flHR is “1”, the pulse wave amplitude fluctuation flag flPW is “ ⁇ 1”, and the blood flow fluctuation flag flBF is “ ⁇ 1”. Also, “LV3” indicating that the risk of blood pressure reduction is high is stored.
- the pulse wave amplitude fluctuation flag flPW is “ ⁇ 1”
- the blood flow fluctuation flag flBF is “ ⁇ 2”
- “LV4” Also, “LV5” indicating that the risk of blood pressure reduction is high is stored.
- the pulse wave amplitude fluctuation flag flPW is “ ⁇ 1”
- the blood flow fluctuation flag flBF is “ ⁇ 2”
- “LV6” indicating that there is a higher risk of lowering blood pressure than “LV5” is stored.
- Such a variation pattern table preliminarily estimates experimentally, empirically, or by simulation the risk of blood pressure drop when a combination of variations in pulse rate HR, blood flow BF, and pulse wave amplitude PW occurs. Thus, it can be created in advance.
- the risk level determination unit 150 determines the blood pressure lowering risk level using the reference result of the variation pattern table (step S150).
- the determined blood pressure reduction risk level is displayed on the monitor 500 by the output unit 170 (step S160).
- the patient such as the living body 900, or a related person such as a doctor or nurse, of the risk of blood pressure reduction.
- the blood pressure reduction risk level is determined, it is determined whether or not the risk level is in a high level with a very high risk level by using short-term fluctuations in the pulse rate HR and the blood flow BF (step). S170).
- FIG. 11 is a flowchart showing the flow of the risk level high determination process.
- step S51 short-term changes in the pulse rate HR and the blood flow BF are calculated (step S51).
- the amount of change is calculated, for example, as a ratio between the past average value and the current value at the appropriate time interval immediately before.
- the past average value may be calculated as an average value for the past 10 seconds, for example.
- what is necessary is just to use what is calculated as an average value of the last 1 second, for example.
- thresholds for the above-described short-term pulse rate HR and blood flow rate BF changes are determined according to the blood pressure reduction risk level determined by the risk level determination unit 150 (step S52).
- the threshold value is typically determined as a lower value as the blood pressure lowering risk level is higher. That is, the higher the blood pressure lowering risk level, the higher the threshold is set. More specifically, for example, the threshold corresponding to “LV0” is “40%”, the threshold corresponding to “LV1” is “35%”, and the threshold corresponding to “LV2” is “30%”, “LV3”.
- the corresponding threshold is “25%”, the threshold corresponding to “LV4” is “20%”, the threshold corresponding to “LV5” is “15%”, the threshold corresponding to “LV6” is “10%”, “LV7” The threshold value corresponding to “5” is “5%”.
- step S53 it is determined whether or not at least one of the change rate of the pulse rate HR and the blood flow rate BF exceeds the threshold value.
- the threshold value it is determined that at least one of the change amount of the pulse rate HR and the blood flow rate BF does not exceed the threshold value (in other words, the change amount of both the pulse rate HR and the blood flow rate BF does not exceed the threshold value) (step S53: NO ).
- the risk level is not high (step S54). In other words, it is determined that there is no state in which the risk of blood pressure reduction is rapidly increasing.
- step S53 when at least one of the change rate of the pulse rate HR and the blood flow rate BF exceeds the threshold value (step S53: YES), it is determined whether both the change rate of the pulse rate HR and the blood flow rate BF exceed the threshold value. (Step S54).
- steps S54 when both the pulse rate HR and the change amount of the blood flow rate BF do not exceed the threshold value (in other words, when only the change amount of either the pulse rate HR or the blood flow rate BF exceeds the threshold value) (step S54: NO), it is determined that the risk level is high A (step S56).
- step S55 YES
- the risk level high B state is set to have a higher risk of lowering blood pressure than the risk level high A state. Therefore, by determining whether the risk level is high A or the risk level high B, it is possible to accurately determine whether the risk is relatively low or high even in the risk level high state.
- the control unit 180 controls the operation of the dialysis apparatus 600 according to the determination result of the risk level high or the blood pressure decrease risk level determined by the risk level determination unit 150 (step S190).
- the control unit 180 controls, for example, the speed and on / off of water removal in the dialyzer 600, the physiological saline dosage, and the like so that the blood pressure of the living body 900 as a patient is unlikely to decrease. Therefore, it is possible to effectively reduce a decrease in blood pressure of the living body 900 as a patient.
