US20020128544A1 - Signal processing apparatus - Google Patents

Abstract

The present invention involves method and apparatus for analyzing two measured signals that are modeled as containing primary and secondary portions. Coefficients relate the two signals according to a model defined in accordance with the present invention. In one embodiment, the present invention involves utilizing a transformation which evaluates a plurality of possible signal coefficients in order to find appropriate coefficients. Alternatively, the present invention involves using statistical functions or Fourier transform and windowing techniques to determine the coefficients relating to two measured signals. Use of this invention is described in particular detail with respect to blood oximetry measurements.

Description

REFERENCE TO PRIOR RELATED APPLICATION
• This application is a continuation of application Ser. No. 09/195,791, filed Nov. 17, 1998, which is a continuation of application Ser. No. 08/859,837, filed May 16, 1997 (now U.S. Pat. No. 6,157,850), which is a continuation of application Ser. No. 08/320,154, filed Oct. 7, 1994 (now U.S. Pat. No. 5,632,272 issued May 27, 1997), which is a continuation-in-part of application Ser. No. 08/132,812, filed Oct. 6, 1993 (now U.S. Pat. No. 5,490,505 issued Feb. 13, 1996), which is a continuation-in-part of application Ser. No. 08/249,690 filed May 26, 1994 (now U.S. Pat. No. 5,482,036), which is a continuation of application Ser. No. 07/666,060, filed Mar. 7, 1991 (now abandoned).[0001]
BACKGROUND OF THE INVENTION
• 1. Field of the Invention[0002]
• The present invention relates to the field of signal processing. More specifically, the present invention relates to the processing of measured signals, containing a primary signal portion and a secondary signal portion, for the removal or derivation of either the primary or secondary signal portion when little is known about either of these components. More particularly, the present invention relates to modeling the measured signals in a novel way which facilitates minimizing the correlation between the primary signal portion and the secondary signal portion in order to produce a primary and/or secondary signal. The present invention is especially useful for physiological monitoring systems including blood oxygen saturation systems.[0003]
• 2. Description of the Related Art[0004]
• Signal processors are typically employed to remove or derive either the primary or secondary signal portion from a composite measured signal including a primary signal portion and a secondary signal portion. For example, a composite signal may contain noise and desirable portions. If the secondary signal portion occupies a different frequency spectrum than the primary signal portion, then conventional filtering techniques such as low pass, band pass, and high pass filtering are available to remove or derive either the primary or the secondary signal portion from the total signal. Fixed single or multiple notch filters could also be employed if the primary and/or secondary signal portion(s) exist at a fixed frequency(s).[0005]
• It is often the case that an overlap in frequency spectrum between the primary and secondary signal portions exists. Complicating matters further, the statistical properties of one or both of the primary and secondary signal portions change with time. In such cases, conventional filtering techniques are ineffective in extracting either the primary or secondary signal. If, however, a description of either the primary or secondary signal portion can be derived, correlation canceling, such as adaptive noise canceling, can be employed to remove either the primary or secondary signal portion of the signal isolating the other portion. In other words, given sufficient information about one of the signal portions, that signal portion can be extracted.[0006]
• Conventional correlation cancelers, such as adaptive noise cancelers, dynamically change their transfer function to adapt to and remove portions of a composite signal. However, correlation cancelers require either a secondary reference or a primary reference which correlates to either the secondary signal portion only or the primary signal portion only. For instance, for a measured signal containing noise and desirable signal, the noise can be removed with a correlation canceler if a noise reference is available. This is often the case. Although the amplitude of the reference signals are not necessarily the same as the amplitude of the corresponding primary or secondary signal portions, they have a frequency spectrum which is similar to that of the primary or secondary signal portions.[0007]
• In many cases, nothing or very little is known about the secondary and/or primary signal portions. One area where measured signals comprising a primary signal portion and a secondary signal portion about which no information can easily be determined is physiological monitoring. Physiological monitoring generally involves measured signals derived from a physiological system, such as the human body. Measurements which are typically taken with physiological monitoring systems include electrocardiographs, blood pressure, blood gas saturation (such as oxygen saturation), capnographs, other blood constituent monitoring, heart rate, respiration rate, electro-encephalograph (EEG) and depth of anesthesia, for example. Other types of measurements include those which measure the pressure and quantity of a substance within the body such as cardiac output, venous oxygen saturation, arterial oxygen saturation, bilirubin, total hemoglobin, breathalyzer testing, drug testing, cholesterol testing, glucose testing, extra vasation, and carbon dioxide testing, protein testing, carbon monoxide testing, and other in-vivo measurements, for example. Complications arising in these measurements are often due to motion of the patient, both external and internal (muscle movement, vessel movement, and probe movement, for example), during the measurement process.[0008]
• Many types of physiological measurements can be made by using the known properties of energy attenuation as a selected form of energy passes through a medium.[0009]
• A blood gas monitor is one example of a physiological monitoring system which is based upon the measurement of energy attenuated by biological tissues or substances. Blood gas monitors transmit light into the test medium and measure the attenuation of the light as a function of time. The output signal of a blood gas monitor which is sensitive to the arterial blood flow contains a component which is a waveform representative of the patient's arterial pulse. This type of signal, which contains a component related to the patient's pulse, is called a plethysmographic wave, and is shown in FIG. 1 as curve s. Plethysmographic waveforms are used in blood gas saturation measurements. As the heart beats, the amount of blood in the arteries increases and decreases, causing increases and decreases in energy attenuation, illustrated by the cyclic wave s in FIG. 1.[0010]
• Typically, a digit such as a finger, an ear lobe, or other portion of the body where blood flows close to the skin, is employed as the medium through which light energy is transmitted for blood gas attenuation measurements. The finger comprises skin, fat, bone, muscle, etc., shown schematically in FIG. 2, each of which attenuates energy incident on the finger in a generally predictable and constant manner. However, when fleshy portions of the finger are compressed erratically, for example by motion of the finger, energy attenuation becomes erratic.[0011]
• An example of a more realistic measured waveform S is shown in FIG. 3, illustrating the effect of motion. The primary plethysmographic waveform portion of the signal s is the waveform representative of the pulse, corresponding to the sawtooth-like pattern wave in FIG. 1. The large, secondary motion-induced excursions in signal amplitude obscure the primary plethysmographic signal s. Even small variations in amplitude make it difficult to distinguish the primary signal component s in the presence of a secondary signal component n.[0012]
• A pulse oximeter is a type of blood gas monitor which non-invasively measures the arterial saturation of oxygen in the blood. The pumping of the heart forces freshly oxygenated blood into the arteries causing greater energy attenuation. As well understood in the art, the arterial saturation of oxygenated blood may be determined from the depth of the valleys relative to the peaks of two plethysmographic waveforms measured at separate wavelengths. Patient movement introduces motion artifacts to the composite signal as illustrated in the plethysmographic waveform illustrated in FIG. 3. These motion artifacts distort the measured signal.[0013]
SUMMARY OF THE INVENTION
• This invention provides improvements upon the methods and apparatus disclosed in U.S. patent application Ser. No. 08/132,812, filed Oct. 6, 1993, entitled Signal Processing Apparatus, which earlier application has been assigned to the assignee of the instant application. The present invention involves several different embodiments using the novel signal model in accordance with the present invention to isolate either a primary signal portion or a secondary signal portion of a composite measured signal. In one embodiment, a signal processor acquires a first measured signal and a second measured signal that is correlated to the first measured signal. The first signal comprises a first primary signal portion and a first secondary signal portion. The second signal comprises a second primary signal portion and a second secondary signal portion. The signals may be acquired by propagating energy through a medium and measuring an attenuated signal after transmission or reflection. Alternatively, the signals may be acquired by measuring energy generated by the medium.[0014]
• In one embodiment, the first and second measured signals are processed to generate a secondary reference which does not contain the primary signal portions from either of the first or second measured signals. This secondary reference is correlated to the secondary signal portion of each of the first and second measured signals. The secondary reference is used to remove the secondary portion of each of the first and second measured signals via a correlation canceler, such as an adaptive noise canceler. The correlation canceler is a device which takes a first and second input and removes from the first input all signal components which are correlated to the second input. Any unit which performs or nearly performs this function is herein considered to be a correlation canceler.[0015]
• An adaptive correlation canceler can be described by analogy to a dynamic multiple notch filter which dynamically changes its transfer function in response to a reference signal and the measured signals to remove frequencies from the measured signals that are also present in the reference signal. Thus, a typical adaptive correlation canceler receives the signal from which it is desired to remove a component and receives a reference signal of the undesired portion. The output of the correlation canceler is a good approximation to the desired signal with the undesired component removed.[0016]
• Alternatively, the first and second measured signals may be processed to generate a primary reference which does not contain the secondary signal portions from either of the first or second measured signals. The primary reference may then be used to remove the primary portion of each of the first and second measured signals via a correlation canceler. The output of the correlation canceler is a good approximation to the secondary signal with the primary signal removed and may be used for subsequent processing in the same instrument or an auxiliary instrument. In this capacity, the approximation to the secondary signal may be used as a reference signal for input to a second correlation canceler together with either the first or second measured signals for computation of, respectively, either the first or second primary signal portions.[0017]
• Physiological monitors can benefit from signal processors of the present invention. Often in physiological measurements a first signal comprising a first primary portion and a first secondary portion and a second signal comprising a second primary portion and a second secondary portion are acquired. The signals may be acquired by propagating energy through a patient's body (or a material which is derived from the body, such as breath, blood, or tissue, for example) or inside a vessel and measuring an attenuated signal after transmission or reflection. Alternatively, the signal may be acquired by measuring energy generated by a patient's body, such as in electrocardiography. The signals are processed via the signal processor of the present invention to acquire either a secondary reference or a primary reference which is input to a correlation canceler, such as an adaptive noise canceler.[0018]
• One physiological monitoring apparatus which benefits from the present invention is a monitoring system which determines a signal which is representative of the arterial pulse, called a plethysmographic wave. This signal can be used in blood pressure calculations, blood constituent measurements, etc. A specific example of such a use is in pulse oximetry. Pulse oximetry involves determining the saturation of oxygen in the blood. In this configuration, the primary portion of the signal is the arterial blood contribution to attenuation of energy as it passes through a portion of the body where blood flows close to the skin. The pumping of the heart causes blood flow to increase and decrease in the arteries in a periodic fashion, causing periodic attenuation wherein the periodic waveform is the plethysmographic waveform representative of the arterial pulse. The secondary portion is noise. In accordance with the present invention, the measured signals are modeled such that this secondary portion of the signal is related to the venous blood contribution to attenuation of energy as it passes through the body. The secondary portion also includes artifacts due to patient movement which causes the venous blood to flow in an unpredictable manner, causing unpredictable attenuation and corrupting the otherwise periodic plethysmographic waveform. Respiration also causes the secondary or noise portion to vary, although typically at a lower frequency than the patients pulse rate. Accordingly, the measured signal which forms a plethysmographic waveform is modeled in accordance with the present invention such that the primary portion of the signal is representative of arterial blood contribution to attenuation and the secondary portion is due to several other parameters.[0019]
• A physiological monitor particularly adapted to pulse oximetry oxygen saturation measurement comprises two light emitting diodes (LED's) which emit light at different wavelengths to produce first and second signals. A detector registers the attenuation of the two different energy signals after each passes through an absorptive media, for example a digit such as a finger, or an earlobe. The attenuated signals generally comprise both primary (arterial attenuator) and secondary (noise) signal portions. A static filtering system, such as a bandpass filter, removes a portion of the secondary signal which is outside of a known bandwidth of interest, leaving an erratic or random secondary signal portion, often caused by motion and often difficult to remove, along with the primary signal portion.[0020]
• A processor in accordance with one embodiment of the present invention removes the primary signal portions from the measured signals yielding a secondary reference which is a combination of the remaining secondary signal portions. The secondary reference is correlated to both of the secondary signal portions. The secondary reference and at least one of the measured signals are input to a correlation canceler, such as an adaptive noise canceler, which removes the random or erratic portion of the secondary signal. This yields a good approximation to a primary plethysmographic signal as measured at one of the measured signal wavelengths. As is known in the art, quantitative measurements of the amount of oxygenated arterial blood in the body can be determined from the plethysmographic signal in a variety of ways.[0021]
• The processor of the present invention may also remove the secondary signal portions from the measured signals yielding a primary reference which is a combination of the remaining primary signal portions. The primary reference is correlated to both of the primary signal portions. The primary reference and at least one of the measured signals are input to a correlation canceler which removes the primary portions of the measured signals. This yields a good approximation to the secondary signal at one of the measured signal wavelengths. This signal may be useful for removing secondary signals from an auxiliary instrument as well as determining venous blood oxygen saturation.[0022]
• In accordance with the signal model of the present invention, the two measured signals each having primary and secondary signal portions can be related by coefficients. By relating the two equations with respect to coefficients defined in accordance with the present invention, the coefficients provide information about the arterial oxygen saturation and about the noise (the venous oxygen saturation and other parameters). In accordance with this aspect of the present invention, the coefficients can be determined by minimizing the correlation between the primary and secondary signal portions as defined in the model. Accordingly, the signal model of the present invention can be utilized in many ways in order to obtain information about the measured signals as will be further apparent in the detailed description of the preferred embodiments.[0023]
• One aspect of the present invention is a method for use in a signal processor in a signal processor for processing at least two measured signals S[0024]₁and S₂each containing a primary signal portion s and a secondary signal portion n, the signals S₁and S₂being in accordance with the following relationship:
• S₁=s₁+n₁
• S₂=s₂+n₂
• where s[0025]₁and s₂, and n₁and n₂are related by:
• S₁=r_as₂andn₁=r_vn₂
• and where r[0026]_aand r_vare coefficients.
• The method comprises a number of steps. A value of coefficient r[0027]_ais determined which minimize correlation between s₁and n₁. Then, at least one of the first and second signals is processed using the determined value for r_ato significantly reduce n from at least one of the first or second measured signal to form a clean signal.
• In one embodiment, the clean signal is displayed on a display. In another embodiment, wherein the first and second signals are physiological signals, the method further comprises the step of processing the clean signal to determine a physiological parameter from the first or second measured signals. In one embodiment, the parameter is arterial oxygen saturation. In another embodiment, the parameter is an ECG signal. In yet another embodiment, wherein the first portion of the measured signals is indicative of a heart plethysmograph, the method further comprises the step of calculating the pulse rate.[0028]
• Another aspect of the present invention involves a physiological monitor. The monitor has a first input configured to receive a first measured signal S[0029]₁having a primary portion, s₁, and a secondary portion n₁. The monitor also has a second input configured to received a second measured signal S₂having a primary portion s₂and a secondary portion n₂. Advantageously, the first and the second measured signals S₁and S₂are in accordance with the following relationship:
• S₁=s₁+n₁
• S₂=s₂+n₂
• where s[0030]₁and s₂, and n₁and n₂are related by:
• s₁=r_as₂and n₁=r_vn₂
• and where r[0031]_aand r_vare coefficients.
• The monitor further has a scan reference processor, the scan reference processor responds to a plurality of possible values for r[0032]_ato multiply the second measured signal by each of the possible values for r_aand for each of the resulting values, to subtract the resulting values from the first measured signal to provide a plurality of output signals. A correlation canceler having a first input configured to receive the first measured signal, and having a second input configured to receive the plurality of output signals from the saturation scan reference processor, provides a plurality of output vectors corresponding to the correlation cancellation between the plurality of output signals and the first measured signal. An integrator having an input configured to receive the plurality of output vectors from the correlation canceler is responsive to the plurality of output vectors to determine a corresponding power for each output vector. An extremum detector is coupled at its input to the output of the integrator. The extremum detector is responsive to the corresponding power for each output vector to detect a selected power.
• In one embodiment, the plurality of possible values correspond to a plurality of possible values for a selected blood constituent. In one embodiment the, the selected blood constituent is arterial blood oxygen saturation. In another embodiment, the selected blood constituent is venous blood oxygen saturation. In yet another embodiment, the selected blood constituent is carbon monoxide.[0033]
• Another aspect of the present invention involves a physiological monitor. The monitor has a first input configured to receive a first measured signal S[0034]₁having a primary portion, s₁, and a secondary portion, n₁. The monitor also has a second input configured to received a second measured signal S₂having a primary portion s₂and a secondary portion n₂. The first and the second measured signals S₁and S₂are in accordance with the following relationship:
• S₁=s₁+n₁
• S₂=s₂+n₂
• where s[0035]₁and s₂, and n₁and n₂are related by:
• s₁=r_as₂
• and[0036]
• n₁=r_vn_s
• and where r[0037]_aand r_vare coefficients.
• A transform module is responsive to the first and the second measured signals and responsive to a plurality of possible values for r[0038]_ato provide at least one power curve as an output. An extremum calculation module is responsive to the at least one power curve to select a value for r_awhich minimizes the correlation between s and n, and to calculate from the value for r_aa corresponding saturation value as an output. A display module is responsive to the output of saturation calculation to display the saturation value.
BRIEF DESCRIPTION OF THE DRAWINGS
• FIG. 1 illustrates an ideal plethysmographic waveform.[0039]
• FIG. 2 schematically illustrates a typical finger.[0040]
• FIG. 3 illustrates a plethysmographic waveform which includes a motion-induced erratic signal portion.[0041]
• FIG. 4[0042]aillustrates a schematic diagram of a physiological monitor to compute primary physiological signals.
• FIG. 4[0043]billustrates a schematic diagram of a physiological monitor to compute secondary signals.
• FIG. 5[0044]aillustrates an example of an adaptive noise canceler which could be employed in a physiological monitor, to compute primary physiological signals.
• FIG. 5[0045]billustrates an example of an adaptive noise canceler which could be employed in a physiological monitor, to compute secondary motion artifact signals.
• FIG. 5[0046]cillustrates the transfer function of a multiple notch filter.
• FIG. 6[0047]aillustrates a schematic of absorbing material comprising N constituents within the absorbing material.
• FIG. 6[0048]billustrates another schematic of absorbing material comprising N constituents, including one mixed layer, within the absorbing material.
• FIG. 6[0049]cillustrates another schematic of absorbing material comprising N constituents, including two mixed layers, within the absorbing material.
• FIG. 7[0050]aillustrates a schematic diagram of a monitor, to compute primary and secondary signals in accordance with one aspect of the present invention.
• FIG. 7[0051]billustrates the ideal correlation canceler energy or power output as a function of the signal coefficients r₁, r₂, . . . r_n. In this particular example, r₃=r_aand r₇=r_v.
• FIG. 7[0052]cillustrates the non-ideal correlation canceler energy or power output as a function of the signal coefficients r₁, r₂, . . . r_n. In this particular example, r₃=r_aand r₇=r_v.
• FIG. 8 is a schematic model of a joint process estimator comprising a least-squares lattice predictor and a regression filter.[0053]
• FIG. 8[0054]ais a schematic model of a joint process estimator comprising a QRD least-squares lattice (LSL) predictor and a regression filter.
• FIG. 9 is a flowchart representing a subroutine for implementing in software a joint process estimator as modeled in FIG. 8.[0055]
• FIG. 9[0056]ais a flowchart representing a subroutine for implementing in software a joint process estimator as modeled in FIG. 8a.
• FIG. 10 is a schematic model of a joint process estimator with a least-squares lattice predictor and two regression filters.[0057]
• FIG. 10[0058]ais a schematic model of a joint process estimator with a QRD least-squares lattice predictor and two regression filters.
• FIG. 11 is an example of a physiological monitor in accordance with the teachings of one aspect of the present invention.[0059]
• FIG. 11[0060]aillustrates an example of a low noise emitter current driver with accompanying digital to analog converter.
• FIG. 12 illustrates the front end analog signal conditioning circuitry and the analog to digital conversion circuitry of the physiological monitor of FIG. 11.[0061]
• FIG. 13 illustrates further detail of the digital signal processing circuitry of FIG. 11.[0062]
• FIG. 14 illustrates additional detail of the operations performed by the digital signal processing circuitry of FIG. 11.[0063]
• FIG. 15 illustrates additional detail regarding the demodulation module of FIG. 14.[0064]
• FIG. 16 illustrates additional detail regarding the decimation module of FIG. 14.[0065]
• FIG. 17 represents a more detailed block diagram of the operations of the statistics module of FIG. 14.[0066]
• FIG. 18 illustrates a block diagram of the operations of one embodiment of the saturation transform module of FIG. 14.[0067]
• FIG. 19 illustrates a block diagram of the operation of the saturation calculation module of FIG. 14.[0068]
• FIG. 20 illustrates a block diagram of the operations of the pulse rate calculation module of FIG. 14.[0069]
• FIG. 21 illustrates a block diagram of the operations of the motion artifact suppression module of FIG. 20.[0070]
• FIG. 21[0071]aillustrates an alternative block diagram for the operations of the motion artifact suppression module of FIG. 20.
• FIG. 22 illustrates a saturation transform curve in accordance with the principles of the present invention.[0072]
• FIG. 23 illustrates a block diagram of an alternative embodiment to the saturation transform in order to obtain a saturation value.[0073]
• FIG. 24 illustrates a histogram saturation transform in accordance with the alternative embodiment of FIG. 23.[0074]
• FIGS.[0075]25A-25C illustrate yet another alternative embodiment in order to obtain the saturation.
• FIG. 26 illustrates a signal measured at a red wavelength λa=λred=660 nm for use in a processor of the present invention for determining the secondary reference n′(t) or the primary reference s′(t) and for use in a correlation canceler. The measured signal comprises a primary portion s[0076]_λa(t) and a secondary portion n_λa(t).
• FIG. 27 illustrates a signal measured at an infrared wavelength λb=λ[0077]_IR=910 nm for use in a processor of the present invention for determining the secondary reference n′(t) or the primary reference s′(t) and for use in a correlation canceler. The measured signal comprises a primary portion s_λb(t) and a secondary portion n_λb(t).
• FIG. 28 illustrates the secondary reference n′(t) determined by a processor of the present invention.[0078]
• FIG. 29 illustrates a good approximation s″[0079]_λa(t) to the primary portion s_λa(t) of the signal S_λa(t) measured at λa=λred=660 nm estimated by correlation cancellation with a secondary reference n′(t).
• FIG. 30 illustrates a good approximation s″[0080]_λb(t) to the primary portion s_λb(t) of the signal S_λb(t) measured at λb=λIR=910 nm estimated by correlation cancellation with a secondary reference n′(t).
• FIG. 31 depicts a set of 3 concentric electrodes, i.e., a tripolar electrode sensor, to derive electrocardiography (ECG) signals, denoted as S[0081]₁, S₂and S₃, for use with the present invention. Each of the ECG signals contains a primary portion and a secondary portion.
DETAILED DESCRIPTION OF THE INVENTION
• The present invention involves a system which utilizes first and second measured signals that each contain a primary signal portion and a secondary signal portion. In other words, given a first and second composite signals S[0082]₁(t)=s₁(t)+n₁(t) and S₂(t)=s₂(t)+n₂(t), the system of the present invention can be used to isolate either the primary signal portion s(t) or the secondary signal portion n(t). Following processing, the output of the system provides a good approximation n″(t) to the secondary signal portion n(t) or a good approximation s″(t) to the primary signal portion s(t).
• The system of the present invention is particularly useful where the primary and/or secondary signal portion n(t) may contain one or more of a constant portion, a predictable portion, an erratic portion, a random portion, etc. The primary signal approximation s″(t) or secondary signal approximation n″(t) is derived by removing as many of the secondary signal portions n(t) or primary signal portions s(t) from the composite signal S(t) as possible. The remaining signal forms either the primary signal approximation s″(t) or secondary signal approximation n″(t), respectively. The constant portion and predictable portion of the secondary signal n(t) are easily removed with traditional filtering techniques, such as simple subtraction, low pass, band pass, and high pass filtering. The erratic portion is more difficult to remove due to its unpredictable nature. If something is known about the erratic signal, even statistically, it could be removed, at least partially, from the measured signal via traditional filtering techniques. However, often no information is known about the erratic portion of the secondary signal n(t). In this case, traditional filtering techniques are usually insufficient.[0083]
• In order to remove the secondary signal n(t), a signal model in accordance with the present invention is defined as follows for the first and second measured signals S[0084]₁and S₂:${\mathrm{<figure-callout\; label="S"\; filenames="US20020128544A1-20020912-D00009.png,US20020128544A1-20020912-D00010.png"\; state="\{\{state\}\}">S</figure-callout>}}_1={\mathrm{<figure-callout\; label="s"\; filenames="US20020128544A1-20020912-D00009.png,US20020128544A1-20020912-D00010.png"\; state="\{\{state\}\}">s</figure-callout>}}_1+n_1$${\mathrm{<figure-callout\; label="S"\; filenames="US20020128544A1-20020912-D00011.png,US20020128544A1-20020912-D00015.png"\; state="\{\{state\}\}">S</figure-callout>}}_2={\mathrm{<figure-callout\; label="s"\; filenames="US20020128544A1-20020912-D00011.png,US20020128544A1-20020912-D00015.png"\; state="\{\{state\}\}">s</figure-callout>}}_2+{\mathrm{<figure-callout\; label="n"\; filenames="US20020128544A1-20020912-D00011.png,US20020128544A1-20020912-D00015.png"\; state="\{\{state\}\}">n</figure-callout>}}_2$$\mathrm{with}s_1=r_as_2\mathrm{and}n_1=r_{\mathrm{<figure-callout\; label="v\; \; n"\; filenames="US20020128544A1-20020912-D00011.png,US20020128544A1-20020912-D00015.png"\; state="\{\{state\}\}">v</figure-callout>}}n_{}{}_2$$\mathrm{or}r_a=\frac{s_1}{{\mathrm{<figure-callout\; label="s"\; filenames="US20020128544A1-20020912-D00011.png,US20020128544A1-20020912-D00015.png"\; state="\{\{state\}\}">s</figure-callout>}}_2}\mathrm{and}n_1=\frac{n_1}{{\mathrm{<figure-callout\; label="n"\; filenames="US20020128544A1-20020912-D00011.png,US20020128544A1-20020912-D00015.png"\; state="\{\{state\}\}">n</figure-callout>}}_2}$

