anup pillai dhanya premkumar nair. current blood pressure sensors in use background long-term...

38
Anup Pillai Dhanya Premkumar Nair

Upload: margaret-rich

Post on 23-Dec-2015

218 views

Category:

Documents


2 download

TRANSCRIPT

Page 1: Anup Pillai Dhanya Premkumar Nair.  Current blood pressure sensors in use  Background  Long-Term Implantable Blood Pressure Monitoring System and Advantages

Anup PillaiDhanya Premkumar Nair

Page 2: Anup Pillai Dhanya Premkumar Nair.  Current blood pressure sensors in use  Background  Long-Term Implantable Blood Pressure Monitoring System and Advantages

Current blood pressure sensors in use Background Long-Term Implantable Blood Pressure

Monitoring System and Advantages Wireless Battery less In VIVO Blood

PressureSensing Micro system and Advantages

System Architecture Our Objectives Timeline and Division of work Conclusions

Page 3: Anup Pillai Dhanya Premkumar Nair.  Current blood pressure sensors in use  Background  Long-Term Implantable Blood Pressure Monitoring System and Advantages

To diagnose critical medical conditions like hypertension

-causes strokes, heart attacks, heart failures

Low blood pressure causes hypotension, which results in dizziness, fainting or shock

Page 4: Anup Pillai Dhanya Premkumar Nair.  Current blood pressure sensors in use  Background  Long-Term Implantable Blood Pressure Monitoring System and Advantages

Auscultatory method Mercury Manometer

Page 5: Anup Pillai Dhanya Premkumar Nair.  Current blood pressure sensors in use  Background  Long-Term Implantable Blood Pressure Monitoring System and Advantages

With the new sensor, no cuff is required

Device takes advantage of the method called pulse wave velocity which allows blood pressure to be calculated by measuring the pulse at 2 points along an artery

This was developed at MIT's d'Arbeloff Laboratory for Information Systems and Technology

Page 6: Anup Pillai Dhanya Premkumar Nair.  Current blood pressure sensors in use  Background  Long-Term Implantable Blood Pressure Monitoring System and Advantages

Current blood pressure sensors in use Background Long-Term Implantable Blood Pressure

Monitoring System and Advantages Wireless Battery less In VIVO Blood

PressureSensing Micro system and Advantages

System Architecture Our Objectives Timeline and Division of work Conclusions

Page 7: Anup Pillai Dhanya Premkumar Nair.  Current blood pressure sensors in use  Background  Long-Term Implantable Blood Pressure Monitoring System and Advantages

In vivo-Latin for “within the living”

Experimentations are done using a whole, living organism

In vivo monitoring is critical for developing effective treatments

Page 8: Anup Pillai Dhanya Premkumar Nair.  Current blood pressure sensors in use  Background  Long-Term Implantable Blood Pressure Monitoring System and Advantages

Long-Term Implantable Blood Pressure Monitoring System

Wireless Battery less In VIVO Blood PressureSensing Micro system

Page 9: Anup Pillai Dhanya Premkumar Nair.  Current blood pressure sensors in use  Background  Long-Term Implantable Blood Pressure Monitoring System and Advantages

Current blood pressure sensors in use Background Long-Term Implantable Blood Pressure

Monitoring System and Advantages Wireless Battery less In VIVO Blood

PressureSensing Micro system and Advantages

System Architecture Our Objectives Timeline and Division of work Conclusions

Page 10: Anup Pillai Dhanya Premkumar Nair.  Current blood pressure sensors in use  Background  Long-Term Implantable Blood Pressure Monitoring System and Advantages

The system employs an instrumented elastic cuff, wound around a blood vessel

Operates in a linear “diameter v.s. pressure” region of the vessel for real time blood pressure monitoring

The elastic cuff is made of soft bio-compatible rubber, filled with bio-compatible insulating fluid with an immersed MEMS pressure sensor

The MEMS sensor detects the vessel blood pressure wave form with a constant scaling factor, independent of the cuff bias pressure exerting on the vessel.