- control unit 180 may control not only the dialysis apparatus 600 but also the operation of the blood pressure decrease prediction apparatus 100 according to various information obtained from the dialysis apparatus 600. For example, it is possible to output the risk level and the risk level high state reflecting information obtained from the dialysis machine 600. More specifically, when signals for calculating a pulse rate and a blood flow value, which are parameters for determining a risk level, are received, but dialysis is not actually performed, dialysis is performed from the dialyzer 600. It is also possible to perform control such that the risk level and the risk level high state are not output after receiving the information that the control is not performed. In this way, the operation of the apparatus can be made more efficient.
- the blood pressure decrease prediction apparatus 100 automatically operates the external device such as the sphygmomanometer by sending a signal to an external device such as a sphygmomanometer according to the blood pressure decrease risk level determined by the risk level determination unit 150. You may do it.
- the blood pressure decrease prediction device 100 is configured to change each of the pulse rate calculated by the pulse rate calculation unit 110, the blood flow rate calculated by the blood flow rate calculation unit 120, and the pulse wave amplitude calculated by the pulse wave amplitude calculation unit 130. May be displayed simultaneously.
- the living body 900 as a patient and a related person such as a doctor or a nurse can intuitively grasp the risk of blood pressure reduction, which is very convenient in practice.
- the blood pressure decrease prediction device 100 does not necessarily need to use a risk level determination table.
- the risk level determination unit 150 may be configured to calculate a correlation value between the blood flow volume and the pulse wave amplitude and determine a blood pressure reduction risk level based on the calculated correlation value. For example, when the blood flow volume and the pulse wave amplitude decrease with a correlation (that is, the correlation value between the blood flow volume and the pulse wave amplitude is greater than a predetermined value, the risk level determination unit 150 determines that the blood flow volume and the pulse wave amplitude are larger. When the wave amplitude decreases), the blood pressure reduction risk level may be determined to be a relatively high level. In this case, it is possible to more appropriately determine the blood pressure reduction risk level.
- the risk level determination unit 150 may be configured to determine the blood pressure reduction risk level based on the average deviation values of the pulse rate, blood flow volume, and pulse wave amplitude. In this case, it is possible to more appropriately determine the blood pressure reduction risk level.
- the blood pressure decrease prediction device 100 is configured to determine the blood pressure decrease risk level based on other information related to the blood pressure decrease obtained from the blood flow waveform in addition to the pulse rate, the blood flow volume, and the pulse wave amplitude. Also good. In this case, it is possible to more appropriately determine the blood pressure reduction risk level. At this time, the blood pressure decrease prediction device 100 may determine the blood pressure decrease risk level based on information related to blood pressure decrease of a patient who has undergone artificial dialysis in the past.
- the blood pressure decrease prediction device 100 measures the blood pressure of the living body 900 with the sphygmomanometer according to the blood pressure decrease risk level determined by the risk level determination unit 150, such as the living body 900 being a patient, a doctor, a nurse, or the like. It may be configured to prompt interested parties. Alternatively, the blood pressure decrease prediction device 100 may be configured to measure the blood pressure of the living body 900 with a sphygmomanometer according to the blood pressure decrease risk level determined by the risk level determination unit 150.
- the blood pressure decrease of the living body 900 can be predicted at an early stage with almost no burden on the living body 900, and the blood pressure indicating the risk that the blood pressure decrease will occur.
- the risk level can be appropriately determined.
- the present invention is not limited to the above-described embodiments, and can be changed as appropriate without departing from the spirit or idea of the invention that can be read from the claims and the entire specification. Is also included in the technical scope of the present invention.
- the present invention can also be applied to an apparatus for predicting dehydration symptoms in a living body. That is, for example, the level of dehydration can be determined according to the blood pressure lowering risk level.
