ULTRASONIC DOPPLER SHIFT METHOD This method of automatic blood pressure measurement is based on the ultrasonic detection of arterial

wall motion. The control logic incorporated in the instrument analyzes the wall motion signals to detect the systolic and diastolic pressures and displays the corresponding values. The observed Doppler frequency can be expressed as: f = 2Vt / c where f = Doppler frequency (Hz) Vt = velocity of the object (m/ s) c = carrier wavelength (m) For blood pressure measurement, the brachial artery is the object from where the ultrasound gets reflected. Arterial movement produces the Doppler frequency shift. c = V c / fc -------- (ii) -------- (i)

where c = wavelength (in meters) of the carrier frequency in the medium Vc = velocity of the carrier frequency in the medium (1480 m/ s in water) fc = carrier frequency in the medium (2 MHz) Substituting these values in equation (ii), c = 1480/ ( 2 x 106 ) = 0.74 x 10-3 m The Doppler frequency is expressed as f = 2 Vt / 0.74 x 10-3 = 2.7 x 103 Vt (Hz) f = 2.7 x 103 Vt -------- (iii)

Thus, f varies directly with the target velocity, i.e. the motion of the brachial artery. To measure blood pressure, the Doppler frequency shift due to the snapping action of the artery must be known. In principle, the instrument consists of four major subsystems (Figure 1). They are Power supply subsystem, Pneumatic subsystem, RF and audio subsystem and Control subsystem.

Function of Power supply subsystem: The power supply block converts the incoming ac line voltage to several filtered and regulated dc voltages required for other subsystems. Function of Pneumatic subsystem: The Pneumatic subsystem inflates the pressure in the cuff to a preset value at a specified rate and deflates the pressure in the cuff at a specified rate. Function of RF and audio subsystem: RF and audio subsystem consists of generator and receiver circuits. The generator circuit generates a 2 MHz carrier, which is given to the transmit transducer located in the cuff. The receiver circuit receives the converted audio signal from the receiver transducer located in the cuff and then it is given to the control subsystem. Function of Control subsystem:
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Control subsystem sends a control signal to the Pneumatic Subsystem to inflate the cuff at a specified rate. It monitors the pressure in the cuff and when the pressure reaches the preset level, it stops the further inflation of cuff.

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It sends a signal to the pneumatic subsystem to bleed off the cuff pressure at a rate determined by the preset bleed rate. It sends a control signal to enable the audio circuits in the RF and audio subsystems to gate-on the transmitter to generate 2 MHz carrier signal. It receives the audio signals from the RF and audio subsystem and registers the audio signals representative of any Doppler frequency shift. It displays the measured systolic and diastolic pressure values.

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Measurement Procedure:

An occlusive cuff is placed on the arm (Figure 2) in the usual manner, with an ultrasonic transducer on the arm over the brachial artery. The cuff is inflated first to above systolic pressure and then deflated at a specified rate. The control system gate-on the transmitter in the RF and audio subsystem, thereby generating a carrier signal, which is given to the transmit transducer, located in the cuff. This transducer converts the RF energy into ultrasonic vibrations, which pass into the patient arm. Thus a low energy ultrasonic beam (less than 50 mw/cm2) at a frequency of 2 MHz is transmitted into the arm. The receiver transducer converts the portion of the ultrasonic vibrations that is reflected by the arterial wall into audio signal. When the pressure in the cuff is above systolic value, the artery vessel remains closed and there is no frequency shift in the reflected ultrasonic sound. At the systolic pressure, the occluded artery snaps open and the arterial blood flow starts. This artery wall motion results in a frequency shift (Doppler shift) in the returning ultrasonic vibrations. The

converted audio frequency signal corresponding to this Doppler shift is recognized as tentative systolic by the control subsystem logic. Four valid artery returns must be recognized in order to register the tentative systole and for it to become fixed as true systole. This reduces the possibility of artefacts from recording a false systole reading. Until the pressure in the cuff is above the diastolic pressure, similar frequency shifts are produced due to the arterial wall movement. When the cuff pressure falls below the diastolic value, the artery is completely opened and its rapid motion suddenly disappears and the Doppler-shift becomes relatively small. The instrument notes the sudden decrease in the amplitude of the Doppler shift and cuff pressure at this point is displayed as diastolic pressure. After the measurement of systolic value, the cuff pressure is allowed to deflate rapidly to atmospheric pressure. --------------------------------------------------------------------------------------------------------------------