  
• where s[0085]₁and n₁are at least somewhat (preferably substantially) uncorrelated and s₂and n₂are at least somewhat (preferably substantially) uncorrelated. The first and second measured signals S₁and S₂are related by correlation coefficients r_aand r_vas defined above. The use and selection of these coefficients is described in further detail below.
• In accordance with one aspect of the present invention, this signal model is used in combination with a correlation canceler, such as an adaptive noise canceler, to remove or derive the erratic portion of the measured signals.[0086]
• Generally, a correlation canceler has two signal inputs and one output. One of the inputs is either the secondary reference n′(t) or the primary reference s′(t) which are correlated, respectively, to the secondary signal portions n(t) and the primary signal portions s(t) present in the composite signal S(t). The other input is for the composite signal S(t). Ideally, the output of the correlation canceler s″(t) or n″(t) corresponds, respectively, to the primary signal s(t) or the secondary signal n(t) portions only. Often, the most difficult task in the application of correlation cancelers is determining the reference signals n′(t) and s′(t) which are correlated to the secondary n(t) and primary s(t) portions, respectively, of the measured signal S(t) since, as discussed above, these portions are quite difficult to isolate from the measured signal S(t). In the signal processor of the present invention, either a secondary reference n′(t) or a primary reference s′(t) is determined from two composite signals measured simultaneously, or nearly simultaneously, at two different wavelengths, λa and λb.[0087]
• A block diagram of a generic monitor incorporating a signal processor according to the present invention, and a correlation canceler is shown in FIGS. 4[0088]aand4b.Two measured signals, S_λa(t) and S_λb(t), are acquired by adetector20. One skilled in the art will realize that for some physiological measurements, more than one detector may be advantageous. Each signal is conditioned by asignal conditioner22aand22b.Conditioning includes, but is not limited to, such procedures as filtering the signals to remove constant portions and amplifying the signals for ease of manipulation. The signals are then converted to digital data by an analog-to-digital converter24aand24b.The first measured signal S_λa(t) comprises a first primary signal portion, labeled herein s_λa(t), and a first secondary signal portion, labeled herein n_λa(t). The second measured signal S_λb(t) is at least partially correlated to the first measured signal S_λa(t) and comprises a second primary signal portion, labeled herein s_λb(t), and a second secondary signal portion, labeled herein n_λb(t). Typically the first and second secondary signal portions, n_λa(t) and n_λb(t), are uncorrelated and/or erratic with respect to the primary signal portions s_λa(t) and s_λb(t). The secondary signal portions n_λa(t) and n_λb(t) are often caused by motion of a patient in physiological measurements.
• The signals S[0089]_λa(t) and S_λb(t) are input to areference processor26. Thereference processor26 multiplies the second measured signal S_λb(t) by either a factor r_a=s_λa(t)/s_λb(t) or a factor r_v=n_λa(t)/n_λb(t) and then subtracts the second measured signal S_λb(t) from the first measured signal S_λa(t). The signal coefficient factors r_aand r_vare determined to cause either the primary signal portions s_λa(t) and s_λb(t) or the secondary signal portions n_λa(t) and n_λb(t) to cancel, respectively, when the two signals S_λa(t) and S_λb(t) are subtracted. Thus, the output of thereference processor26 is either a secondary reference signal n′(t)=n_λa(t)−r_an_λb(t), in FIG. 4a,which is correlated to both of the secondary signal portions n_λa(t) and n_λb(t) or a primary reference signal s′(t)=s_λa(t)−r_sλb(t), in FIG. 4b, which is correlated to both of the primary signal portions s_λa(t) and s_λb(t). A reference signal n′(t) or s′(t) is input, along with one of the measured signals S_λa(t) or S_λb(t), to acorrelation canceler27 which uses the reference signal n′(t) or s′(t) to remove either the secondary signal portions n_λa(t) or n_λb(t) or the primary signal portions s_λa(t) or s_λb(t) from the measured signal S_λa(t) or S_λb(t). The output of thecorrelation canceler27 is a good primary signal approximation s″(t) or secondary signal approximation n″(t). In one embodiment, the approximation s″(t) or n″(t) is displayed on adisplay28.
• In one embodiment, an[0090]adaptive noise canceler30, an example of which is shown in block diagram form in FIG. 5a,is employed as thecorrelation canceler27, to remove either one of the erratic, secondary signal portions n_λa(t) and n_λb(t) from the first and second signals S_λa(t) and S_λb(t). Theadaptive noise canceler30 in FIG. 5ahas as one input a sample of the secondary reference n′(t) which is correlated to the secondary signal portions n_λa(t) and n_λb(t). The secondary reference n′(t) is determined from the two measured signals S_λa(t) and S_λb(t) by theprocessor26 of the present invention as described herein. A second input to the adaptive noise canceler, is a sample of either the first or second composite measured signals S_λa(t)=s_λa(t)+n_λa(t) or S_λb(t)=s_λb(t)+n_λb(t).
• The[0091]adaptive noise canceler30, in FIG. 5b,may also be employed to remove either one of primary signal portions s_λa(t) and s_λb(t) from the first and second measured signals S_λa(t) and S_λb(t). Theadaptive noise canceler30 has as one input a sample of the primary reference s′(t) which is correlated to the primary signal portions s_λa(t) and s_λb(t). The primary reference s′(t) is determined from the two measured signals S_λa(t) and S_λb(t) by theprocessor26 of the present invention as described herein. A second input to theadaptive noise canceler30 is a sample of either the first or second measured signals S_λa(t)=s_λa(t)+n_λa(t) or S_λb(t)=s_λb(t)+n_λb(t).
• The[0092]adaptive noise canceler30 functions to remove frequencies common to both the reference n′(t) or s′(t) and the measured signal S_λa(t) or S_λb(t). Since the reference signals are correlated to either the secondary signal portions n_λa(t) and n_λb(t) or the primary signal portions s_λa(t) and s_λb(t), the reference signals will be correspondingly erratic or well behaved. Theadaptive noise canceler30 acts in a manner which may be analogized to a dynamic multiple notch filter based on the spectral distribution of the reference signal n′(t) or s′(t).
• FIG. 5[0093]cillustrates an exemplary transfer function of a multiple notch filter. The notches, or dips in the amplitude of the transfer function, indicate frequencies which are attenuated or removed when a signal passes through the notch filter. The output of the notch filter is the composite signal having frequencies at which a notch is present removed. In the analogy to anadaptive noise canceler30, the frequencies at which notches are present change continuously based upon the inputs to theadaptive noise canceler30.
• The adaptive noise canceler[0094]30 (FIGS. 5aand5b) produces an output signal, labeled herein as s″_λa(t), s″_λb(t), n″_λa(t) or n″_λb(t) which is fed back to aninternal processor32 within theadaptive noise canceler30. Theinternal processor32 automatically adjusts its own transfer function according to a predetermined algorithm such that the output of theinternal processor32 labeled b_λ(t) in FIG. 5aand c_λ(t) in FIG. 5b,closely resembles either the secondary signal portion n_λa(t) or n_λb(t) or the primary signal portion s_λa(t) or s_λb(t). The output b_λ(t) of theinternal processor32 in FIG. 5ais subtracted from the measured signal, S_λa(t) or S_λb(t), yielding a signal output s″_λa(t)=s_λa(t)+n_λa(t)−b_λa(t) or a signal output s″_λb(t)=s_λb(t)+n_λb(t)−b_λb(t). The internal processor optimizes s″_λa(t) or s″_λb(t) such that s″_λa(t) or s″_λb(t) is approximately equal to the primary signal s_λa(t) or s_λb(t), respectively. The output c_λ(t) of theinternal processor32 in FIG. 5bis subtracted from the measured signal, S_λa(t) or S_λb(t), yielding a signal output given by n″_λa(t)=s_λa(t)+n_λa(t)−c_λa(t) or a signal output given by n″_λb(t)=s_λb(t)+n_λb(t)−c_λb(t). The internal processor optimizes n″_λa(t) or n″_λb(t) such that n″_λa(t) or n″_λb(t) is approximately equal to the secondary signal portion n_λa(t) or n_λb(t), respectively.
• One algorithm which may be used for the adjustment of the transfer function of the[0095]internal processor32 is a least-squares algorithm, as described in Chapter 6 andChapter 12 of the bookAdaptive Signal Processingby Bernard Widrow and Samuel Stearns, published by Prentice Hall, copyright 1985. This entire book, includingChapters 6 and 12, is hereby incorporated herein by reference.
• [0096]Adaptive processors30 in FIGS. 5aand5bhave been successfully applied to a number of problems including antenna sidelobe canceling, pattern recognition, the elimination of periodic interference in general, and the elimination of echoes on long distance telephone transmission lines. However, considerable ingenuity is often required to find a suitable reference signal n′(t) or s′(t) since the portions n_λa(t), n_λb(t), s_λa(t) and s_λb(t) cannot easily be separated from the measured composite signals S_λa(t) and S_λb(t). If either the actual secondary portion n_λa(t) or n_λb(t) or the primary signal portion s_λa(t) or s_λb(t) were a priori available, techniques such as correlation cancellation would not be necessary.
• Generalized Determination of Primary and Secondary Reference Signals[0097]
• An explanation which describes how the reference signals n′(t) and s′(t) may be determined follows. A first signal is measured at, for example, a wavelength λa, by a detector yielding a signal S[0098]_λa(t):
• S_λa(t)=s_λa(t)+n_λa(t)  (1)
• where s[0099]_λa(t) is the primary signal portion and n_λa(t) is the secondary signal portion.
• A similar measurement is taken simultaneously, or nearly simultaneously, at a different wavelength, λb, yielding:[0100]
• S_λb(t)=s_λb(t)+n_λb(t).  (2)
• Note that as long as the measurements, S[0101]_λa(t) and S_λb(t), are taken substantially simultaneously, the secondary signal components, n_λa(t) and n_λb(t), are correlated because any random or erratic functions affect each measurement in nearly the same fashion. The substantially predictable primary signal components, s_λa(t) and s_λb(t), are also correlated to one another.
• To obtain the reference signals n′(t) and s′(t), the measured signals S[0102]_λa(t) and S_λb(t) are transformed to eliminate, respectively, the primary or secondary signal components. In accordance with the present invention one way of doing this is to find proportionality constants, r_aand r_v, between the primary signal portions s_λa(t) and s_λb(t) and the secondary signal portions n_λa(t) and n_λb(t) such that the signals can be modeled as follows:
• s_λa(t)=r_as_λb(t)
• n_λa(t)=r_vn_λb(t).  (3)
• In accordance with the inventive signal model of the present invention, these proportionality relationships can be satisfied in many measurements, including but not limited to absorption measurements and physiological measurements. Additionally, in accordance with the signal model of the present invention, in most measurements, the proportionality constants r[0103]_aand r_vcan be determined such that:
• n_λa(t)≠r_an_λb(t)
• s_λa(t)≠r_vs_λb(t).  (4)
• Multiplying equation (2) by r[0104]_aand then subtracting equation (2) from equation (1) results in a single equation wherein the primary signal terms s_λa(t) and s_λb(t) cancel:
• n′(t)=S_λa(t)−r_aS_λb(t)=n_λa(t)r_an_λb(t);  (5a)
• a non-zero signal which is correlated to each secondary signal portion n[0105]_λa(t) and n_λb(t) and can be used as the secondary reference n′(t) in a correlation canceler such as an adaptive noise canceler.
• Multiplying equation (2) by r[0106]_vand then subtracting equation (2) from equation (1) results in a single equation wherein the secondary signal terms n_λa(t) and n_λb(t) cancel, leaving:
• s′(t)=S_λa(t)−r_vS_λb(t)=s_λa(t)−r_vs_λb(t);  (5b)
• a non-zero signal which is correlated to each of the primary signal portions s[0107]_λa(t) and s_λb(t) and can be used as the signal reference s′(t) in a correlation canceler such as an adaptive noise canceler.
• Example of Determination of Primary and Secondary Reference Signals in an Absorptive System[0108]
• Correlation canceling is particularly useful in a large number of measurements generally described as absorption measurements. An example of an absorption type monitor which can advantageously employ correlation canceling, such as adaptive noise canceling, based upon a reference n′(t) or s′(t) determined by a processor of the present invention is one which determines the concentration of an energy absorbing constituent within an absorbing material when the material is subject to change. Such changes can be caused by forces about which information is desired or primary, or alternatively, by random or erratic secondary forces such as a mechanical force on the material. Random or erratic interference, such as motion, generates secondary components in the measured signal. These secondary components can be removed or derived by the correlation canceler if a suitable secondary reference n′(t) or primary reference s′(t) is known.[0109]
• A schematic N constituent absorbing material comprising a[0110]container42 having N different absorbing constituents, labeled A₁, A₂, A₃, . . . A_N, is shown in FIG. 6a.The constituents A₁through A_Nin FIG. 6aare arranged in a generally orderly, layered fashion within thecontainer42. An example of a particular type of absorptive system is one in which light energy passes through thecontainer42 and is absorbed according to the generalized Beer-Lambert Law of light absorption. For light of wavelength λa, this attenuation may be approximated by:$\begin{array}{cc}I=I_o\exp \left(-\sum _{i=1}^N{\in }_{i,\lambda a}c_ix_i\right)& \left(6\right)\end{array}$

  
• Initially transforming the signal by taking the natural logarithm of both sides and manipulating terms, the signal is transformed such that the signal components are combined by addition rather than multiplication, i.e.:[0111]$\begin{array}{cc}{S}_{\pi }=\ln \left(I_o/I\right)=\sum _{i=1}^N{\in }_{i,\lambda a}c_ix_i& \left(7\right)\end{array}$

  
• where I[0112]₀is the incident light energy intensity; I is the transmitted light energy intensity, ε_i,λais the absorption coefficient of the i^thconstituent at the wavelength λa; x_i(t) is the optical path length of i^thlayer, i.e., the thickness of material of the i^thlayer through which optical energy passes; and c_i(t) is the concentration of the i^thconstituent in the volume associated with the thickness x_i(t). The absorption coefficients ε₁through ε_Nare known values which are constant at each wavelength. Most concentrations c₁(t) through c_N(t) are typically unknown, as are most of the optical path lengths x_i(t) of each layer. The total optical path length is the sum of each of the individual optical path lengths x_i(t) of each layer.
• When the material is not subject to any forces which cause change in the thicknesses of the layers, the optical path length of each layer, x[0113]_i(t), is generally constant. This results in generally constant attenuation of the optical energy and thus, a generally constant offset in the measured signal. Typically, this offset portion of the signal is of little interest since knowledge about a force which perturbs the material is usually desired. Any signal portion outside of a known bandwidth of interest, including the constant undesired signal portion resulting from the generally constant absorption of the constituents when not subject to change, is removed. This is easily accomplished by traditional band pass filtering techniques. However, when the material is subject to forces, each layer of constituents may be affected by the perturbation differently than other layers. Some perturbations of the optical path lengths of each layer x_i(t) may result in excursions in the measured signal which represent desired or primary information. Other perturbations of the optical path length of each layer x_i(t) cause undesired or secondary excursions which mask primary information in the measured signal. Secondary signal components associated with secondary excursions must also be removed to obtain primary information from the measured signal. Similarly, the ability to compute secondary signal components caused by secondary excursions directly allows one to obtain primary signal components from the measured signal via simple subtraction, or correlation cancellation techniques.
• The correlation canceler may selectively remove from the composite signal, measured after being transmitted through or reflected from the absorbing material, either the secondary or the primary signal components caused by forces which perturb or change the material differently from the forces which perturbed or changed the material to cause respectively, either the primary or secondary signal component. For the purposes of illustration, it will be assumed that the portion of the measured signal which is deemed to be the primary signal s[0114]_λa(t) is the attenuation term ε₅c₅x₅(t) associated with a constituent of interest, namely A₅, and that the layer of constituent A₅is affected by perturbations different than each of the layers of other constituents A₁through A₄and A₆through A_N. An example of such a situation is when layer A₅is subject to forces about which information is deemed to be primary and, additionally, the entire material is subject to forces which affect each of the layers. In this case, since the total force affecting the layer of constituent A₅is different than the total forces affecting each of the other layers and information is deemed to be primary about the forces and resultant perturbation of the layer of constituent A₅, attenuation terms due to constituents A₁through A₄and A₆through A_Nmake up the secondary signal portion n_λa(t). Even if the additional forces which affect the entire material cause the same perturbation in each layer, including the layer of A₅, the total forces on the layer of constituent A₅cause it to have different total perturbation than each of the other layers of constituents A₁through A₄and A₆through A_N.
• It is often the case that the total perturbation affecting the layers associated with the secondary signal components is caused by random or erratic forces. This causes the thickness of layers to change erratically and the optical path length of each layer, x[0115]_i(t), to change erratically, thereby producing a random or erratic secondary signal component n_λa(t). However, regardless of whether or not the secondary signal portion n_λa(t) is erratic, the secondary signal component n_λa(t) can be either removed or derived via a correlation canceler, such as an adaptive noise canceler, having as one input, respectively, a secondary reference n′(t) or a primary reference s′(t) determined by a processor of the present invention as long as the perturbation on layers other than the layer of constituent A₅is different than the perturbation on the layer of constituent A₅. The correlation canceler yields a good approximation to either the primary signal s_λa(t) or the secondary signal n_λa(t). In the event that an approximation to the primary signal is obtained, the concentration of the constituent of interest, c₅(t), can often be determined since in some physiological measurements, the thickness of the primary signal component, x₅(t) in this example, is known or can be determined.
• The correlation canceler utilizes either the secondary reference n′(t) or the primary reference s′(t) determined from two substantially simultaneously measured signals S[0116]_λa(t) and S_λb(t). S_λa(t) is determined as above in equation (7). S_λb(t) is determined similarly at a different wavelength λb. To find either the secondary reference n′(t) or the primary reference s′(t), attenuated transmitted energy is measured at the two different wavelengths λa and λb and transformed via logarithmic conversion. The signals S_λa(t) and S_λb(t) can then be written (logarithm converted) as:$\begin{array}{cc}{S}_{\lambda a}\left(t\right)={\in }_{5,\lambda a}{\mathrm{<figure-callout\; label="c"\; filenames="US20020128544A1-20020912-D00017.png,US20020128544A1-20020912-D00023.png"\; state="\{\{state\}\}">c</figure-callout>}}_5x_5\left(t\right)+\sum _{i=1}^4{\in }_{i,\lambda a}c_ix_i+\sum _{i=6}^N{\in }_{i,\lambda a}c_ix_i& \left(8\right)\end{array}$

  

   S_λa(t)=ε_5,λac₅x₅(t)+n_λa(t)  (9)
• [0117]$\begin{array}{cc}{S}_{\lambda b\left(t\right)}={\in }_{5,\lambda b}{\mathrm{<figure-callout\; label="c"\; filenames="US20020128544A1-20020912-D00017.png,US20020128544A1-20020912-D00023.png"\; state="\{\{state\}\}">c</figure-callout>}}_5x_5\left(t\right)+\sum _{i=1}^4{\in }_{i,\lambda b}c_ix_i+\sum _{i=6}^N{\in }_{i,\lambda b}c_ix_i& \left(10\right)\end{array}$

  

   S_λb(t)=ε_5,λbc₅x₅(t)+n_λb(t)  (11)
• Further transformations of the signals are the proportionality relationships in accordance with the signal model of the present invention defining r[0118]_aand r_v, similar to equation (3), which allows determination of a noise reference n′(t) and a primary reference s′(t). These are:
• ε_5,λa=r_aε_5,λb  (12a)
• n_λa=r_vn_λb  (12b)
• where[0119]
• n_λa≠r_an_λb  (13a)
• ε_5,λa≠r_vε_5,λb.  (13b)
• It is often the case that both equations (12) and (13) can be simultaneously satisfied. Multiplying equation (11) by r[0120]_aand subtracting the result from equation (9) yields a non-zero secondary reference which is a linear sum of secondary signal components:
• n′(t)=S_λa(t)−r_aS_λb(t)=n_λa(t)−r_an_λb(t)  (14a)
• [0121]$\begin{array}{cc}=\sum _{i=1}^4{\in }_{i,\lambda a}c_ix_i\left(t\right)+\sum _{i+6}^N{\in }_{i,\lambda a}c_ix_i\left(t\right)-\hspace{1em}\sum _{i=1}^4r_a{\in }_{i,\lambda b}c_ix_i\left(t\right)+\sum _{i=6}^Nr_a{\in }_{i,\lambda b}c_ix_i\left(t\right)& \left(15a\right)\end{array}$

  

  $\begin{array}{cc}=\sum _{i=1}^4c_ix_i\left(t\right)\left[{\in }_{i,\lambda a}-r_a{\in }_{i,\lambda a}-r_a{\in }_{i,\lambda b}\right]+\sum _{i=6}^Nc_ix_i\left(t\right)\left[{\in }_{1,\lambda a}-r_a{\in }_{i,\lambda b}\right]& \left(16a\right)\end{array}$

  
• Multiplying equation (11) by r[0122]_vand subtracting the result from equation (9) yields a primary reference which is a linear sum of primary signal components:
• s′(t)=S_λa(t)−r_vS_λb(t)=s_λa(t)−r_vs_λb(t)  (14b)
• =c₅x₅(t)ε_5,λa−r_vc₅x₅(t)ε_5,λb  (15b)
• =c₅x₅(t)[ε_5,λa−r_vε_5,λb].  (16b)
• A sample of either the secondary reference n′(t) or the primary reference s′(t), and a sample of either measured signal S[0123]_λa(t) or S_λb(t), are input to acorrelation canceler27, such as anadaptive noise canceler30, an example of which is shown in FIGS. 5aand5band a preferred example of which is discussed herein under the heading PREFERRED CORRELATION CANCELER USING A JOINT PROCESS ESTIMATOR IMPLEMENTATION. Thecorrelation canceler27 removes either the secondary portion n_λa(t) or n_λb(t), or the primary portions, s_λa(t) or s_λb(t), of the measured signal yielding a good approximation to either the primary signals s″_λa(t)≈ε_5,λac₅x₅(t) or s″_λb(t)≈ε_5,λbc₅x₅(t) or the secondary signals n″_λa(t)≈n_λa(t) or n″_λb(t)≈n_λb(t). In the event that the primary signals are obtained, the concentration c₅(t) may then be determined from the approximation to the primary signal s″_λa(t) or s″_λb(t) according to:
• c₅(t)≈s″_λa(t)/ε_5,λax₅(t)  (17a)
• or[0124]
• c₅(t)≈s″_λb(t)/ε_5,λbx₅(t)  (17b)
• As discussed previously, the absorption coefficients are constant at each wavelength λa and λb and the thickness of the primary signal component, x[0125]₅(t) in this example, is often known or can be determined as a function of time, thereby allowing calculation of the concentration c₅(t) of constituent A₅.
• Determination of Concentration or Saturation in a Volume Containing More Than one Constituent[0126]
• Referring to FIG. 6[0127]b,another material having N different constituents arranged in layers is shown. In this material, two constituents A₅and A₆are found within one layer having thickness x_5,6(t)=x₅(t)+x₆(t), located generally randomly within the layer. This is analogous to combining the layers of constituents A₅and A₆in FIG. 6a.A combination of layers, such as the combination of layers of constituents A₅and A_6,is feasible when the two layers are under the same total forces which result in the same change of the optical path lengths x₅(t) and x₆(t) of the layers.
• Often it is desirable to find the concentration or the saturation, i.e., a percent concentration, of one constituent within a given thickness which contains more than one constituent and is subject to unique forces. A determination of the concentration or the saturation of a constituent within a given volume may be made with any number of constituents in the volume subject to the same total forces and therefore under the same perturbation or change. To determine the saturation of one constituent in a volume comprising many constituents, as many measured signals as there are constituents which absorb incident light energy are necessary. It will be understood that constituents which do not absorb light energy are not consequential in the determination of saturation. To determine the concentration, as many signals as there are constituents which absorb incident light energy are necessary as well as information about the sum of concentrations.[0128]
• It is often the case that a thickness under unique motion contains only two constituents. For example, it may be desirable to know the concentration or saturation of A[0129]₅within a given volume which contains A₅and A₆. In this case, the primary signals s_λa(t) and s_λb(t) comprise terms related to both A₅and A₆so that a determination of the concentration or saturation of A₅or A₆in the volume may be made. A determination of saturation is discussed herein. It will be understood that the concentration of A₅in a volume containing both A₅and A₆could also be determined if it is known that A₅+A₆=1, i.e., that there are no constituents in the volume which do not absorb incident light energy at the particular measurement wavelengths chosen. The measured signals S_λa(t) and S_λb(t) can be written (logarithm converted) as:
• S_λa(t)=ε_5,λac₅x_5,6(t)+ε_6,λac₆x_5,6(t)+n_λa(t)  (18a)
• =s_λa(t)+n_λa(t)  (18b)
• S_λb(t)=ε_5,λbc₅x_5,6(t)+ε_6,λbc₆x_5,6(t)+n_λb(t)  (19a)
• =s_λb(t)+n_λb(t).  (19b)
• It is also often the case that there may be two or more thicknesses within a medium each containing the same two constituents but each experiencing a separate motion as in FIG. 6[0130]c.For example, it may be desirable to know the concentration or saturation of A₅within a given volume which contains A₅and A₆as well as the concentration or saturation of A₃within a given volume which contains A₃and A₄, A₃and A₄having the same constituency as A₅and A₆respectively. In this case, the primary signals s_λa(t) and s_λb(t) again comprise terms related to both A₅and A₆and portions of the secondary signals n_λa(t) and n_λb(t) comprise terms related to both A₃and A₄. The layers, A₃and A₄, do not enter into the primary equation because they are assumed to be perturbed by a different frequency, or random or erratic secondary forces which are uncorrelated with the primary force. Sinceconstituents3 and5 as well asconstituents4 and6 are taken to be the same, they have the same absorption coefficients (i.e., ε_3,λa=ε_5,λa; ε_3,λb=ε_5,λb; ε_4,λa=ε_6,λaand ε_4,λb=ε_6,λb. Generally speaking, however, A₃and A₄will have different concentrations than A₅and A₆and will therefore have a different saturation. Consequently a single constituent within a medium may have one or more saturations associated with it. The primary and secondary signals according to this model may be written as:
• s_λa(t)=[ε_5,λac₅+ε_6,λac₆]x_5,6(t)  (20a)
• [0131]$\begin{array}{cc}{n}_{\lambda a}\left(t\right)=\left[{\mathrm{<figure-callout\; label="\varepsilon "\; filenames="US20020128544A1-20020912-D00017.png,US20020128544A1-20020912-D00023.png"\; state="\{\{state\}\}">\varepsilon </figure-callout>}}_{5,\lambda a}c_3+{\varepsilon }_{6,\lambda a}c_4\right]x_{3,4}\left(t\right)+\sum _{i=1}^2{\in }_{i,\lambda a}c_ix_i\left(t\right)+\sum _{i=7}^n{\in }_{i,\lambda a}c_ix_i\left(t\right)& \left(20b\right)\end{array}$

