WO2008096241A2

WO2008096241A2 - Multifunctional apparatus for detecting physiological parameters

Info

Publication number: WO2008096241A2
Application number: PCT/IB2008/000265
Authority: WO
Inventors: Gianampellio Storti
Original assignee: Gianampellio Storti
Priority date: 2007-02-06
Filing date: 2008-02-06
Publication date: 2008-08-14
Also published as: WO2008096241A3; ITLI20070002A1

Abstract

Multifunctional apparatus for measuring and/or monitoring at least two physiological parameters of a patient comprising means for selecting at least- one clinical examination (304) to carry out among a plurality of examinations; at least one interaction element (306-310) adapted to be located into contact with predetermined points of the surface body of said patient, or of supports for biological material to examine, for measuring a corresponding electric signal; an electronic conditioning unit (305a - 305e) connected to said, or each, interaction element, adapted to condition said, or each, detected electric signal, said conditioning unit comprising a plurality of associated electronic circuits to determine electric characteristics; a control unit adapted to analyse said, or each, electric signal to generate a physiological data, in said control unit a program being resident for adapting said electric characteristics according to the clinical examination to carry but and for generating respective output signals.

Description

TITLE MULTIFUNCTIONAL APPARATUS FOR DETECTING

PHYSIOLOGICAL PARAMETERS

DESCRIPTION Field of the invention.

The present invention relates to the doctoral field and, in particular, it relates to a multifunctional apparatus for detecting different physiological parameters, such as ECG, blood pressure, oxygen saturation ratio in blood (3pO2), temperature, heart beat, oximetry test, blood test, in particular, cholesterol and hemoglobin. Description of the prior art.

In the clinical practice different devices exist for determining the electric activity of the heart and the clinical status of a patient. Among these there are electrocardiographs, sensors of blood pressure and of temperature, oximeters, analysers of pulmonary activity.

Each apparatus is capable of measuring a single physiological parameter. In particular, in hospitals, heart functionality of a patient is controlled by an analysis of the graph of the electrocardiogram (ECG) , which represents the graphic course of the cardiac potential versus time. The electrocardiogram is in fact a record of the electric activity of the heart whose signals propagate for electric conductivity up to the body surface where they are picked up by suitably arranged electrodes. Possible damages to the conductive tissues of the heart change the path of the electrochemical signals and the frequency of the pulses, changing therefore also the signals measured on the body- surface, i.e. the morphology of the electrocardiogram.

Therefore, by investigating the changes in the graph shape of the electrocardiogram with respect to standard graphs, it is possible to distinguish many diseases of the cardiac tissue.

The electrocardiogram provides, then, data on occurring diseases or on diseases that have already produced destructive effects on the heart, thus resulting a very useful tool for diagnosing diseases of the cardiac system. Often, a cardiopathy that is sudden and short is a signal for avoiding an often irreversible further evolution thereof. For example, by measuring in advance the coronary insufficiency, an effective therapy for prevention of the infarction of the myocardium can be arranged. Disorders in the regularity of the heart beat can warn a doctor on the presence of a disease damaging the cardiac impulse conductivity tissue. An apparatus that "captures" acute transitory phenomena is known as HOLTER. This is in substance an electrocardiographic recorder of minimum encumbrance capable of measuring and storing the electrocardiogram for very long periods, which can exceed 24 hours. For measuring blood pressure, instead, a sphygmomanometer is normally used. As known it comprises a manometer having an inflatable sleeve with a hand pump and a discharge valve. The sleeve put on an arm is inflated up to compress the brachial artery blocking the blood such that a phonendoscope put under the sleeve in the inner part of the arm does not reveal any sound. By deflating slowly the chamber through the valve, as the arterial blood pressure balances the pressure of the sleeve, the phonendoscope reveals heart beats, indicating a blood flow and the (sistolic) pressure is read on the manometer. Then, starting from a moment when the phonendoscope does not reveal any sound again, the pressure indicated in that moment by the manometer the minimum (diastolic) blood pressure. However, the use of a sphygmomanometer for measuring the blood pressure is complicated since it requires the presence of a qualified doctor.

Another instrument for monitoring in a non-invasive way the cardiorespiratory system of a patient is a pulsoximeter. This instrument measures the amount of arterial blood hemoglobin, i.e. the average amount of oxygen for each molecule of hemoglobin.

