Dynamic cardiovascular monitor

A patient monitoring system that estimates blood pressure at a first site using a blood pressure measurement performed at a second site, the system comprising:

• a system controller that controls operation of the patient monitoring system;
• a first data storage device, operationally coupled to the system controller, that stores data about blood pressure pulse wave propagation;
• a first communication device, operationally coupled to the system controller, by which a user provides information about a patient and the measurement device;
• a first blood pressure pulse measurement device, operationally coupled to the system controller, that continuously measures the blood pressure at the second site to produce a first blood pressure measurement;
• a first computational device, operationally coupled to the system controller, that constructs a first mathematical relationship using the data stored in the first data storage device to estimate blood pressure at the first site using the first blood pressure measurement;
• a first blood pressure measurement modification device, operationally coupled to the system controller, that produces a second blood pressure measurement by removing a mean pressure from the first blood pressure measurement;
• a first blood pressure measurement comparator, operationally coupled to the system controller, that compares the estimated blood pressure at the first site with the second blood pressure measurement;
• a second communication device, operationally coupled to the system controller, that transfers results of the first blood pressure measurement device, first computational device, first blood pressure measurement modification device and the first blood pressure measurement comparator to a user or a second data storage device;
• a systole detector, operationally coupled to the system controller, that detects initiation of a blood pressure pulse;
• a third data storage device, operationally coupled to the system controller, that retains the mean pressure removed from the first blood pressure measurement for recombination with the estimated blood pressure at the first site;
• an artery occlusion device, operationally coupled to the system controller, that temporarily restricts blood flow in a path of the vascular system between a heart and the second site;
• a second blood pressure pulse measurement device, operationally coupled to the system controller, that measures a third blood pressure measurement, or a representation thereof, at, or proximate to, the artery occlusion device;
• a third blood pressure pulse measurement device, operationally coupled to the system controller, that measures a fourth blood pressure measurement, or a representation thereof, at a third point that is at, or proximate to, an end of a blood pressure pulse propagation path;
• a second blood pressure measurement modification device, operationally coupled to the system controller, that modifies the fourth blood pressure measurement by removing changes in the measurement produced by frequency response characteristics of the third blood pressure pulse measurement device;
• a pulse propagation time determination device, operationally coupled to the system controller, that measures a time required for the blood pressure pulse of a given heart beat to travel to the first, third and fourth blood pressure measurement sites from the heart and times required for the blood pressure pulse to travel between each of the first, third and fourth pulse measurement sites;
• a second computational device, operationally coupled to the system controller, that uses information from any of the first data storage device, the first blood pressure measurement comparator, the systole detector, the first, second and third data storage devices, the artery occlusion device, the first blood pressure measurement modification device, the first and second blood pressure measurement devices and the pulse propagation time determination device, to construct a computational relationship between the blood pressure measured by the blood pressure measurement device and the blood pressure at the first site;
• a third computational device, operationally coupled to the system controller, that uses the estimate of the blood pressure at the first site to produce a second estimate of the blood pressure measurement at the second and third sites;
• a fourth computational device, operationally coupled to the system controller, that continuously estimates the blood pressure at the third site from the blood pressure measured at the second site;
• a second blood pressure measurement comparator, operationally coupled to the system controller, that continuously compares the blood pressure measured at the third site to the estimated blood pressure at the third site and the propagation time between the first and third sites to produce a measurement indicating whether the first mathematical relationship is accurate;
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• an optimizer, operationally coupled to the system controller, that adjusts the first mathematical relationship to improve accuracy with which the system estimates blood pressure at the first site.