WO1993006772A1 - Method and apparatus for measuring blood parameters - Google Patents
Method and apparatus for measuring blood parameters Download PDFInfo
- Publication number
- WO1993006772A1 WO1993006772A1 PCT/EP1992/002135 EP9202135W WO9306772A1 WO 1993006772 A1 WO1993006772 A1 WO 1993006772A1 EP 9202135 W EP9202135 W EP 9202135W WO 9306772 A1 WO9306772 A1 WO 9306772A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- fibre optic
- optic probe
- side sample
- probe
- blood
- Prior art date
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/145—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
- A61B5/1455—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
- A61B5/1459—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 invasive, e.g. introduced into the body by a catheter
Definitions
- This invention relates to a method and apparatus for measuring blood parameters.
- US-A-4 682 895 discloses a fibre optic probe with a
- WO-A-91/18306 discloses a multi-sensor fibre optic probe for intra-corporeal insertion into blood vessels to measure various blood parameters.
- the probe shown in 10 the figures has three side sample chambers disposed uniformly around the circumference of the probe.
- the side sample chambers are used to measure the CO2 and O2 content of the blood and the pH.
- the measure ⁇ ments can be adversely affected by "wall effect".
- active metabolism of the cells of the blood vessel wall and/or the effects of restricted blood flow between the fibre optic probe and the blood vessel wall 20 can result in a microenvironment adjacent the blood vessel wall where the blood parameters significantly differ from those in the area of less restricted blood flow.
- wall effect is most noticeable in blood vessels it also occurs, to a much lesser extent, in 25 extra corporeal tubes used to transfer blood. In this case, the wall effect is believed to be due to the formation of clots on the wall of the tube.
- a method of measuring blood para- 30 meters comprises inserting a fibre optic probe having at least one side sample chamber into a tube, and measuring a blood parameter via said side sample chamber, characterized in that said method fur ⁇ ther comprises rotating said fibre optic probe in one 35 sense and re-measuring said blood parameter via said side sample chamber.
- the tube will normally be a blood vessel although it could be a length of tubing used to convey blood.
- a fibre optic probe is inserted in a patient's blood vessel and a blood para ⁇ meter, for example the CO2 content, is continuously monitored. If a significant change occurs it is first essential to determine whether the change is caused by a change in the patient' s condition or merely the fibre optic probe rotating so that the side sample chamber is in the vicinity of the wall of the blood vessel, i.e., in the region of "wall effect” . If the changed value was typical of "wall effect" values and the measurement returns to its previous level on rotation of the fibre optic probe then this is a strong indication that the change was due to "wall effect". However, preferably, said method further includes rotating said fibre optic probe in the opposite sense and again measuring said blood parameter.
- the fibre optic probe is rotated in said opposite sense by an angle substantially equal to said rotation in said one sense. If the measured value of the blood parameter returns to its previous level when the fibre optic probe is rotated to its initial position then it is substantially conclusive that the change was due to "wall effect".
- said fibre optic probe is rotated by at least 30° in said one sense.
- a multi-sensor fibre optic probe for insertion into a tube to measure blood parameters, said fibre optic probe having at least two side sample chambers, characterized in that said side sample cham ⁇ bers are not disposed uniformly around the perimeter of said optical fibre probe.
- said side sample chambers subtend an angle of less than 120° and preferably less than 60°.
- the side sample chambers are arranged circumferentially side by side to subtend the smallest practical angle.
- Fig. 1 is a schematic side view, partially in cross-section, of one embodiment of a fibre optic probe in accordance with the invention in vivo within a blood vessel;
- Fig, 2 is a cross-sectional view of the fibre optic probe in the blood vessel
- Fig. 3 is a cross-sectional view of the fibre optic probe of Fig. 2 shown in a different position;
- Fig. 4a is a cross-sectional view of a second embodiment of a fibre optic probe in accordance with the invention
- Fig. 4b is a scrap perspective view of the fibre optic probe of Fig. 4a;
- Fig. 5 is a graph which illustrates the occurrence of wall effect and rotation of a fibre optic probe to counteract the wall effect; and Fig. 6 shows graphs illustrating the occurrence of wall effect and rotation of a fibre optic probe to counteract it.