At the basis of the operation of the pulsoximeter there are two essential principles. Firstly, the different absorption of light by hemoglobin at two different wavelengths when hemoglobin oxygenation is different, Furthermore, the light signal following the transmission through the tissues has a pulsatile component/ which is due to a variable volume of arterial blood with each heart beat. This can be detected by the microprocessor through the non-pulsatile component that due to the absorption of light of the veins, of the capillaries and of the tissues.

Also the pulsoximeter requires the presence of specialized operators for being used in an appropriate way. In fact, a pulsoximeter does not provide any indication of the ventilation of a patient, but only its oxygenation, and then a false sensation of safety is achieved by simply supplying additional given oxygen. Furthermore, a certain time can pass between the occurrence of a potentially hypoxic event that is a respiratory impediment and the detection of a low saturation of oxygen by the pulsoximeter.

For using all the devices above described together a lot of space has to be available. Moreover, in a first aid station, such devices are either associated to intensive care machines, reserved to the urgent cases, or are separated from one another and for measuring and monitoring all the main physiological parameters of a patient a long time is required for using all the different devices. Therefore, hospitalization of the patient is sometimes preferable.

In particular, in case of cardiac crisis, for example owing to cardiac ischemia, if the disease is not diagnosed soon at the first aid station, there is a risky loss of time before executing a first operation on the patient. Summary of the invention

It is then a feature of the present invention to provide a multifunctional apparatus adapted to carry out different clinical examinations such as ECG, blood pressure, oximetry test, body temperature, blood test, etc.

It is another feature of the present invention to provide such a multifunctional apparatus for grouping in a single instrument the functions presently accomplished by several apparatus singularly.

It is another feature of the present invention to provide such a multifunctional apparatus that has reduced size and weight and that is then easily portable for executing in a desired place the clinical examinations normally made only in surgeries, first aid stations and other specialized departments.

It is also a feature of the present invention to provide such a multifunctional apparatus that has low energy consumption and that then is cheap with respect to orher apparatus of the prior art.

It is a further feature of the present invention to provide such a multifunctional apparatus capable of communicating with a remote assistance where a doctor is present who analyses the results. These and other features are accomplished with one exemplary multifunctional apparatus for measuring and/or monitoring at least two physiological parameters of a patient, according to the invention, said apparatus Comprising:

- means for selecting at least one clinical examination to carry out among a plurality of examinations; - at least one interaction element adapted to be located into contact with predetermined points of the surface body of said patient, or of supports for biological material to examine, for carrying out said clinical examination by measuring a corresponding electric signal of physiological nature; an electronic conditioning unit connected to said, or each, interaction element, adapted to condition said, or each, detected electric signal, said conditioning unit comprising a plurality of associated electronic circuits to determine electric characteristics;

- a control unit adapted to analyse said, or each, electric signal to generate a physiological data, in said control unit a program being resident for adapting said electric characteristics according to said clinical examination and for generating respective output signals.

In particular, said conditioning unit comprises a plurality of switches, said program turning off/on said switches for connecting determined electronic circuits of said plurality according to the type of clinical examination to carry out in order to provide a determined circuit configuration. Advantageously, through said means for selecting one of the following operations is carried out:

- selecting a clinical examination among a. list of clinical examinations, - selecting a succession of clinical examinations in turn among a list of clinical examinations.

Advantageously, the apparatus, according to the invention, is capable of providing at least two clinical examinations selected from the group comprised of:

- ECG;

- blood pressure;

- body temperature;

- oximetry; - blood test.

More in detail, in case of selection of the blood test it is possible to carry out a further selection among:

- reflectance photometry method; - amperoitietric method.

Similarly, in case the selected clinical examination is an oximetry test, it is possible to carry out a selection further among:

- standard oximetry; - pulsed oximetry.

In particular, , furthermore, a device can be provided of displaying said physiological data selected from the group comprised of:

- a printer; - a display, in particular, a monitor of LCD type.

Advantageously, said electronic conditioning unit comprises at least one among:

- an adjustable gain amplifier; an adjustable pass band digital filter. Advantageously, according to the type of clinical examination said program carries out at least one of the following operations:

- selecting the gain of said, or each, adjustable gain amplifier;

- selecting the frequency of said, or each adjustable pass band filter.