  

   n_λa(t)=[ε_5,λac₃+ε_6,λac₄]x_3,4(t)+n_λa(t)  (20c)
• s_λb(t)=[ε_5,λbc₅+ε_6,λbc₆]x_5,6(t)  (21a)
• [0132]$\begin{array}{cc}{n}_{\lambda b}\left(t\right)=\hspace{1em}\left[{\mathrm{<figure-callout\; label="\varepsilon "\; filenames="US20020128544A1-20020912-D00017.png,US20020128544A1-20020912-D00023.png"\; state="\{\{state\}\}">\varepsilon </figure-callout>}}_{5,\lambda b}c_3+{\varepsilon }_{6,\lambda b}c_4\right]x_{3,4}\left(t\right)+\sum _{i=1}^2{\in }_{i,\lambda b}c_ix_i\left(t\right)+\sum _{i=7}^N{\in }_{i,\lambda b}c_ix_i\left(t\right).& \left(21b\right)\end{array}$

  

   n_λb(t)=[ε_5,λbc₃+ε_6,λbc₄]x_3,4(t)+n_λb(t)  (21c)
• where signals n[0133]_λa(t) and n_λb(t) are similar to the secondary signals n_λa(t) and n_λb(t) except for the omission of the 3, 4 layer.
• Any signal portions whether primary or secondary, outside of a known bandwidth of interest, including the constant undesired secondary signal portion resulting from the generally constant absorption of the constituents when not under perturbation, should be removed to determine an approximation to either the primary signal or the secondary signal within the bandwidth of interest. This is easily accomplished by traditional band pass filtering techniques. As in the previous example, it is often the case that the total perturbation or change affecting the layers associated with the secondary signal components is caused by random or erratic forces, causing the thickness of each layer, or the optical path length of each layer, x[0134]_i(t), to change erratically, producing a random or erratic secondary signal component n_λa(t). Regardless of whether or not the secondary signal portion n_λa(t) is erratic, the secondary signal component n_λa(t) can be removed or derived via a correlation canceler, such as an adaptive noise canceler, having as one input a secondary reference n′(t) or a primary reference s′(t) determined by a processor of the present invention as long as the perturbation in layers other than the layer of constituents A₅and A₆is different than the perturbation in the layer of constituents A₅and A₆. Either the erratic secondary signal components n_λa(t) and n_λb(t) or the primary components s_λa(t) and s_λb(t) may advantageously be removed from equations (18) and (19), or alternatively equations (20) and (21), by a correlation canceler. The correlation canceler, again, requires a sample of either the primary reference s′(t) or the secondary reference n′(t) and a sample of either of the composite signals S_λa(t) or S_λb(t) of equations (18) and (19).
• Determination of Primary and Secondary Reference Signals for Saturation Measurements[0135]
• One method for determining reference signals s′(t) or n′(t) from the measured signals S[0136]_λa(t) and S_λb(t) in accordance with one aspect of the invention is what will be referred to as the constant saturation approach. In this approach, it is assumed that the saturation of A₅in the volume containing A₅and A₆and the saturation of A₃in the volume containing A₃and A₄remains relatively constant over some period of time, i.e.:
• Saturation(A₅(t))=c₅(t)/[c₅(t)+c₆(t)]  (22a)
• Saturation(A₃(t))=c₃(t)/[c₃(t)+c₄(t)]  (22b)
• Saturation(A₅(t))={1+[c₆(t)/c₅(t)]}⁻¹  (23a)
• Saturation(A₃(t))={1+[c₄(t)/c₃(t)]}⁻¹  (23b)
• are substantially constant over many samples of the measured signals S[0137]_λaand S_λb. This assumption is accurate over many samples since saturation generally changes relatively slowly in physiological systems.
• The constant saturation assumption is equivalent to assuming that:[0138]
• c₅(t)/c₆(t)=constant₁  (24a)
• c₃(t)/c₄(t)=constant₂  (24b)
• since the only other term in equations (23a) and (23b) is a constant, namely the[0139]numeral 1.
• Using this assumption, the proportionality constants r[0140]_aand r_vwhich allow determination of the secondary reference signal n′(t) and the primary reference signal s′(t) in the constant saturation method are:$\begin{array}{cc}{r}_a=\frac{{\mathrm{<figure-callout\; label="\varepsilon "\; filenames="US20020128544A1-20020912-D00017.png,US20020128544A1-20020912-D00023.png"\; state="\{\{state\}\}">\varepsilon </figure-callout>}}_{5,\lambda a}c_{5-}{\mathrm{<figure-callout\; label="x"\; filenames="US20020128544A1-20020912-D00017.png,US20020128544A1-20020912-D00023.png"\; state="\{\{state\}\}">x</figure-callout>}}_{5,6}\left(t\right)+{\varepsilon }_{6,\lambda a}c_6x_{5,6}\left(t\right)}{{\mathrm{<figure-callout\; label="\varepsilon "\; filenames="US20020128544A1-20020912-D00017.png,US20020128544A1-20020912-D00023.png"\; state="\{\{state\}\}">\varepsilon </figure-callout>}}_{5,\lambda b}{\mathrm{<figure-callout\; label="c"\; filenames="US20020128544A1-20020912-D00017.png,US20020128544A1-20020912-D00023.png"\; state="\{\{state\}\}">c</figure-callout>}}_5x_{5,6}\left(t\right)+{\varepsilon }_{6,\lambda b}c_6x_{5,6}\left(t\right)}& \left(25a\right)\end{array}$

  

   =s_λa(t)/s_λb(t)  (26a)
• [0141]$\begin{array}{cc}=\frac{{\varepsilon }_{5,\lambda a}c_5+{\varepsilon }_{6,\lambda a}c_6}{{\varepsilon }_{5,\lambda b}c_5+{\varepsilon }_{6,\lambda b}c_6}& \text{(27a)}\\ =\frac{{\varepsilon }_{5,\lambda a}\left(c_5/c_6\right)+{\varepsilon }_{6,\lambda a}}{{\varepsilon }_{5,\lambda b}\left(c_5/c_6\right)+{\varepsilon }_{6,\lambda b}}& \text{(28a)}\\ \approx s_{\lambda a}^{″}\left(t\right)/s_{\lambda b}^{″}\left(t\right)={\mathrm{constant}}_3;\mathrm{where}& \text{(29a)}\\ n_{\lambda a}\left(t\right)\ne r_a\left(t\right)n_{\lambda b}\left(t\right)\mathrm{and}& \text{(30a)}\\ r_v=\frac{{\varepsilon }_{5,\lambda a}c_3x_{3,4}\left(t\right)+{\varepsilon }_{6,\lambda a}c_4x_{3,4}\left(t\right)}{{\varepsilon }_{5,\lambda b}c_3x_{3,4}\left(t\right)+{\varepsilon }_{6,\lambda b}c_4x_{3,4}\left(t\right))}& \text{(25b)}\end{array}$

  

   =n_λa(t)/n_λb(t)  (26b)
• [0142]$\begin{array}{cc}=\frac{{\mathrm{<figure-callout\; label="\varepsilon "\; filenames="US20020128544A1-20020912-D00017.png,US20020128544A1-20020912-D00023.png"\; state="\{\{state\}\}">\varepsilon </figure-callout>}}_{5,\lambda a}c_3+{\varepsilon }_{6,\lambda a}{\mathrm{<figure-callout\; label="c"\; filenames="US20020128544A1-20020912-D00021.png"\; state="\{\{state\}\}">c</figure-callout>}}_4}{{\mathrm{<figure-callout\; label="\varepsilon "\; filenames="US20020128544A1-20020912-D00017.png,US20020128544A1-20020912-D00023.png"\; state="\{\{state\}\}">\varepsilon </figure-callout>}}_{5,\lambda b}c_3+{\varepsilon }_{6,\lambda b}c_4}& \text{(27b)}\\ =\frac{{\mathrm{<figure-callout\; label="\varepsilon "\; filenames="US20020128544A1-20020912-D00017.png,US20020128544A1-20020912-D00023.png"\; state="\{\{state\}\}">\varepsilon </figure-callout>}}_{5,\lambda a}\left(c_3/c_4\right)+{\varepsilon }_{6,\lambda a}}{{\mathrm{<figure-callout\; label="\varepsilon "\; filenames="US20020128544A1-20020912-D00017.png,US20020128544A1-20020912-D00023.png"\; state="\{\{state\}\}">\varepsilon </figure-callout>}}_{5,\lambda b}\left(c_3/c_4\right)+{\varepsilon }_{6,\lambda b}}& \text{(28b)}\end{array}$

  

   ≈n″_λa(t)/n″_λb(t)=constant₄; where   (29b)
• s_λa(t)≠r_v(t)s_λb(t).  (30b)
• In accordance with the present invention, it is often the case that both equations (26) and (30) can be simultaneously satisfied to determine the proportionality constants r[0143]_aand r_v. Additionally, the absorption coefficients at each wavelength ε_5,λa, ε_6,λa, ε_5,λb, and ε_6,λbare constant and the central assumption of the constant saturation method is that c₅(t)/c₆(t) and c₃(t)/c₄(t) are constant over many sample periods. Thus, new proportionality constants r_aand r_vmay be determined every few samples from new approximations to either the primary or secondary signal as output from the correlation canceler. Thus, the approximations to either the primary signals s_λa(t) and s_λb(t) or the secondary signals n_λa(t) and n_λb(t), found by the correlation canceler for a substantially immediately preceding set of samples of the measured signals S_λa(t) and S_λb(t) are used in a processor of the present invention for calculating the proportionality constants, r_aand r_v, for the next set of samples of the measured signals S_λa(t) and S_λb(t).
• Multiplying equation (19) by r[0144]_aand subtracting the resulting equation from equation (18) yields a non-zero secondary reference signal:
• n′(t)=S_λa(t)−r_aSλb(t)=n_λa(t)−r_an_λb(t).  (31a)
• Multiplying equation (19) by r[0145]_vand subtracting the resulting equation from equation (18) yields a non-zero primary reference signal:
• s′(t)=S_λa(t)−r_vS_λb(t)=s_λa(t)−r_vs_λb(t).  (31b)
• When using the constant saturation method in patient monitoring, initial proportionality coefficients can be determined as further explained below. It is not necessary for the patient to remain motionless even for an initialization period. With values for the proportionality coefficients r[0146]_aand r_vdetermined, a correlation canceler may be utilized with a secondary reference n′(t) or a primary reference s′(t).
• Determination of Signal Coefficients for Primary and Secondary Reference Signals Using the Constant Saturation Method[0147]
• In accordance with one aspect of the present invention, the[0148]reference processor26 FIG. 4aand FIG. 4bof the present invention may be configured to multiply the second measured assumed signal S_λb(t)=s_λb(t)+n_λb(t) by each of a plurality of signal coefficients r₁, r₂, . . . r_nand then subtract each result from the first measured signal S_λa(t)=s_λa(t)+n_λa(t) to obtain a plurality of reference signals
• R′(r, t)=s_λa(t)−rs_λb(t)  (32)
• for r=r[0149]₁, r₂, . . . r_nas shown in FIG. 7a.In other words, a plurality of signal coefficients are chosen to represent a cross section of possible signal coefficients.
• In order to determine either the primary reference s′(t) or the secondary reference n′(t) from the above plurality of reference signals of equation (32), signal coefficients r[0150]_aand r_vare determined from the plurality of assumed signal coefficients r₁, r₂, . . . r_n. The coefficients r_aand r_vare selected such that they cause either the primary signal portions s_λa(t) and s_λb(t) or the secondary signal portions n_λa(t) and n_λb(t) to cancel or nearly cancel when they are substituted into the reference function R′(r, t), e. g.
• s_λa(t)=r_as_λb(t)  (33a)
• n_λa(t)=r_vn_λb(t)  (33b)
• n′(t)=R′(r_a, t)=n_λa(t)−r_an_λb(t)  (33c)
• s′(t)=R′(r_v, t)=s_λa(t)−r_vs_λb(t).  (33d)
• In other words, coefficients r[0151]_aand r_vare selected at values which reflect the minimum of correlation between the primary signal portions and the secondary signal portions. In practice, one does not usually have significant prior information about either the primary signal portions s_λa(t) and s_λb(t) or the secondary signal portions n_λa(t) and n_λb(t) of the measured signals S_λa(t) and S_λb(t). The lack of this information makes it difficult to determine which of the plurality of coefficients r₁, r₂, . . . r_ncorrespond to the signal coefficients r_a=s_λa(t)/s_λb(t) and r_v=n_λa(t)/n_λb(t).
• One approach to determine the signal coefficients r[0152]_aand r_vfrom the plurality of coefficients r₁, r₂, . . . r_nemploys the use of acorrelation canceler27, such as an adaptive noise canceler, which takes a first input which corresponds to one of the measured signals S_λa(t) or S_λb(t) and takes a second input which corresponds to successively each one of the plurality of reference signals R′(r₁, t), R′(r₂, t), . . . , R′(r_n, t) as shown in FIG. 7a.For each of the reference signals R′(r₁, t), R′(r₂, t), . . . , R′(r_n, t) the corresponding output of thecorrelation canceler27 is input to a “squares”operation28 which squares the output of thecorrelation canceler27. The output of thesquares operation28 is provided to anintegrator29 for forming a cumulative output signal (a summation of the squares). The cumulative output signal is subsequently input to anextremum detector31. The purpose of theextremum detector31 is to chose signal coefficients r_aand r_vfrom the set r₁, r₂, . . . r_nby observing which provide a maximum in the cumulative output signal as in FIGS. 7band7c.In other words, coefficients which provide a maximum integrated output, such as energy or power, from thecorrelation canceler27 correspond to the signal coefficients r_aand r_vwhich relate to a minimum correlation between the primary signal portions and the secondary signal portions in accordance with the signal model of the present invention. One could also configure a system geometry which would require one to locate the coefficients from the set r₁, r₂, . . . r_nwhich provide a minimum or inflection in the cumulative output signal to identify the signal coefficients r_aand r_v.
• Use of a plurality of coefficients in the processor of the present invention in conjunction with a[0153]correlation canceler27 to determine the signal coefficients r_aand r_vmay be demonstrated by using the properties of correlation cancellation. If x, y and z are taken to be any collection of three time varying signals, then the properties of some correlation cancelers C(x, y) may be defined as follows:
• Property (1)C(x, y)=0 for x, y correlated  (34a)
• Property (2)C(x, y)=x for x, y uncorrelated  (34b)
• Property (3)C(x+y, z)=C(x, z)+C(y, z)  (34c)
• With properties (1), (2) and (3) it is easy to demonstrate that the energy or power output of a correlation canceler with a first input which corresponds to one of the measured signals S[0154]_λa(t) or S_λb(t) and a second input which corresponds to successively each one of a plurality of reference signals R′(r₁, t), R′(r₂, t), . . . , R′(r_n, t) can determine the signal coefficients r_aand r_vneeded to produce the primary reference s′(t) and secondary reference n′(t). If we take as a first input to the correlation canceler the measured signal S_λa(t) and as a second input the plurality of reference signals R′(r₁, t), R′(r₂, t), . . . , R′(r_n, t) then the outputs of the correlation canceler C(S_λa(t), R′(r_j,t)) for j=1, 2, . . . , n may be written as
• C(s_λa(t)+n_λa(t)−r_js_λb(t)+n_λa(t)−r_jn_λb(t))  (35)
• where j=1, 2, . . . n and we have used the expressions[0155]
• R′(r, t)=S_λa(t)−rS_λb(t)+n_λa  (36)
• S_λa(t)=s_λa(t)  (37a)
• S_λb(t)=s_λb(t)+n_λb(t).  (37b)
• The use of property (3) allows one to expand equation (35) into two terms[0156]
• C(S_λa(t),R′(r,t))=C(s_λa(t),s_λa(t)−rs_λb(t)+n_λa(t)−rn_λb(t))
• +C(n_λa(t),s_λa(t)−rs_λb(t)+n_λa(t)−rn_λb(t))  (38)
• so that upon use of properties (1) and (2) the correlation canceler output is given by[0157]
• C(S_λa(t),R′(r_j,t))=s_λa(t)δ(r_j−r_a)+n_λa(t)δ(r_j−r_v)  (39)
• where δ(x) is the unit impulse function[0158]
• δ(x)=0 ifx≠0
• δ(x)=1 ifx=0  (40)
• The time variable, t, of the correlation canceler output C(S[0159]_λa(t), R′(r_j, t)) may be eliminated by computing its energy or power. The energy of the correlation canceler output is given by
• E_λa(r_j)=∫C²(S_λa(t),R′(r_j, t)dt
• =δ(r_j−r_a)∫s²_λa(t)dt+δ(r_j−r_v)∫n²_λa(t)dt.  (41a)
• It should be understood that one could, equally well, have chosen the measured signal S[0160]_λb(t) as the first input to the correlation canceler and the plurality of reference signals R′(r₁, t), R′(r₂, t), . . . ,R′(r_n, t) as the second input. In this event, the correlation canceler energy output is
• E_λb(r_j)=∫C²(S_λb(t),R′(r, t)dt
• =δ(r_j−r_a)∫s²_λb(t)dt+δ(r_j−r_v)∫n²_λb(t)dt.  (41b)
• It should also be understood that in practical situations the use of discrete time measurement signals may be employed as well as continuous time measurement signals. A system which performs a discrete transform (e.g., a saturation transform in the present example) in accordance with the present invention is described with reference to FIGS.[0161]11-22. In the event that discrete time measurement signals are used, integration approximation methods such as the trapezoid rule, midpoint rule, Tick's rule, Simpson's approximation or other techniques may be used to compute the correlation canceler energy or power output. In the discrete time measurement signal case, the energy output of the correlation canceler may be written, using the trapezoid rule, as$\begin{array}{cc}{E}_{\lambda a}\left(r_j\right)=\delta \left(r_j-r_a\right)\Delta t\left\{\sum _{i=0}^ns_{\lambda a}^2\left(t_i\right)-0.5\left(s_{\lambda a}^2\left(t_0\right)+s_{\lambda a}^2\left(t_n\right)\right)\right\}+\delta \left(r_j-r_v\right)\Delta t\left\{\sum _{i=0}^nn_{\lambda a}^2\left(t_i\right)-0.5\left(n_{\lambda a}^2\left(t_0\right)+n_{\lambda a}^2\left(t_n\right)\right)\right\}& \text{(42a)}\\ E_{\lambda b}\left(r\right)=\delta \left(r_j-r_a\right)\Delta t\left\{\sum _{i=0}^ns_{\lambda b}^2\left(t_i\right)-0.5\left(s_{\lambda b}^2\left(t_0\right)+s_{\lambda b}^2\left(t_n\right)\right)\right\}+\delta \left(r_j-r_v\right)\Delta t\left\{\sum _{i=0}^nn_{\lambda b}^2\left(t_i\right)-0.5\left(n_{\lambda b}^2\left(t_0\right)+n_{\lambda b}^2\left(t_n\right)\right)\right\}& \text{(42b)}\end{array}$

  
• where t[0162]_iis the i^thdiscrete time, t₀is the initial time, t_nis the final time and Δt is the time between discrete time measurement samples.
• The energy functions given above, and shown in FIG. 7[0163]b,indicate that the correlation canceler output is usually zero due to correlation between the measured signal S_λa(t) or S_λb(t) and many of the plurality of reference signals R′(r₁, t), R′(r₂, t), . . . , R′(r_n, t). However, the energy functions are non zero at values of r_jwhich correspond to cancellation of either the primary signal portions s_λa(t) and s_λb(t) or the secondary signal portions n_λa(t) and n_λb(t) in the reference signal R′(r_j, t). These values correspond to the signal coefficients r_aand r_v.
• It should be understood that there may be instances in time when either the primary signal portions s[0164]_λa(t) and s_λb(t) or the secondary signal portions n_λa(t) and n_λb(t) are identically zero or nearly zero. In these cases, only one signal coefficient value will provide maximum energy or power output of the correlation canceler.
• Since there may be more than one signal coefficient value which provides maximum correlation canceler energy or power output, an ambiguity may arise. It may not be immediately obvious which signal coefficient together with the reference function R′(r, t) provides either the primary or secondary reference. In such cases, it is necessary to consider the constraints of the physical system at hand. For example, in pulse oximetry, it is known that arterial blood, whose signature is the primary plethysmographic wave, has greater oxygen saturation than venous blood, whose signature is the secondary erratic or random signal. Consequently, in pulse oximetry, the ratio of the primary signals due to arterial pulsation r[0165]_a=s_λa(t)/s_λb(t) is the smaller of the two signal coefficient values while the ratio of the secondary signals due to mainly venous blood dynamics r_v=n_λa(t)/n_λb(t) is the larger of the two signal coefficient values, assuming λa=660 nm and λb=910 nm.
• It should also be understood that in practical implementations of the plurality of reference signals and cross correlator technique, the ideal features listed as properties (1), (2) and (3) above will not be precisely satisfied but will be approximations thereof. Therefore, in practical implementations of this embodiment of the present invention, the correlation canceler energy curves depicted in FIG. 7[0166]bwill not consist of infinitely narrow delta functions but will have finite width associated with them as depicted in FIG. 7c.
• It should also be understood that it is possible to have more than two signal coefficient values which produce maximum energy or power output from a correlation canceler. This situation arises when the measured signals each contain more than two components each of which are related by a ratio as follows:[0167]$\begin{array}{cc}{s}_{\lambda a}\left(t\right)=\sum _{i=0}^nf_{\lambda a,i}\left(t\right)s_{\lambda b}\left(t\right)=\sum _{i=0}^nf_{\lambda b,i}\left(t\right)\mathrm{where}f_{\lambda a,i}\left(t\right)=r_if_{\lambda b,i}\left(t\right)i=1,\dots ,nr_i\ne r_j.& \left(43\right)\end{array}$

  
• Thus, reference signal techniques together with a correlation cancellation, such as an adaptive noise canceler, can be employed to decompose a signal into two or more signal components each of which is related by a ratio.[0168]
• Preferred Correlation Canceler Using a Joint Process Estimator Implementation[0169]
• Once either the secondary reference n′(t) or the primary reference s′(t) is determined by the processor of the present invention, the correlation canceler can be implemented in either hardware or software. The preferred implementation of a correlation canceler is that of an adaptive noise canceler using a joint process estimator.[0170]
• The least mean squares (LMS) implementation of the[0171]internal processor32 described above in conjunction with the adaptive noise canceler of FIG. 5a5bis relatively easy to implement, but lacks the speed of adaptation desirable for most physiological monitoring applications of the present invention. Thus, a faster approach for adaptive noise canceling, called a least-squares lattice joint process estimator model, is used in one embodiment. Ajoint process estimator60 is shown diagrammatically in FIG. 8 and is described in detail inChapter 9 ofAdaptive Filter Theoryby Simon Haykin, published by Prentice-Hall, copyright 1986. This entire book, includingChapter 9, is hereby incorporated herein by reference.
• The function of the joint process estimator is to remove either the secondary signal portions n[0172]_λa(t) or n_λb(t) or the primary signal portions s_λa(t) or s_λb(t) from the measured signals S_λa(t) or S_λb(t), yielding either a primary signal approximation s″_λa(t) or s″_λb(t) or a secondary signal approximation n″_λa(t) or n″_λb(t). Thus, the joint process estimator estimates either the value of the primary signals s_λa(t) or s_λb(t) or the secondary signals n_λa(t) or n_λb(t). The inputs to thejoint process estimator60 are either the secondary reference n′(t) or the primary reference s′(t) and the composite measured signal S_λa(t) or S_λb(t). The output is a good approximation to the signal S_λa(t) or S_λb(t) with either the secondary signal or the primary signal removed, i.e. a good approximation to either s_λa(t), s_λb(t), n_λa(t) or n_λb(t).
• The[0173]joint process estimator60 of FIG. 8 utilizes, in conjunction, a leastsquare lattice predictor70 and aregression filter80. Either the secondary reference n′(t) or the primary reference s′(t) is input to the leastsquare lattice predictor70 while the measured signal S_λa(t) or S_λb(t) is input to theregression filter80. For simplicity in the following description, S_λa(t) will be the measured signal from which either the primary portion s_λa(t) or the secondary portion n_λa(t) will be estimated by thejoint process estimator60. However, it will be noted that S_λb(t) could also be input to theregression filter80 and the primary portion s_λb(t) or the secondary portion n_λb(t) of this signal could be estimated.
• The[0174]joint process estimator60 removes all frequencies that are present in both the reference n′(t) or s′(t), and the measured signal S_λa(t). The secondary signal portion n_λa(t) usually comprises frequencies unrelated to those of the primary signal portion s_λa(t). It is improbable that the secondary signal portion n_λa(t) would be of exactly the same spectral content as the primary signal portion s_λa(t). However, in the unlikely event that the spectral content of s_λa(t) and n_λa(t) are similar, this approach will not yield accurate results. Functionally, thejoint process estimator60 compares the reference input signal n′(t) or s′(t), which is correlated to either the secondary signal portion n_λa(t) or the primary signal portion s_λa(t), and input signal S_λa(t) and removes all frequencies which are identical. Thus, thejoint process estimator60 acts as a dynamic multiple notch filter to remove those frequencies in the secondary signal component n_λa(t) as they change erratically with the motion of the patient or those frequencies in the primary signal component s_λa(t) as they change with the arterial pulsation of the patient. This yields a signal having substantially the same spectral content and amplitude as either the primary signal s_λa(t) or the secondary signal n_λa(t). Thus, the output s″_λa(t) or n″_λa(t) of thejoint process estimator60 is a very good approximation to either the primary signal s_λa(t) or the secondary signal n_λa(t).
• The[0175]joint process estimator60 can be divided into stages, beginning with a zero-stage and terminating in an m^th-stage, as shown in FIG. 8. Each stage, except for the zero-stage, is identical to every other stage. The zero-stage is an input stage for thejoint process estimator60. The first stage through the m^th-stage work on the signal produced in the immediately previous stage, i.e., the (m−1)^th-stage, such that a good primary signal approximation s″_λa(t) or secondary signal approximation n″_λa(t) is produced as output from the m^th-stage.
• The least-[0176]squares lattice predictor70 comprisesregisters90 and92, summingelements100 and102, and delayelements110. Theregisters90 and92 contain multiplicative values of a forward reflection coefficient Γ_f,m(t) and a backward reflection coefficient Γ_b,m(t) which multiply the reference signal n′(t) or s′(t) and signals derived from the reference signal n′(t) or s′(t). Each stage of the least-squares lattice predictor outputs a forward prediction error f_m(t) and a backward prediction error b_m(t). The subscript m is indicative of the stage.
• For each set of samples, i.e. one sample of the reference signal n′(t) or s′(t) derived substantially simultaneously with one sample of the measured signal S[0177]_λa(t), the sample of the reference signal n′(t) or s′(t) is input to the least-squares lattice predictor70. The zero-stage forward prediction error f₀(t) and the zero-stage backward prediction error b₀(t) are set equal to the reference signal n′(t) or s′(t). The backward prediction error b₀(t) is delayed by one sample period by thedelay element110 in the first stage of the least-squares lattice predictor70. Thus, the immediately previous value of the reference n′(t) or s′(t) is used in calculations involving the first-stage delay element110. The zero-stage forward prediction error is added to the negative of the delayed zero-stage backward prediction error b₀(t−1) multiplied by the forward reflection coefficient value Γ_f,1(t) register90 value, to produce a first-stage forward prediction error f₁(t). Additionally, the zero-stage forward prediction error f₀(t) is multiplied by the backward reflection coefficient Γ_b,1(t) register92 value and added to the delayed zero-stage backward prediction error b₀(t−1) to produce a first-stage backward prediction error b₁(t). In each subsequent stage, m, of the leastsquare lattice predictor70, the previous forward and backward prediction error values, f_m−1(t) and b_m−1(t−1), the backward prediction error being delayed by one sample period, are used to produce values of the forward and backward prediction errors for the present stage, f_m(t) and b_m(t).
• The backward prediction error b[0178]_m(t) is fed to the concurrent stage, m, of theregression filter80. There it is input to aregister96, which contains a multiplicative regression coefficient value κ_m,λa(t). For example, in the zero-stage of theregression filter80, the zero-stage backward prediction error b₀(t) is multiplied by the zero-stage regression coefficient κ_0,λa(t) register96 value and subtracted from the measured value of the signal S_λa(t) at a summingelement106 to produce a first stage estimation error signal e_1,λa(t). The first-stage estimation error signal e_1,λa(t) is a first approximation to either the primary signal or the secondary signal. This first-stage estimation error signal e_1,λa(t) is input to the first-stage of theregression filter80. The first-stage backward prediction error b₁(t), multiplied by the first-stage regression coefficient κ_1,λa(t) register96 value is subtracted from the first-stage estimation error signal e_1,λa(t) to produce the second-stage estimation error e_2,λa(t). The second-stage estimation error signal e_2,λa(t) is a second, somewhat better approximation to either the primary signal s_λa(t) or the secondary signal n_λa(t).
• The same processes are repeated in the least-[0179]squares lattice predictor70 and theregression filter80 for each stage until a good approximation e_m,λa(t), to either the primary signal s_λa(t) or the secondary signal n_λa(t) is determined. Each of the signals discussed above, including the forward prediction error f_m(t), the backward prediction error b_m(t), the estimation error signal e_m,λa(t), is necessary to calculate the forward reflection coefficient Γ_f,m(t), the backward reflection coefficient Γ_b,m(t), and the regression coefficient κ_m,λa(t)register90,92, and96 values in each stage, m. In addition to the forward prediction error f_m(t), the backward prediction error b_m(t), and the estimation error e_m,λa(t) signals, a number of intermediate variables, not shown in FIG. 8 but based on the values labeled in FIG. 8, are required to calculate the forward reflection coefficient Γ_f,m(t), the backward reflection coefficient Γ_b,m(t), and the regression coefficient κ_m,λa(t)register90,92, and96 values.
• Intermediate variables include a weighted sum of the forward prediction error squares ℑ[0180]_m(t), a weighted sum of the backward prediction error squares β_m(t), a scalar parameter Δ_m(t), a conversion factor γ_m(t), and another scalar parameter ρ_m,λa(t). The weighted sum of the forward prediction errors ℑ_m(t) is defined as:$\begin{array}{cc}{}_m\left(t\right)=\sum _{i=1}^t{\lambda }^{t-i}{f_m\left(i\right)}^2;& \left(44\right)\end{array}$

