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WO2003090615A1 - Procede et appareil de mesure non invasive de la consommation d'oxygene par voie percutanee - Google Patents

Procede et appareil de mesure non invasive de la consommation d'oxygene par voie percutanee Download PDF

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Publication number
WO2003090615A1
WO2003090615A1 PCT/SE2003/000561 SE0300561W WO03090615A1 WO 2003090615 A1 WO2003090615 A1 WO 2003090615A1 SE 0300561 W SE0300561 W SE 0300561W WO 03090615 A1 WO03090615 A1 WO 03090615A1
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WO
WIPO (PCT)
Prior art keywords
oxygen
partial pressure
boundary layer
skin
area
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/SE2003/000561
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English (en)
Inventor
Gert Nilsson
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
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Individual
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Filing date
Publication date
Application filed by Individual filed Critical Individual
Priority to AU2003222545A priority Critical patent/AU2003222545A1/en
Publication of WO2003090615A1 publication Critical patent/WO2003090615A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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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 or pH-value ; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid or cerebral tissue
    • A61B5/1455—Measuring characteristics of blood in vivo, e.g. gas concentration or pH-value ; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid or cerebral tissue using optical sensors, e.g. spectral photometrical oximeters
    • A61B5/14551—Measuring characteristics of blood in vivo, e.g. gas concentration or pH-value ; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid or cerebral tissue using optical sensors, e.g. spectral photometrical oximeters for measuring blood gases
    • A61B5/14552—Details of sensors specially adapted therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/44—Detecting, measuring or recording for evaluating the integumentary system, e.g. skin, hair or nails
    • A61B5/441—Skin evaluation, e.g. for skin disorder diagnosis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/44—Detecting, measuring or recording for evaluating the integumentary system, e.g. skin, hair or nails
    • A61B5/441—Skin evaluation, e.g. for skin disorder diagnosis
    • A61B5/445—Evaluating skin irritation or skin trauma, e.g. rash, eczema, wound, bed sore
    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
    • G01N13/00—Investigating surface or boundary effects, e.g. wetting power; Investigating diffusion effects; Analysing materials by determining surface, boundary, or diffusion effects