In particular, the interaction element with the patient can comprise at least one element for measuring an electric signal of physiological nature selected from the group comprised of: - a plurality of electrodes for ECG,

- a pressure sensor, a pressure transducer,

- an oximetry biosensor,

- a blood test biosensor, - a temperature sensor.

Advantageously, a plurality of sensing elements is provided for measuring corresponding electric signals of physiological nature, in particular, biosensors, operatively connected to at least one among: - an adjustable gain amplifier,

- an adjustable pass band filter. Advantageously, in case of pressure test the sensor, or transducer, of pressure is provided in pneumatic connection with a pneumatic circuit comprising: - a sleeve that is arranged about a limb of the patient;

- a discharge valve;

- a compressor.

Preferably, the control unit comprises a microcontroller adapted to be interfaced with means for communicating the detected physiological data to a remote computer .

In particular, the means for communicating the physiological data to the remote computer allow a communication between the microcontroller and the remote computer according to a mode selected from the group comprised of: cable;

- infrared,

- RF in UHF b - Bluetooth connection;

- Zigbee connection.

This way, it is possible to carry out examinations on patient remotely from a clinical station where the remote computer is present assisted by a doctor that can then draw up a diagnosis in real time and suggest the type of treatment, or other examinations, or other operations, saving time with respect to presently used technologies.

It is, furthermore, provided an unit for supplying electric power to said plurality of electronic circuits controlled by said control unit, said control unit operating said unit for supplying to provide a measured voltage to said plurality of electronic circuits only when the selected clinical examination is carried out.

This allows to limit energy consumption to the only time of acquisition and control of the electric signals of physiological nature.

In particular, the control unit can comprise also storing unit, for example of flash card type, in which the data for long term analysis are recorded. This way, it is possible to use the apparatus as Cardiac and pressure Holter or for other long term examinations. Furthermore, by using a suitable number of precordial amplifier electrically connected it is possible to use the apparatus also as polygraph, in particular, of the type used in the coronary units and in the surgeries for displaying 8, or 12 tracks.

Furthermore, the possibility is provided to connect several apparatus units, according to the invention, with computers in order to provide a network that allows different examinations, an evaluation and a memorization of the centralized notwithstanding the pick up is carried out in different and distant points.

Furthermore, warning and alarm devices can be provided either optical or acoustic for warning the operator on the end of the test, or of failure of the apparatus, or to determine clinical events of the patient being tested.

In particular, the heart beats can be measured when the pressure and oximetry software is selected.

Alternatively, the heart beats can be calculated using a sensor of phonendoscopic type. The amplified signal, filtered and encoded digitally is presented and sent to the external computer for being recorded and displayed.

In particular, the electronic circuits provided in the apparatus, according to the invention, have similar parts and circuits among which amplifier, filters, final amplifiers, AD conversion circuits, memories, supplies, etc. Therefore, the performances of the different circuits of the apparatus can be controlled by the program in order to to adapt them to the examinations to carry out. Then, a single unit is obtained for high flexibility and multifunctional performances. analog and digital components and technology are used. This way, the apparatus, according to the invention, has a high flexibility and a multiplicity of operation of the data.

The base program allows a control of the input output signals , of the frequencies of the filters, of the gain of the amplifier, and a selection of the same to obtain the performances according to the type of selected clinical examination, as well as the connection and communication to the outer world. Specific program modules accomplish the evaluation and calculation functions typical of each test. Brief description of the drawings_.._.

The invention will be made clearer with the following description of an exemplary embodiment thereof, exemplifying but not limitative, with reference to the attached drawings wherein:

Figure 1 shows in a block diagram a possible succession of steps made by the multifunctional apparatus, according to the invention, for measuring and/or monitoring at least two physiological parameters of a patient;

- Figure 2 shows some components of the apparatus of figure 1, according to the invention, and, in particular, a possible configuration of the microcontroller that can be used for it;

- Figure 3 shows diagrammatically the possibility of connecting the apparatus, according to the invention, with output devices, such as printers, monitors, or of sending the data by means of Bluetooth communication, or similar, to remote computers;

- Figure 4 shows a possible diagrammatical circuit of the apparatus, according to the invention; Figure 5 shows a possible configuration of a device of the invention for measuring the blood pressure of a patient and evaluating the data measured by the apparatus, according to the invention;

- Figure β shows diagrammatically the course of the pressure with time during the use of the device of figure 5.