- a cannula 1 is inserted in vivo into a blood vessel 2 which has an Interior wall 7.
- a fibre optic probe 5 is inserted into and through the cannula 1 and into the blood vessel 2 so that the free end 3 of the fibre optic probe 5 extends into the blood vessel 2.
- a threaded connector 4 mates with a threaded body 8 holding the fibre optic probe 5 in position with respect to the cannula 1, thereby maintaining the position of the fibre optic probe 5 within the blood vessel 2. Rotation of the threaded body 8 rotates the fibre optic probe 5 in the blood vessel 2.
- a detection apparatus 20 interfaces with the fibre optic probe 5 and provides an indication of a level of a blood parameter sensed by side sample chambers.
- the fibre optic probe 20 has side sample chambers 24 and 26.
- Side sample chamber 26 is in contact with the interior wall 28 of the vessel 22 and is, therefore, subject to the undesirable results of wall effect.
- Fig. 3 shows the fibre optic probe 20 rotated to a new position in which both side sample chambers 24, 26 are well away from the wall 28 so that the wall effect is reduced or eliminated.
- Fig. 5 illustrates an occurrence of wall effect and employment of a method and apparatus according to the present invention to counteract the wall effect.
- the vertical axis in Fig. 5 indicates CO2 concen ⁇ tration in millimetres of mercury.
- the horizontal axis indicates time in hours.
- a multi-sensor probe similar to that disclosed in WO-A-91/18306 was inserted in vivo into a human artery.
- the side sample chambers of this fibre optic probe included pH, C0 2 , and 0 2 sensing cham ⁇ bers which were disposed generally on one side of the fibre optic probe within an arc of about 120° when viewed from the end in cross-section (a disposition not shown in the prior application).
- Fig. 4a and 4b show a fibre optic probe 30 accord ⁇ ing to the present invention that includes a plurality of spaced-apart side sample chambers 31 all of which are relatively close together and within an arc of less than 180° (actually within an arc of 120° or less) as viewed from the end of the fibre optic probe 30.
- the side sample chambers 31 are shown within the fibre optic probe 30 but it is within the scope of this invention for them to be on rather than within the fibre optic probe.
- Fig. 6 illustrates the simultaneous wall effect on all the sensing elements for indicating CO2 and O2 concentrations and pH level. All three sensing elements subtended an arc of less than 180° of the fibre optic probe cross-section. Between the time as in ⁇ icated on the horizontal axes of the three graphs as about "13" and about “13.5", there is indicated a decrease in pH, a corresponding increase in C0 2 level, and a decrease in
- an artery is constricted at one area (e.g., at an area of trauma or an area of cannula entry) and location of a probe at a wider area of an artery is desired. This is accom ⁇ plished by extending the probe further in the artery (or other vessel or conduit) to an area of larger cross- section.
Abstract
In order to check that a change in a reading obtained from a side sample chamber (24, 26) of a fibre optic probe inserted in a blood vessel (2) is not due to wall effect, the fibre optic probe (3) is first rotated in one sense and a reading obtained. The fibre optic probe (3) is then rotated by the same amount in the opposite sense and a further reading obtained. By comparing the readings it can be determined whether a change is due to the side sample chamber (26) resting against or coming into close proximity with the wall (7) of a blood vessel (2) or whether there is a change in the patient's condition. In a multi-sensor fibre optic probe the side sample chambers (24, 26; 31) are arranged in one area rather than arranged uniformly around the circumference of the probe.
Description
METHOD AND APPARATUS FOR MEASURING BLOOD PARAMETERS
This invention relates to a method and apparatus for measuring blood parameters.
US-A-4 682 895 discloses a fibre optic probe with a
'V 5 side sample chamber for intra-corporeal insertion into blood vessels to measure various blood parameters.
WO-A-91/18306 discloses a multi-sensor fibre optic probe for intra-corporeal insertion into blood vessels to measure various blood parameters. The probe shown in 10 the figures has three side sample chambers disposed uniformly around the circumference of the probe. The side sample chambers are used to measure the CO2 and O2 content of the blood and the pH.
