CA1104373A

CA1104373A - Limb blood flowmeter

Info

Publication number: CA1104373A
Application number: CA301,614A
Authority: CA
Inventors: Kenichi Yamakoshi
Original assignee: Asahi Medical Co Ltd
Current assignee: Asahi Kasei Medical Co Ltd
Priority date: 1977-09-07
Filing date: 1978-04-20
Publication date: 1981-07-07
Also published as: JPS5441584A; JPS6213013B2; US4204545A

Abstract

Abstract of the Disclosure A human limb to be examined is pressurized on the side of the heart to occlude the venous return alone for the measurement of admittance of the limb, and the measured initial admittance is retained and compared with subsequently measured admittance to detect a difference .DELTA.Y therebetween.
The blood resistivity p, the length L of the limb segment to be examined and its tissue volume VO are respectively set, and

Description

This invention reiates to a limb blood flowmeter for measuring the blood flow rate in human limb segments, ~or example, in the case of using an artificial kidney, the blood is dialyzed by a hemodialyzer. In such a case, the measurement of the blood flow rate i~
indispensable to the determination of the period time for hemodialysis, that is, the time for each application of blood of substantially the whole body to the hemodialyzer.
One method that has usually been employed in conventionaI
hemodialyzers for the measurement of the blood flow rate is to make transparent a blood flow path between the hemo- '-dialyzer and the human body, form a bubble in the path at a certain placè and measure the time for the passage of the bubble for a predetermined distance in the path, thereby to measure the blood flow rate. However, such a method is very troublesome, and the bubble in the blood entails a danger to the patient and, on top of that 7 the accurate ~0 measurement is little obtained.

, , 1:~0~3'73 1 In vie~ of the abovesaid defects, there is a s-trong demand for means for accurately measuring the blood flow rate in -the human body by a non-invasive method. One method for measuring blood flow rate or blood volume change non~invasivel~ is the venous occlusion method. With this method, an occluding pressure cuff is wrapped around a limb such as an arm or leg to occlude the venous return and hence cause an increase in the tissue volume in the limb by the arterial inflow, and the increased tissue volume is measured to detect the blood flow rate. ~hus the blood flow rate can be measured non-invasively without taking out a blood vessel for directly measuring the blood flow rate. This measurement is carried out in the following manner~- For example 9 an arm is immersed in water or like liquid contained in a measuring chamber, and the venous return is stopped, with the arm and the chamber held liquid-tight therebetween. An increase in the tissue volume of the arm by the arterial inflow is detected from the quantity of liauid ove flo~m by the arterial inflow, and then the blood volume flow is measvred from the amount of tissue volume thus increased. However9 a change in condition of the hv~an limb due to the liquid temperatl~e change during the measurement introduces an error in measurement. Accordingly the liqvid temperature must be kept constant, and its control is complicated and, further, in such a condition that the arm is immersed in the liquid for a long period of time, as mentioned above 9 the blood flow rate cannot be measured repeatedly and continuously.
A method that has been proi~osed for easy and 0 continuous measurement o~ the limb blood flow by the venous 110~3'~3 1 OCClllSiOn CeC~liqUe i5 the impedance plethysmo~,~raphyO This is set forth, for instance, in Medical Physics,9 lJol. II, Year Boo~ 736/74-3 (1950) 9 J. Nyboer9 "Plethysmograph Irilp~d~nce", Aerospace Med. Vol. 379 120~/1212 (1966) 9 W. G.
I~ukicek et al, "~e~elopme~~t and ~valuation of an Impedance ~ardiac Output Sys-tem" ancl so on. This method is to supply a high-frequency, very small current to a limb segment and measure the limb blood flow from a change in the electrieal impedance of the limb segment caused by the venous occlusion. This method enables non-invasive and continuous measurement of the blood flow, but the impedanee variation by a change in the blood volume is af~ected by the init;al impedance value o~ the segmcnt to be examined and does not coincide accurately with the aetual change in the volume.
Consequently the impedance variation is measured inclusive of the electrical eharacteristics of other tissues than that of the region desired to be examined, therefore the abovesaid method is defective in theory and in the accuracy of measurement.
Further9 in his thesis submitted to the ~aculty of t~e Graduate School of the University of Minnesota9 19659 "~ardiac Output Determinations IJsing Impedance Plethysmographyi', Ro P. Patterson made a theoretical propo,,al that measurement of admittance variations by volume changes in the region to be e,xamined would make it possible to direetly measure ehanges in the blood volume regardless of the initial admittanee value of the limb.
An object of this invention is to provide a limb blood flowmeter which enables non-invasive9 eontinuous and ~0 accurate measurement of the limb blood flow rate.