Description of preferred exemplary embodiments. In figure 1 a block diagram is shown that shows a possible succession of steps carried out by the software of the data management in the multifunctional apparatus, according to the invention, for measuring and/or monitoring at least two physiological parameters of a patient.

At start of a computer connected to the apparatus, according to the invention, block 301, data relative to the patient being tested are inserted, block 302. Furthermore, a step can be provided of introducing the personal data of the patient, block 303, such as date and place of birth for constructing a personal database of the patient .

Them, a selection is made of the clinical examination to carry out on the patient, block 304, or alternatively, of a succession of clinical examinations to carry out in turn.

According to the type of selected clinical examination, a program that resides in a control unit according to the invention, configures the apparatus according to the type of selected clinical examination, block 305a-305e. The list of clinical examinations among which selecting the clinical examination, or the succession of clinical examinations, to carry out, can comprise the blood test, block 306, the body temperature measurement, block 307, the oximetry test, block 308, the blood pressure measurement 309, the ECG, block 309, each of which associated, as above described, to a corresponding configuration of the apparatus.

Then, the detected analog signal relative to the parameter of physiological nature corresponding to the examination as carried out, is digitally encoded, block 311 and 312, and recorded, block 313. The successive steps then depend by the type of selected clinical examination, block 314.

For example, as in case of the ECG, it is possible to display directly the parameter of physiological nature without the need of analysing further the corresponding data. This can be made by an output device such as a monitor, for example a monitor of LCD type, block 317, or a standard printer, block 316. The parameter of physiological nature can also be sent to a computer, or to a remote monitor, block 318, for example provided in a clinical station assisted by a doctor, which can then examine remotely the results of the clinical examination carried out for advising the type of first operation to carry out by the operators assisting the patient, or advising in such as hospital department the patient has to be brought .

On the other hand, other examinations, such as a measurement of the blood pressure, require a successive control of the physiological parameter as detected, block 315, before carrying out a successive action, block 319. This can consist of displaying the parameter of physiological nature, or of sending the parameter to a remote computer as above described. In addition, or alternatively, the next action can provide for example operating determined medical devices, or the supply of drugs, for example operating a valve of a phleboclysis.

The transmission of the parameter of physiological nature can be carried out both by means of radiofrequencies, block 321, and by means of serial connection, or USB, block 320.

In an example shown in the diagrammatical circuit of figure 4, the apparatus, according to the invention, comprises a determined number of electrodes for ECG that, as well known, are arranged at contact of the surface of the patient in determined points for measuring corresponding electric signals. For example, the electric signals can be measured at the right arm, of the left leg, of the right leg, of left arm and of left leg of the patient 100 being tested. The corresponding electric signals are sent to a conditioning unit 120 respectively at input knots 81, 82, 83, 84 and 85-

More in detail, the electric signals sent to the knots 81, 82 and 83 form a first channel of the signal that is filtered by a filter 60a adjustable pass band, and amplified by a adjustable gain amplifier 55 before being sent to a microcontroller 40 of evolute type with wide performances to allow the acquisition of the data, either single channel, or multichannel, and the control of many counters and I/O ports. The electric signals sent to the knots 84 and 85 form instead a second channel that is filtered by a filter 60b with capacity commutation, also this with adjustable pass band, and amplified by an adjustable gain amplifier 56 before being sent to the microcontroller 40. In particular, once selected by the operator the type of ECG to execute, the program then sets the electric characteristics of the circuits, i.e. the high pass band values and low pass band, as well as of reiection for filters 60a and 60b as capacity commutation and gain commutation, for differential amplifier 55 and 56. The gain of the amplifier is adjusted acting on respective counter- reaction resistance 55a and 5βa. As shown in detail in figure 3, the analog signal is digitally encoded by an AD converter, This can be external to the microcontroller 40, not shown in the figure, or internal to it, see converter 46 in the figure. The digital signal is then sent to an external computer 150 for displaying the results of the examination on a monitor 151 and/or printing them.

In case of the ECG, the scanning frequency, the limit bandwidth values and the gain are selected according to the desired quality for the results. The control unit, as diagrammatically shown in figure 2, comprises a microcontroller 40 of the low consumption type connected to a visualizer and to a keyboard 152 for introducing the controls by a operator.

Microcontroller 40 comprises an inner microprocessor 45 operated by the control program and have an interconnection bus 48 to which the auxiliary inner devices are connected for operating the microprocessor 45, among which there are a clock generator 41, a program memory 47, for example of flash type, or EEPROM, a system memory 44, of RAM type, a timer circuit 41, I/O ports 43 and communication ports 42.