One of the disadvantages when using the prior art 15 fibre optic probes described above is that the measure¬ ments can be adversely affected by "wall effect". In particular, active metabolism of the cells of the blood vessel wall and/or the effects of restricted blood flow between the fibre optic probe and the blood vessel wall 20 can result in a microenvironment adjacent the blood vessel wall where the blood parameters significantly differ from those in the area of less restricted blood flow. Although "wall effect" is most noticeable in blood vessels it also occurs, to a much lesser extent, in 25 extra corporeal tubes used to transfer blood. In this case, the wall effect is believed to be due to the formation of clots on the wall of the tube.
According to one aspect of the present invention there is provided a method of measuring blood para- 30 meters, which method comprises inserting a fibre optic probe having at least one side sample chamber into a tube, and measuring a blood parameter via said side sample chamber, characterized in that said method fur¬ ther comprises rotating said fibre optic probe in one 35 sense and re-measuring said blood parameter via said
side sample chamber.
The tube will normally be a blood vessel although it could be a length of tubing used to convey blood.
In a typical situation a fibre optic probe is inserted in a patient's blood vessel and a blood para¬ meter, for example the CO2 content, is continuously monitored. If a significant change occurs it is first essential to determine whether the change is caused by a change in the patient' s condition or merely the fibre optic probe rotating so that the side sample chamber is in the vicinity of the wall of the blood vessel, i.e., in the region of "wall effect" . If the changed value was typical of "wall effect" values and the measurement returns to its previous level on rotation of the fibre optic probe then this is a strong indication that the change was due to "wall effect". However, preferably, said method further includes rotating said fibre optic probe in the opposite sense and again measuring said blood parameter. Advantageously, the fibre optic probe is rotated in said opposite sense by an angle substantially equal to said rotation in said one sense. If the measured value of the blood parameter returns to its previous level when the fibre optic probe is rotated to its initial position then it is substantially conclusive that the change was due to "wall effect".
Preferably, said fibre optic probe is rotated by at least 30° in said one sense.
As indicated previously, the side sample chambers in multi-sensor fibre optic probes have been evenly distributed around the circumference of the fibre optic probe.
.According to another aspect of the present inven¬ tion, there is provided a multi-sensor fibre optic probe for insertion into a tube to measure blood parameters,
said fibre optic probe having at least two side sample chambers, characterized in that said side sample cham¬ bers are not disposed uniformly around the perimeter of said optical fibre probe. Preferably, said side sample chambers subtend an angle of less than 120° and preferably less than 60°.
In a particularly preferred form the side sample chambers are arranged circumferentially side by side to subtend the smallest practical angle.
For a better understanding of the present invention reference will now be made, by way of example, to the accompanying drawings in whic :-
Fig. 1 is a schematic side view, partially in cross-section, of one embodiment of a fibre optic probe in accordance with the invention in vivo within a blood vessel;
Fig, 2 is a cross-sectional view of the fibre optic probe in the blood vessel; Fig. 3 is a cross-sectional view of the fibre optic probe of Fig. 2 shown in a different position;
Fig. 4a is a cross-sectional view of a second embodiment of a fibre optic probe in accordance with the invention; Fig. 4b is a scrap perspective view of the fibre optic probe of Fig. 4a;
Fig. 5 is a graph which illustrates the occurrence of wall effect and rotation of a fibre optic probe to counteract the wall effect; and Fig. 6 shows graphs illustrating the occurrence of wall effect and rotation of a fibre optic probe to counteract it.
Referring now to Fig. 1, a cannula 1 is inserted in vivo into a blood vessel 2 which has an Interior wall 7. A fibre optic probe 5 is inserted into and through the cannula 1 and into the blood vessel 2 so that the free end 3 of the fibre optic probe 5 extends into the blood vessel 2.
A threaded connector 4 mates with a threaded body 8 holding the fibre optic probe 5 in position with respect to the cannula 1, thereby maintaining the position of the fibre optic probe 5 within the blood vessel 2. Rotation of the threaded body 8 rotates the fibre optic probe 5 in the blood vessel 2. A detection apparatus 20 interfaces with the fibre
optic probe 5 and provides an indication of a level of a blood parameter sensed by side sample chambers.