Definitions

  • the present invention concerns a method and apparatus for noninvasive measuring of transcutaneous oxygen uptake.
  • An adequate oxygen supply is of paramount importance in any wound healing and tissue repair process.
  • periphery vascular disease and diabetes It has been known for a long time that the skin is supplied with oxygen partly through an inward diffusion of oxygen molecules from ambient air (cutaneous respiration) and partly by the nutritive component of microcirculation, for example via capillary blood vessels.
  • These two routes of oxygen supply are dependent on a number of factors, such as the stratum corneum barrier permeability and the functionality of the dermal microvasculature .
  • the transcutaneous partial pressure of oxygen is only useful for indicating changes in the partial pressure of oxygen in the arterial blood. Nevertheless, mainly due to lack of more reliable methods, the transcutaneous partial pressure of oxygen have been used for the clinical evaluation of the severity of leg ulcers, critical limb ischemia and diabetes microangiopathy .
  • US 5 376 336 An effort to improve the transcutaneous monitoring is shown in US 5 376 336.
  • the document shows an apparatus having a sensor block defining opposite first and second sensing layers, where the first sensor layer is positioned against the skin and has a luminescence-optical indicator immobilised on the sensor layer. On the opposite side of the sensor block the second sensor layer is provided.
  • the sensing layers present a known or predetermined resistance to the material flow to be measured.
  • the second sensor layer is dispensed with as the inventors are of the opinion that partial pressure of oxygen is a constant in ambient air.
  • the sensor is preferably controlled by a thermostat and a gas-tight cap is preferably arranged over the sensor to inhibit the flow of gas .
  • a problem with the transcutaneous sensor of US 5 376 336 is that it cannot reflect the true undisturbed oxygen uptake by the skin from the ambient air. This is due to the fact that the sensor block is attached to and against the skin area to be measured, either by an adhesive or by vacuum. This is even more true when a gas-tight cap is used and/or the skin area is heated by the thermostat, whereby the skin blood perfusion is arterialised.
  • An object of the present invention is to provide a method and an apparatus for noninvasive measuring of the transcutaneous oxygen uptake from ambient air.
  • the measurement will take place without any contact with the skin and any obstructing material at the site of measurement. It is in its natural surroundings without adding anything and the sensors will not consume any of the gas to be measured. For the first time it is possible to assess the true oxygen consumption of a skin site exposed to ambient air.
  • the human body In the absence of forced convection, the human body is surrounded by a boundary layer having a thickness of 7-10 mm, which forms a physical barrier against the environment. This layer constitutes a transition zone or diffusion zone for exchange of gases between the body and ambient air. Tests have been performed in the superficial skin layer with microelectrodes for measuring the partial pressure of oxygen in the tissue. These tests have shown that a negative profile of partial pressure of oxygen exists in superficial skin layer and that this actively forces the oxygen molecules from ambient air through the superficial skin layer for consumption in the underlying tissue layers .
  • A the area
  • m the amount of oxygen
  • D 0 v diffusion constant for oxygen in tissue
  • dp/dx the gradient for the partial pressure of oxygen.
  • D 0L is the diffusion constant for oxygen in air.
  • the amount of oxygen can be measured by measuring the gradient or estimate this gradient by measuring the partial pressure of oxygen in at least two points within the boundary layer on different levels from the skin surface. By shielding off the area to be examined, the boundary layer is protected from the adverse effect of circulating air current.
  • the sensors used for measuring the partial pressure of oxygen are freely arranged in the volume defined by the shielded area of the boundary layer, i.e. not arranged in any material blocking the natural diffusion.
  • the method and apparatus according to the present invention gives a measure of how much oxygen a tissue can absorb from ambient air and how much this amount of oxygen contributes to the overall consumption of oxygen in the tissue, which also comprises a component delivered by the microvascular network.
  • Fig. 1 illustrates the principle of a measuring method and apparatus according to the present invention
  • Fig. 2 illustrates a further embodiment of the method and apparatus of fig. 1.
  • Fig. 3 shows an embodiment of an apparatus according to the present invention
  • Fig. 1 shows an area of skin surface 1 partly shielded by a shield 2 for measuring the flux of oxygen 3 into the skin 1. The measuring takes place and the apparatus is positioned in the boundary layer 6 above the skin surface 1. At least two sensors for sensing the partial pressure of oxygen, an upper sensor 4 and a lower sensor 5, are provided in a space 9 defined by the shield 2 and the boundary layer 6.
  • a thermistor 7 is provided in the space 9 for measuring the temperature.
  • a thermistor 7 is provided in the space 9 for measuring the temperature.
  • a thermistor 7 is provided in the space 9 for measuring the temperature.
  • a thermistor 7 is provided in the space 9 for measuring the temperature.
  • FIG. 3 an embodiment of an apparatus according to the present invention is shown.
  • the apparatus comprises a probe 8 provided with a shield 2 within which an upper 4 and a lower 5 sensor for partial pressure of oxygen are freely arranged, i.e. not arranged in any material blocking the natural diffusion.
  • the probe 8 is connected to a measurement instrument (not shown) comprising means for the evaluation of the sensed measurements according to the equation
  • the means for evaluation calculates the gradient for the partial pressure of oxygen and the amount of oxygen taken up by the tissue through the skin surface.
  • the shield 2 is open downwards facing the area 1 to be examined and upwards facing the ambient air, like a chimney.
  • the cross section of the inner space 9 may have any shape, for example circular shape.
  • the height of the shield 2 should be the same height as the boundary layer 6, i.e. 7- 10 mm.
  • the shield 2 is removable and made in a material suitable for disinfection in any suitable way.
  • the shield 2 may be open in the side wall for connection with the probe 8.
  • the probe 8 may preferably be handheld.
  • the sensors 4, 5 for measuring the partial pressure of oxygen could be fluorescence-based optical sensors, for example FOXY Fiber Optical Oxygen Sensor from Ocean Optics Inc.
  • the operating principle of the preferred sensors is based on dynamic fluorescence quenching response to the partial pressure of oxygen.
  • the tip of an optical fibre is provided with fluorescence material, which emit light of another wave length than illuminated with in the presence of oxygen. Either the same optical fibre or a second optical fibre transmits the emitted light to the measurement instrument.
  • the sensor has preferably a response time less than one second.
  • the sensor life-time without recalibration is preferably one year.
  • the upper sensor 4 is provided further away in a vertical direction from the skin surface 1 than the lower sensor 5 but both are provided within the boundary layer 6 and closer to the skin surface 1 than the upper edge 10 of the shield 2.
  • the upper 4 and lower 5 sensor need not be arranged vertically above each other but can be horizontally displaced from each other.
  • An alternative sensor for partial pressure of oxygen is a platinum electrode, also called Clark- electrode, but this sensor has the disadvantage of consuming oxygen.
  • the diffusion constant for oxygen in air might be slightly dependent on the temperature.
  • a use of a thermistor 7 will increase the reliability of the result.
  • the thermistor 7 is arranged between the two sensors 4, 5, and will measure the temperature and, when needed, compensate for the temperature in the area 1 to be examined.
  • the temperature at each tip of the sensors 4, 5 will be measured, for example by means of two separate thermistors. These temperature measures may be used for compensation of possible temperature sensitivity of the sensors .
  • the method and apparatus of the present invention could for example be used in evaluation of wounds, leg ulcers, peripheral vascular disease, critical limb ischemia, hyperbar medicine therapy, burn lesions and so on. Another use is the evaluation of the oxygen barrier function of for example artificial skin.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Physics & Mathematics (AREA)
  • General Health & Medical Sciences (AREA)
  • Pathology (AREA)
  • Engineering & Computer Science (AREA)
  • Animal Behavior & Ethology (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • Surgery (AREA)
  • Molecular Biology (AREA)
  • Biophysics (AREA)
  • Medical Informatics (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Dermatology (AREA)
  • Chemical & Material Sciences (AREA)
  • Analytical Chemistry (AREA)
  • Biochemistry (AREA)
  • Immunology (AREA)
  • General Physics & Mathematics (AREA)
  • Spectroscopy & Molecular Physics (AREA)
  • Optics & Photonics (AREA)
  • Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)