liO~3'~3 Another object of this invention is to provide a limb blood flowmeter which enables accurate measurement of the limb blood flow rate regardless of the initial admittance value of the limb and without including the electrical characteristics of other tissues than that of the region to be examined.
Still another object of this invnetion is to provide a limb blood flowmeter using the admittance method which is capable of direct measurement of a change in the blood 10 volume independently of the initial admittance value of the limb to be examined.
Summary of the Invention According to one aspect of the invention there is provided a limb blood flowmeter comprising: occluding pressure means for applying pressure to a limb to be examined on the side of the heart to occlude only the venous return; admittance measuring means for mesuring the admittance of the limb; means for holding an initial admittance of the limb at the start of measurement; a 20 subtractor for deriving an admittance change AY from the difference between the initial admittance and an admit-tance measured subsequently and operative to produce an electrical signal corresponding to ~Y; means for setting the value of the blood resistivity p of the limb and operative to produce a corresponding electrical signal;
means for setting the value of the l~ g h L of the region of the limb to be examined and operative to produce a corresponding electrical signal; means for setting the value of the tissue volume V0 of the region to be 30 examined and operative to produce a corresponding elec-trical signal; a calculator responsive to said electrical 110~373 signals for calculating ~L2~Y/Vo based on an output Y from the subtractor and the blood resistivity p, the length L and the volume V0 set in the setting means, and a controller for controlling the occluding pressure means and the holding of the initial admittance of the limb.
According to another aspect of the invention there is provided a limb blood flow rate measuring method comprising the steps of: applying pressure to a limb to be examined on the side of the heart to occlude only the venous return;
measuring the admittance of the limb and holding the ini-tial admittance of the limb at the start of measurement;
measuring the admittance of the limb after holding of the initial admittance and subtracting the measured value from the initial admittance to obtain an admittance change QY;
calculating QV = PL V AY based on the blood resistivity p of the limb to be measured and the length ~ and the tissue volume VO of the region of the limb to be examined; and obtaining the limb blood flow rate from an initial grad-ient of the calculated QV.
In accordance with this invention, therefore, at least in the preferred forms, the venous return in the limb to be examined is occluded, and the initial admittance value of the limb is measured and held and is then compared with the subsequent admittance value of the limb due to the venous occlusion to obtain the difference QY between them.
The blood resistivity p, the length L of the segment to be examined and its volume V0 are respectively set in setters, and PV AY is computated, and then the computation result is recorded on a writer. A series of operations for the venous occlusion, the holding of the initial ad-mittance and the drive of the recorder are sequentially - 4a -,".~

11043'~3 carried out under the control of a controller. ThuS t:he blood flow rate can be obtained from the initial gradient of a plethysmogram recorded on the recorder to time. In the above calculation, p, L2 and VO are constants and thus it is obvious that the blood volume change is directly proportional to the difference ~Y alone.