Microcontroller 40, furthermore, is connected by a external additional memory 49, for example of flash type, or flash card, to a converter D/A 110, for making the analog signal to the printer and the analog external monitors, to a RF circuit 130 with function of transmitting and receiving in UHF band, or Bluetooth, or Zigbee, or of GPRS type (General Packet Radio Service) , besides possible circuits of alarm optical and acoustic 140 and to a supplier 145 with battery and circuits for controlling the supplies and of stabilization.

Microcontroller 40 is then connected to a circuit condithionedre 120 comprising a plurality of ciruiti electronic through which the detected electric signal by the sensors, or by the transducers, or by the electrodes provided for different clinical examinations, is amended for then being displayed as a corresponding dato of physiological nature by the output devices, or sent to a processor by means of one of the methods of communication above described.

In figure 5 is diagrammatically shown a possible configuration of the interaction element of the invention for measuring the blood pressure of the patient 100.

The interaction element comprises a sleeve 251 that is arranged about arm 105 of the patient 100 patient to the clinical examination. The sleeve 251 is in communication with a pneumatic circuit 252 comprising a compressor 254, a discharge valve 253 and a pressure transducer 255 that detects the pressure in the pneumatic circuit 252. for the measurement the pressure are used algorithms for adjusting the speed of 'unloading the sleeve 251 and for analysis statistic of the data to obtain the results more precise of the measure.

In particular, the method used for analysing the measurement the pressure can be selected in housing configuration. For example, the chosen can be carried out between the method oscillometric, the method for the transit of the impulso, the method Korotoff, etc.

A possible succession of operations through which it is possible to calculate the measurement the pressure of the patient 100 comprises a step for controlling the pressure in the sleeve 251 that is adjusted according to a value probable of the pressure systolic. follows the control of the speed of outflow of the pneumatic circuit 252 to obtain the results according to the differential between the pressure systolic and the pressure diastolic.

Viene then done the acquisition of the values of the pressure present in the sleeve 251 for computing the pressure systolic and of the pressure diastolic . The values of pressure taken are then transmitted to a computer that computes the data using a analysis statistic to determine the values relative to the pressure and to the pulsation.

The analysis statistic can be made detecting an each heart beats the values of the pressure in the sleeve 251.

In particular, in a first step, portion increasing ^VVI" in figure 6, the sleeve 251 is inflated by the compressor 252 maintaining closed the valve of outflow 254 up to measure a pressure P* with the pressure sensor 255. The pressure P* corresponds in particular, to value provided for pressure systolic, or pressure maximum of the patient .

Then, the compressor 252 is stopped and the valve 254 , open to allow the outflow of the air by the pneumatic circuit 253, portion decreasing ^XNII" in figure 6. In this step ho of the pulses of pressure with peaks and gobbe obtained from the prevalere of the pressure arterial on the pressure of the sleeve 251.

The analysis statistic is done detecting an each heart beats the values of the pressure in the sleeve, the height of the impulse, value corresponding to the range of time after by the heart beats previous and a value corresponding to the number of the pulsation. Such values are loaded in a determined number of adjusti, for example a terπa of adjusti, slidingly whereby there is the sliding the four data associated with it associated an each in the pulsation. an algorithm intervenes in particular, to interpretare the ampieze of the pulses, when occurs the condition whereby three values following have a same value of peak, or in any case values comprised within a small range, the before the three registers contains value of the pressure systolic and the time starting the measure. The values are loaded in a particular memory.

Like is causes the pressure diastolic when instead two values following are less than the previous, is law value of the pressure dynamic before the three registers that is value of the pressure diastolic. The difference- of the time between the reading the systolic and of the diastolic diviso for number of the pulses provides value of the pulsation.

The values of the pressure systolic, diastolic and of the heart beats are displayed on a monitor 151 and/or printed by a printer 152 and/or transmitted to a remote computer 156.