  
• where λ without a wavelength identifier, a or b, is a constant multiplicative value unrelated to wavelength and is typically less than or equal to one, i.e., λ≦1. The weighted sum of the backward prediction errors β[0181]_m(t) is defined as:$\begin{array}{cc}{\beta }_m\left(t\right)=\sum _{i=1}^t{\lambda }^{t=i}{b_m\left(i\right)}^2& \left(45\right)\end{array}$

  
• where, again, λ without a wavelength identifier, a or b, is a constant multiplicative value unrelated to wavelength and is typically less than or equal to one, i.e., λ≦1. These weighted sum intermediate error signals can be manipulated such that they are more easily solved for, as described in[0182]Chapter 9, §9.3 of the Haykin book referenced above and defined hereinafter in equations (59) and (60).
• Description of the Joint Process Estimator[0183]
• The operation of the[0184]joint process estimator60 is as follows. When thejoint process estimator60 is turned on, the initial values of intermediate variables and signals including the parameter Δ_m−1(t), the weighted sum of the forward prediction error signals ℑ_m−1(t), the weighted sum of the backward prediction error signals β_m−1(t), the parameter ρ_m,λa(t), and the zero-stage estimation error e_0,λa(t) are initialized, some to zero and some to a small positive number δ:
• Δ_m−1(0)=0;  (46)
• ℑ_m−1(0)=δ;  (47)
• β_m−1(0)=δ;  (48)
• ρ_m,λa(0)=0;  (49)
• e_0,λa(t)=S_λa(t) fort≧0.  (50)
• After initialization, a simultaneous sample of the measured signal S[0185]_λa(t) or S_λb(t) and either the secondary reference n′(t) or the primary reference s′(t) are input to thejoint process estimator60, as shown in FIG. 8. The forward and backward prediction error signals f₀(t) and b₀(t), and intermediate variables including the weighted sums of the forward and backward error signals ℑ₀(t) and β₀(t), and the conversion factor γ₀(t) are calculated for the zero-stage according to:
• f₀(t)=b₀(t)=n′(t)  (51a)
• ℑ₀(t)=β₀(t)λℑ₀(t−1)+|n′(t)|²  (52a)
• γ₀(t−1)=1  (53a)
• if a secondary reference n′(t) is used or according to:[0186]
• f₀(t)=b₀(t)=s′(t)  (51b)
• ℑ₀(t)=β₀(t)=λℑ₀(t−1)+|s′(t)|²  (52b)
• ⁶⁵₀(t−1)=1  (53b)
• if a primary reference s′(t) is used where, again, λ without a wavelength identifier, a or b, is a constant multiplicative value unrelated to wavelength.[0187]
• Forward reflection coefficient Γ[0188]_f,m(t), backward reflection coefficient Γ_b,m(t), and regression coefficient κ_m,λa(t)register90,92 and96 values in each stage thereafter are set according to the output of the previous stage. The forward reflection coefficient Γ_f,1(t), backward reflection coefficient Γ_b,1(t), and regression coefficient κ_1,λa(t)register90,92 and96 values in the first stage are thus set according to the algorithm using values in the zero-stage of thejoint process estimator60. In each stage, m≧1, intermediate values and register values including the parameter Δ_m−1(t); the forward reflection coefficient Γ_f,m(t) register90 value; the backward reflection coefficient Γ_b,m(t) register92 value; the forward and backward error signals f_m(t) and b_m(t); the weighted sum of squared forward prediction errors ℑ_f,m(t), as manipulated in §9.3 of the Haykin book; the weighted sum of squared backward prediction errors β_b,m(t), as manipulated in §9.3 of the Haykin book; the conversion factor γ_m(t); the parameter ρ_m,λa(t); the regression coefficient κ_m,λa(t) register96 value; and the estimation error e_m+1λa(t) value are set according to:
• Δ_m−1(t)=λΔ_m−1(t−1)+{b_m−1(t−1)f*_m−1(t)/γ_m−1(t−1)}  (54)
• Γ_f,m(t)=−{Δ_m−1(t)/β_m−1(t−1)}  (55)
• Γ_b,m(t)=−{Δ*_m−1(t)/ℑ_m−1(t)}  (56)
• f_m(t)=f_m−1(t)+Γ*_f,m(t)b_m−1(t−1)  (57)
• b_m(t)=b_m−1(t−1)+Γ*_b,m(t)f_m−1(t)  (58)
• ℑ_m(t)=ℑ_m−1(t)−{|Δ_m−1(t)|²/β_m−1(t−1)}  (59)
• β_m(t)=β_m−1(t−1)−{|Δ_m−1(t)|²/ℑ_m−1(t)}  (60)
• γ_m(t−1)=γ_m−1(t−1)−{|b_m−1)|²/β_m−1(t−1)}  (61)
• ρ_m,λa(t)=λρ_m,λa(t−1)+{b_m(t)ε*_m,λa(t)/γ_m(t)}  (62)
• κ_m,λa(t)={ρ_m,λa(t)/β_m(t)}  (63)
• ε_m+1,λa(t)=ε_m,λa(t)−κ*_m(t)b_m(t)  (64)
• where a (*) denotes a complex conjugate.[0189]
• These equations cause the error signals f[0190]_m(t), b_m(t), e_m,λa(t) to be squared or to be multiplied by one another, in effect squaring the errors, and creating new intermediate error values, such as Δ_m−1(t). The error signals and the intermediate error values are recursively tied together, as shown in the above equations (54) through (64). They interact to minimize the error signals in the next stage.
• After a good approximation to either the primary signal s[0191]_λa(t) or the secondary signal n_λa(t) has been determined by thejoint process estimator60, a next set of samples, including a sample of the measured signal S_λa(t) and a sample of either the secondary reference n′(t) or the primary reference s′(t), are input to thejoint process estimator60. The re-initialization process does not re-occur, such that the forward and backward reflection coefficient Γ_f,m(t) and Γ_b,m(t)register90,92 values and the regression coefficient κ_m,λa(t) register96 value reflect the multiplicative values required to estimate either the primary signal portion s_λa(t) or the secondary signal portion n_λa(t) of the sample of S_λa(t) input previously. Thus, information from previous samples is used to estimate either the primary or secondary signal portion of a present set of samples in each stage.
• In a more numerically stable and preferred embodiment of the above described joint process estimator, a normalized joint process estimator is used. This version of the joint process estimator normalizes several variables of the above-described joint process estimator such that the normalized variables fall between −1 and 1. The derivation of the normalized joint process estimator is motivated in the Haykin text as[0192]problem 12 onpage 640 by redefining the variables defined according to the following conditions:${\stackrel{\_}{f}}_m\left(t\right)=\frac{f_m\left(t\right)}{\sqrt{{}_m\left(t\right){\gamma }_m\left(t-1\right)}}$$\stackrel{\_}{b}\left(t\right)=\frac{b_m\left(t\right)}{\sqrt{{\beta }_m\left(t\right){\gamma }_m\left(t\right)}}$${\stackrel{\_}{\Delta }}_m\left(t\right)=\frac{{\Delta }_m\left(t\right)}{\sqrt{{}_m\left(t\right){\beta }_m\left(t-1\right)}}$

  
• This transformation allows the conversion of Equations (54)-(64) to the following normalized equations:[0193]
• {overscore (Δ)}_m−1(t)={overscore (Δ)}_m−1(t−1)[1−|f_m−1(t)|²]^½[1−|{overscore (b)}_m−1(t−1)|²]^½+{overscore (b)}_m−1(t−1){overscore (f)}_m−1(t)
• [0194]${\stackrel{\_}{b}}_m\left(t\right)=\frac{\left[{\stackrel{\_}{b}}_{m-1}\left(t-1\right)-{\stackrel{\_}{\Delta }}_{m-1}\left(t\right){\stackrel{\_}{f}}_{m-1}\left(t\right)\right]}{{{\left[1-{{\stackrel{\_}{\Delta }}_{m-1}\left(t\right)}^2\right]}^{1/2}\left[1-{{\stackrel{\_}{f}}_{m-1}\left(t\right)}^2\right]}^{1/2}}$${\stackrel{\_}{f}}_m\left(t\right)=\frac{\left[{\stackrel{\_}{f}}_{m-1}\left(t\right)-{\stackrel{\_}{\Delta }}_{m-1}\left(t\right){\stackrel{\_}{b}}_{m-1}\left(t-1\right)\right]}{{{\left[1-{{\stackrel{\_}{\Delta }}_{m-1}\left(t\right)}^2\right]}^{1/2}\left[1-{{\stackrel{\_}{b}}_{m-1}\left(t-1\right)}^2\right]}^{1/2}}$

  

   β_m(t)=[1−|{overscore (Δ)}_m−1(t)|²]β_m−1(t−1)
• γ_m(t)=γ_m−1(t)[1−|{overscore (b)}_m−1(t)|²]
• [0195]${\rho }_m\left(t\right)=\lambda ·{\left[\frac{{\gamma }_m\left(t\right){\beta }_m\left(t-1\right)}{{\gamma }_m\left(t-1\right){\beta }_m\left(t\right)}\right]}^{1/2}{\rho }_m\left(t-1\right)+{\stackrel{\_}{b}}_m\left(t\right){\varepsilon }_m\left(t\right)$

  

   ε_m+1,λa(t)=ε_m,.λa(t)−ρ_m(t){overscore (b)}_m(t)
• Initialization of Normalized Joint Process Estimator[0196]
• Let N(t) be defined as the reference noise input at time index n and U(t) be defined as combined signal plus noise input at time index t the following equations apply (see Haykin, p. 619):[0197]
• 1. To initialize the algorithm, at time t=0 set[0198]
• {overscore (Δ)}_m−1(0)=0
• β_m−1(0)=δ=10⁻⁶
• γ₀(0)=1
• 2. At each instant t≧1, generate the various zeroth-order variables as follows:[0199]
• γ₀(t−1)=1
• β₀(t)=λβ₀(t−1)+N²(t)${\stackrel{\_}{b}}_0\left(t\right)={\stackrel{\_}{f}}_0\left(t\right)=\frac{N\left(t\right)}{\sqrt{{\mathrm{<figure-callout\; label="\beta "\; filenames="US20020128544A1-20020912-D00012.png,US20020128544A1-20020912-D00013.png"\; state="\{\{state\}\}">\beta </figure-callout>}}_0\left(t\right)}}$

  
• 3. For regression filtering, initialize the algorithm by setting at time index t=0[0200]
• ρ_m(0)=0
• 4. At each instant t≧1, generate the zeroth-order variable[0201]
• ε₀(t)=U(t).
• Accordingly, a normalized joint process estimator can be used for a more stable system.[0202]
• In yet another embodiment, the correlation cancellation is performed with a QRD algorithm as shown diagrammatically in FIG. 8[0203]aand as described in detail in Chapter 18 ofAdaptive Filter Theoryby Simon Haykin, published by Prentice-Hall, copyright 1986.
• The following equations adapted from the Haykin book correspond to the QRD-LSL diagram of FIG. 8[0204]a(also adapted from the Haykin book).
• Computations[0205]
• a. Predictions: For time t=1, 2, . . . , and prediction order m=1, 2, . . . , M, where M is the final prediction order, compute:[0206]
• β_m−1(t−1)=λβ_m−1(t−2)+|ε_b,m−1(t−1)|²$c_{b,m-1}\left(t+1\right)=\frac{{\mathrm{<figure-callout\; label="\lambda "\; filenames="US20020128544A1-20020912-D00009.png,US20020128544A1-20020912-D00010.png"\; state="\{\{state\}\}">\lambda </figure-callout>}}^{1/2}{\beta }_{m-1}^{1/2}\left(t-2\right)}{{\beta }_{m-1}^{1/2}\left(t-1\right)}$$s_{b,m-1}\left(t-1\right)=\frac{{\varepsilon }_{b,m-1}^{*}\left(t-1\right)}{{\beta }_{m-1}^{1/2}\left(t-1\right)}$

  

   ε_f,m(t)=c_b,m−1(t−1)ε_f,m−1(t)−s^·_b,m−1(t−1)λ^½π^·_f,m−1(t−1)
• π_f,m−1^·(t)=c_b,m−1(t−1)λ^½π_f,m−1^·(t−1)+s_b,m−1(t−1)ε_f,m−1(t)
• γ_m^½(t−1)=c_b,m−1(t−1)γ_m−1^½(t−1)
• ℑ_m−1(t)=λℑ_m−1(t−1)+|ε_f,m−1(t)|²
• [0207]$c_{f,m-1}\left(t\right)=\frac{{\mathrm{<figure-callout\; label="\lambda "\; filenames="US20020128544A1-20020912-D00009.png,US20020128544A1-20020912-D00010.png"\; state="\{\{state\}\}">\lambda </figure-callout>}}^{1/2}{}_{m-1}^{1/2}\left(t-1\right)}{{}_{m-1}^{1/2}\left(t\right)}$$s_{f,m-1}\left(t\right)=\frac{{\varepsilon }_{f,m-1}^{*}\left(t\right)}{{}_{m-1}^{1/2}\left(t\right)}$

  

   ε_b,m(t)=c_f,m−1(t)ε_b,m−1(t−1)−s_f,m−1^·(t)λ^½π_b,m−1^·(t−1)
• π_b,m−1¹⁹(t)=c_f,m−1(t)λ^½π_b,m−1^·(t−1)+s_f,m−1(t)ε_b,m−1(t−1)
• b. Filtering: For order m=0, 1, . . . , M−1; and time t=1, 2, . . . , compute[0208]
• β_m(t)=λβ_m(t−1)+|ε_b,m(t)|²$c_{b,m}\left(t\right)=\frac{{\mathrm{<figure-callout\; label="\lambda "\; filenames="US20020128544A1-20020912-D00009.png,US20020128544A1-20020912-D00010.png"\; state="\{\{state\}\}">\lambda </figure-callout>}}^{1/2}{\beta }_m^{1/2}\left(t-1\right)}{{\beta }_{\mathrm{<figure-callout\; label="m"\; filenames="US20020128544A1-20020912-D00009.png,US20020128544A1-20020912-D00010.png"\; state="\{\{state\}\}">m</figure-callout>}}^{1/2}\left(t\right)}$$s_{b,m}\left(t\right)=\frac{{\varepsilon }_{b,m}^{*}\left(t\right)}{{\beta }_m^{1/2}\left(t\right)}$

  

   ε_m+1(t)=c_b,m(t)ε_m(t)−s_b,m^·(t)λ^½ρ_m^·(t−1)
• ρ_m^·(t)=c_b,m(t)λ^½ρ_m^·(t−1)+s_b,m(t)ε_m(t)${\gamma }_{m+1}^{1/2}\left(t\right)=c_{b,m}\left(t\right){\gamma }_m^{1/2}\left(t\right)$${\varepsilon }_{m+1}\left(t\right)={\lambda }_{m+1}^{1/2}\left(t\right){\varepsilon }_{m+1}\left(t\right)$

  
• 5. Initialization[0209]
• a. Auxiliary parameter initialization: for order m=1, 2, . . . , M, set[0210]
• π_f,m−1(0)=π_b,m−1(0)=0
• p_m(0)=0
• b. Soft constraint initialization: For order m=0, 1, . . . , M, set[0211]
• β_m(−1)=δ
• ℑ_m(0)=δ
• where δ is a small positive constant.[0212]
• c. Data initialization: For t=1, 2, . . . , compute[0213]
• ε_f,0(t)=ε_b,0(t)=μ(t)
• ε₀(t)=d(t)
• γ₀(t)=1
• where μ(t) is the input and d(t) is the desired response at time t.[0214]
• Flowchart of Joint Process Estimator[0215]
• In a signal processor, such as a physiological monitor incorporating a reference processor of the present invention to determine a reference n′(t) or s′(t) for input to a correlation canceler, a[0216]joint process estimator60 type adaptive noise canceler is generally implemented via a software program having an iterative loop. One iteration of the loop is analogous to a single stage of the joint process estimator as shown in FIG. 8. Thus, if a loop is iterated m times, it is equivalent to an m stagejoint process estimator60.
• A flow chart of a subroutine to estimate the primary signal portion s[0217]_λa(t) or the secondary signal portion n_λa(t) of a measured composite signal, S_λa(t) is shown in FIG. 9. The flow chart illustrates the function of a reference processor for determining either the secondary reference n′(t) or the primary reference s′(t). The flowchart for the joint process estimator is implemented in software.
• A one-time initialization is performed when the physiological monitor is powered-on, as indicated by an “INITIALIZE NOISE CANCELER”[0218]action block120. The initialization sets allregisters90,92, and96 and delayelement variables110 to the values described above in equations (46) through (50).
• Next, a set of simultaneous samples of the composite measured signals S[0219]_λa(t) and S_λb(t) is input to the subroutine represented by the flowchart in FIG. 9. Then a time update of each of the delay element program variables occurs, as indicated in a “TIME UPDATE OF [Z⁻¹] ELEMENTS”action block130. The value stored in each of thedelay element variables110 is set to the value at the input of thedelay element variable110. Thus, the zero-stage backward prediction error b₀(t) is stored as the first-stage delay element variable, and the first-stage backward prediction error b₁(t) is stored as the second-stage delay element variable, and so on.
• Then, using the set of measured signal samples S[0220]_λa(t) and S_λb(t), the reference signal is obtained using the ratiometric or the constant saturation methods described above. This is indicated by a “CALCULATE REFERENCE [n′(t) or s′(t)] FOR TWO MEASURED SIGNAL SAMPLES”action block140.
• A zero-stage order update is performed next as indicated in a “ZERO-STAGE UPDATE”[0221]action block150. The zero-stage backward prediction error b₀(t), and the zero-stage forward prediction error f₀(t) are set equal to the value of the reference signal n′(t) or s′(t). Additionally, the weighted sum of the forward prediction errors ℑ_m(t) and the weighted sum of backward prediction errors β_m(t) are set equal to the value defined in equations (47) and (48).
• Next, a loop counter, m, is initialized as indicated in a “m=0”[0222]action block160. A maximum value of m, defining the total number of stages to be used by the subroutine corresponding to the flowchart in FIG. 9, is also defined. Typically, the loop is constructed such that it stops iterating once a criterion for convergence upon a best approximation to either the primary signal or the secondary signal has been met by thejoint process estimator60. Additionally, a maximum number of loop iterations may be chosen at which the loop stops iteration. In a preferred embodiment of a physiological monitor of the present invention, a maximum number of iterations, m=6 to m=10, is advantageously chosen.
• Within the loop, the forward and backward reflection coefficient Γ[0223]_f,m(t) and Γ_b,m(t) register90 and92 values in the least-squares lattice filter are calculated first, as indicated by the “ORDER UPDATE MTH CELL OF LSL-LATTICE”action block170 in FIG. 9. This requires calculation of intermediate variable and signal values used in determiningregister90,92, and96 values in the present stage, the next stage, and in theregression filter80.
• The calculation of regression filter register[0224]96 value κ_m,λa(t) is performed next, indicated by the “ORDER UPDATE MTH STAGE OF REGRESSION FILTER(S)”action block180. The two order update action blocks170 and180 are performed in sequence m times, until m has reached its predetermined maximum (in the preferred embodiment, m=6 to m=10) or a solution has been converged upon, as indicated by a YES path from a “DONE”decision block190. In a computer subroutine, convergence is determined by checking if the weighted sums of the forward and backward prediction errors ℑ_m(t) and β_m(t) are less than a small positive number. An output is calculated next, as indicated by a “CALCULATE OUTPUT”action block200. The output is a good approximation to either the primary signal or secondary signal, as determined by thereference processor26 andjoint process estimator60 subroutine corresponding to the flow chart of FIG. 9. This is displayed (or used in a calculation in another subroutine), as indicated by a “TO DISPLAY”action block210.
• A new set of samples of the two measured signals S[0225]_λa(t) and S_λb(t) is input to the processor andjoint process estimator60 adaptive noise canceler subroutine corresponding to the flowchart of FIG. 9 and the process reiterates for these samples. Note, however, that the initialization process does not re-occur. New sets of measured signal samples S_λa(t) and S_λb(t) are continuously input to thereference processor26 and joint process estimator adaptive noise canceler subroutine. The output forms a chain of samples which is representative of a continuous wave. This waveform is a good approximation to either the primary signal waveform s_λa(t) or the secondary waveform n_λa(t) at wavelength λa. The waveform may also be a good approximation to either the primary signal waveform s_λb(t) or the secondary waveform n″_λb(t) at wavelength λb.
• A corresponding flowchart for the QRD algorithm of FIG. 8[0226]ais depicted in FIG. 9a,with reference numeral corresponding in number with an ‘a’ extension
• Calculation of Saturation from Correlation Canceler Output[0227]
• Physiological monitors may use the approximation of the primary signals s″[0228]_λa(t) or s″_λb(t) or the secondary signals n″_λa(t) or n″_λb(t) to calculate another quantity, such as the saturation of one constituent in a volume containing that constituent plus one or more other constituents. Generally, such calculations require information about either a primary or secondary signal at two wavelengths. For example, the constant saturation method requires a good approximation of the primary signal portions s_λa(t) and s_λb(t) of both measured signals S_λa(t) and S_λb(t). The arterial saturation is determined from the approximations to both signals, i.e. s″_λa(t) and s″_λb(t). The constant saturation method also requires a good approximation of the secondary signal portions n_λa(t) or n_λb(t). An estimate of the venous saturation may be determined from the approximations to these signals i.e. n″_λa(t) and n″_λb(t).
• A[0229]joint process estimator60 having two regression filters80aand80bis shown in FIG. 10. A first regression filter80aaccepts a measured signal S_λa(t). A second regression filter80baccepts a measured signal S_λb(t) for a use of the constant saturation method to determine the reference signal n′(t) or s′(t). The first and second regression filters80aand80bare independent. The backward prediction error b_m(t) is input to each regression filter80aand80b,the input for the second regression filter80bbypassing the first regression filter80a.
• The second regression filter[0230]80bcomprisesregisters98, and summingelements108 arranged similarly to those in the first regression filter80a.The second regression filter80boperates via an additional intermediate variable in conjunction with those defined by equations (54) through (64), i.e.:
• ρ_m,λb(t)=λρ_·m,λb(t−1)+{b_m(t)e*_m,λb(t)/γ_m(t)}; and  (65)
• ρ_0,λb(0)=0.  (66)
• The second regression filter[0231]80bhas an error signal value defined similar to the first regression filter error signal values, e_m+1,λa(t), i.e.:
• e_m+1,λb(t)=e_m,λb(t)−κ*_m,λb(t)b_m(t); and   (67)
• e_0,λb(t)=S_λb(t) for t≧0.  (68)
• The second regression filter has a regression coefficient κ[0232]_m,λb(t) register98 value defined similarly to the first regression filter error signal values, i.e.:
• κ_m,λb(t)={ρ_m,λb(t)/β_m(t)}; or   (69)
• These values are used in conjunction with those intermediate variable values, signal values, register and register values defined in equations (46) through (64). These signals are calculated in an order defined by placing the additional signals immediately adjacent a similar signal for the wavelength λa.[0233]
• For the constant saturation method, S[0234]_λb(t) is input to the second regression filter80b.The output is then a good approximation to the primary signal s″_λb(t) or secondary signal s″_λb(t).
• The addition of the second regression filter[0235]80bdoes not substantially change the computer program subroutine represented by the flowchart of FIG. 9. Instead of an order update of the m^thstage of only one regression filter, an order update of the m^thstage of both regression filters80aand80bis performed. This is characterized by the plural designation in the “ORDER UPDATE OF m^thSTAGE OF REGRESSION FILTER(S)”activity block180 in FIG. 9. Since the regression filters80aand80boperate independently, independent calculations can be performed in the reference processor andjoint process estimator60 adaptive noise canceler subroutine modeled by the flowchart of FIG. 9.
• An alternative diagram for the joint process estimator of FIG. 10, using the QRD algorithm and having two regression filters is shown in FIG. 10[0236]a.This type of joint process estimator would be used for correlation cancellation using the QRD algorithm described in the Haykin book.
• Calculation of Saturation[0237]
• Once good approximations to the primary signal portions s″[0238]_λa(t) and s″_λb(t) or the secondary signal portion, n″_λa(t) and n″_λb(t), have been determined by thejoint process estimator60, the saturation of A₅in a volume containing A₅and A₆, for example, may be calculated according to various known methods. Mathematically, the approximations to the primary signals can be written in terms of λa and λb, as:
• s″_λa(t)≈ε_5,λac₅x_5,6(t)+ε_6,λac₆x_5,6(t); and   (70)
• s″_λb(t)≈ε_5,λbc₅x_5,6(t)+ε_6,λbc₆x_5,6(t).  (71)
• Equations (70) and (71) are equivalent to two equations having three unknowns, namely c[0239]₅(t), c₆(t) and x_5,6(t). The saturation can be determined by acquiring approximations to the primary or secondary signal portions at two different, yet proximate times t₁and t₂over which the saturation of A₅in the volume containing A₅and A₆and the saturation of A₃in the volume containing A₃and A₄does not change substantially. For example, for the primary signals estimated at times t₁and t₂:
• s″_λa(t₁)≈ε_5,λac₅x_5,6(t₁)+ε_6,λac₆x_5,6(t₁)  (72)
• s″_λb(t₁)≈ε_5,λbc₅x_5,6(t₁)+ε_6,λbc₆x_5,6(t₁)  (73)
• s″_λa(t₂)≈ε_5,λac₅x_5,6(t₂)+ε_6,λac₆x_5,6(t₂)  (74)
• s″_λb(t₂)≈ε_5,λbc₅x_5,6(t₂)+ε_6,λbc₆x_5,6(t₂)  (75)
• Then, difference signals may be determined which relate the signals of equations (72) through (75), i.e.:[0240]
• Δs_λa=s″_λa(t₁)−s″_λa(t₂)≈ε_5,λac₅Δx+ε_6,λac₆Δx;  (76)
• and[0241]
• Δs_λb=s″_λb(t₁)−s″_λb(t₂)≈ε_5,λbc₅Δx+ε_,λbc₆Δx;  (77)
• where Δx=x[0242]_5,6(t₁)−x_5,6(t₂). The average saturation at time t=(t₁+t₂)/2 is:
• Saturation(t)=c₅(t)/[c₅(t)+c₆(t)]  (78)$\begin{array}{cc}=\frac{{\varepsilon }_{6,\lambda a}-{\varepsilon }_{6,\lambda b}\left(\Delta s_{\lambda a}/\Delta s_{\lambda b}\right)}{{\varepsilon }_{6,\lambda a}-{\mathrm{<figure-callout\; label="\varepsilon "\; filenames="US20020128544A1-20020912-D00017.png,US20020128544A1-20020912-D00023.png"\; state="\{\{state\}\}">\varepsilon </figure-callout>}}_{5,\lambda a}-\left({\varepsilon }_{6,\lambda b}-{\mathrm{<figure-callout\; label="\varepsilon "\; filenames="US20020128544A1-20020912-D00017.png,US20020128544A1-20020912-D00023.png"\; state="\{\{state\}\}">\varepsilon </figure-callout>}}_{5,\lambda b}\right)\left(\Delta s_{\lambda a}/\Delta s_{\lambda b}\right)}& \left(79\right)\end{array}$