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1:104373 1 Brief Description of the Drawin~s Fig. 1 sho~s a schematic diagram of the four electrodes method and the position of the pneumatic cuff for venous occlusion in a human limb 9 Fig. 2 is a block diagram illustrating an embodi-ment of the limb blood flow rate of this invention;
Fig. 3 is a block diagram showing an example of a cuff pressure generating unit utilized in the embodiment of ~ig. 2 9 Figs. 4A to 4E are timing signals showing the sequencial control of a logic circuit used in the embodiment of ~igs. 2;
Fig. 5 shows plethysmograms obtained in experi-ments conducted with the blood flowmeter of this invention;
~ig. 6 shows a graphical representation of human limb blood flow variations of before and after exercise obtained by the blood flowmeter of this invention.
Description of the Preferred Embod ments In measurement of the limb blood flow, the venous return in the limb to be examined is occluded9 for instance9 by a method such as shown in Fig. 1. In ~ig. 19 an occluding pressure cuff 12 9 usually employed in sphygmomano-metry9 is wrapped around the forearm 11 at the side of the heart 9 in this case~ on the upper arm, and inflated to occlude the venous returnO ~he occluding pressure is usually lower than the diastolic blood pressure but higher than the venous pressure and about 40 to 50 m~Xg in the case of a healthy subject. ~lectrodes 13 and 14 are wound around the forearm 11 in its longitudinal direction and electrically connected thereto. An AC signal of 50 ~Hz9 l~V43'73 1 for exa;,lplez ls appllecl across the electrodes 13 and ]4.
On the inside of -the elect~odes 13 and 149 measl1ring electrodes 15 and 16 are similarly wrapped around the fore-arm 11 to measure the admittance of the segment between the measuring electrodes 15 and 16. ~etting L represent the distance between the measuring electrodes 15 and 16, i.e.
the length of the segment to be examined 9 ~ repre~ent the blood resistivity and ~Y represent the difference between ; the admittance between the measuring electrodes 15 and 16 before venous occlusion and the admittance when the tissue volume of the segment to be examined has been increased by the arterial inflow after venous occlusion9 an increase ~V
in the limb volume by the arterial inflow is expressed as followso-; 15 ~V _ p ~2 ~y 0,.,.O,.... O.. O,,OOO.,OO (1) ~rom this, the blood flow rate F is given as the following time differentiation of the increase ~V in the limb volume immediately after venous occlusiono-~ 2 d~ ................. ,.. Ø... (2) Usually the blood flow rate ~' is normalized to 100 ml of limb volume. Accordingly~ a volume change ~V' per unit " limb volume is given as followso-~V = e~V `Y ...... ,..... o.. ~... o................... oo.... (3) where VO is the volume of the limb segment to be examined.
~he volume change ~V' is recorded and the initial gradient of its recorded curve to time or the differentiated value of the volume change ~V'~ -that iS9 the limb blood flow rate per unit limb volume is measured. The reason for such measurement of the limb blood flow rate by recording is llV~3'73 1 that the volume change ~Vi is very slow and hence is dif-ficult to obtain by differentiation with a calcul.ator circui-t.
In the present invention 9 the volume change ~V' is measured by the employment of such a circuit structure as shown in Fig. 2. In Figo 2 9 reference numeral 22 indicates generally an admittance measuring unit 9 in which an ~C current of 1 mA and 50 ~z 9 generated from an AC
current genera~or 2~ 9 for e~ample 9 iS applied across the electrodes 13 and 14, with the common potential point electrically isolated from the AC current generator 23.
~o this end, the output from the AC current generator 23 is applied across t;he electrodes 13 and 14 via an isolating transformer 24. Tl1e current applying across the electrodes 13 and 14 is maintained accurately at a constant value of 1 mA9 for instance~ ~or this purpose9 a current detecting resistor 25 is connected in series with the secondary side of the transformer 2~ and is connected at both ends to the primary side of an transformer 26. ~he secondary side of

2~ the transformer 26 is grounded at one end and connected at the other end to a comparator 27. In the comparator 27 9 a voltage detected by the detecting resistor 25 is compared with a reference voltage from a terminal 28 9 and the compared output from the comparator 27 is negativel~ ~ed back to the AC current generator 23 to control it to hold its output current constant.
A si~nal indicative of the impedance value between the measuring electrodes 15 and 16 9 that is 9 a voltage d.rop based on the abovesaid AC current 9 iS picked up, with the common potential point isolated f~om these electrodes.

110~3'73 1 In the illustra'~ed embodiment, the above signal is picked up by usin~ a high input impedance lest the A~ current should ~low in the signal pick-up side to introduce a:n error in the measured value. To perform this 9 the measuring electrodes 15 and 16 are respe~,-tively connected via coupling capacitors 29 and 31 -to a differential ampli~ier 32 of high input impedance, the output from which is supplied to an AC-DC converter 34 via a common potential point isolating transformer 33. In the converter 34 9 an AC signal inputted thereto is smoothed after being subjected to full-wave rectification to provide a DC
current value corresponding to the impedance between the measuring electrodes 15 and 16. The DC output from the converter 34 is applied to an analog divider 35 to obtain the reciprocal of the DC output; in other words 9 ,the DC
output is converted to the admittance value between the measuring electrodes 15 and 16. It is also possible to convert the output from the AC-DC converter 34 by an ~-D
converter 36 into a digital signal and supply it via an output terminal 37 to a display (not shown) for providing a display of the impedance between the measuring electrodes 15 and 16.
The ini-tial value of the admittance measuring unit 22 is retained by a sampling and holding circuit 38 and an initial admittance V0 is stored therein. An admittance value having changed with a variation in the tissue volume of the segment being examined 9 as a result of venous occlusion, is provided in the analog divider 35 9 and this admittance value and the initial one Y0 are subtracted from each other in a subtractor 39 to obtain a d.ifference ~Y