According to the type of pressure detected, i.e. pressure statica, i.e. that detected to the sleeve, or pressure dynamic, i.e. that detected during the step II of outflow, the corresponding detected electric signal by the transducer 255 follows a determined path circuite. More in detail, the electric signal corresponding to the pressure static is directly given through the branch 256 to the microcontroller 40. The electric signal relative to the pressure dynamic is, instead, amplified by a amplifier 57 and filtered before being sent to microcontroller 40 through branch 257 (figure 4) . Concerning the oximetry test, it is a spectrophotometry technique based on the different absorption of the light by the hemoglobin owing to the oxygen and can be of type standard, or of type pulsed. Even an this case once selected the type of examination desired by the operator, the program provides to set the electric characteristics of the circuits.

With reference to the diagrammatical circuit of figure 4, the detected electric signal by a biosensor 87 of the prior art is amplified by a amplifier to transimpedance 58, elabored, encoded digitally, for then being comunicato to the external computer that provides to the evaluation, visualization and/or to the stampa of the values obtained.

In case of standard oximetry test, the detected electric signal and amplified is sent to a switch 92 that carries out the reading and carries them to the microcontroller. for the pulsed oximetry test, instead, the electric signal relative to the measurement the oximetry is detected in synchronism with the heart beats of the patient. This can be detected using a sensor of heart beats 36 located on a finger of the hand or on the lobo of the orecchio of the patient 100. The electric signal coming from the sensor of heart beats 86 is sent to microcontroller 40 in order to operating a generator of pulses 91 in synchronism with the heart beats of the patient 100. Alternatively, or in addition to the sensor 8β can be used a sensor of heart beats 88 dedicated.

Also for blood test can be used a diagrammatical circuit similar to that above described for measuring the oximetry except from the generator of pulses 91.

In particular, also in this case the operator selects the type of blood test desired between a list of possible methods, comprising for example reflectance photometry, and amperometric so that the program configides then the apparatus . more in detail, in case of the photometry to reflectence, a strip containing a sample of blood is patient to optical sensors, for example LED, optotransistors, etc. connected to a amplifier to transimpedance 58. are, furthermore, provided two devices generators to the red and to the infrared operated by suitable circuit to provide pulses of energy to the red and to the infrared that are projected on the sample examined. once detected the variation of the intensity of the colour due to the reaction on the strip sample it is "tradotta" from circuits encoders in a dato numerical for defining the concentration of the cholesterol and of the glucose in the blood.

Tn case of the amperometric method, the strip sample is connected to amplifier to transimpedance 58 for measuring the charge measured by the reaction chemica. Value read is then transformed in a number that is displayed on a monitor, or printed, or sent to a remote computer. for the examination of the temperature can be used a common temperature sensor 89 through which is drawn and sent to amplifier 55 when it has been chosen by the program on a determined value of gain. Then, the signal is encoded by analog to digital, for being computed and then displayed and/or transmitted to the external computer for visualization and/or stampa of the data. Can be, furthermore, provided devices of signalling acoustic 171 and/or devices of signalling optical 172 for warning the operator on the end of the test, or of failure of the apparatus . Furthermore, as above described circuits 130 RF in UHF band are provided, to use free for communications to brief and long distance by means of technologies Bluetooth, or Zigbee, or apparatus GPRS. The apparatus comprises furthermore, an unit external of memorization of the data 180 equipped with a memory, for example of flash card type, to allow the load of a high number of data for analysis for long term, such as the monitoring pressure of 24 hours. The supplies is supplied by battery incorpored with stabilization and circuit of refill with device outer. Using only the supplies from battery inner the insulation galvanic of the apparatus is total whereby can be used in applications critiche. Circuits specific 190 can be then used for turning on and the turning off to time for reducing the consumi to the only time of acquisition and control by means of control from program that allows the supplies the circuits limited to the period of activeta. for the condithionedre of signals 120 are used operational amplifier differential amplifier, for example of the type instruments to low comes from and consumption and high value of CMRR. are, furthermore, provided of the commutation circuits analog that allow the adjusting the pass band the filters and of the gain of the amplifier.

The circuits of input and the condithionedri aσσeptano signals obtained from electrodes for ECG, transducers of pressure for pressure, sensors for measuring the temperature, biosensors for oximetry and for blood test. The signals analog as input are filtered with values of pass-banda suitable, converted digitally signal from encoders To and amplified by adjustable gain amplifier.

Both the frequencies of the filters both the gain of the amplifier are defined by the program according to the test. The control of all the functions of the circuits is demandato to the microcontroller. The data are computed and immagazinati in a memory of mass statica. Then the signals are transmitted to a external computer for control, the visualization and the stampa. The connection there is via line serial for brief distance or via RF, Bluetooth or Zigbee to apparati GPSM for connections to long distance.