Page 11: Anup Pillai Dhanya Premkumar Nair.  Current blood pressure sensors in use  Background  Long-Term Implantable Blood Pressure Monitoring System and Advantages

Cuff

Vein

Insulating Liquid

MEMS sensor

Page 12: Anup Pillai Dhanya Premkumar Nair.  Current blood pressure sensors in use  Background  Long-Term Implantable Blood Pressure Monitoring System and Advantages

This technique avoids vessel insertion

Also substantially minimizes vessel movement restriction due to the soft cuff elasticity

Attractive for minimizing long-term adverse biological effects

Page 13: Anup Pillai Dhanya Premkumar Nair.  Current blood pressure sensors in use  Background  Long-Term Implantable Blood Pressure Monitoring System and Advantages

Current blood pressure sensors in use Background Long-Term Implantable Blood Pressure

Monitoring System and Advantages Wireless Battery less In VIVO Blood

PressureSensing Micro system and Advantages

System Architecture Our Objectives Timeline and Division of work Conclusions

Page 14: Anup Pillai Dhanya Premkumar Nair.  Current blood pressure sensors in use  Background  Long-Term Implantable Blood Pressure Monitoring System and Advantages

Wireless powering and data telemetry are also incorporated in the micro system

This eliminates the need of external wire connections and any bulky battery

The micro system can be used to obtain reliable measurements without suffering from stress induced distortion

Page 15: Anup Pillai Dhanya Premkumar Nair.  Current blood pressure sensors in use  Background  Long-Term Implantable Blood Pressure Monitoring System and Advantages
Page 16: Anup Pillai Dhanya Premkumar Nair.  Current blood pressure sensors in use  Background  Long-Term Implantable Blood Pressure Monitoring System and Advantages

Current blood pressure sensors in use Background Long-Term Implantable Blood Pressure

Monitoring System and Advantages Wireless Battery less In VIVO Blood

PressureSensing Micro system and Advantages

System Architecture Our Objectives Timeline and Division of work Conclusions

Page 17: Anup Pillai Dhanya Premkumar Nair.  Current blood pressure sensors in use  Background  Long-Term Implantable Blood Pressure Monitoring System and Advantages
Page 18: Anup Pillai Dhanya Premkumar Nair.  Current blood pressure sensors in use  Background  Long-Term Implantable Blood Pressure Monitoring System and Advantages
Page 19: Anup Pillai Dhanya Premkumar Nair.  Current blood pressure sensors in use  Background  Long-Term Implantable Blood Pressure Monitoring System and Advantages

Current blood pressure sensors in use Background Long-Term Implantable Blood Pressure

Monitoring System and Advantages Wireless Battery less In VIVO Blood

PressureSensing Micro system and Advantages

System Architecture Our Objectives Timeline and Division of work Conclusions

Page 20: Anup Pillai Dhanya Premkumar Nair.  Current blood pressure sensors in use  Background  Long-Term Implantable Blood Pressure Monitoring System and Advantages

The sensor specified in the background exhibits increased noise levels

The transmitter of the same dissipated a 80% of the system power

Our objectives are: a) To design a similar sensor which exhibits

less noise levels

b) To design a better and more power efficient transmitter for the sensor

Page 21: Anup Pillai Dhanya Premkumar Nair.  Current blood pressure sensors in use  Background  Long-Term Implantable Blood Pressure Monitoring System and Advantages

To find a solution which exhibits less noise levels

We began by investigating the reason for the high noise levels in the current design

Page 22: Anup Pillai Dhanya Premkumar Nair.  Current blood pressure sensors in use  Background  Long-Term Implantable Blood Pressure Monitoring System and Advantages

Animal body vapor penetration into the device

Affect the functioning of the electrical connections within the sensor.

Page 23: Anup Pillai Dhanya Premkumar Nair.  Current blood pressure sensors in use  Background  Long-Term Implantable Blood Pressure Monitoring System and Advantages

The high impedance node can be highly sensitive to vapor penetration

Electrical connections between the sensor diaphragm and IC chip

Page 24: Anup Pillai Dhanya Premkumar Nair.  Current blood pressure sensors in use  Background  Long-Term Implantable Blood Pressure Monitoring System and Advantages

Protection for moisture penetration is required for the sensor diaphragm as well as the electrical connections between the sensor diaphragm and IC chip.

Page 25: Anup Pillai Dhanya Premkumar Nair.  Current blood pressure sensors in use  Background  Long-Term Implantable Blood Pressure Monitoring System and Advantages

A passivation layer, such as silicon dioxide (SiO2) and silicon nitride (Si3N4), can be deposited on the top of diaphragm.

An encapsulant material with strong moisture resistance can be used to protect the bond wires between the sensor and IC before applying silicone passivation layer.