  
• It will be understood that the Δx term drops out from the saturation calculation because of the division. Thus, knowledge of the thickness of the primary constituents is not required to calculate saturation.[0243]
• Pulse Oximetry Measurements[0244]
• A specific example of a physiological monitor utilizing a processor of the present invention to determine a secondary reference n′(t) for input to a correlation canceler that removes erratic motion-induced secondary signal portions is a pulse oximeter. Pulse oximetry may also be performed utilizing a processor of the present invention to determine a primary signal reference s′(t) which may be used for display purposes or for input to a correlation canceler to derive information about patient movement and venous blood oxygen saturation.[0245]
• A pulse oximeter typically causes energy to propagate through a medium where blood flows close to the surface for example, an ear lobe, or a digit such as a finger, a forehead or a fetus' scalp. An attenuated signal is measured after propagation through or reflected from the medium. The pulse oximeter estimates the saturation of oxygenated blood.[0246]
• Freshly oxygenated blood is pumped at high pressure from the heart into the arteries for use by the body. The volume of blood in the arteries varies with the heartbeat, giving rise to a variation in absorption of energy at the rate of the heartbeat, or the pulse.[0247]
• Oxygen depleted, or deoxygenated, blood is returned to the heart by the veins along with unused oxygenated blood. The volume of blood in the veins varies with the rate of breathing, which is typically much slower than the heartbeat. Thus, when there is no motion induced variation in the thickness of the veins, venous blood causes a low frequency variation in absorption of energy. When there is motion induced variation in the thickness of the veins, the low frequency variation in absorption is coupled with the erratic variation in absorption due to motion artifact.[0248]
• In absorption measurements using the transmission of energy through a medium, two light emitting diodes (LED's) are positioned on one side of a portion of the body where blood flows close to the surface, such as a finger, and a photodetector is positioned on the opposite side of the finger. Typically, in pulse oximetry measurements, one LED emits a visible wavelength, preferably red, and the other LED emits an infrared wavelength. However, one skilled in the art will realize that other wavelength combinations could be used. The finger comprises skin, tissue, muscle, both arterial blood and venous blood, fat, etc., each of which absorbs light energy differently due to different absorption coefficients, different concentrations, different thicknesses, and changing optical pathlengths. When the patient is not moving, absorption is substantially constant except for the flow of blood. The constant attenuation can be determined and subtracted from the signal via traditional filtering techniques. When the patient moves, this causes perturbation such as changing optical pathlength due to movement of background fluids (e.g., venous blood having a different saturation than the arterial blood). Therefore, the measured signal becomes erratic. Erratic motion induced noise typically cannot be predetermined and/or subtracted from the measured signal via traditional filtering techniques. Thus, determining the oxygen saturation of arterial blood and venous blood becomes more difficult.[0249]
• A schematic of a physiological monitor for pulse oximetry is shown in FIGS.[0250]11-13. FIG. 11 depicts a general hardware block diagram of apulse oximeter299. Asensor300 has twolight emitters301 and302 such as LED's. OneLED301 emitting light of red wavelengths and anotherLED302 emitting light of infrared wavelengths are placed adjacent afinger310. A photodetector320, which produces an electrical signal corresponding to the attenuated visible and infrared light energy signals is located opposite the LED's301 and302. The photodetector320 is connected to front end analogsignal conditioning circuitry330.
• The front end analog[0251]signal conditioning circuitry330 has outputs coupled to analog todigital conversion circuit332. The analog todigital conversion circuitry332 has outputs coupled to a digitalsignal processing system334. The digitalsignal processing system334 provides the desired parameters as outputs for adisplay336. Outputs for display are, for example, blood oxygen saturation, heart rate, and a clean plethysmographic waveform.
• The signal processing system also provides an emitter[0252]current control output337 to a digital-to-analog converter circuit338 which provides control information forlight emitter drivers340. Thelight emitter drivers340 couple to thelight emitters301,302. The digitalsignal processing system334 also provides again control output342 for the front end analogsignal conditioning circuitry330.
• FIG. 11[0253]aillustrates a preferred embodiment for the combination of theemitter drivers340 and the digital toanalog conversion circuit338. As depicted in FIG. 11a,the driver comprises first and second input latches321,322, a synchronizinglatch323, avoltage reference324, a digital toanalog conversion circuit325, first andsecond switch banks326,327, first and second voltage tocurrent converters328,329 and theLED emitters301,302 corresponding to theLED emitters301,302 of FIG. 11.
• The preferred driver depicted in FIG. 11[0254]ais advantageous in that the present inventors recognized that much of the noise in theoximeter299 of FIG. 11 is caused by theLED emitters301,302. Therefore, the emitter driver circuit of FIG. 11ais designed to minimize the noise from theemitters301,302. The first and second input latches321,324 are connected directly to the DSP bus. Therefore, these latches significantly minimizes the bandwidth (resulting in noise) present on the DSP bus which passes through to the driver circuitry of FIG. 11a.The output of the first and second input latches only changes when these latched detect their address on the DSP bus. The first input latch receives the setting for the digital toanalog converter circuit325. The second input latch receives switching control data for theswitch banks326,327. The synchronizing latch accepts the synchronizing pulses which maintain synchronization between the activation ofemitters301,302 and the analog todigital conversion circuit332.
• The voltage reference is also chosen as a low noise DC voltage reference for the digital to[0255]analog conversion circuit325. In addition, in the present embodiment, the voltage reference has an lowpass output filter with a very low corner frequency (e.g., 1 Hz in the present embodiment). The digital toanalog converter325 also has a lowpass filter at its output with a very low corner frequency (e.g., 1 Hz). The digital to analog converter provides signals for each of theemitters301,302.
• In the present embodiment, the output of the voltage to[0256]current converters328,329 are switched such that with theemitters301,302 connected in back-to-back configuration, only one emitter is active an any given time. In addition, the voltage to current converter for the inactive emitter is switched off at its input as well, such that it is completely deactivated. This reduces noise from the switching and voltage to current conversion circuitry. In the present embodiment, low noise voltage to current converters are selected (e.g.,Op 27 Op Amps), and the feedback loop is configured to have a low pass filter to reduce noise. In the present embodiment, the low pass filtering function of the voltage tocurrent converter328,329 has a corner frequency of just above 625 Hz, which is the switching speed for the emitters, as further discussed below. Accordingly, the preferred driver circuit of FIG. 11a,minimizes the noise of theemitters301,302.
• In general, the red and infrared[0257]light emitters301,302 each emits energy which is absorbed by thefinger310 and received by the photodetector320. The photodetector320 produces an electrical signal which corresponds to the intensity of the light energy striking the photodetector320. The front end analogsignal conditioning circuitry330 receives the intensity signals and filters and conditions these signals as further described below for further processing. The resultant signals are provided to the analog-to-digital conversion circuitry332 which converts the analog signals to digital signals for further processing by the digitalsignal processing system334. The digitalsignal processing system334 utilizes the two signals in order to provide a what will be called herein a “saturation transform.” It should be understood, that for parameters other than blood saturation monitoring, the saturation transform could be better termed as a concentration transform, in-vivo transform, or the like, depending on the desired parameter. The term saturation transform is used to describe an operation which converts the sample data from time domain to saturation domain values as will be apparent from the discussion below. In the present embodiment, the output of the digitalsignal processing system334 provides clean plethysmographic waveforms of the detected signals and provides values for oxygen saturation and pulse rate to thedisplay336.
• It should be understood that in different embodiments of the present invention, one or more of the outputs may be provided. The digital[0258]signal processing system334 also provides control for driving thelight emitters301,302 with an emitter current control signal on the emittercurrent control output337. This value is a digital value which is converted by the digital-to-analog conversion circuit338 which provides a control signal to the emittercurrent drivers340. The emittercurrent drivers340 provide the appropriate current drive for thered emitter301 and theinfrared emitter302. Further detail of the operation of the physiological monitor for pulse oximetry is explained below. In the present embodiment, the light emitters are driven via the emittercurrent driver340 to provide light transmission with digital modulation at 625 Hz. In the present embodiment, thelight emitters301,302 are driven at a power level which provides an acceptable intensity for detection by the detector and for conditioning by the front end analogsignal conditioning circuitry330. Once this energy level is determined for a given patient by the digitalsignal processing system334, the current level for the red and infrared emitters is maintained constant. It should be understood, however, that the current could be adjusted for changes in the ambient room light and other changes which would effect the voltage input to the front end analogsignal conditioning circuitry330. In the present invention, the red and infrared light emitters are modulated as follows: for one complete 625 Hz red cycle, thered emitter301 is activated for the first quarter cycle, and off for the remaining three-quarters cycle; for one complete 625 Hz infrared cycle, theinfrared light emitter302 is activated for one quarter cycle and is off for the remaining three-quarters cycle. In order to only receive one signal at a time, the emitters are cycled on and off alternatively, in sequence, with each only active for a quarter cycle per 625 Hz cycle and a quarter cycle separating the active times.
• The light signal is attenuated (amplitude modulated) by the pumping of blood through the finger[0259]310 (or other sample medium). The attenuated (amplitude modulated) signal is detected by the photodetector320 at the 625 Hz carrier frequency for the red and infrared light. Because only a single photodetector is used, the photodetector320 receives both the red and infrared signals to form a composite time division signal.
• The composite time division signal is provided to the front analog[0260]signal conditioning circuitry330. Additional detail regarding the front end analogsignal conditioning circuitry330 and the analog todigital converter circuit332 is illustrated in FIG. 12. As depicted in FIG. 12, thefront end circuitry302 has apreamplifier342, a high pass filter344, anamplifier346, aprogrammable gain amplifier348, and alow pass filter350. Thepreamplifier342 is a transimpedance amplifier that converts the composite current signal from the photodetector320 to a corresponding voltage signal, and amplifies the signal. In the present embodiment, the preamplifier has a predetermined gain to boost the signal amplitude for ease of processing. In the present embodiment, the source voltages for thepreamplifier342 are −15 VDC and +15 VDC. As will be understood, the attenuated signal contains a component representing ambient light as well as the component representing the infrared or the red light as the case may be in time. If there is light in the vicinity of thesensor300 other than the red and infrared light, this ambient light is detected by the photodetector320. Accordingly, the gain of the preamplifier is selected in order to prevent the ambient light in the signal from saturating the preamplifier under normal and reasonable operating conditions.
• In the present embodiment, the[0261]preamplifier342 comprises an Analog Devices AD743JR OpAmp. This transimpedance amplifier is particularly advantageous in that it exhibits several desired features for the system described, such as: low equivalent input voltage noise, low equivalent input current noise, low input bias current, high gain bandwidth product, low total harmonic distortion, high common mode rejection, high open loop gain, and a high power supply rejection ratio.
• The output of the[0262]preamplifier342 couples as an input to the high pass filter344. The output of the preamplifier also provides afirst input346 to the analog todigital conversion circuit332. In the present embodiment, the high pass filter is a single-pole filter with a corner frequency of about ½-1 Hz. However, the corner frequency is readily raised to about 90 Hz in one embodiment. As will be understood, the 625 Hz carrier frequency of the red and infrared signals is well above a 90 Hz corner frequency. The high-pass filter344 has an output coupled as an input to anamplifier346. In the present embodiment, theamplifier346 comprises a unity gain amplifier. However, the gain of theamplifier346 is adjustable by the variation of a single resistor. The gain of theamplifier346 would be increased if the gain of thepreamplifier342 is decreased to compensate for the effects of ambient light.
• The output of the[0263]amplifier346 provides an input to aprogrammable gain amplifier348. Theprogrammable gain amplifier348 also accepts a programming input from the digitalsignal processing system334 on a gaincontrol signal line343. The gain of theprogrammable gain amplifier348 is digitally programmable. The gain is adjusted dynamically at initialization or sensor placement for changes in the medium under test from patient to patient. For example, the signal from different fingers differs somewhat. Therefore, a dynamically adjustable amplifier is provided by theprogrammable gain amplifier348 in order to obtain a signal suitable for processing.
• The programmable gain amplifier is also advantageous in an alternative embodiment in which the emitter drive current is held constant. In the present embodiment, the emitter drive current is adjusted for each patient in order to obtain the proper dynamic range at the input of the analog to[0264]digital conversion circuit332. However, changing the emitter drive current can alter the emitter wavelength, which in turn affects the end result in oximetry calculations. Accordingly, it would be advantageous to fix the emitter drive current for all patients. In an alternative embodiment of the present invention, the programmable gain amplifier can be adjusted by the DSP in order to obtain a signal at the input to the analog to digital conversion circuit which is properly within the dynamic range (+3 v to −3 v in the present embodiment) of the analog todigital conversion circuit332. In this manner, the emitter drive current could be fixed for all patients, eliminating the wavelength shift due to emitter current drive changes.
• The output of the[0265]programmable gain amplifier348 couples as an input to a low-pass filter350. Advantageously, thelow pass filter350 is a single-pole filter with a corner frequency of approximately 10 Khz in the present embodiment. This low pass filter provides anti-aliasing in the present embodiment.
• The output of the low-[0266]pass filter350 provides asecond input352 to the analog-to-digital conversion circuit332. FIG. 12 also depicts additional defect of the analog-to-digital conversion circuit. In the present embodiment, the analog-to-digital conversion circuit332 comprises a first analog-to-digital converter354 and a second analog-to-digital converter356. Advantageously, the first analog-to-digital converter354 accepts input from thefirst input346 to the analog-to-digital conversion circuit332, and the second analog todigital converter356 accepts input on thesecond input352 to the analog-to-digital conversion circuitry332.
• In one advantageous embodiment, the first analog-to-[0267]digital converter354 is a diagnostic analog-to-digital converter. The diagnostic task (performed by the digital signal processing system) is to read the output of the detector as amplified by thepreamplifier342 in order to determine if the signal is saturating the input to the high-pass filter344. In the present embodiment, if the input to the high pass filter344 becomes saturated, the front end analogsignal conditioning circuits330 provides a ‘0’ output. Alternatively, the first analog-to-digital converter354 remains unused.
• The second analog-to-[0268]digital converter352 accepts the conditioned composite analog signal from the front endsignal conditioning circuitry330 and converts the signal to digital form. In the present embodiment, the second analog todigital converter356 comprises a single-channel, delta-sigma converter. In the present embodiment, a Crystal Semiconductor CS5317-KS delta-sigma analog to digital converter is used. Such a converter is advantageous in that it is low cost, and exhibits low noise characteristics. More specifically, a delta-sigma converter consists of two major portions, a noise modulator and a decimation filter. The selected converter uses a second order analog delta-sigma modulator to provide noise shaping. Noise shaping refers to changing the noise spectrum from a flat response to a response where noise at the lower frequencies has been reduced by increasing noise at higher frequencies. The decimation filter then cuts out the reshaped, higher frequency noise to provide 16-bit performance at a lower frequency. The present converter samples the data 128 times for every 16 bit data word that it produces. In this manner, the converter provides excellent noise rejection, dynamic range and low harmonic distortion, that help in critical measurement situations like low perfusion and electrocautery.
• In addition, by using a single-channel converter, there is no need to tune two or more channels to each other. The delta-sigma converter is also advantageous in that it exhibits noise shaping, for improved noise control. An exemplary analog to digital converter is a Crystal Semiconductor CS5317. In the present embodiment, the second analog to[0269]digital converter356 samples the signal at a 20 Khz sample rate. The output of the second analog todigital converter356 provides data samples at 20 Khz to the digital signal processing system334 (FIG. 11).
• The digital[0270]signal processing system334 is illustrated in additional detail in FIG. 13. In the present embodiment, the digital signal processing system comprises amicrocontroller360, adigital signal processor362, aprogram memory364, asample buffer366, adata memory368, a read onlymemory370 and communication registers372. In the present embodiment, thedigital signal processor362 is an Analog Devices AD 21020. In the present embodiment, themicrocontroller360 comprises a Motorola 68HC05, with built in program memory. In the present embodiment, thesample buffer366 is a buffer which accepts the 20 Khz sample data from the analog todigital conversion circuit332 for storage in thedata memory368. In the present embodiment, thedata memory368 comprises 32 KWords (words being 40 bits in the present embodiment) of static random access memory.
• The[0271]microcontroller360 is connected to theDSP362 via a conventional JTAG Tap line. Themicrocontroller360 transmits the boot loader for theDSP362 to theprogram memory364 via the Tap line, and then allows theDSP362 to boot from theprogram memory364. The boot loader inprogram memory364 then causes the transfer of the operating instructions for theDSP362 from the read onlymemory370 to theprogram memory364. Advantageously, theprogram memory364 is a very high speed memory for theDSP362.
• The[0272]microcontroller360 provides the emitter current control and gain control signals via the communications register372.
• FIGS.[0273]14-20 depict functional block diagrams of the operations of thepulse oximeter299 carried out by the digitalsignal processing system334. The signal processing functions described below are carried out by theDSP362 in the present embodiment with themicrocontroller360 providing system management. In the present embodiment, the operation is software/firmware controlled. FIG. 14 depicts a generalized functional block diagram for the operations performed on the 20 Khz sample data entering the digitalsignal processing system334. As illustrated in FIG. 14, a demodulation, as represented in ademodulation module400, is first performed. Decimation, as represented in adecimation module402 is then performed on the resulting data. Certain statistics are calculated, as represented in astatistics module404 and a saturation transform is performed, as represented in asaturation transform module406, on the data resulting from the decimation operation. The data subjected to the statistics operations and the data subjected to the saturation transform operations are forwarded to saturation operations, as represented by asaturation calculation module408 and pulse rate operations, as represented in a pulserate calculation module410.
• In general, the demodulation operation separates the red and infrared signals from the composite signal and removes the 625 Hz carrier frequency, leaving raw data points. The raw data points are provided at 625 Hz intervals to the decimation operation which reduces the samples by an order of 10 to samples at 62.5 Hz. The decimation operation also provides some filtering on the samples. The resulting data is subjected to statistics and to the saturation transform operations in order to calculate a saturation value which is very tolerant to motion artifacts and other noise in the signal. The saturation value is ascertained in the[0274]saturation calculation module408, and a pulse rate and a clean plethysmographic waveform is obtained through thepulse rate module410. Additional detail regarding the various operations is provided in connection with FIGS.15-21.
• FIG. 15 illustrates the operation of the[0275]demodulation module400. The modulated signal format is depicted in FIG. 15. One full 625 Hz cycle of the composite signal is depicted in FIG. 15 with the first quarter cycle being the active red light plus ambient light signal, the second quarter cycle being an ambient light signal, the third quarter cycle being the active infrared plus ambient light signal, and the fourth quarter cycle being an ambient light signal. As depicted in FIG. 15, with a 20 KHz sampling frequency, the single full cycle at 625 Hz described above comprises 32 samples of 20 KHz data, eight samples relating to red plus ambient light, eight samples relating to ambient light, eight samples relating to infrared plus ambient light, and finally eight samples related to ambient light.
• Because the[0276]signal processing system334 controls the activation of thelight emitters300,302, the entire system is synchronous. The data is synchronously divided (and thereby demodulated) into four 8-sample packets, with a time division demultiplexing operation as represented in ademultiplexing module421. One eight-sample packet422 represents the red plus ambient light signal; a second eight-sample packet424 represents an ambient light signal; a third eight-sample packet426 represents the attenuated infrared light plus ambient light signal; and a fourth eight-sample packet428 represents the ambient light signal. A select signal synchronously controls the demultiplexing operation so as to divide the time-division multiplexed composite signal at the input of thedemultiplexer421 into its four subparts.
• A sum of the last four samples from each packet is then calculated, as represented in the summing[0277]operations430,432,434,436 of FIG. 15. In the present embodiment, the last four samples are used because a low pass filter in the analog todigital converter356 of the present embodiment has a settling time. Thus, collecting the last four samples from each 8-sample packet allows the previous signal to clear. This summing operation provides an integration operation which enhances noise immunity. The sum of the respective ambient light samples is then subtracted from the sum of the red and infrared samples, as represented in thesubtraction modules438,440. The subtraction operation provides some attenuation of the ambient light signal present in the data. In the present embodiment, it has been found that approximately 20 dB attenuation of the ambient light is provided by the operations of thesubtraction modules438,440. The resultant red and infrared sum values are divided by four, as represented in the divide by fourmodules442,444. Each resultant value provides one sample each of the red and infrared signals at 625 Hz.
• It should be understood that the 625 Hz carrier frequency has been removed by the[0278]demodulation operation400. The 625 Hz sample data at the output of thedemodulation operation400 is sample data without the carrier frequency. In order to satisfy Nyquist sampling requirements, less than 20 Hz is needed (understanding that the human pulse is about 25 to 250 beats per minute, or about 0.4 Hz-4 Hz). Accordingly, the 625 Hz resolution is reduced to 62.5 Hz in the decimation operation.
• FIG. 16 illustrates the operations of the[0279]decimation module402. The red and infrared sample data is provided at 625 Hz to respective red and infrared buffer/filters450,452. In the present embodiment, the red and infrared buffer/filters are 519 samples deep. Advantageously, the buffer filters450,452 function as continuous first-in, first-out buffers. The 519 samples are subjected to low-pass filtering. Preferably, the low-pass filtering has a cutoff frequency of approximately 7.5 Hz with attenuation of approximately −110 dB. The buffer/filters450,452 form a Finite Impulse Response (FIR) filter with coefficients for 519 taps. In order to reduce the sample frequency by ten, the low-pass filter calculation is performed every ten samples, as represented in respective red and infrared decimation by 10modules454,456. In other words, with the transfer of each new ten samples into the buffer/filters450,452, a new low pass filter calculation is performed by multiplying the impulse response (coefficients) by the 519 filter taps. Each filter calculation provides one output sample for respective red andinfrared output buffers458,460. In the present embodiment, the red andinfrared output buffers458,460 are also continuous FIFO buffers that hold 570 samples of data. The 570 samples provide respective infrared and red samples or packets (also denoted “snapshot” herein) of samples. As depicted in FIG. 14, the output buffers provide sample data for thestatistics operation module404,saturation transform module406, and thepulse rate module410.
• FIG. 17 illustrates additional functional operation details of the[0280]statistics module404. In summary, thestatistics module404 provides first order oximetry calculations and RMS signal values for the red and infrared channels. The statistics module also provides a cross-correlation output which indicates a cross-correlation between the red and infrared signals.
• As represented in FIG. 17, the statistics operation accepts two packets of samples (e.g., 570 samples at 62.5 Hz in the present embodiment) representing the attenuated infrared and red signals, with the carrier frequency removed. The respective packets for infrared and red signals are normalized with a log function, as represented in the[0281]Log modules480,482. The normalization is followed by removal of the DC portion of the signals, as represented in theDC Removal modules484,486. In the present embodiment, the DC removal involves ascertaining the DC value of the first one of the samples (or the mean of the first several or the mean of an entire snapshot) from each of the respective red and infrared snapshots, and removing this DC value from all samples in the respective packets.
• Once the DC signal is removed, the signals are subjected to bandpass filtering, as represented in red and infrared[0282]Bandpass Filter modules488,490. In the present embodiment, with 570 samples in each packet, the bandpass filters are configured with 301 taps to provide a FIR filter with a linear phase response and little or no distortion. In the present embodiment, the bandpass filter has a pass band from 34 beats/minute to 250 beats/minute. The 301 taps slide over the 570 samples in order to obtain 270 filtered samples representing the filtered red signal and 270 filtered samples representing the filtered infrared signal. In an ideal case, thebandpass filters488,490 remove the DC in the signal. However, theDC removal operations484,486 assist in DC removal in the present embodiment.
• After filtering, the last 120 samples from each packet (of now 270 samples in the present embodiment) are selected for further processing as represented in[0283]Select Last 120Samples modules492,494. The last 120 samples are selected because, in the present embodiment, the first 150 samples fall within the settling time for theSaturation Transfer module406, which processes the same data packets, as further discussed below.
• Conventional saturation equation calculations are performed on the red and infrared 120-sample packets. In the present embodiment, the conventional saturation calculations are performed in two different ways. For one calculation, the 120-sample packets are processed to obtain their overall RMS value, as represented in the first red and[0284]infrared RMS modules496,498. The resultant RMS values for red and infrared signals provide input values to a first RED_RMS/IR_RMS ratio operation500, which provides the RMS red value to RMS infrared value ratio as an input to asaturation equation module502. As well understood in the art, the ratio of the intensity of red to infrared attenuated light as detected for known red and infrared wavelengths (typically λ_red=650 nm and λ_IR=910 nm) relates to the oxygen saturation of the patient. Accordingly, thesaturation equation module502 represents a conventional look-up table or the like which, for predetermined ratios, provides known saturation values at itsoutput504. The red and infrared RMS values are also provided as outputs of thestatistics operations module404.
• In addition to the[0285]conventional saturation operation502, the 120-sample packets are subjected to a cross-correlation operation as represented in afirst cross-correlation module506. Thefirst cross-correlation module506 determines if good correlation exists between the infrared and red signals. This cross correlation is advantageous for detecting defective or otherwise malfunctioning detectors. The cross correlation is also advantageous in detecting when the signal model (i.e., the model of Equations (1)-(3)) is satisfied. If correlation becomes too low between the two channels, the signal model is not met. In order to determine this, the normalized cross correlation can be computed by thecross-correlation module506 for each snapshot of data. One such correlation function is as follows:$\frac{\sum s_1s_2}{\sqrt{\sum s_1^2s_2^2}}$