As shown in Fig. 2, the fibre optic probe 20 has side sample chambers 24 and 26. Side sample chamber 26 is in contact with the interior wall 28 of the vessel 22 and is, therefore, subject to the undesirable results of wall effect.
Fig. 3 shows the fibre optic probe 20 rotated to a new position in which both side sample chambers 24, 26 are well away from the wall 28 so that the wall effect is reduced or eliminated.
Fig. 5 illustrates an occurrence of wall effect and employment of a method and apparatus according to the present invention to counteract the wall effect. The vertical axis in Fig. 5 indicates CO2 concen¬ tration in millimetres of mercury. The horizontal axis indicates time in hours. A multi-sensor probe similar to that disclosed in WO-A-91/18306 was inserted in vivo into a human artery. The side sample chambers of this fibre optic probe included pH, C02, and 02 sensing cham¬ bers which were disposed generally on one side of the fibre optic probe within an arc of about 120° when viewed from the end in cross-section (a disposition not shown in the prior application). At about 60 hours and 15 minutes into the test, an apparent sudden dramatic increase in measured C02 occurred, (from point A to point B on the graph) an increase from about 43mm Hg to about 57mm Hg. Rotation of the fibre optic probe 30° to the right immediately brought the C02 reading down, indicating that the probe had been moved so that the sensing elements were no longer near or in contact with the vessel wall. To verify that the probe had been subject to wall effect, the operator rotated the fibre optic probe back 30° to the left to approximately the previous undesirable position ( indicated by the change
from point C to point D on the graph) and the wall effect was duplicated. Again the fibre optic probe was rotated 30° to the right (indicated by the change from point D to point E on the graph) to re-position the sample chambers and permit accurate blood gas readings uninfluenced by wall effect.
Fig. 4a and 4b show a fibre optic probe 30 accord¬ ing to the present invention that includes a plurality of spaced-apart side sample chambers 31 all of which are relatively close together and within an arc of less than 180° (actually within an arc of 120° or less) as viewed from the end of the fibre optic probe 30. The side sample chambers 31 are shown within the fibre optic probe 30 but it is within the scope of this invention for them to be on rather than within the fibre optic probe.
It is also within the scope of this invention to provide a method which is the alternate of the methods described above; i.e., a method for detecting and mea- suring parameters of intra-vessel wall tissue by select¬ ively moving a probe from a more central blood measuring position to a position adjacent to or in contact with the wall.
Fig. 6 illustrates the simultaneous wall effect on all the sensing elements for indicating CO2 and O2 concentrations and pH level. All three sensing elements subtended an arc of less than 180° of the fibre optic probe cross-section. Between the time as inαicated on the horizontal axes of the three graphs as about "13" and about "13.5", there is indicated a decrease in pH, a corresponding increase in C02 level, and a decrease in
02 level. These changes were due to unintended rotation of the fibre optic probe resulting in the fibre optic probe contacting the wall of the vessel in which it was positioned and the ensuing undesirable wall effect on
the fibre optic probe readings. Rotation of the fibre optic probe to its original position resulted in re- establishment of a probe position away from the vessel wall (in this case an artery of a dog) and the resump- tion of normal readings unaffected by wall effect. The vertical axes of the three graphs indicate calibrated values for pH (top graph); CO2 concentration (middle graph); and 02 concentration (lower graph). For more accurate readings there may be cases in which an artery is constricted at one area (e.g., at an area of trauma or an area of cannula entry) and location of a probe at a wider area of an artery is desired. This is accom¬ plished by extending the probe further in the artery (or other vessel or conduit) to an area of larger cross- section.
Claims
1. A method of measuring blood parameters, which method comprises inserting a fibre optic probe having at least one side sample chamber into a tuber and measuring a blood parameter via said side sample chamber, charac¬ terized in that said method further comprises rotating said fibre optic probe in one sense and re-measuring said blood parameter via said side sample chamber.
2. A method according to Claim 1, including rotating said fibre optic probe in the opposite sense and again measuring said blood parameter.
3. A method according to Claim 2, wherein the fibre optic probe is rotated in said opposite sense by an angle substantially equal to said rotation in said one sense.