Page 26: Anup Pillai Dhanya Premkumar Nair.  Current blood pressure sensors in use  Background  Long-Term Implantable Blood Pressure Monitoring System and Advantages

To design a better and more power efficient transmitter for the sensor

In the microsystem, an oscillator based FSK transmitter was employed for data telemetry

This transmitter was on throughout and hence resulted in 80% power dissipation

Page 27: Anup Pillai Dhanya Premkumar Nair.  Current blood pressure sensors in use  Background  Long-Term Implantable Blood Pressure Monitoring System and Advantages

To use a transmitter operating with a low duty cycle

One can also use a transmitter with an increased bandwidth

Page 28: Anup Pillai Dhanya Premkumar Nair.  Current blood pressure sensors in use  Background  Long-Term Implantable Blood Pressure Monitoring System and Advantages

If the sampling frequency is 2 kHz, with data rate of 48 kbps, corresponding bit rate is 24 per 0.5 ms

This is the current specification for the system

Page 29: Anup Pillai Dhanya Premkumar Nair.  Current blood pressure sensors in use  Background  Long-Term Implantable Blood Pressure Monitoring System and Advantages

Instead if we the transmitter is designed to be on for 0.05 ms and off for the remaining 0.45 ms

This results in one order magnitude power reduction at increased data rate of 480 kbps

This corresponds to 72% overall system power reduction

Page 30: Anup Pillai Dhanya Premkumar Nair.  Current blood pressure sensors in use  Background  Long-Term Implantable Blood Pressure Monitoring System and Advantages

Current blood pressure sensors in use Background Long-Term Implantable Blood Pressure

Monitoring System and Advantages Wireless Battery less In VIVO Blood

PressureSensing Micro system and Advantages

System Architecture Our Objectives Timeline and Division of work Conclusions

Page 31: Anup Pillai Dhanya Premkumar Nair.  Current blood pressure sensors in use  Background  Long-Term Implantable Blood Pressure Monitoring System and Advantages

February March April May

Research project topic and preparation for report 1

Report 1

Objective 1

Presentation 2

Objective 2

Final Report

Page 32: Anup Pillai Dhanya Premkumar Nair.  Current blood pressure sensors in use  Background  Long-Term Implantable Blood Pressure Monitoring System and Advantages

First Objective:

To design a similar sensor which exhibits less noise levels-A. Pillai

Second Objective: To design a better and more power efficient

transmitter for the sensor-D. Nair

Page 33: Anup Pillai Dhanya Premkumar Nair.  Current blood pressure sensors in use  Background  Long-Term Implantable Blood Pressure Monitoring System and Advantages

A review of current in-vivo blood pressure sensors was presented in this review study

We identified the potential problems with existing solutions

We have proposed two solutions that will enhance the performance of the current design

Page 34: Anup Pillai Dhanya Premkumar Nair.  Current blood pressure sensors in use  Background  Long-Term Implantable Blood Pressure Monitoring System and Advantages

"Normal Blood Pressure Range Adults". Health and Life. http://www.nhlbi.nih.gov/health/dci/Diseases/hyp/hyp_whatis.html  Klabunde, Richard (2005). Cardiovascular Physiology Concepts. Lippincott Williams & Wilkins.

pp. 93–4. ISBN 978-0781750301. Chobanian AV, Bakris GL, Black HR, et al (December 2003). "Seventh report of the Joint National

Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure".Hypertension 42 (6): 1206–52. doi:10.1161/01.HYP.0000107251.49515.c2. PMID 14656957.

"Diseases and conditions index - hypotension". National Heart Lung and Blood Institute. September 2008. Retrieved 2008-09-16.

 "Hypertension: management of hypertension in adults in primary care". NICE clinical guideline 34. London: National Institute for Health and Clinical Excellence (NICE). June 2006. Retrieved 2008-09-15.

 "Understanding blood pressure readings". American Heart Association. 11 January 2011. Retrieved 30 March 2011.

 Pesola GR, Pesola HR, Nelson MJ, Westfal RE (January 2001). "The normal difference in bilateral indirect BP recordings in normotensive individuals". American Journal of Emergency Medicine 19 (1): 43–5. doi:10.1053/ajem.2001.20021. PMID 11146017.

 Reckelhoff, Jane F (1 May 2001). "Gender differences in the regulation of blood pressure". Hypertension 37 (5): 1199–208. PMID 11358929.

Page 35: Anup Pillai Dhanya Premkumar Nair.  Current blood pressure sensors in use  Background  Long-Term Implantable Blood Pressure Monitoring System and Advantages

National Heart, Lung and Blood Institute. Blood pressure tables for children and adolescents. (Note that the median BP is given by the 50th percentile and hypertension is defined by the 95th percentilefor a given age, height, and gender.)