  
• If the cross correlation is too low, the[0286]oximeter299 provides a warning (e.g., audible, visual, etc.) to the operator. In the present embodiment, if a selected snapshot yields a normalized correlation of less than 0.75, the snapshot does not qualify. Signals which satisfy the signal model will have a correlation greater than the threshold.
• The red and infrared 120-sample packets are also subjected to a second saturation operation and cross correlation in the same manner as described above, except the 120 samples are divided into 5 equal bins of samples (i.e., 5 bins of 24 samples each). The RMS, ratio, saturation, and cross correlation operations are performed on a bin-by-bin basis. These operations are represented in the Divide Into Five[0287]Equal Bins modules510,512, the second red andinfrared RMS modules514,516, the second RED-RMS/IR-RMS ratio module518, the secondsaturation equation module520 and the secondcross correlation module522 in FIG. 17.
• FIG. 18 illustrates additional detail regarding the[0288]saturation transform module406 depicted in FIG. 14. As illustrated in FIG. 18, thesaturation transform module406 comprises areference processor530, acorrelation canceler531, a masterpower curve module554, and a binpower curve module533. Thesaturation transform module406 can be correlated to FIG. 7awhich has areference processor26 and acorrelation canceler27 and anintegrator29 to provide a power curve for separate signal coefficients as depicted in FIG. 7c.Thesaturation transform module406 obtains a saturation spectrum from the snapshots of data. In other words, thesaturation transform406 provides information of the saturation values present in the snapshots.
• As depicted in FIG. 18, the[0289]reference processor530 for thesaturation transform module406 has asaturation equation module532, areference generator module534, aDC removal module536 and abandpass filter module538. The red and infrared 570-sample packets from the decimation operation are provided to thereference processor530. In addition, a plurality of possible saturation values (the “saturation axis scan”) are provided as input to thesaturation reference processor530. In the present embodiment, 117 saturation values are provided as the saturation axis scan. In a preferred embodiment, the 117 saturation values range uniformly from a blood oxygen saturation of 34.8 to 105.0. Accordingly, in the present embodiment, the 117 saturation values provide an axis scan for thereference processor530 which generates a reference signal for use by thecorrelation canceler531. In other words, the reference processor is provided with each of the saturation values, and a resultant reference signal is generated corresponding to the saturation value. The correlation canceler is formed by ajoint process estimator550 and alow pass filter552 in the present embodiment.
• It should be understood that the scan values could be chosen to provide higher or lower resolution than 117 scan values. The scan values could also be non-uniformly spaced.[0290]
• As illustrated in FIG. 18, the[0291]saturation equation module532 accepts the saturation axis scan values as an input and provides a ratio “r_n” as an output. In comparison to the general discussion of FIG. 7a-7c,this ratio “r_n” corresponds to the plurality of scan value discussed above in general. The saturation equation simply provides a known ratio “r” (red/infrared) corresponding to the saturation value received as an input.
• The ratio “r[0292]_n” is provided as an input to thereference generator534, as are the red and infrared sample packets. Thereference generator534 multiplies either the red or infrared samples by the ratio “r_n” and subtracts the value from the infrared or red samples, respectively. For instance, in the present embodiment, thereference generator534 multiplies the red samples by the ratio “r_n” and subtracts this value from the infrared samples. The resulting values become the output of thereference generator534. This operation is completed for each of the saturation scan values (e.g., 117 possible values in the present embodiment). Accordingly, the resultant data can be described as 117 reference signal vectors of 570 data points each, hereinafter referred to as the reference signal vectors. This data can be stored in an array or the like.
• In other words, assuming that the red and infrared sample packets represent the red S[0293]_red(t) and infrared S_IR(t) measured signals which have primary s(t) and secondary n(t) signal portions, the output of the reference generator becomes the secondary reference signal n′(t), which complies with the signal model defined above, as follows:
• n′(t)=s_ir(t)−r_ns_red(t)
• In the present embodiment, the reference signal vectors and the infrared signal are provided as input to the[0294]DC removal module536 of thereference processor530. TheDC removal module536, like theDC removal modules484,486 in thestatistics module404, ascertains the DC value of the first of the samples for the respective inputs (or mean of the first several or all samples in a packet) and subtracts the respective DC baseline from the sample values. The resulting sample values are subjected to abandpass filter538.
• The[0295]bandpass filter538 of thereference processor530 performs the same type of filtering as thebandpass filters488,490 of thestatistics module404. Accordingly, each set of 570 samples subjected to bandpass filtering results in 270 remaining samples. The resulting data at afirst output542 of thebandpass filter538 is one vector of 270 samples (representing the filtered infrared signal in the present embodiment). The resulting data at asecond output540 of thebandpass filter538, therefore, is 117 reference signal vectors of 270 data points each, corresponding to each of the saturation axis scan values provided to thesaturation reference processor530.
• It should be understood that the red and infrared sample packets may be switched in their use in the[0296]reference processor530. In addition, it should be understood that theDC removal module536 and thebandpass filter module538 can be executed prior to input of the data to thereference processor530 because the calculations performed in the reference processor are linear. This results in a significant processing economy.
• The outputs of the[0297]reference processor530 provide first and second inputs to ajoint process estimator550 of the type described above with reference to FIG. 8. The first input to thejoint process estimator550 is the 270-sample packet representing the infrared signal in the present embodiment. This signal contains primary and secondary signal portions. The second input to the joint process estimator is the 117 reference signal vectors of 270 samples each.
• The joint process estimator also receives a[0298]lambda input543, aminimum error input544 and a number ofcells configuration input545. These parameters are well understood in the art. The lambda parameter is often called the “forgetting parameter” for a joint process estimator. Thelambda input543 provides control for the rate of cancellation for the joint process estimator. In the present embodiment, lambda is set to a low value such as 0.8. Because statistics of the signal are non-stationary, a low value improves tracking. Theminimum error input544 provides an initialization parameter (conventionally known as the “initialization value”) for thejoint process estimator550. In the present embodiment, the minimum error value is 10⁻⁶. This initialization parameter prevents the joint process estimator500 from dividing by zero upon initial calculations. The number of cells input545 to thejoint process estimator550 configures the number of cells for the joint process estimator. In the present embodiment, the number of cells for thesaturation transform operation406 is six. As well understood in the art, for each sine wave, the joint process estimator requires two cells. If there are two sine waves in the 35-250 beats/minute range, six cells allows for the two heart beat sine waves and one noise sine wave.
• The[0299]joint process estimator550 subjects the first input vector on thefirst input542 to a correlation cancellation based upon each of the plurality of reference signal vectors provided in thesecond input540 to the correlation canceler531 (all 117 reference vectors in sequence in the present embodiment). The correlation cancellation results in a single output vector for each of the 117 reference vectors. Each output vector represents the information that the first input vector and the corresponding reference signal vector do not have in common. The resulting output vectors are provided as an output to the joint process estimator, and subjected to the lowpass filter module552. In the present embodiment, thelow pass filter552 comprises a FIR filter with 25 taps and with a corner frequency of 10 Hz with the sampling frequency of 62.5 Hz (i.e., at the decimation frequency).
• The[0300]joint process estimator550 of the present embodiment has a settling time of 150 data points. Therefore, the last 120 data points from each 270 point output vector are used for further processing. In the present embodiment, the output vectors are further processed together as a whole, and are divided into a plurality of bins of equal number of data points. As depicted in FIG. 18, the output vectors are provided to a masterpower curve module554 and to a Divide into fiveEqual Bins module556. The Divide into FiveEqual Bins module556 divides each of the output vectors into five bins of equal number of data points (e.g., with 120 data points per vector, each bin has 24 data points). Each bin is then provided to the Bin Power Curvesmodule558.
• The Master[0301]Power Curve module554 performs a saturation transform as follows: for each output vector, the sum of the squares of the data points is ascertained. This provides a sum of squares value corresponding to each output vector (each output vector corresponding to one of the saturation scan values). These values provide the basis for a master power curve555, as further represented in FIG. 22. The horizontal axis of the power curve represents the saturation axis scan values and the vertical axis represents the sum of squares value (or output energy) for each output vector. In other words, as depicted in FIG. 22, each of the sum of squares could be plotted with the magnitude of the sum of squares value plotted on the vertical “output” axis at the point on the horizontal axis of the corresponding saturation scan value which generated that output vector. This results in amaster power curve558, an example of which is depicted in FIG. 22. This provides a saturation transform in which the spectral content of the attenuated energy is examined by looking at every possible saturation value and examining the output value for the assumed saturation value. As will be understood, where the first and second inputs to thecorrelation canceler531 are mostly correlated, the sum of squares for the corresponding output vector of thecorrelation canceler531 will be very low. Conversely, where the correlation between the first and second inputs to thecorrelation canceler531 are not significantly correlated, the sum of squares of the output vector will be high. Accordingly, where the spectral content of the reference signal and the first input to the correlation canceler are made up mostly of physiological (e.g., movement of venous blood due to respiration) and non-physiological (e.g., motion induced) noise, the output energy will be low. Where the spectral content of the reference signal and the first input to the correlation canceler are not correlated, the output energy will be much higher.
• A corresponding transform is completed by the Bin Power Curves[0302]module558, except a saturation transform power curve is generated for each bin. The resulting power curves are provided as the outputs of thesaturation transform module406.
• In general, in accordance with the signal model of the present invention, there will be two peaks in the power curves, as depicted in FIG. 22. One peak corresponds to the arterial oxygen saturation of the blood, and one peak corresponds to the venous oxygen concentration of the blood. With reference to the signal model of the present invention, the peak corresponding to the highest saturation value (not necessarily the peak with the greatest magnitude) corresponds to the proportionality coefficient r[0303]_a. In other words, the proportionality coefficient r_acorresponds to the red/infrared ratio which will be measured for the arterial saturation. Similarly, peak that corresponds to the lowest saturation value (not necessarily the peak with the lowest magnitude) will generally correspond to the venous oxygen saturation, which corresponds to the proportionality coefficient r_vin the signal model of the present invention. Therefore, the proportionality coefficient r_vwill be a red/infrared ratio corresponding to the venous oxygen saturation.
• In order to obtain arterial oxygen saturation, the peak in the power curves corresponding to the highest saturation value could be selected. However, to improve confidence in the value, further processing is completed. FIG. 19 illustrates the operation of the[0304]saturation calculation module408 based upon the output of thesaturation transform module406 and the output of thestatistics module404. As depicted in FIG. 19, the bin power curves and the bin statistics are provided to thesaturation calculation module408. In the present embodiment, the master power curves are not provided to thesaturation module408 but can be displayed for a visual check on system operation. The bin statistics contain the red and infrared RMS values, the seed saturation value, and a value representing the cross-correlation between the red and infrared signals from thestatistics module404.
• The[0305]saturation calculation module408 first determines a plurality of bin attributes as represented by the Compute Bin Attributesmodule560. The Compute Bin Attributesmodule560 collects a data bin from the information from the bin power curves and the information from the bin statistics. In the present embodiment, this operation involves placing the saturation value of the peak from each power curve corresponding to the highest saturation value in the data bin. In the present embodiment, the selection of the highest peak is performed by first computing the first derivative of the power curve in question by convolving the power curve with a smoothing differentiator filter function. In the present embodiment, the smoothing differentiator filter function (using a FIR filter) has the following coefficients:
• 0.014964670230367[0306]
• 0.098294046682706[0307]
• 0.204468276324813[0308]
• 2.717182664241813[0309]
• 5.704485606695227[0310]
• 0.000000000000000[0311]
• −5.704482606695227[0312]
• −2.717182664241813[0313]
• −0.204468276324813[0314]
• −0.098294046682706[0315]
• −0.014964670230367[0316]
• This filter performs the differentiation and smoothing. Next, each point in the original power curve in question is evaluated and determined to be a possible peak if the following conditions are met: (1) the point is at least 2% of the maximum value in the power curve; (2) the value of the first derivative changes from greater than zero to less than or equal to zero. For each point that is found to be a possible peak, the neighboring points are examined and the largest of the three points is considered to be the true peak.[0317]
• The peak width for these selected peaks is also calculated. The peak width of a power curve in question is computed by summing all the points in the power curve and subtracting the product of the minimum value in the power curve and the number of points in the power curve. In the present embodiment, the peak width calculation is applied to each of the bin power curves. The maximum value is selected as the peak width.[0318]
• In addition, the infrared RMS value from the entire snapshot, the red RMS value, the seed saturation value for each bin, and the cross correlation between the red and infrared signals from the[0319]statistics module404 are also placed in the data bin. The attributes are then used to determine whether the data bin consists of acceptable data, as represented in a BinQualifying Logic module562.
• If the correlation between the red and infrared signals is too low, the bin is discarded. If the saturation value of the selected peak for a given bin is lower than the seed saturation for the same bin, the peak is replaced with the seed saturation value. If either red or infrared RMS value is below a very small threshold, the bins are all discarded, and no saturation value is provided, because the measured signals are considered to be too small to obtain meaningful data. If no bins contain acceptable data, the[0320]exception handling module563 provides a message to thedisplay336 that the data is erroneous.
• If some bins qualify, those bins that qualify as having acceptable data are selected, and those that do not qualify are replaced with the average of the bins that are accepted. Each bin is given a time stamp in order to maintain the time sequence. A[0321]voter operation565 examines each of the bins and selects the three highest saturation values. These values are forwarded to a clip andsmooth operation566.
• The clip and[0322]smooth operation566 basically performs averaging with a low pass filter. The low pass filter provides adjustable smoothing as selected by a SelectSmoothing Filter module568. The SelectSmoothing Filter module568 performs its operation based upon a confidence determination performed by a HighConfidence Test module570. The high confidence test is an examination of the peak width for the bin power curves. The width of the peaks provides some indication of motion by the patient—wider peaks indicating motion. Therefore, if the peaks are wide, the smoothing filter is slowed down. If peaks are narrow, the smoothing filter speed is increased. Accordingly, the smoothingfilter566 is adjusted based on the confidence level. The output of the clip andsmooth module566 provides the oxygen saturation values in accordance with the present invention.
• In the presently preferred embodiment, the clip and[0323]smooth filter566 takes each new saturation value and compares it to the current saturation value. If the magnitude of the difference is less than 16 (percent oxygen saturation) then the value is pass. Otherwise, if the new saturation value is less than the filtered saturation value, the new saturation value is changed to 16 less than the filtered saturation value. If the new saturation value is greater than the filtered saturation value, then the new saturation value is changed to 16 more than the filtered saturation value.
• During high confidence (no motion), the smoothing filter is a simple one-pole or exponential smoothing filter which is computed as follows:[0324]
• y(n)=0.6*x(n)+0.4*y(n−1)
• where x(n) is the clipped new saturation value, and y(n) is the filtered saturation value.[0325]
• During motion condition, a three-pole IIR (infinite impulse response) filter is used. Its characteristics are controlled by three time constants t[0326]_a, t_b, and t_cwith values of 0.985, 0.900, and 0.94 respectively. The coefficients for a direct form I, IIR filter are computed from these time constants using the following relationships:
• a₀=0
• a₁=t_b+(t_c)(t_a+t_b)
• a₂=(−t_b)(t_c)(t_a+t_b+(t_c)(_a))
• a₃=(t_b)²(t_c)²(t_a)
• b₀=1−t_b−(t_c)(t_a+(t_c)(t_b))
• b₁=2(t_b)(t_c)(t_a−1)
• b₂=(t_b)(t_c)(t_b+(t_c)(t_a)−(t_b)(t_c)(t_a)−t_a)
• FIGS. 20 and 21 illustrate the pulse rate module[0327]410 (FIG. 14) in greater detail. As illustrated in FIG. 20, theheart rate module410 has a transient removal andbandpass filter module578, a motionartifact suppression module580, asaturation equation module582, amotion status module584, first and secondspectral estimation modules586,588, aspectrum analysis module590, a slewrate limiting module592, anoutput filter594, and an outputfilter coefficient module596.
• As further depicted in FIG. 20, the[0328]heart rate module410 accepts the infrared and red 570-sample snapshots from the output of thedecimation module402. Theheart rate module410 further accepts the saturation value which is output from thesaturation calculation module408. In addition, the maximum peak width as calculated by the confidence test module570 (same as peak width calculation described above) is also provided as an input to theheart rate module410. The infrared and red sample packets, the saturation value and the output of themotion status module584 are provided to the motionartifact suppression module580.
• The average peak width value provides an input to a[0329]motion status module584. In the present embodiment, if the peaks are wide, this is taken as an indication of motion. If motion is not detected, spectral estimation on the signals is carried out directly without motion artifact suppression.
• In the case of motion, motion artifacts are suppressed using the motion[0330]artifact suppression module580. The motionartifact suppression module580 is nearly identical to thesaturation transform module406. The motionartifact suppression module580 provides an output which connects as an input to the secondspectral estimation module588. The first and secondspectral estimation modules586,588 have outputs which provide inputs to thespectrum analysis module590. Thespectrum analysis module590 also receives an input which is the output of themotion status module584. The output of thespectrum analysis module590 is the initial heart rate determination of theheart rate module410 and is provided as input to the slewrate limiting module592. The slewrate limiting module592 connects to theoutput filter594. Theoutput filter594 also receives an input from the outputfilter coefficient module596. Theoutput filter594 provides the filtered heart rate for the display336 (FIG. 11).
• In the case of no motion, one of the signals (the infrared signal in the present embodiment) is subjected to DC removal and bandpass filtering as represented in the DC removal and[0331]bandpass filter module578. The DC removal andbandpass filter module578 provide the same filtering as the DC removal andbandpass filter modules536,538. During no motion conditions, the filtered infrared signal is provided to the firstspectral estimation module586.
• In the present embodiment, the spectral estimation comprises a Chirp Z transform that provides a frequency spectrum of heart rate information. The Chirp Z transform is used rather than a conventional Fourier Transform because a frequency range for the desired output can be designated in a Chirp Z transform. Accordingly, in the present embodiment, a frequency spectrum of the heart rate is provided between 30 and 250 beats/minute. In the present embodiment, the frequency spectrum is provided to a[0332]spectrum analysis module590 which selects the first harmonic from the spectrum as the pulse rate. Usually, the first harmonic is the peak in the frequency spectrum that has the greatest magnitude and represents the pulse rate. However, in certain conditions, the second or third harmonic can exhibit the greater magnitude. With this understanding, in order to select the first harmonic, the first peak that has an amplitude of at least {fraction (1/20)}th of the largest peak in the spectrum is selected). This minimizes the possibility of selecting as the heart rate a peak in the Chirp Z transform caused by noise.
• In the case of motion, a motion artifact suppression is completed on the snapshot with the motion[0333]artifact suppression module580. The motionartifact suppression module580 is depicted in greater detail in FIG. 21. As can be seen in FIG. 21, the motionartifact suppression module580 is nearly identical to the saturation transform module406 (FIG. 18). Accordingly, the motion artifact suppression module has a motionartifact reference processor570 and a motionartifact correlation canceler571.
• The motion[0334]artifact reference processor570 is the same as thereference processor530 of thesaturation transform module406. However, thereference processor570 utilizes the saturation value from thesaturation module408, rather than completing an entire saturation transform with the 117 saturation scan values. Thereference processor570, therefore, has asaturation equation module581, areference generator582, aDC removal module583, and abandpass filter module585. These modules are the same as corresponding modules in the saturationtransform reference processor530. In the present embodiment, thesaturation equation module581 receives the arterial saturation value from thesaturation calculation module408 rather than doing a saturation axis scan as in thesaturation transform module406. This is because the arterial saturation has been selected, and there is no need to perform an axis scan. Accordingly, the output of thesaturation equation module581 corresponds to the proportionality constant r_a(i.e., the expected red to infrared ratio for the arterial saturation value). Otherwise, thereference processor570 performs the same function as thereference processor530 of thesaturation transform module406.
• The motion[0335]artifact correlation canceler571 is also similar to the saturation transform correlation canceler531 (FIG. 18). However, the motion artifactsuppression correlation canceler571 uses a slightly different motion artifactjoint process estimator572. Accordingly, the motion artifactsuppression correlation canceler571 has ajoint process estimator572 and a low-pass filter573. The motion artifactjoint process estimator572 differs from the saturation transformjoint process estimator550 in that there are a different number of cells (between 6 and 10 in the present embodiment), as selected by the Number ofCells input574, in that the forgetting parameter differs (0.98 in the present embodiment), and in that the time delay due to adaptation differs. The low-pass filter573 is the same as thelow pass filter552 of the saturationtransform correlation canceler531.
• Because only one saturation value is provided to the reference processor, only one output vector of 270 samples results at the output of the motion artifact[0336]suppression correlation canceler571 for each input packet of 570 samples. In the present embodiment, where the infrared wavelength is provided as a first input to the correlation canceler, the output of thecorrelation canceler571 provides a clean infrared waveform. It should be understood that, as described above, the infrared and red wavelength signals could be switched such that a clean red waveform is provided at the output of the motion artifactsuppression correlation canceler571. The output of thecorrelation canceler571 is a clean waveform because the actual saturation value of the patient is known which allows thereference processor570 to generate a noise reference for inputting to thecorrelation canceler571 as the reference signal. The clean waveform at the output of the motionartifact suppression module580 is a clean plethysmograph waveform which can be forwarded to thedisplay336.
• As described above, an alternative joint process estimator uses the QRD least squares lattice approach (FIGS. 8[0337]a,9aand10a). Accordingly, the joint process estimator573 (as well as the joint process estimator550) could be replaced with a joint process estimator executing the QRD least squares lattice operation.
• FIG. 21[0338]adepicts an alternative embodiment of the motion artifact suppression module with a joint process estimator572areplacing thejoint process estimator572. The joint process estimator572acomprises a QRD least squares lattice system as in FIG. 10a.In accordance with this embodiment, different initialization parameters are used as necessary for the QRD algorithm.
• The initialization parameters are referenced in FIG. 21[0339]aas “Number of Cells,” “Lambda,” “MinSumErr,” “GamsInit,” and “SumErrInit.” Number of Cells and Lambda correspond to like parameters in thejoint process estimator572. GamsInit corresponds to the γ initialization variable for all stages except the zero order stage, which as set forth in the QRD equations above is initialized to ‘1’. SumErrInit provides the δ initialization parameter referenced above in the QRD equations. In order to avoid overflow, the larger of the actual calculated denominator in each division in the QRD equations and MinSumErr is used. In the present embodiment, the preferred initialization parameters are as follows:
• Number of Cells=6[0340]
• Lambda=0.8[0341]
• MinSumErr=10[0342]⁻²⁰
• GamsInit=10[0343]⁻²
• SumErrInit=10[0344]⁻⁶.
• The clean waveform output from the motion[0345]artifact suppression module580 also provides an input to the secondspectral estimation module588. The secondspectral estimation module588 performs the same Chirp Z transform as the firstspectral estimation module586. In the case of no motion, the output from the firstspectral estimation module586 is provided to thespectrum analysis module586; in the case of motion, the output from the secondspectral estimation module588 is provided to aspectrum analysis module590. Thespectrum analysis module590 examines the frequency spectrum from the appropriate spectral estimation module to determine the pulse rate. In the case of motion, thespectrum analysis module590 selects the peak in the spectrum with the highest amplitude, because the motionartifact suppression module580 attenuates all other frequencies to a value below the actual heart rate peak. In the case of no motion, the spectrum analysis module selects the first harmonic in the spectrum as the heart rate as described above.
• The output of the[0346]spectrum analysis module590 provides the raw heart rate as an input to the slewrate limiting module592, which provides an input to anoutput filter594. In the present embodiment, the slewrate limiting module592 prevents changes greater that 20 beats/minute per 2 second interval.
• The[0347]output filter594 comprises an exponential smoothing filter similar to the exponential smoothing filter described above with respect to the clip andsmooth filter566. The output filter is controlled via an outputfilter coefficient module596. If motion is large, this filter is slowed down, if there is little or no motion, this filter can sample much faster and still maintain a clean value. The output from theoutput filter594 is the pulse of the patient, which is advantageously provided to thedisplay336.
• Alternative to Saturation Transform Module—Bank of Filters[0348]
• An alternative to the saturation transform of the[0349]saturation transform module406 can be implemented with a bank of filters as depicted in FIG. 23. As seen in FIG. 23, two banks of filters, afirst filter bank600 and asecond filter bank602 are provided. Thefirst filter bank600 receives a first measured signal S_λb(t) (the infrared signal samples in the present embodiment) on a corresponding first filter bank input604, and thesecond filter bank602 receives a second measured signal S_λa(t) (the red samples in the present embodiment) on a corresponding secondfilter bank input606. In a preferred embodiment, the first and second filter banks utilize static recursive polyphase bandpass filters with fixed center frequencies and corner frequencies. Recursive polyphase filters are described in an article Harris, et. al. “Digital Signal Processing With Efficient Polyphase Recursive All-Pass filters” attached hereto as Appendix A. However, adaptive implementations are also possible. In the present implementation, the recursive polyphase bandpass filter elements are each designed to include a specific center frequency and bandwidth.
• There are N filter elements in each filter bank. Each of the filter elements in the[0350]first filter bank600 have a matching (i.e., same center frequency and bandwidth) filter element in thesecond filter bank602. The center frequencies and the corner frequencies of N elements are each designed to occupy N frequency ranges, 0 to F₁, F₁-F₂, F₂-F₃, F₃-F₄. . . F_N−1-F_Nas shown in FIG. 23.
• It should be understood that the number of filter elements can range from 1 to infinity. However, in the present embodiment, there are approximately 120 separate filter elements with center frequencies spread evenly across a frequency range of 25 beats/minute-250 beats/minute.[0351]
• The outputs of the filters contain information about the primary and secondary signals for the first and second measured signals (red and infrared in the present example) at the specified frequencies. The outputs for each pair of matching filters (one in the[0352]first filter bank600 and one in the second filter bank602) are provided tosaturation determination modules610. FIG. 23 depicts only onesaturation determination module610 for ease of illustration. However, a saturation determination module can be provided for each matched pair of filter elements for parallel processing. Each saturation determination module has aratio module616 and asaturation equation module618.
• The[0353]ratio module616 forms a ratio of the second output to the first output. For instance, in the present example, a ratio of each red RMS value to each corresponding infrared RMS value (Red/IR) is completed in theratio module616. The output of theratio module616 provides an input to thesaturation equation module618 which references a corresponding saturation value for the input ratio.
• The output of the[0354]saturation equation modules618 are collected (as represented in the histogram module620) for each of the matched filter pairs. However, the data collected is initially a function of frequency and saturation. In order to form a saturation transform curve similar to the curve depicted in FIG. 22, a histogram or the like is generated as in FIG. 24. The horizontal axis represents the saturation value, and the vertical axis represents a summation of the number of points (outputs from the saturation equation modules618) collected at each saturation value. In other words, if the output of thesaturation equation module618 for ten different matched filter pairs indicates a saturation value of 98%, then a point in the histogram of FIG. 24 would reflect a value of 10 at 98% saturation. This results in a curve similar to the saturation transform curve of FIG. 22. This operation is completed in thehistogram module620.
• The results of the histogram provide a power curve similar to the power curve of FIG. 22. Accordingly, the arterial saturation can be calculated from the histogram by selecting the peak (greatest number of occurrences in the area of interest) corresponding to the highest saturation value (e.g., the peak ‘c’ in Figure peaks corresponding to the highest saturation value peak. Similarly, the venous or background saturation can be determined from the histogram by selecting the peak corresponding to the lowest saturation value (e.g., the peak ‘d’ in FIG. 24), in a manner similar to the processing in the[0355]saturation calculation module408.
• It should be understood that as an alternative to the histogram, the output saturation (not necessarily a peak in the histogram) corresponding to the highest saturation value could be selected as the arterial saturation with the corresponding ratio representing r[0356]_a. Similarly, the output saturation corresponding to the lowest saturation value could be selected as the venous or background saturation with the corresponding ratio representing r_v. For example, in this embodiment, the entry ‘a’ in the histogram of FIG. 24 would be chosen as the arterial saturation and the entry in the histogram ‘b’ with the lowest saturation value would be chosen as the venous or background saturation.
• Alternative Determination of Coefficients r[0357]_aand r_v
• As explained above, in accordance with the present invention, primary and secondary signal portions, particularly for pulse oximetry, can be modeled as follows:[0358]
• S_red=s₁+n₁(red)  (89)
• S_IR=s₂+n₂(infrared)  (90)
• s₁=r_as₂andn₁=r_vn₂  (91)
• Substituting Equation (91) into Equation (89) provides the following:[0359]
• S_red=r_as₂+r_vn_{2 (red)}  (92)
• Note that S[0360]_redand S_IRare used in the model of equations (89)-(92). This is because the discussion below is particularly directed to blood oximetry. S_redand S_IRcorrespond to S₁and S₂in the preceding text, and the discussion that follows could be generalized for any measure signal S₁and S₂.
• As explained above, determining r[0361]_aand r_v(which correspond to arterial and venous blood oxygen saturation via a saturation equation) can be accomplished using the saturation transform described above doing a scan of many possible coefficients. Another method to obtain r_aand r_vbased on red and infrared data is to look for r_aand r_vwhich minimize the correlation between s_kand n_k, assuming s_kis at least somewhat (and preferably substantially) uncorrelated with n_k(where k=1 or 2). These values can be found by minimizing the following statistical calculation function for k=2:$\begin{array}{cc}Correlation\left({\mathrm{<figure-callout\; label="s"\; filenames="US20020128544A1-20020912-D00011.png,US20020128544A1-20020912-D00015.png"\; state="\{\{state\}\}">s</figure-callout>}}_2,n_2\right)=\left|\sum _is_2\left(S_{red_i},S_{IR_i},r_a,r_v\right){\mathrm{<figure-callout\; label="n"\; filenames="US20020128544A1-20020912-D00011.png,US20020128544A1-20020912-D00015.png"\; state="\{\{state\}\}">n</figure-callout>}}_2\left(S_{red_i},S_{IR_i},r_a,r_v\right)\right|& \left(93\right)\end{array}$