l~Q4373 1 therebetween, which is led to a calculation circuit 41.
On the o-ther hand 9 there are provided a setter 42 for setting the blood resistivity p, a setter 43 for setting the length ~ of the segment to be examined and a setter 44 for the limb volume VO of the segment to be examined. For facilitating the setting of these values, they can be set, for example, by digital switches, and the set values are converted to analog signals for input to the calculation circuit 41. The unit of -the blood resistivity p is n cm, and resistivities of 50 -to 199 Q-cm can be set at intervals of 1 Q-cm, for instance. The blood resistivity varies with the hematocrit value Hct, and the following experimen'cal formula can be employed for the correction of the blood resistivity with respect to the hematocrit value Hct:-p = 50.7 exp (0.023 Hct) The hematocrit value Hct of an ordinary healthy subJect is substantially constant, and the blood resistivity p is about 140 Q~cm. The length ~ ~etween the measuring electrodes 15 and 16 is measured in cm, and the limb volume VO between these electrodes is measured in 100 ml.
The set outputs ~, ~ and VO from the abo~e-mentioned setters 42 through 44 and the output ~ from the subtractor 39 are provided to the calculation circuit 41 for achieving the calculation of the aforesaid formula (3).
In this case9 for example, ~ is calculated first and is then multiplied by ~Y. The output from the calculation circuit 41 is supplied, for instance, to a heat-pen recorder 45 for recording.
A cuff pressure control unit 46 is provided for controlling the pressure to the cuff 12 used for occlusion _ g _ 11()~3'73 1 of the venous return. 'rhe cuff pressureS the sampling and holdin~7 circuit 38 and the recorder 45 are all controlled by a control circuit 47. The cuff pressure control unit 46 has a construction such, for example 9 as illustrated in Fig. 3. In Fig. 3, since the control circuit 47 is housed in a casing in close proximity to the calculator circuit and others, an electrical signal -for the cuff pressure control is converted to a pneumatic æignal so as to prevent that the cuff pressure control generates a large magnetic field to affect the operations of the other electric circuits. That is to say, compres~ed air from a small compressor 48 is applied via a precision reducing valve 49 to an air tank 51, from wh~ch the air pressure is supplied to the cuff 12 via a three-way valve 52 and a throttle 53.
In case of controlling the three-way valve 52 with an electrical signal, an appreciably large electrical signal i5 required and generates a large magnetic field, as referred to aboveO To avoid this 9 a converter 54 is provided for converting an elec-trical signal to a pneumatic one, and the air pressure from the compressor 48 is branched to be supplied via a fluidic diode 55 to the air tank 56, from which the air provides a pneumatic control signal to the three-way valve 52 via a pneumatic relay 57. On the other hand 9 the air from the air tank 56 is branched to be supplied via a throttle 58 to a nozzle 59 and the pneumatic relay 57. A flapper 61 is disposed opposite the tip of the nozzle 59 and controlled by an electromagnetic coil 62 in its position. Upon energization of the electromagnetic coil 62 to pull the flapper 61 apart from the nozzle 59, the three-way valve 52 is controlled by the OUtpllt from the llV4373 1 pneumatic relay 57 to permit the air supply from the air tank 51 to the cuff 12. The pressure of the air tank 51 is inclicated by a pressure indicator 63, The control circuit 47 in Fig. 2 is constructed to perform the operations such9 for example, as shown in Fig, 4, That is, a main timer incorporated in the control circuit 47 generates a pulse such as depicted in Fig, 4A
which has a period Tl and a pulse width Wl The period Tl can be selected to be for instance, 10 minutes 9 30 minutes, an hour or two hours, and thé pulse width Wl is selected to be approximately 30 seconds, With the leading edge of the pulse from the main timer, a trigger pulse shown in Fig. 4~ is produced, and when required, a pulse for driving a buzzer informing the start of measurement to a subject is generated by the trigger pulse. Further, the trigger pulse is used for driving the small compressor 48 in Fig. 3 and feeding a recording paper of the recorder 45 in Fig, 2 and heating i-ts recording pen, as depicted in Figso 4D, E and F~