Abstract

L'invention concerne un procédé qui permet de mesurer de façon non invasive, à partir de l'air ambiant, la consommation d'oxygène par voie percutané. Le procédé consiste à: protéger (2) des courants d'air une zone de la peau à examiner afin d'y ménager une couche limite stable (6); détecter (4, 5) la pression partielle de l'oxygène en au moins deux points différents placés sur au moins deux hauteurs différentes, à partir de la surface de la peau (1) située à l'intérieur de la couche limite stable (6) mais hors de la surface de la peau (1); appliquer l'équation (I) selon laquelle A représente ladite zone, m représente la quantité d'oxygène, dp/dx représente le gradient de la pression partielle d'oxygène, et DOL représente la constante de diffusion de l'oxygène présent dans l'air, ce qui permet de calculer le gradient de la pression partielle d'oxygène dans la couche limite (6). L'invention concerne en outre un appareil pour mettre en oeuvre le procédé de l'invention.
PCT/SE2003/000561 2002-04-26 2003-04-07 Procede et appareil de mesure non invasive de la consommation d'oxygene par voie percutanee Ceased WO2003090615A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU2003222545A AU2003222545A1 (en) 2002-04-26 2003-04-07 Method and apparatus for noninvasive measuring of transcutaneous oxygen uptake

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
SE0201269A SE523698C2 (sv) 2002-04-26 2002-04-26 Metod och anordning för icke-invasiv mätning av transkutan syreupptagning
SE0201269-8 2002-04-26

Publications (1)

Publication Number Publication Date
WO2003090615A1 true WO2003090615A1 (fr) 2003-11-06

Family

ID=20287697

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/SE2003/000561 Ceased WO2003090615A1 (fr) 2002-04-26 2003-04-07 Procede et appareil de mesure non invasive de la consommation d'oxygene par voie percutanee

Country Status (3)

Country Link
AU (1) AU2003222545A1 (fr)
SE (1) SE523698C2 (fr)
WO (1) WO2003090615A1 (fr)

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4114602A (en) * 1975-07-10 1978-09-19 L. Eschweiler & Co. Process and arrangement for determining the perfusion factor of a gas in a sample
US4197853A (en) * 1977-07-26 1980-04-15 G. D. Searle & Co. PO2 /PCO2 sensor
US4930506A (en) * 1986-11-17 1990-06-05 Hellige Gmbh Combined sensor for the transcutaneous measurement of oxygen and carbon dioxide in the blood
WO1996003074A1 (fr) * 1994-07-22 1996-02-08 The Trustees Of The University Of Pennsylvania Appareil et procede de mesure percutanee de l'oxygenation des tissus par decroissance de la phosphorescence en fonction de la teneur en oxygene
US20010034479A1 (en) * 2000-04-19 2001-10-25 Ring Lawrence S. Optically based transcutaneous blood gas sensor

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4114602A (en) * 1975-07-10 1978-09-19 L. Eschweiler & Co. Process and arrangement for determining the perfusion factor of a gas in a sample
US4197853A (en) * 1977-07-26 1980-04-15 G. D. Searle & Co. PO2 /PCO2 sensor
US4930506A (en) * 1986-11-17 1990-06-05 Hellige Gmbh Combined sensor for the transcutaneous measurement of oxygen and carbon dioxide in the blood
WO1996003074A1 (fr) * 1994-07-22 1996-02-08 The Trustees Of The University Of Pennsylvania Appareil et procede de mesure percutanee de l'oxygenation des tissus par decroissance de la phosphorescence en fonction de la teneur en oxygene
US20010034479A1 (en) * 2000-04-19 2001-10-25 Ring Lawrence S. Optically based transcutaneous blood gas sensor

Also Published As

Publication number Publication date
AU2003222545A1 (en) 2003-11-10
SE523698C2 (sv) 2004-05-11
SE0201269L (sv) 2003-10-27
SE0201269D0 (sv) 2002-04-26

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