  
• where i represents time.[0362]
• It should be understood that other correlation functions such as a normalized correlation could also be used.[0363]
• Minimizing this quantity often provides a unique pair of r[0364]_aand r_vif the noise component is uncorrelated to the desired signal component. Minimizing this quantity can be accomplished by solving Equations (90) and (92) for s₂and n₂, and finding the minimum of the correlation for possible values of r_aand r_v. Solving for s2 and n₂provides the following:$\left(\begin{array}{c}{S}_{\mathrm{red}}\\ S_{\mathrm{IR}}\end{array}\right)=\left(\begin{array}{cc}{r}_a& r_{\mathrm{<figure-callout\; label="v"\; filenames="US20020128544A1-20020912-D00009.png,US20020128544A1-20020912-D00010.png"\; state="\{\{state\}\}">v</figure-callout>}}\\ 1& 1\end{array}\right)\left(\begin{array}{c}{s}_2\\ n_2\end{array}\right)$

  
• inverting the two-by-two matrix provides:[0365]
• Thus,[0366]${\left(\begin{array}{cc}{r}_a& {\mathrm{<figure-callout\; label="r\; v"\; filenames="US20020128544A1-20020912-D00009.png,US20020128544A1-20020912-D00010.png"\; state="\{\{state\}\}">r</figure-callout>}}_v\\ 1& 1\end{array}\right)}^{-1}=\frac{1}{r_a-r_v}\left(\begin{array}{cc}1& -r_v\\ -1& r_a\end{array}\right)$$\left(\begin{array}{c}{s}_2\\ n_2\end{array}\right)=\frac{1}{r_a-r_v}\left(\begin{array}{cc}1& -r_v\\ -1& r_a\end{array}\right)\left(\begin{array}{c}{s}_{\mathrm{red}}\\ s_{\mathrm{IR}}\end{array}\right)$$\mathrm{or}:s_2=\frac{1}{r_a-r_v}\left(s_{\mathrm{red}}-r_vs_{\mathrm{IR}}\right)$${\mathrm{<figure-callout\; label="n"\; filenames="US20020128544A1-20020912-D00011.png,US20020128544A1-20020912-D00015.png"\; state="\{\{state\}\}">n</figure-callout>}}_2=\frac{1}{r_a-r_v}\left(-s_{\mathrm{red}}+r_as_{\mathrm{IR}}\right)$

  
• Preferably, the correlation of equation (93) is enhanced with a user specified window function as follows:[0367]$\begin{array}{cc}Correlation\left({\mathrm{<figure-callout\; label="s"\; filenames="US20020128544A1-20020912-D00011.png,US20020128544A1-20020912-D00015.png"\; state="\{\{state\}\}">s</figure-callout>}}_2,n_2\right)=\left|\stackrel{N}{\sum _{i=1}}w_is_2\left(s_{red_i},s_{IR_i},r_a,r_v\right){\mathrm{<figure-callout\; label="n"\; filenames="US20020128544A1-20020912-D00011.png,US20020128544A1-20020912-D00015.png"\; state="\{\{state\}\}">n</figure-callout>}}_2\left(s_{red_i},s_{IR_i},r_a,r_v\right)\right|& \text{(93a)}\end{array}$

  
• The Blackman Window is the presently preferred embodiment. It should be understood that there are many additional functions which minimize the correlation between signal and noise. The function above is simply one. Thus,[0368]$\begin{array}{cc}\begin{array}{c}\mathrm{Correlation}\left({\mathrm{<figure-callout\; label="s"\; filenames="US20020128544A1-20020912-D00011.png,US20020128544A1-20020912-D00015.png"\; state="\{\{state\}\}">s</figure-callout>}}_2,n_2\right)=\sum _{i=1}^N\left[\frac{w_i}{{\left(r_a-r_v\right)}^2}\left(s_{{\mathrm{red}}_i}-r_vs_{{\mathrm{IR}}_i}\right)\left(-s_{{\mathrm{red}}_i}-r_as_{{\mathrm{IR}}_i}\right)\right]\\ =\frac{1}{{\left(r_a-r_v\right)}^2}-\sum _{i=1}^N{\left(s_{{\mathrm{red}}_i}\right)}^2w_i+\left(r_a+r_v\right)\sum _{i=1}^Ns_{{\mathrm{IR}}_i}s_{{\mathrm{red}}_i}w_i+\sum _{i=1}^N{\left(s_{{\mathrm{IR}}_i}\right)}^2w_i\end{array}& 93\left(b\right)\end{array}$

  
• In order to implement the minimization on a plurality of discrete data points, the sum of the squares of the red sample points, the sum of the squares of the infrared sample points, and the sum of the product of the red times the infrared sample points are first calculated (including the window function, w[0369]_i):$\begin{array}{c}\mathrm{RR}=\sum _{I=1}^n{\left(S_{{\mathrm{red}}_i}\right)}^2w_i\\ \mathrm{II}=\sum _{i=1}^N{\left(S_{{\mathrm{IR}}_i}\right)}^2w_i\\ \mathrm{IRR}=\sum _{i=1}^N\left(S_{\mathrm{IR}}\right)\left(S_{{\mathrm{red}}_i}\right)w_i\end{array}$

  
• These values are used in the correlation equation (93b). Thus, the correlation equation becomes an equation in terms of two variables, r[0370]_aand r_v. To obtain r_aand r_v, an exhaustive scan is executed for a good cross-section of possible values for r_aand r_v(e.g., 20-50 values each corresponding to saturation values ranging from 30-105). The minimum of the correlation function is then selected and the values of r_aand r_vwhich resulted in the minimum are chosen as r_aand r_v.
• Once r[0371]_aand r_vhave been obtained, arterial oxygen saturation and venous oxygen saturation can be determined by provided r_aand r_vto a saturation equation, such as thesaturation equation502 of thestatistics module404 which provides an oxygen saturation value corresponding to the ratios r_aand r_v.
• In a further implementation to obtain r[0372]_aand r_v, the same signal model set forth above is again used. In order to determine r_aand r_vin accordance with this implementation, the energy in the signal s₂is maximized under the constraint that s₂is uncorrelated with n₂. Again, this implementation is based upon minimizing the correlation between s and n and on the signal model of the present invention where the signal s relates to the arterial pulse and the signal n is the noise (containing information on the venous blood, as well as motion artifacts and other noise); r_ais the ratio (RED/IR) related to arterial saturation and r_vis the ratio (RED/IR) related to venous saturation. Accordingly, in this implementation of the present invention, r_aand r_vare determined such that the energy of the signal s₂is maximized where s₂and n₂are uncorrelated. The energy of the signal s₂is given by the following equation:$\begin{array}{cc}\mathrm{ENERGY}\left(s_2\right)=\frac{1}{{\left(r_a-r_v\right)}^2}\sum _{i=1}^N{\left(s_{\mathrm{red}}-r_vs_{\mathrm{IR}}\right)}^2& \left(94\right)\\ =\frac{1}{{\left(r_a-r_v\right)}^2}\sum _{i=1}^N\left(s_{{\mathrm{red}}_i}^2\right)-2r_v\sum _{i=1}^N\left(s_{{\mathrm{red}}_i}s_{{\mathrm{IR}}_i}\right)+{\mathrm{<figure-callout\; label="r\; v"\; filenames="US20020128544A1-20020912-D00011.png,US20020128544A1-20020912-D00015.png"\; state="\{\{state\}\}">r</figure-callout>}}_v^{}\sum _{i=1}^N\left(s_{{\mathrm{IR}}_i}^2\right)& \left(95\right)\\ =\frac{1}{{\left(r_a-r_v\right)}^2}\left[R_1-2r_v{\mathrm{<figure-callout\; label="R"\; filenames="US20020128544A1-20020912-D00009.png,US20020128544A1-20020912-D00010.png"\; state="\{\{state\}\}"><figure-callout\; label="R"\; filenames="US20020128544A1-20020912-D00011.png,US20020128544A1-20020912-D00015.png"\; state="\{\{state\}\}">R</figure-callout></figure-callout>}}_{1,2}+{\mathrm{<figure-callout\; label="r\; v"\; filenames="US20020128544A1-20020912-D00011.png,US20020128544A1-20020912-D00015.png"\; state="\{\{state\}\}">r</figure-callout>}}_v^{}R_2\right]& \left(96\right)\end{array}$

  
• where R[0373]₁is the energy of the red signal, R₂is the energy of the infrared signal and R_1,2is the correlation between the red and infrared signals.
• The correlation between s[0374]₂and n₂is given by$\begin{array}{cc}\begin{array}{c}\mathrm{Correlation}\left({\mathrm{<figure-callout\; label="s"\; filenames="US20020128544A1-20020912-D00011.png,US20020128544A1-20020912-D00015.png"\; state="\{\{state\}\}">s</figure-callout>}}_2,n_2\right)=\frac{1}{{\left(r_a-r_v\right)}^2}\sum _{i=1}^N\left(S_{{\mathrm{red}}_i}-r_vS_{{\mathrm{ir}}_i}\right)\left(-S_{{\mathrm{red}}_i}+r_aS_{{\mathrm{IR}}_i}\right)\\ =\frac{1}{{\left(r_a-r_v\right)}^2}\left[-{\mathrm{<figure-callout\; label="R"\; filenames="US20020128544A1-20020912-D00009.png,US20020128544A1-20020912-D00010.png"\; state="\{\{state\}\}">R</figure-callout>}}_1+\left(r_a+r_v\right){\mathrm{<figure-callout\; label="R"\; filenames="US20020128544A1-20020912-D00009.png,US20020128544A1-20020912-D00010.png"\; state="\{\{state\}\}">R</figure-callout>}}_{1,2}-r_vr_aR_2\right]\end{array}& \left(97\right)\end{array}$

  
• As explained above, the constraint is that s[0375]_kand n_k(k=2 for the present example) are uncorrelated. This “decorrelation constraint” is obtained by setting the correlation of Equation (97) to zero as follows:
• −R₁+(r_a+r_v)R₁₂−r_ar_vR₂=0  (98)
• In other words, the goal is to maximize equation (94) under the constraint of equation (98).[0376]
• In order to obtain the goal, a cost function is defined (e.g., a Lagrangian optimization in the present embodiment) as follows:[0377]$\begin{array}{cc}J\left(r_a,r_v,\mu \right)=\frac{1}{{\left(r_a-r_v\right)}^2}\left[R_1-2r_v{\mathrm{<figure-callout\; label="R"\; filenames="US20020128544A1-20020912-D00009.png,US20020128544A1-20020912-D00010.png"\; state="\{\{state\}\}"><figure-callout\; label="R"\; filenames="US20020128544A1-20020912-D00011.png,US20020128544A1-20020912-D00015.png"\; state="\{\{state\}\}">R</figure-callout></figure-callout>}}_{1,2}+{\mathrm{<figure-callout\; label="r\; v"\; filenames="US20020128544A1-20020912-D00011.png,US20020128544A1-20020912-D00015.png"\; state="\{\{state\}\}">r</figure-callout>}}_v^{}{\mathrm{<figure-callout\; label="R"\; filenames="US20020128544A1-20020912-D00011.png,US20020128544A1-20020912-D00015.png"\; state="\{\{state\}\}">R</figure-callout>}}_2+\mu \left(-{\mathrm{<figure-callout\; label="R"\; filenames="US20020128544A1-20020912-D00009.png,US20020128544A1-20020912-D00010.png"\; state="\{\{state\}\}">R</figure-callout>}}_1+\left(r_a+r_v\right){\mathrm{<figure-callout\; label="R"\; filenames="US20020128544A1-20020912-D00009.png,US20020128544A1-20020912-D00010.png"\; state="\{\{state\}\}">R</figure-callout>}}_{1,2}-r_ar_vR_2\right)\right]& \left(99\right)\end{array}$

  
• where μ is the Lagrange multiplier. Finding the value of r[0378]_a, r_vand μ that solve the cost function can be accomplished using a constrained optimization method such as described in Luenberger,Linear&Nonlinear Programming,Addison-Wesley, 2d Ed., 1984.
• Along the same lines, if we assume that the red and infrared signals S[0379]_redand S_IRare non-static, the functions R₁, R₂and R₁₂defined above are time dependent. Accordingly, with two equations, two unknowns can be obtained by expressing the decorrelation constraint set forth in equation (98) at two different times. The decorrelation constraint can be expressed at two different times, t₁and t₂, as follows:
• −R₁(t₁)+(r_a+r_v)R₁₂(t₁)−r_ar_vR₂(t₁)=0  (100)
• −R₁(t₂)+(r_a+r_v)R₁₂(t₂)−r_ar_vR₂(t₂)=0  (101)
• Because equations (100) and (101) are non-linear in r[0380]_aand r_v, a change of variables allows the use of linear techniques to solve these two equations. Accordingly, with x=r_a+r_v; y=r_ar_vequations (100) and (101) become
• R₁₂(t₁)x−R₂(t₁)y=R₁(t₁)  (102)
• R₁₂(t₂)x−R₂(t₂)y=R₁(t₂)  (103)
• These equation (102) and (103) can be solved for x and y. Then, solving for r[0381]_aand r_vfrom the changes of variables equations provides the following:$\begin{array}{cc}{r}_v+\frac{y}{r_v}=x\Rightarrow r_v^2-{\mathrm{xr}}_v+y=0& \left(104\right)\end{array}$

  
• Solving equation (104) results in two values for r[0382]_v. In the present embodiment, the r_vvalue that results in x²−r_vy>0 is selected. If both values of r_vresult in x²−r_vy>0, the r_vthat maximizes the energy of s₂(Energy(s₂)) at t₂is selected. r_vis then substituted into the equations above to obtain r_a. Alternatively r_acan be found directly in the same manner r_vwas determined.
• Alternative To Saturation Transform—Complex FFT[0383]
• The blood oxygen saturation, pulse rate and a clean plethysmographic waveform of a patient can also be obtained using the signal model of the present invention using a complex FFT, as explained further with reference to FIGS.[0384]25A-25C. In general, by utilizing the signal model of equations (89)-(92) with two measured signals, each with a first portion and a second portion, where the first portion represents a desired portion of the signal and the second portion represents the undesired portion of the signal, and where the measured signals can be correlated with coefficients r_aand r_v, a fast saturation transform on a discrete basis can be used on the sample points from the output of thedecimation operation402.
• FIG. 25A corresponds generally to FIG. 14, with the fast saturation transform replacing the previously described saturation transform. In other words, the operations of FIG. 25A can replace the operations of FIG. 14. As depicted in FIG. 25A, the fast saturation transform is represented in a fast saturation transform/pulse[0385]rate calculation module630. As in FIG. 14, the outputs are arterial oxygen saturation, a clean plethysmographic waveform, and pulse rate. FIG. 25B and 25C illustrate additional detail regarding the fast saturation transform/pulserate calculation module630. As depicted in FIG. 25B, the fastsaturation transform module630 has infrared log andred log modules640,642 to perform a log normalization as in the infrared andred log modules480,482 of FIG. 17. Similarly, there are infrared DC removal and redDC removal modules644,646. In addition, there are infrared and red high-pass filter modules645,647,window function modules648,640,complex FFT modules652,654,select modules653,655,magnitude modules656,658,threshold modules660,662, a point-by-point ratio module670, asaturation equation module672, and aselect saturation module680. There are alsophase modules690,692, aphase difference module694, and aphase threshold module696. The output of theselect saturation module680 provides the arterial saturation on an arterialsaturation output line682.
• In this alternative embodiment, the snapshot for red and infrared signals is 562 samples from the[0386]decimation module402. The infraredDC removal module644 and the red DC removal module646 are slightly different from the infrared and redDC removal modules484,486 of FIG. 17. In the infrared and redDC removal modules644,646 of FIG. 25B, the mean of all 563 sample points for each respective channel is calculated. This mean is then removed from each individual sample point in the respective snapshot in order to remove the baseline DC from each sample. The outputs of the infrared and redDC removal modules644,646 provide inputs to respective infrared high-pass filter module645 and red high-pass filter module647.
• The high-[0387]pass filter modules645,647 comprise FIR filters with 51 taps for coefficients. Preferably, the high-pass filters comprise Chebychev filters with a side-lobe level parameter of 30 and a corner frequency of 0.5 Hz (i.e., 30 beats/minute). It will be understood that this filter could be varied for performance. With 562 sample points entering the high-pass filters, and with 51 taps for coefficients, there are 512 samples provided from these respective infrared and red snapshots at the output of the high-pass filter modules. The output of the high-pass filter modules provides an input to thewindow function modules648,650 for each respective channel.
• The[0388]window function modules648,650 perform a conventional windowing function. A Kaiser windowing function is used in the present embodiment. The functions throughout FIG. 25B maintain a point-by-point analysis. In the present embodiment, the time bandwidth product for the Kaiser window function is 7. The output of the window function modules provides an input to the respective complex Fast Fourier Transform (FFT)modules652,654.
• The[0389]complex FFT modules652,654 perform complex FFTs on respective infrared and red channels on the data snapshots. The data from the complex FFTs is then analyzed in two paths, once which examines the magnitude and one which examines the phase from the complex FFT data points. However, prior to further processing, the data is provided to respective infrared and redselect modules653,655 because the output of the FFT operation will provide repetitive information from 0-½ the sampling rate and from ½ the sampling rate to the sampling rate. The select modules select only samples from 0-½ the sampling rate (e.g., 0-31.25 Hz in the present embodiment) and then select from those samples to cover a frequency range of the heart rate and one or more harmonics of the heart rate. In the present embodiment, samples which fall in the frequency range of 20 beats per minute to 500 beats per minute are selected. This value can be varied in order to obtain harmonics of the heart rate as desired. Accordingly, the output of the select modules results in less than 256 samples. In the present embodiment, the sample points 2-68 of the outputs of the FFTs are utilized for further processing.
• In the first path of processing, the output from the[0390]select modules653,655 are provided to respective infrared andred magnitude modules656,658. Themagnitude modules656,658 perform a magnitude function wherein the magnitude on a point-by-point basis of the complex FFT points is selected for each of the respective channels. The outputs of themagnitude modules656,658 provide an input to infrared andred threshold modules660,662.
• The[0391]threshold modules660,662 examine the sample points, on a point-by-point basis, to select those points where the magnitude of an individual point is above a particular threshold which is set at a percentage of the maximum magnitude detected among all the remaining points in the snapshots. In the present embodiment, the percentage for the threshold operation is selected as 1% of the maximum magnitude.
• After thresholding, the data points are forwarded to a point-by-[0392]point ratio module670. The point-by-point ratio module takes the red over infrared ratio of the values on a point-by-point basis. However, a further test is performed to qualify the points for which a ratio is taken. As seen in FIG. 25B, the sample points output from theselect modules653,655 are also provided to infrared andred phase modules690,692. Thephase modules690,692 select the phase value from the complex FFT points. The output of thephase modules690,692 is then presented to aphase difference module694.
• The[0393]phase difference module694 calculates the difference in phase between the corresponding data points from thephase modules690,692. If the magnitude of the phase difference between any two corresponding points is less than a particular threshold (e.g., 0.1 radians) in the present embodiment), then the sample points qualify. If the phase of two corresponding sample points is too far apart, then the sample points are not used. The output of thephase threshold module696 provides an enable input to the RED/IR rate module670. Accordingly, in order for the ratio of a particular pair of sample points to be taken, the three tests are executed:
• 6. the red sample must pass the[0394]red threshold660;
• 7. the infrared sample must pass the[0395]infrared threshold662; and
• 8. the phase between the two points must be less than the predefined threshold as determined in the[0396]phase threshold696.
• For those sample points which qualify, a ratio is taken in the[0397]ratio module670. For those points which do not qualify, the saturation is set to zero at the output of thesaturation equation672.
• The resulting ratios are provided to a saturation equation module which is the same as the[0398]saturation equation modules502,520 in thestatistics module504. In other words, thesaturation equation module672 accepts the ratio on a point-by-point basis and provides as an output a corresponding saturation value corresponding to the discrete ratio points. The saturation points output from thesaturation equation module672 provide a series of saturation points which could be plotted as saturation with respect to frequency. The frequency reference was entered into the points at the complex FFT stage.
• The arterial (and the venous) saturation can then be selected, as represented in the select[0399]arterial saturation module680, in one of two methods according to the present invention. According to one method, the arterial saturation value can be selected simply as the point corresponding to the largest saturation value for all points output from thesaturation equation module672 for a packet. Alternatively, a histogram similar to the histogram of FIG. 22 can be generated in which the number of saturation values at different frequencies (points) are summed to form a histogram of the number of occurrences for each particular saturation value. In either method, the arterial saturation can be obtained and provided as an output to the select arterial saturation module on the arterialsaturation output line682. In order to obtain the venous saturation, the minimum arterial saturation value, of points that exhibit non-zero value, is selected rather than the maximum arterial saturation value. The saturation can be provided to thedisplay336.
• The fast saturation transform information can also be used to provide the pulse rate and the clean plethysmographic wave form as further illustrated in FIG. 25C. In order to obtain the pulse rate and a clean plethysmographic wave form, several additional functions are necessary. As seen in FIG. 25C, the pulse rate and clean plethysmographic wave form are determined using a[0400]window function module700, aspectrum analysis module702 and an inversewindow function module704.
• As depicted in FIG. 25C, the input to the[0401]window function module700 is obtained from the output of thecomplex FFT modules652 or654. In the present embodiment, only one measured signal is necessary. Another input to thewindow function module700 is the arterial saturation obtained from the output of the selectarterial saturation module680.
• The window function module performs a windowing function selected to pass those frequencies that significantly correlate to the frequencies which exhibited saturation values very close to the arterial saturation value. In the present embodiment, the following windowing function is selected:[0402]$\begin{array}{cc}1-{\left[\frac{{\mathrm{SAT}}_{\mathrm{art}}-{\mathrm{SAT}}_n}{100}\right]}^{15}& \left(105\right)\end{array}$