The foregoing description of a specific embodiment will so fully reveal the invention according to the conceptual point of view, so that others, by applying current knowledge, will be able to modify and/or adapt for various applications such an embodiment without further research and_. without parting from the invention, and it is therefore to be understood that such adaptations and modifications will have to be considered as equivalent to the specific embodiment. The means and the materials to realise the different functions described herein could have a different nature without, for this reason, departing from the field of the invention. It is to be understood that the phraseology or terminology employed herein is for the purpose of description and not of limitation.

Claims

1. Multifunctional apparatus for measuring and/or monitoring at least two physiological parameters of a patient said apparatus being characterised in that it comprises:

- means for selecting at least one clinical examination to carry out among a plurality of examinations ;

- at least one interaction element adapted to be located into contact with predetermined points of the surface body of said patient, or of supports for biological material to examine, for measuring a corresponding electric signal of physiological nature;

- an electronic conditioning unit connected to said, or each, interaction element, adapted to condition said, or each, detected electric signal, said conditioning unit comprising a plurality of associated electronic circuits to determine electric characteristics; - a control unit adapted to analyse said, or each, electric signal to generate a physiological data, in said control unit a program being resident for adapting said electric characteristics according to the clinical examination to carry out and for generating respective output signals.

2. ^' Apparatus, according to claim 1, wherein said electronic conditioning unit comprises a plurality of switches, said program turning off/on said switches for connecting determined electronic circuits of said plurality according to the type of clinical examination to carry out in order to provide a determined circuit configuration.

3. Apparatus, according to claim 1, wherein through said means for selecting one of the following operations is carried out:

- selecting a clinical examination among a list of clinical examinations, - selecting a succession of clinical examinations in turn among a list of clinical examinations.

4. Apparatus, according to claim 1, wherein said apparatus is capable of providing at least two clinical examinations selected from the group comprised of:

- ECG;

- blood pressure;

- body temperature;

- oximetry; - blood test.

5. Apparatus, according to claim 4, where in case of selection of the blood test a further selection is done among :

- reflectance photometry method; - amperometric method.

6. Apparatus, according to claim 4, where in case of selection of the oximetry test a further selection is done among:

- standard oximetry; - pulsed oximetry.

7. Apparatus, according to claim 1, wherein said electronic conditioning unit comprises at least one among :

- an adjustable gain amplifier; - an adjustable pass band digital filter.

8. Apparatus, according to claim 1, wherein according to the type of clinical examination said program carries out at least one of the following operations:

- selecting the gain of said, or each, adjustable gain amplifier;

- selecting the frequency of said, or each adjustable pass band filter.

9. Apparatus, according to claim 1, wherein said interaction element with said patient comprises at least one element for measuring an electric signal of physiological nature selected from the group comprised of:

- a plurality of electrodes for ECG,

- a pressure sensor;

- a pressure transducer;

- an oximetry biosensor; - a blood test biosensor;

- a temperature sensor.

10. Apparatus, according to claim 1, wherein a plurality of sensing elements is provided for corresponding electric signals of physiological nature, in particular, biosensors, operatively connected to at least one among:

- an adjustable gain amplifier,

- an adjustable pass band filter.

11. Apparatus, according to claim 1, where in case said clinical examination is the blood pressure measurement and said sensor, or transducer, of pressure is provided in pneumatic connection with a circuit comprising:

- a sleeve arranged about a limb of said patient; - a discharge valve;

- a compressor.

12. Apparatus, according to claim 1, wherein said control unit comprises a microcontroller adapted to be interfaced with means for communicating said detected physiological data to a remote computer, in particular, with a mode of communication selected from the group comprised of:

- cable;

- infrared,

- RF in UHF band;

- Bluetooth connection; - Zigbee connection.

13. Apparatus, according to claim 1, wherein an unit is provided for supplying electric power to said plurality of electronic circuits controlled by said control unit, said control unit operating said unit for supplying to provide a measured voltage to said plurality of electronic circuits only when the selected clinical examination is carried out.

14. Apparatus, according to claim 1, wherein said control unit comprises a storing unit in which the physiological data for long term analysis are recorded.

15. Apparatus, according to claim 1, wherein devices of alarm are provided for warning the operator on the end of the test, or of failure of the apparatus, or to determine clinical events of the patient being tested.