respectively. As shown in Fig. 4G7 the electromagnetic coil 62 in Fig. 3 is energized after a period T2 9 for instance, 10 seconds, to thereby generate the cuff pressure.
The cuff pressure is maintained for a period T3, for example, 15 seconds, As illustrated in Fig. 4H, a period T4, for example, about 1.0 second af-ter the generation of the cuff pressure, the sampling and holding circuit 38 in Fig, 2 samples and holds the output from the divider 35 to retain the initial admittance Y0. For about 15 seconds ~a period T3) during which the cuff pressure is applied, the output from the calculator cireuit 41 in Fig~ 2 is recorded by the recorder 45. Thereafter, -the cuff pressure is removed to 110~373 1 ~eturn the respective partæ of the device to their initial state. The period Tl after the abovesaid trigger pulse, a trigger pulse i9 generated again to achieve the same operations as described above. In the recording, before venous occlusion, the sampling and holding circuit 38 achieves sampling alone and, at this time, the recording pen of the recorder 45 is held to read "zero" and, upon venous occlusion, the sampling and holding circuit 38 is switched to the holding mode of operation to enable recording of only a change in the volume of the limb segment to be egamined. ~he sampling and holding circuit 38 is switched by a timer signal between such modes of operation.
~ he recording by the recorder 45 takes such a form as indicated by 65 to 67 in ~ig. 5. ~he start of each of the curves 65 to 67, that is, the leftàhand ena of each curve in Fig. 5 9 shows the moment of generation of the trigger pulse. The points indicated by the arrows 68 9 after the elapse of time ~2~ each show the moment of application of the cuff pressure. Before the application of the cuff pressure, the recording pen is held -to read null and alæo immediately after the application of the cuff pressure, the recording pen is still maintained at the zero point because the operator output from the calculation circuit undergoes a transient change the instant of application of the cuff pressure. Then9 the output from the calculation circuit 41 is recorded. In ~igo 5, the arrow 69 indicates the moment of release of the cuff pressure. ~he initial gradients of the recorded curveæ of the calculation reæults to the time axis (-the abscissa), that is, tke angles of straight lines 71 to 73 along the ~()4373 1 rising of the curves 65 to 67 -to the lengthwise direction of the recording paper, represent the limb blood f]ow ra-tes desired to obtain. '~he illustrated examples irere obtained in -the case where p = 142 Q-cm~ ~ = 15 cm and V0 = 5.25 lOOml ancl the ambient temperature was changed in three ways.
The blood flow rate is ~easured in the manner described above. ~ig. 6 shows examples of measurement of blood flow variations after exercise in an examinee, the curve 74 indicating the case of -the forearm being examined and the curve 75 the case of the colf being examined.
The examinee had some exercise for five minutes 9 as indicated by 76 in Fig. 6. It will be seen fron ~ig. 6 that the blood flow rate m~rkedly increases immediately after exercise but naturally decreases to return to the state at rest before the exercise as time passes. As referred to previously, this blood flowmeter is capable of automatically monitoring the blood flow rate at regular time intervals 'rl9 but it is also possible to achieve the measurement by generating the trigger pulse at a desired moment. ~or the calibration of such recording, it is arranged that the output ~V' from the computation circuit 41 becomes 0.25 ml/100 ml7 for example9 when p = 111 Q-cm, = 15 cm and V0 = 999 ml and ~Y (=0.1 mmU) is applied to the computation circuit 41. '~his is in the case where the recording sensitivity is 0.25 m/100 m/~S9 and the sensitivity of the recorder 45 is adjusted so that the recorder reaches its full scale under the abovesaid conditions. ~or such calibration, a calibration bo~ is incorporated in the blood flowmeter, which box sets resistance values, for instance, 0 to 200 Q at intervals - 13 ~