  
• where SAT[0403]_nequals the saturation value corresponding to each particular frequency for the sample points and SAT_artrepresents the arterial saturation as chosen at the output of the selectarterial saturation module680. This window function is applied to the window function input representing the complex FFT of either the red or the infrared signal. The output of thewindow function module700 is a red or infrared signal represented with a frequency spectrum as determined by the FFT, with motion artifacts removed by the windowing function. It should be understood that many possible window functions can be provided. In addition, with the window function described above, it should be understood that using a higher power will provide more noise suppression.
• In order to obtain pulse rate, the output points from the[0404]window function module700 are provided to aspectrum analysis module702. Thespectrum analysis module702 is the same as thespectrum analysis module590 of FIG. 20. In other words, thespectrum analysis module702 determines the pulse rate by determining the first harmonic in the frequency spectrum represented by the output points of thewindowing function700. The output ofspectrum analysis module702 is the pulse rate.
• In order to obtain a clean plethysmographic waveform, the output of the[0405]windowing function700 is applied to an inversewindow function module704. The inversewindow function module704 completes an inverse of the Kaiser window function of thewindow function module648 or650 of FIG. 25B. In other words, theinverse window function704 does a point-by-point inverse of the Kaiser function for points that are still defined. The output is a clean plethysmographic waveform.
• Accordingly, by using a complex FFT and windowing functions, the noise can be suppressed from the plethysmographic waveform in order to obtain the arterial saturation, the pulse rate, and a clean plethysmographic waveform. It should be understood that although the above description relates to operations primarily in the frequency domain, operations that obtain similar results could also be accomplished in the time domain.[0406]
• Relation to Generalized Equations[0407]
• The measurements described for pulse oximetry above are now related back to the more generalized discussion above. The signals (logarithm converted) transmitted through the[0408]finger310 at each wavelength λa and λb are:
• S_λa(t)=S_λred1(t)=ε_HbO2,λac^A_HbO2x^A(t)+ε_Hb,λac^A_Hbx^A(t)+ε_HbO2,λac^V_HbO2x^V(t)+ε_Hb,λac^v_Hbx^v(t)+n_λa(t);  (105a)
• S_λa(t)=ε_HbO2,λac^A_HbO2x^A(t)+ε_Hb,λac^A_Hbx^A(t)+n_λa(t);  (105b)
• S_λa(t)=s_λa(t)+n_λa(t);  (105c)
• S_λb(t)=S_λred2(t)=ε_HbO2,λbc^A_HbO2x^A(t)+ε_Hb,λbc^A_Hbx^A(t)+ε_HbO2,λbc^V_HbO2x^V(t)+ε_Hb,λbc^V_Hbx^V(t)+n_λb(t);  (106a)
• S_λb(t)=ε_HbO2,λbc^A_HbO2x^A(t)+ε_Hb,λbc^A_Hbx^A(t)+n_λb(t)  (106b)
• S_λb(t)=s_λb(t)+n_λb(t)  (106c)
• The variables above are best understood as correlated to FIG. 6[0409]cas follows: assume the layer in FIG. 6ccontaining A₃and A₄represents venous blood in the test medium, with A₃representing deoxygenated hemoglobin (Hb) and A₄representing oxygenated hemoglobin (HBO2) in the venous blood. Similarly, assume that the layer in FIG. 6ccontaining A₅and A₆represents arterial blood in the test medium, with A₅representing deoxygenated hemoglobin (Hb) and A₆representing oxygenated hemoglobin (HBO2) in the arterial blood. Accordingly, c^VHbO2 represents the concentration of oxygenated hemoglobin in the venous blood, c^VHb represents the concentration of deoxygenated hemoglobin in the venous blood, x^Vrepresents the thickness of the venous blood (e.g., the thickness the layer containing A3 and A₄). Similarly, c^AHbO₂represents the concentration of oxygenated hemoglobin in the arterial blood, c^AHb represents the concentration of deoxygenated hemoglobin in the arterial blood, and x^Arepresents the thickness of the arterial blood (e.g., the thickness of the layer containing A₅and A₆).
• The wavelengths chosen are typically one in the visible red range, i.e., λa, and one in the infrared range, i.e., λb. Typical wavelength values chosen are λa=660 nm and λb=910 nm. In accordance with the constant saturation method, it is assumed that c[0410]^A_HbO2(t)/c^A_Hb(t)=constant₁and c^V_HbO2(t)/c^V_Hb(t)=constant₂. The oxygen saturation of arterial and venous blood changes slowly, if at all, with respect to the sample rate, making this a valid assumption. The proportionality coefficients for equations (105) and (106) can then be written as:$\begin{array}{cc}{r}_a\left(t\right)=\frac{{\epsilon }_{\mathrm{Hb}02,\lambda a}c_{\mathrm{Hb}02}^Ax\left(t\right)+{\epsilon }_{\mathrm{Hb},\lambda a}c_{\mathrm{Hb}}x\left(t\right)}{{\epsilon }_{\mathrm{Hb}02,\lambda b}c_{\mathrm{Hb}02}^Ax\left(t\right)+{\epsilon }_{\mathrm{Hb},\lambda b}C_{\mathrm{Hb}}^Ax\left(t\right)}*& \left(107\right)\end{array}$

  

   s_λa(t)=r_a(t)s_λb(t)  (108a)
• n_λa(t)≠r_a(t)n_λb(t)  (109a)
• n_λa(t)=r_v(t)n_λb(t)  (108b)
• s_λa(t)≠r_v(t)s_λb(t)  (109b)
• In pulse oximetry, it is typically the case that both equations (108) and (109) can be satisfied simultaneously.[0411]
• Multiplying equation (106) by r[0412]_a(t) and then subtracting equation (106) from equation (105), a non-zero secondary reference signal n′(t) is determined by:
• n′(t)=S_λa(t)−r_a(t)S_λb(t)  (110a)
• =ε_HbO2,λac^V_HbO2x^V(t)+ε_Hb,λac^V_Hbx^V(t)+n_λa(t)−r_a(t)[ε_HbO2,λbc^V_HbO2x^V(t)+ε_Hb,λbc^V_Hbx^V(t)+n_λb(t)]  (111a)
• Multiplying equation (106) by r[0413]_v(t) and then subtracting equation (106) from equation (105), a non-zero primary reference signal s′(t) is determined by:
• s′(t)=S_λa(t)−r_v(t)S_λb(t)  (110b)
• =s_λa(t)−r_v(t)s_λb(t)  (111b)
• The constant saturation assumption does not cause the venous contribution to the absorption to be canceled along with the primary signal portions s[0414]_λa(t) and s_λb(t). Thus, frequencies associated with both the low frequency modulated absorption due to venous absorption when the patient is still and the modulated absorption due to venous absorption when the patient is moving are represented in the secondary reference signal n′(t). Thus, the correlation canceler or other methods described above remove or derive both erratically modulated absorption due to venous blood in the finger under motion and the constant low frequency cyclic absorption of venous blood.
• To illustrate the operation of the oximeter of FIG. 11 to obtain clean waveform, FIGS. 26 and 27 depict signals measured for input to a reference processor of the present invention which employs the constant saturation method, i.e., the signals S[0415]_λa(t)=S_λred(t) and S_λb(t)=S_λIR(t). Afirst segment26aand27aof each of the signals is relatively undisturbed by motion artifact, i.e., the patient did not move substantially during the time period in which these segments were measured. Thesesegments26aand27aare thus generally representative of the primary plethysmographic waveform at each of the measured wavelengths. Asecond segment26band27bof each of the signals is affected by motion artifact, i.e., the patient did move during the time period in which these segments were measured. Each of thesesegments26band27bshows large motion induced excursions in the measured signal. Athird segment26cand27cof each of the signals is again relatively unaffected by motion artifact and is thus generally representative of the primary plethysmographic waveform at each of the measured wavelengths.
• FIG. 28 shows the secondary reference signal n′(t)=n[0416]_λa(t)−r_an_λb(t), as determined by a reference processor of the present invention. Again, the secondary reference signal n′(t) is correlated to the secondary signal portions n_λaand n_λb. Thus, a first segment28aof the secondary reference signal n′(t) is generally flat, corresponding to the fact that there is very little motion induced noise in thefirst segments26aand27aof each signal. Asecond segment28bof the secondary reference signal n′(t) exhibits large excursions, corresponding to the large motion induced excursions in each of the measured signals. Athird segment28cof the noise reference signal n′(t) is generally flat, again corresponding to the lack of motion artifact in thethird segments26cand27cof each measured signal.
• It should also be understood that a reference processor could be utilized in order to obtain the primary reference signal s′(t)=s[0417]_λa−r_vs_λb(t). The primary reference signal s′(t) would be generally indicative of the plethysmograph waveform.
• FIGS. 29 and 30 show the approximations s″[0418]_λa(t) and s″_λb(t) to the primary signals s_λa(t) and s_λb(t) as estimated by a correlation canceler using a secondary reference signal n′(t). Note that the scale of FIGS. 26 through 30 is not the same for each figure to better illustrate changes in each signal. FIGS. 29 and 30 illustrate the effect of correlation cancellation using the secondary reference signal n′(t) as determined by the reference processor.Segments29band30bare not dominated by motion induced noise as weresegments26band27bof the measured signals. Additionally,segments29a,30a,29c,and30chave not been substantially changed from the measuredsignal segments26a,27a,26c,and27cwhere there was no motion induced noise.
• It should be understood that approximation n″[0419]_λa(t) and n″_λb(t) to the secondary signals n_λa(t) and n_λb(t) as estimated by a correlation canceler using a primary reference signal s′(t) can also be determined in accordance with the present invention.
• Method for Estimating Primary and Secondary Signal Portions of Measured Signals in a Pulse Oximeter[0420]
• Implementing the various embodiments of the correlation canceler described above in software is relatively straightforward given the equations set forth above, and the detailed description above. However, a copy of a computer program subroutine, written in the C programming language, which calculates a primary reference s′(t) using the constant saturation method and, using a[0421]joint process estimator572 which implements a joint process estimator using the equations (54)-(64) is set forth in Appendix B. This joint process estimator estimates a good approximation to the primary signal portions of two measured signals, each having a primary portion which is correlated to the primary reference signal s′(t) and a secondary portion which is correlated to the secondary reference signal n′(t). This subroutine is, another way to implement the steps illustrated in the flowchart of FIG. 9 for a monitor particularly adapted for pulse oximetry. The two signals are measured at two different wavelengths λa and λb, where λa is typically in the visible region and λb is typically in the infrared region. For example, in one embodiment of the present invention, tailored specifically to perform pulse oximetry using the constant saturation method, λa=660 nm and λb=940 nm.
• The correspondence of the program variables to the variables defined in equations (54)-(64) in the discussion of the joint process estimator is as follows:[0422]
• Δ[0423]_m(t)=nc[m].Delta
• Γ[0424]_f,m(t)=nc[m].fref
• Γ[0425]_b,m(t)=nc[m].bref
• f[0426]_m(t)=nc[m].ferr
• b[0427]_m(t)=nc[m].berr
• ℑ[0428]_m(t)=nc[m].Fswsqr
• β[0429]_m(t)=nc[m].Bswsqr
• γ[0430]_m(t)=nc[m].Gamma
• ρ[0431]_m,λa(t)=nc[m].Roh_a
• ρ[0432]_m,λb(t)=nc[m].Roh_b
• e[0433]_m,λa(t)=nc[m].err_a
• e[0434]_m,λb(t)=nc[m].err_b
• κ[0435]_m,λa(t)=nc[m].K_a
• κ[0436]_m,λb(t)=nc[m].K_b
• A first portion of the program performs the initialization of the[0437]registers90,92,96, and98 and intermediate variable values as in the “INITIALIZED CORRELATION CANCELER”action block120. A second portion of the program performs the time updates of thedelay element variables110 with the value at the input of eachdelay element variable110 is stored in the delay element variable110 as in the “TIME UPDATE OF LEFT [Z⁻¹] ELEMENTS”action block130. The calculation of saturation is performed in a separate module. Various methods for calculation of the oxygen saturation are known to those skilled in the art. One such calculation is described in the articles by G. A. Mook, et al, and Michael R. Neuman cited above. Once the concentration of oxygenated hemoglobin and deoxygenated hemoglobin are determined, the value of the saturation is determined similarly to equations (72) through (79) wherein measurements at times t₁and t₂are made at different, yet proximate times over which the saturation is relatively constant. For pulse oximetry, the average saturation at time t=(t₁+t₂)/2 is then determined by:$\begin{array}{cc}{\mathrm{Sat}}_{\mathrm{arterial}}\left(t\right)=\frac{C_{\mathrm{Hb}02}^A\left(t\right)}{C_{\mathrm{Hb}02}^A\left(t\right)+C_{\mathrm{Hb}}^A\left(t\right)}& \text{(112a)}\\ =\frac{{\epsilon }_{\mathrm{Hb},\lambda a}-{\epsilon }_{\mathrm{Hb},\lambda b}\left(\Delta S_{\lambda a}/\Delta S_{\lambda b}\right)}{{\epsilon }_{\mathrm{HB},\lambda a}-{\epsilon }_{\mathrm{Hb}02,\lambda a}-\left({\epsilon }_{\mathrm{HB},\lambda b}-{\epsilon }_{\mathrm{Hb}02,\lambda b}\right)\left(\Delta S_{\lambda a}/\Delta S_{\lambda b}\right)}& \text{(112b)}\\ {\mathrm{Sat}}_{\mathrm{venous}}\left(t\right)=\frac{C_{\mathrm{Hb}02}^V\left(t\right)}{C_{\mathrm{Hb}02}^V\left(t\right)+C_{\mathrm{Hb}}^V\left(t\right)}& \text{(113a)}\\ =\frac{{\epsilon }_{\mathrm{Hb},\lambda a}-{\epsilon }_{\mathrm{Hb},\lambda b}\left(\Delta n_{\lambda a}/\Delta n_{\lambda b}\right)}{{\epsilon }_{\mathrm{HB},\lambda a}-{\epsilon }_{\mathrm{Hb}02,\lambda a}-\left({\epsilon }_{\mathrm{HB},\lambda b}-{\epsilon }_{\mathrm{Hb}02,\lambda b}\right)\left(\Delta n_{\lambda a}/\Delta n_{\lambda b}\right)}& \text{(113b)}\end{array}$

  
• A third portion of the subroutine calculates the primary reference or secondary reference, as in the “CALCULATE PRIMARY OR SECONDARY REFERENCE (s′(t) or n′(t)) FOR TWO MEASURED SIGNAL SAMPLES” action block[0438]140 for the signals S_λa(t) and S_λb(t) using the proportionality constants r_a(t) and r_v(t) determined by the constant saturation method as in equation (3). The saturation is calculated in a separate subroutine and a value of r_a(t) or r_v(t) is imported to the present subroutine for estimating either the primary portions s_λa(t) and s_λb(t) or the secondary portions n_λa(t) and n_λb(t) of the composite measured signals S_λa(t) and S_λb(t).
• A fourth portion of the program performs Z-stage update as in the “ZERO STAGE UPDATE” action block[0439]150 where the Z-stage forward prediction error F_o(t) and Z-stage backward prediction error b_o(t) are set equal to the value of the reference signal n′(t) or s′(t) just calculated. Additionally zero-stage values of intermediate variables ℑ_oand β₀(t)(nc[m].Fswsqr and nc[m].Bswsqr in the program) are calculated for use in settingregisters90,92,96, and98 values in the least-squares lattice predictor70 in the regression filters80aand80b.
• A fifth portion of the program is an iterative loop wherein the loop counter, M, is reset to zero with a maximum of m=NC_CELLS, as in the “m=0”[0440]action block160 in FIG. 9. NC_CELLS is a predetermined maximum value of iterations for the loop. A typical value for NC_CELLS is between 6 and 10, for example. The conditions of the loop are set such that the loop iterates a minimum of five times and continues to iterate until a test for conversion is met or m-NC_CELLS. The test for conversion is whether or not the sum of the weighted sum of four prediction errors plus the weighted sum of backward prediction errors is less than a small number, typically 0.00001 (i.e., ℑ_m(t)+βm(t)≦0.00001).
• A sixth portion of the program calculates the forward and backward reflection coefficient Γ[0441]_m,f(t) and Γ_m,b(t) register90 and92 values (nc[m].fref and nc[m].bref in the program) as in the “ORDER UPDATE m^th-STAGE OF LSL-PREDICTOR”action block170. Then forward and backward prediction errors f_m(t) and b_m(t) (nc[m].ferr and nc[m].berr in the program) are calculated. Additionally, intermediate variables ℑ_m(t), βm(t), and γ(t) (nc[m].Fswsqr, nc[m].Bswsqr, nc[m]. gamma in the program) are calculated. The first cycle of the loop uses the value for nc[0].Fswsqr and nc[0].Bswsqr calculated in the ZERO STAGE UPDATE portion of the program.
• A seventh portion of the program, still within the loop begun in the fifth portion of the program, calculates the[0442]regression coefficient register96 and98 values κ_m,λa(t) and κ_m,λb(t) (nc[m].K_a and nc[m].K_b in the program) in both regression filters, as in the “ORDER UPDATE m^thSTAGE OF REGRESSION FILTER(S)”action block180. Intermediate error signals and variables e_m,λa(t), e_m,λb(t), ρ_m,λa(t), and ρ_m,λb(t) (nc[m].err_a and nc[m].err_b, nc[m].roh_a and nc[m].roh_b in the subroutine) are also calculated.
• The loop iterates until the test for convergence is passed. The test for convergence of the joint process estimator is performed each time the loop iterates analogously to the “DONE”[0443]action block190. If the sum of the weighted sums of the forward and backward prediction errors ℑ_m(t)+βm(t) is less than or equal to 0.00001, the loop terminates. Otherwise, sixth and seventh portions of the program repeat.
• The output of the present subroutine is a good approximation to the primary signals s″[0444]_λa(t) and s″_λb(t) or the secondary signals n″_λa(t) and n″_λb(t) for the set of samples S_λa(t) and S_λb(t) input to the program. After approximations to the primary signal portions or the secondary signals portions of many sets of measured signal samples are estimated by the joint process estimator, a compilation of the outputs provides waves which are good approximations to the plethysmographic wave or motion artifact at each wavelength, λa and λb.
• It should be understood that the subroutine of Appendix B is merely one embodiment which implements the equations (54)-(64). Although implementation of the normalized and QRD-LSL equations is also straightforward, a subroutine for the normalized equations is attached as Appendix C, and a subroutine for the QRD-LSL algorithm is attached as Appendix D.[0445]
• While one embodiment of a physiological monitor incorporating a processor of the present invention for determining a reference signal for use in a correlation canceler, such as an adaptive noise canceler, to remove or derive primary and secondary components from a physiological measurement has been described in the form of a pulse oximeter, it will be obvious to one skilled in the art that other types of physiological monitors may also employ the above described techniques.[0446]
• Furthermore, the signal processing techniques described in the present invention may be used to compute the arterial and venous blood oxygen saturations of a physiological system on a continuous or nearly continuous time basis. These calculations may be performed, regardless of whether or not the physiological system undergoes voluntary motion.[0447]
• Furthermore, it will be understood that transformations of measured signals other than logarithmic conversion and determination of a proportionality factor which allows removal or derivation of the primary or secondary signal portions for determination of a reference signal are possible. Additionally, although the proportionality factor r has been described herein as a ratio of a portion of a first signal to a portion of a second signal, a similar proportionality constant determined as a ratio of a portion of a second signal to a portion of a first signal could equally well be utilized in the processor of the present invention. In the latter case, a secondary reference signal would generally resemble n′(t)=n[0448]_λb(t)−m_m,λa(t).
• Furthermore, it will be understood that correlation cancellation techniques other than joint process estimation may be used together with the reference signals of the present invention. These may include but are not limited to least mean square algorithms, wavelet transforms, spectral estimation techniques, neural networks, Weiner and Kalman filters among others.[0449]
• One skilled in the art will realize that many different types of physiological monitors may employ the teachings of the present invention. Other types of physiological monitors include, but are in not limited to, electro cardiographs, blood pressure monitors, blood constituent monitors (other than oxygen saturation) monitors, capnographs, heart rate monitors, respiration monitors, or depth of anesthesia monitors. Additionally, monitors which measure the pressure and quantity of a substance within the body such as a breathalizer, a drug monitor, a cholesterol monitor, a glucose monitor, a carbon dioxide monitor, a glucose monitor, or a carbon monoxide monitor may also employ the above described techniques.[0450]
• Furthermore, one skilled in the art will realize that the above described techniques of primary or secondary signal removal or derivation from a composite signal including both primary and secondary components can also be performed on electrocardiography (ECG) signals which are derived from positions on the body which are close and highly correlated to each other. It should be understood that a tripolar Laplacian electrode sensor such as that depicted in FIG. 31 which is a modification of a bipolar Laplacian electrode sensor discussed in the article “Body Surface Laplacian ECG Mapping” by Bin He and Richard J. Cohen contained in the journal IEEE Transactions on Biomedical Engineering, Vol. 39, No. 11, November 1992 could be used as an ECG sensor. It must also be understood that there are a myriad of possible ECG sensor geometry's that may be used to satisfy the requirements of the present invention. The same type of sensor could also be used for EEG and EMG measurements.[0451]
• Furthermore, one skilled in the art will realize that the above described techniques can also be performed on signals made up of reflected energy, rather than transmitted energy. One skilled in the art will also realize that a primary or secondary portion of a measured signal of any type of energy, including but not limited to sound energy, X-ray energy, gamma ray energy, or light energy can be estimated by the techniques described above. Thus, one skilled in the art will realize that the techniques of the present invention can be applied in such monitors as those using ultrasound where a signal is transmitted through a portion of the body and reflected back from within the body back through this portion of the body. Additionally, monitors such as echo cardiographs may also utilize the techniques of the present invention since they too rely on transmission and reflection.[0452]
• While the present invention has been described in terms of a physiological monitor, one skilled in the art will realize that the signal processing techniques of the present invention can be applied in many areas, including but not limited to the processing of a physiological signal. The present invention may be applied in any situation where a signal processor comprising a detector receives a first signal which includes a first primary signal portion and a first secondary signal portion and a second signal which includes a second primary signal portion and a second secondary signal portion. Thus, the signal processor of the present invention is readily applicable to numerous signal processing areas.[0453]

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

Claims (26)

What is claimed is:

1. A method of determining blood oxygen saturation comprising:

sensing physiological signals resulting from the attenuation of light of at least first and second wavelengths by body tissue carrying pulsing blood;

determining at least two values corresponding to oxygen saturation based upon at least two alternative methods of using the physiological signals; and

determining a resulting value for oxygen saturation from the at least two values corresponding to oxygen saturation.

2. The method ofclaim 1, wherein the step of determining a resulting value comprises selecting from the at least two values at least one value that is a maximum among the at least two values.

3. The method ofclaim 1, wherein the step of determining a resulting value comprises averaging at least some of the at least two values.

4. The method ofclaim 1, wherein one of the alternative methods comprises at least one calculation in the frequency domain.

5. The method ofclaim 4, wherein the calculation in the frequency domain comprises performing a Fourier Transform on the physiological signals.

6. The method ofclaim 1, wherein at least one of the at least two alternative methods comprises a calculation based on a ratio of a normalized representation of the physiological signal resulting from the first wavelength to a normalized representation of the physiological signal resulting from the second wavelength.

7. The method ofclaim 6, wherein at least one of the at least two alternative methods comprises a calculation based on the physiological signals after they have been effected by a recursive polyphase bandpass filter.

8. The method ofclaim 6, wherein at least one of the at least two alternative methods comprises a calculation based on the physiological signals after they have been effected by an adaptive implementation of a recursive polyphase bandpass filter.

9. The method ofclaim 6, wherein at least one of the at least two alternative methods comprises a calculation based on the physiological signals after they have been effected by a bank of filters.

10. The method ofclaim 6, wherein at least one of the at least two alternative methods comprises a calculation based on the physiological signals after they have been effected by a sum of squares analysis.

11. The method ofclaim 6, wherein at least one of the at least two alternative methods comprises a calculation based on a scan of possible saturation values.

12. The method ofclaim 11, wherein the calculation based on a scan of possible saturation values comprises a discrete saturation transform.

13. The method ofclaim 6, wherein at least one of the at least two alternative methods comprises a calculation based on determining values for saturation that minimize the correlation between a signal portion and a noise portion of at least one of the physiological signals.

14. The method ofclaim 6, wherein at least one of the at least two alternative methods comprises a calculation based on the physiological signals after they have been effected by a Kalman filter.

15. The method ofclaim 6, wherein at least one of the at least two alternative methods comprises a calculation based on the physiological signals after they have been effected by a neural network.

16. The method ofclaim 6, wherein at least one of the at least two alternative methods comprises a calculation based on the physiological signals after they have been effected with spectral estimation techniques.

17. The method ofclaim 6, wherein at least one of the at least two alternative methods comprises selecting at least one of the at least two values based on characteristics of the physiological signals indicative of the quality of the physiological signals.

18. The method ofclaim 6, wherein step of determining comprises averaging the resulting value over time, said averaging dependent upon characteristics of the physiological signals indicative of the quality of the physiological signal.

19. The method ofclaim 18, wherein the averaging is based on confidence in the quality of the physiological signals.

20. The method ofclaim 19, wherein the confidence is determined by analyzing whether there is significant motion noise present in the physiological signals.

21. The method ofclaim 6, wherein at least one of the at least two alternative methods comprises a calculation based on the physiological signals after they have been effected by an adaptive algorithm.

22. The method ofclaim 21, wherein at least one of the at least two alternative methods comprises a calculation based upon a scan of values potentially indicative of said physiological parameter.

23. A method of determining pulse rate comprising:

sensing physiological signals resulting from the attenuation of light of at least first and second wavelengths by body tissue carrying pulsing blood;

determining at least two values corresponding to pulse rate based upon at least two alternative methods of processing the physiological signals; and

determining a resulting value for pulse rate from the at least two values corresponding to pulse rate.

24. The method ofclaim 23, wherein the step of determining comprises selecting at least one of the at least two values based on a determination of confidence in the accuracy of physiological signals.

25. The method ofclaim 23, wherein determining a resulting value comprises averaging the at least two values.

26. The method ofclaim 25, wherein said step of averaging comprises averaging over a time window, wherein said window is increased for potential of said physiological parameter having a lower confidence of accuracy and decreased for potential values of said physiological parameter having a higher confidence of accuracy.

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