(Pickering et al. 2005, p. 145) See Isolated Systolic Hypertension. "...more than half of all Americans aged 65 or older have hypertension." (Pickering et al. 2005, p.

144) Eguchi K, Yacoub M, Jhalani J, Gerin W, Schwartz JE, Pickering TG (February 2007). "Consistency of

blood pressure differences between the left and right arms". Arch Intern Med 167 (4): 388–93.doi:10.1001/archinte.167.4.388. PMID 17325301.

Agarwal R, Bunaye Z, Bekele DM (March 2008). "Prognostic significance of between-arm blood pressure differences". Hypertension 51 (3): 657–62. doi:10.1161/HYPERTENSIONAHA.107.104943.PMID 18212263.

Appel LJ, Brands MW, Daniels SR, Karanja N, Elmer PJ, Sacks FM (February 2006). "Dietary approaches to prevent and treat hypertension: a scientific statement from the American Heart Association".Hypertension 47 (2): 296–308. doi:10.1161/01.HYP.0000202568.01167.B6. PMID 16434724.

Mayo Clinic staff (2009-05-23). "Low blood pressure (hypotension) — Causes". MayoClinic.com. Mayo Foundation for Medical Education and Research. Retrieved 2010-10-19.

Rosenson RS, Wolff D, Green D, Boss AH, Kensey KR (February 2004). "Aspirin. Aspirin does not alter native blood viscosity". J. Thromb. Haemost. 2 (2): 340–1. PMID 14996003.

Klabunde, RE (2007). "Cardiovascular Physiology Concepts - Mean Arterial Pressure". Retrieved 2008-09-29. Archived version 2009-10-03

Page 36: Anup Pillai Dhanya Premkumar Nair.  Current blood pressure sensors in use  Background  Long-Term Implantable Blood Pressure Monitoring System and Advantages

Klabunde, RE (2007). "Cardiovascular Physiology Concepts - Pulse Pressure". Retrieved 2008-10-02. Archived version 2009-10-03

Markham LW, Knecht SK, Daniels SR, Mays WA, Khoury PR, Knilans TK (November 2004). "Development of exercise-induced arm-leg blood pressure gradient and abnormal arterial compliance in patients with repaired coarctation of the aorta". Am. J. Cardiol. 94 (9): 1200–2. doi:10.1016/j.amjcard.2004.07.097. PMID 15518624.

Messerli FH, Williams B, Ritz E (2007). "Essential hypertension". Lancet 370 (9587): 591–603. doi:10.1016/S0140-6736(07)61299-9. PMID 17707755.

O'Rourke M (1 July 1995). "Mechanical principles in arterial disease". Hypertension 26 (1): 2–9. PMID 7607724.

Mitchell GF (2006). "Triangulating the peaks of arterial pressure". Hypertension 48 (4): 543–5. doi:10.1161/01.HYP.0000238325.41764.41. PMID 16940226.

Klabunde, RE (2007). "Cardiovascular Physiology Concepts - Arterial Baroreceptors". Retrieved 2008-09-09. Archived version 2009-10-03

Booth, J (1977). "A short history of blood pressure measurement". Proceedings of the Royal Society of Medicine 70 (11): 793–9. PMC 1543468. PMID 341169. Retrieved 2009-10-06.

"Vital Signs (Body Temperature, Pulse Rate, Respiration Rate, Blood Pressure)". OHSU Health Information. Oregon Health & Science University. Retrieved 2010-04-16.

Deakin CD, Low JL (September 2000). "Accuracy of the advanced trauma life support guidelines for predicting systolic blood pressure using carotid, femoral, and radial pulses: observational study". BMJ321 (7262): 673–4. doi:10.1136/bmj.321.7262.673. PMC 27481. PMID 10987771.

Interpretation - Blood Pressure - Vitals, University of Florida. Retrieved on 2008-03-18. G8 Secondary Survey, "Manitoba". Retrieved on 2008-03-18. (Pickering et al. 2005, p. 146) See Blood Pressure Measurement Methods.