4. A method according to Claims 1, 2 or 3, wherein said fibre optic probe is rotated by at least 30° in said one sense.
5. A method according to any preceding Claim, wherein said tube is a human blood vessel.
6. A multi-sensor fibre optic probe for insertion into a tube to measure blood parameters, said fibre optic probe having at least two side sample chambers, charac¬ terized in that said side sample chambers are not dis- posed uniformly around the perimeter of said optical fibre probe.
7. A multi-sensor fibre optic probe as claimed in Claim 6, wherein said side sample chambers subtend an angle of less than 120°.
8. A multi-sensor fibre optic probe as claimed in Claim 7, wherein said side sample chambers subtend an angle of less than 60°.
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US774,693 | 1991-10-09 | ||
US07/774,693 US5271398A (en) | 1991-10-09 | 1991-10-09 | Intra-vessel measurement of blood parameters |
Publications (1)
Publication Number | Publication Date |
---|---|
WO1993006772A1 true WO1993006772A1 (en) | 1993-04-15 |
Family
ID=25101980
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/EP1992/002135 WO1993006772A1 (en) | 1991-10-09 | 1992-09-14 | Method and apparatus for measuring blood parameters |
Country Status (3)
Country | Link |
---|---|
US (1) | US5271398A (en) |
AU (1) | AU2567592A (en) |
WO (1) | WO1993006772A1 (en) |
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US5476434A (en) * | 1992-05-27 | 1995-12-19 | Kalb; Irvin M. | Female incontinence device including electronic sensors |
US5673694A (en) * | 1995-08-08 | 1997-10-07 | Henry Ford Health System | Method and apparatus for continuous measurement of central venous oxygen saturation |
US6019735A (en) * | 1997-08-28 | 2000-02-01 | Visco Technologies, Inc. | Viscosity measuring apparatus and method of use |
US6428488B1 (en) | 1997-08-28 | 2002-08-06 | Kenneth Kensey | Dual riser/dual capillary viscometer for newtonian and non-newtonian fluids |
US6322525B1 (en) | 1997-08-28 | 2001-11-27 | Visco Technologies, Inc. | Method of analyzing data from a circulating blood viscometer for determining absolute and effective blood viscosity |
US6322524B1 (en) | 1997-08-28 | 2001-11-27 | Visco Technologies, Inc. | Dual riser/single capillary viscometer |
US6402703B1 (en) * | 1997-08-28 | 2002-06-11 | Visco Technologies, Inc. | Dual riser/single capillary viscometer |
US6450974B1 (en) | 1997-08-28 | 2002-09-17 | Rheologics, Inc. | Method of isolating surface tension and yield stress in viscosity measurements |
US6484565B2 (en) | 1999-11-12 | 2002-11-26 | Drexel University | Single riser/single capillary viscometer using mass detection or column height detection |
US20030158500A1 (en) * | 1999-11-12 | 2003-08-21 | Kenneth Kensey | Decreasing pressure differential viscometer |
US6412336B2 (en) | 2000-03-29 | 2002-07-02 | Rheologics, Inc. | Single riser/single capillary blood viscometer using mass detection or column height detection |
US6484566B1 (en) | 2000-05-18 | 2002-11-26 | Rheologics, Inc. | Electrorheological and magnetorheological fluid scanning rheometer |
US9700215B2 (en) | 2012-10-24 | 2017-07-11 | Makaha Medical, Llc. | Systems and methods for assessing vasculature health and blood clots |
US10132672B2 (en) * | 2013-03-28 | 2018-11-20 | Mettler-Toledo Gmbh | Digital linearization in a weighing cell |
US10376678B2 (en) | 2016-01-08 | 2019-08-13 | Makaha Medical, Llc. | Systems and methods for controlling reperfusion in a vessel |
US10595818B2 (en) | 2016-03-19 | 2020-03-24 | Makaha Medical, Llc. | Medical systems and methods for density assessment using ultrasound |
US11076808B2 (en) | 2016-03-26 | 2021-08-03 | Makaha Medical, LLC | Flexible medical device with marker band and sensor |
US11478150B2 (en) | 2016-03-28 | 2022-10-25 | Becton, Dickinson And Company | Optical fiber sensor |
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Also Published As
Publication number | Publication date |
---|---|
US5271398A (en) | 1993-12-21 |
AU2567592A (en) | 1993-05-03 |
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