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Abstract
Description
先ず、本実施例に係る血圧低下予測装置の構成について、図1を参照して説明する。ここに図1は、本実施例に係る血圧低下予測装置の構成を示すブロック図である。
次に、脈拍数算出部110、血流量算出部120及び脈波振幅算出部130における脈拍数、血流量及び脈波振幅の具体的な算出方法について、図2を参照して説明する。ここに図2は、血流波形に基づく、脈拍数、血流量及び脈波振幅の算出方法の一例を説明するためのグラフである。尚、図2には、血流波形出力装置800が出力する血流波形の一例が示されている。
次に、血圧低下予測部140において実行される血圧低下予測処理について、図3を参照して説明する。ここに図3は、血圧低下予測処理の流れを示すフローチャートである。である。
110 脈拍数算出部
120 血流量算出部
130 脈波振幅算出部
140 血圧低下予測部
149 変動パターンテーブル
150 リスクレベル決定部
160 リスクレベルハイ判定部
170 出力部
180 制御部
500 モニタ
600 透析装置
800 血流波形出力装置
900 生体
Claims (9)
- 生体の血圧低下を予測する血圧低下予測装置であって、
前記生体の脈拍数を算出する脈拍数算出部と、
前記生体の血流量を算出する血流量算出部と、
前記算出された脈拍数及び前記算出された血流量の少なくとも一方の変動に基づいて、前記血圧低下が発生するリスクを示すリスクレベルを決定するリスクレベル決定部と、
前記算出された脈拍数及び前記算出された血流量の少なくとも一方の所定期間での変動幅が、前記決定されたリスクレベルに応じて定まる閾値を超えた場合に、前記血圧低下が発生するリスクが、前記決定されたリスクレベルよりも高いリスクレベルハイ状態であると判定するリスクレベルハイ判定部と
を備えることを特徴とする血圧低下予測装置。 - 前記リスクレベルハイ判定部は、前記算出された脈拍数及び前記算出された血流量のいずれか一方の変動幅が前記決定されたリスクレベルに応じて定まる閾値を超えた場合と比べて、前記算出された脈拍数及び前記算出された血流量の両方の変動幅が前記決定されたリスクレベルに応じて定まる閾値を超えた場合の方が、前記血圧低下が発生するリスクが高いリスクレベルハイ状態であると判定することを特徴とする請求の範囲第1項に記載の血圧低下予測装置。
- 前記リスクレベル決定部は、前記脈拍数及び前記血流量の少なくとも一方の変動と、前記リスクレベルとが対応付けられた所定のリスクレベル決定テーブルを参照することにより、前記リスクレベルを決定することを特徴とする請求の範囲第1項に記載の血圧低下予測装置。
- 前記脈拍数算出部は、前記生体の血流量の経時的な変化を示す血流波形に基づいて、前記生体の脈拍数を算出し、
前記血流量算出部は、前記血流波形に基づいて、前記生体の血流量を算出する
ことを特徴とする請求の範囲第1項に記載の血圧低下予測装置。 - 前記生体の脈波振幅を算出する脈波振幅算出部を更に備え、
前記リスクレベル決定部は、前記算出された脈拍数及び前記算出された血流量の少なくとも一方に加えて、前記算出された脈波振幅の変動に基づいて、前記血圧低下が発生するリスクを示すリスクレベルを決定することを特徴とする請求の範囲第1項に記載の血圧低下予測装置。 - 前記リスクレベル決定部は、前記脈拍数及び前記血流量の少なくとも一方、並びに前記脈波振幅の各々の変動の組み合わせと、前記リスクレベルとが対応付けられた所定のリスクレベル決定テーブルを参照することにより、前記リスクレベルを決定することを特徴とする請求の範囲第5項に記載の血圧低下予測装置。
- 前記脈拍数算出部は、前記生体の血流量の経時的な変化を示す血流波形に基づいて、前記生体の脈拍数を算出し、
前記血流量算出部は、前記血流波形に基づいて、前記生体の血流量を算出し、
前記脈波振幅算出部は、前記血流波形に基づいて、前記生体の脈波振幅を算出する
ことを特徴とする請求の範囲第5項に記載の血圧低下予測装置。 - 前記リスクレベル決定部によって決定されたリスクレベルを外部に出力する第1出力部を更に備えることを特徴とする請求の範囲第1項に記載の血圧低下予測装置。
- 前記リスクレベルハイ判定部によって判定されたリスクレベルハイ状態を外部に出力する第2出力部を更に備えることを特徴とする請求の範囲第1項に記載の血圧低下予測装置。
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EP2730302A4 (en) | 2014-12-03 |
EP2730302A1 (en) | 2014-05-14 |
EP2730302B8 (en) | 2017-04-19 |
EP2730302B1 (en) | 2016-11-30 |
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