Page 37: Anup Pillai Dhanya Premkumar Nair.  Current blood pressure sensors in use  Background  Long-Term Implantable Blood Pressure Monitoring System and Advantages

(Pickering et al. 2005, p. 147) See The Oscillometric Technique. Laurent, P (2003-09-28). "Blood Pressure & Hypertension". Retrieved 2009-10-05. Elliot, Victoria Stagg (2007-06-11). "Blood pressure readings often unreliable". American Medical News (American

Medical Association). Retrieved 2008-08-16. Jhalani, Juhee; Tanya Goyal, Lynn Clemow, et al (2005). "Anxiety and outcome expectations predict the white-coat

effect". Blood Pressure Monitoring 10 (6): 317–9. doi:10.1097/00126097-200512000-00006. PMID 16496447. Retrieved 2009-10-03.

(Pickering et al. 2005, p. 145) See White Coat Hypertension or Isolated Office Hypertension. (Pickering et al. 2005, p. 146) See Masked Hypertension or Isolated Ambulatory Hypertension. Mancia G, De Backer G, Dominiczak A, et al. (June 2007). "2007 Guidelines for the management of arterial hypertension:

The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC)". Eur Heart J 28 (12): 1462–536. doi:10.1093/eurheartj/ehm236. PMID 17562668.

Niiranen, TJ; Kantola IM, Vesalainen R, et al (2006). "A comparison of home measurement and ambulatory monitoring of blood pressure in the adjustment of antihypertensive treatment". Am J Hypertens19 (5): 468–74. doi:10.1016/j.amjhyper.2005.10.017. PMID 16647616.

Shimbo, Daichi; Thomas G. Pickering, Tanya M. Spruill, et al (2007). "Relative utility of home, ambulatory, and office blood pressures in the prediction of end-organ damage". Am J Hypertens 20 (5): 476–82. doi:10.1016/j.amjhyper.2006.12.011. PMC 1931502. PMID 17485006.[dead link]

National Heart, Lung and Blood Institute. Tips for having your blood pressure taken. Table 30-1 in: Trudie A Goers; Washington University School of Medicine Department of Surgery; Klingensmith, Mary E;

Li Ern Chen; Sean C Glasgow (2008). The Washington manual of surgery. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. ISBN 0-7817-7447-0.

Dugdale, David. "Blood Pressure". Retrieved 1 April 2011. Klabunde, Richard. "Arterial Blood Pressure". Retrieved 31 March 2011. Fung, Yuan-cheng (1997). Biomechanics:Circulation. New York: Springer. pp. 571. ISBN 038794383.

Page 38: Anup Pillai Dhanya Premkumar Nair.  Current blood pressure sensors in use  Background  Long-Term Implantable Blood Pressure Monitoring System and Advantages

Munson; Young, Okiishi, Huebsch (2009). Fundamentals of Fluid Mechanics (Sixth ed.). New Jersey: John Wiley &Sons, Inc.. pp. 725. ISBN 9780470262849.

Womersley, J. R. (1955). "Method for The Calculation of Velocity, Rate of Flow and Viscous Drag in Arteries When The Pressure Gradient is Known". Journal of Physiology 127: 553–563.

Sircar, Sabyasach (2008). Principles of Medical Physiology. India: vistasta Publishing. ISBN 978158890572. Fung, Yuan-cheng; Zweifach, B.W. (1971). "Microcirculation: Mechanics of Blood Flow in Capillaries". Annual

Review of Fluid Mechanics 3: 189–210. What Is Pulmonary Hypertension? From Diseases and Conditions Index (DCI). National Heart, Lung, and

Blood Institute. Last updated September 2008. Retrieved on 6 April 2009. Chapter 41, page 210 in: Cardiology secrets By Olivia Vynn Adair Edition: 2, illustrated Published by Elsevier

Health Sciences, 2001 ISBN 1560534206, 9781560534204 Struijk PC, Mathews VJ, Loupas T, et al (October 2008). "Blood pressure estimation in the human fetal

descending aorta". Ultrasound Obstet Gynecol 32 (5): 673–81. doi:10.1002/uog.6137.PMID 18816497. Sharon, S. M. & Emily, S. M.(2006). Foundations of Maternal-Newborn Nursing. (4th ed p.476).

Philadelphia:Elsevier. Textbook of Medical Physiology, 7th Ed., Guyton & Hall, Elsevier-Saunders, ISBN 0-7216-0240-1, page 220. Gottdiener JS, Panza JA, St John Sutton M, Bannon P, Kushner H, Weissman NJ (July 2002). "Testing the test:

The reliability of echocardiography in the sequential assessment of valvular regurgitation".American Heart Journal 144 (1): 115–21. doi:10.1067/mhj.2002.123139. PMID 12094197. Retrieved 2010-06-30.