1 of 10~ and is capable of changing each resistance value by 0.1~ and 1 n. Various values of ~Y are produced wlth the calibration box and applied as the reference values of ~r to the computation circuit 41 for the abovesai~
calibration. By picking up the AC components in the output from the divider 35 or the subtractor 39, arterial ripples are measured. ~or example, in Fig. 2, the output from the analog divider 38 is branched by a capacitor 81, and only the AC components are picked up. The AC components are shaped by a wave-form shaping circuit 82 into shaped pulses, which are counted by a counter 83 for unit time. The count value of the colmter 83 is indicative of the heart rate.
Such simultaneous measurement of -the heart rate with the blood flow rate enables an analysis of their relationship to each other.
On top of that, the blood flowmeter of this invention can be employed for sphygmomanometry. In the measurement of the blood flow rate the cuff pressure is selected, for instance, about 50 mmHg to occlude the venous return alone, but in the ~easurement of blood pressure the cuff pressure is further raised to occlude the arterial inflow as well as the venous return. Upon occlusion of the arterial inflow, the cuff pressure is gradually reduced, and the generation of the arterial inflow is detected in the foxm of generation of a ripple, for instance 9 by means of a monitor 84 connected to the input side of the wa~eform shaking circuit 82, and then the systolic blood pressur-e is measured from the cuff pressure at which the arterial in*low is permitted. The cuff pressure is further lowered, and restoration of` the arterial inflow to its steady state is 1 detected from the amplitude of -the ripple having become constant in the monitor 82, and then the diastolic blood pressure is measured from the cuff pressure at that time.
It is also possible that the cuff pressure at that time.
It is also possible that the cuff pressure at which the ripple disappears as a result of raising the cuff pressure is used as the systolic blood pressure.
'~he blood flow rate ls obtained by recording with the recorder but may also be obtained in the following manner-- ~or instance, in ~ig. 2, the output level of the calculation circuit 41 is sampled by a circuit 85 under an instruction from the control circuit 47 T5 seconds after the application of the cuff pressure, and the sampled output is multiplied by 60/T5 in a circuit 86 to be i5 converted into the blood flow rate per minute, thereafter being displayed in a digital or analog form on a display 87.
As has been described in the foregoing, it is possible with the limb blood flowmeter to measure the limb blood flow non-invasively and successively. On top of that, since the measured output bears no relationship to the initial admittance, as expressed by the formula (3), the measured value excludes the electrical characteristics of tïssues outside of the object to be examined9 and hence is accurate. Further, the blood flowmeter of this invention can be easily used without any danger to examinees and is also convenient for measuring the limb blood flow rates of many persons. As described previously with regard to ~ig. 2, an AC signal is applied to the limb to be examined, but since the measuring device and the common potential are isolated by the transformers 24 9 26 and 33 from each other, 1 there i9 no possibility of the limb receiving an electrical shock. The measuring electrodes 15 and 16 are connected via capacitors to the input side of a differential amplifier, so that a circuit of high input impedance can be connected to the electrodes 15 and 16. For example~ in the ca~e of connecting the isolating transformer 33 directly between the electrodes 15 and 16, even if a high input impedance transformer is employed, its input impedance becomes appreciably low to introduce an error in measurement, but the abovesaid embodiment is free from such a defect and ensures highly accurate measurement, The current applying across the electrodes 13 and 14 is detected by the resistor 25 and controlled by the detected output to remain constant, and this also assures measurement of high accuracy~ For instance, even if the AC
signal generator 2~ itself is so constructed as to provide a constant current output, a constant AC current cannot always be produced due to a change in the contact resistance betweell the electrodes 13 and 14 and the limb 11 being examined, but the circuit structure shown in Fig. 2 ensures to accurately provide a constant current. While the foregoing has described the blood flowmeter of this invention in connection with the case where the impedanoe components are measured and then the admittance is obtained b~ way of division9 it is also possible to design the blood flowmeter to directly measure the admittance. In such a case, a method of voltage clamp is availabl~ to the limb to be exa~ined in place of the method of current clamp.
It will be apparent that many modifications and variations may be affected without departing from the scope of the novel concepts of this invention.
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Claims

The embodiments of the invention in which an exclusive property or privilege is claimed are defined as follows:

1. A limb blood flowmeter comprising:
occluding pressure means for applying pressure to a limb to be examined on the side of the heart to occlude only the venous return;
admittance measuring means for mesuring the admittance of the limb;
means for holding an initial admittance of the limb at the start of measurement;
a subtractor for deriving an admittance change .DELTA.Y
from the difference between the initial admittance and an admittance measured subsequently and operative to produce an electrical signal corresponding to .DELTA.Y;
means for setting the value of the blood resistivity p of the limb and operative to produce a corresponding electrical signal;
means for setting the value of the length L of the region of the limb to be examined and operative to produce a corresponding electrical signal;
means for setting the value of the tissue volume V0 of the region to be examined and operative to produce a corresponding electrical signal;
a calculator responsive to said electrical signals for calculating based on an output Y from the subtractor and the blood resistivity p, the length L and the volume V0 set in the setting means, and a controller for controlling the occluding pressure means and the holding of the initial admittance of the limb.

2. A limb blood flowmeter according to Claim 1, wherein the admittance measuring means is composed of impedance measuring means for measuring the impedance of the limb and a divider for obtaining the reciprocal of the measured impedance.

3. A limb blood flowmeter according to Claim 2, wherein the impedance measuring means is composed of first and second electrodes disposed on the limb at spaced positions in the longitudinal direction of the limb, AC current supply means for applying a substantially constant AC
current across the first and second electrodes, third and fourth electrodes disposed on the limb on the inside of the arrangement of the first and second electrodes, and impedance signal detecting means for obtaining a voltage corresponding to the impedance between the third and fourth electrodes.

4. A limb blood flowmeter according to Claim 3, wherein the AC signal supply means is composed of an AC current generator, an isolating transformer for applying the AC
current from the AC current generator across the first and second electrodes, a current detecting resistor connected in series to the secondary side of the isolating trans-former to provide a voltage proportional to the magnitude of the applied AC current, a transformer having its pri-mary side connected to both ends of the current detecting resistor, and a comparator for comparing a voltage pro-duced at the secondary side of the transformer with a reference voltage to control the AC current generator by negative feedback to make constant the current flowing across the first and second electrodes.

5. A limb blood flowmeter according to Claim 3, wherein the impedance signal detecting means is composed of first and second coupling capacitors respectively connected at one end to the third and fourth electrodes, a differential amplifier connected between the other ends of the first and second coupling capacitors, a transformer connected to the output side of the differential amplifier, and an AC-DC converter connected to the secondary side of the transformer.

6. A limb blood flowmeter according to Claim 1, wherein the calculator is composed of a part for calculating and a part for multiplying the calculated result by Y.

7. A limb blood flowmeter according to Claim 1, wherein the occluding pressure means is composed of a band-like bag wrapped around the limb on the side of the heart and supplied with pressurized air to be inflated, and a pressure control part for controlling the supply of the pressurized air.

8. A limb blood flowmeter according to Claim 7, wherein the pressure control part is composed of a compressed air source, means for converting a pressure control electrical signal from the controller to a pneumatic signal, and a three-way valve controlled by the converted pneumatic signal to switchingly connect the band-like bag to the compressed air source and the outside air.

9. A limb blood flowmeter according to Claim 1, which further includes a recorder supplied with an output from the calculator to record it.

10. A limb blood flowmeter according to Claim 1, which further includes a circuit for sampling an output from the calculator T5 seconds after the occlusion of the venous return, a circuit for multiplying the sampled value by 60/T5, and a display for displaying the multiplied result.

11. A limb blood flowmeter according to Claim 1, which further includes means for picking up AC components of the measured admittance from the admittance measuring means, means for counting pulses of the AC components every unit time, and means for displaying the counted result as the heart rate.

12. A limb blood flowmeter according to Claim 1, wherein the occluding pressure means is so constructed as to pro-vide a pressure for occluding the arterial inflow in the limb, too, and which further includes means for detecting the magnitude of the arterial inflow in the limb, means for displaying, as the systolic blood pressure, the pres-sure of the occluding pressure means upon stoppage or starting of the arterial inflow by pressure increasing or decreasing control of the occluding pressure means, and means for displaying, as the diastolic blood pressure, the pressure of the occluding pressure means at the moment of the amplitude of the arterial inflow becoming constant when the occluding pressure means is switched from its pressure increasing state to its pressure decreasing state.

13. A limb blood flow rate measuring method comprising the steps of:
applying pressure to a limb to be examined on the side.
of the heart to occlude only the venous return;
measuring the admittance of the limb and holding the initial admittance of the limb at the start of measurement;
measuring the admittance of the limb after holding of the initial admittance and subtracting the measured value from the initial admittance to obtain an admittance change .DELTA.Y;
calculating based on the blood resistivity p of the limb to be measured and the length L
and the tissue volume VO of the region of the limb to be examined; and obtaining the limb blood flow rate from an initial gradient of the calculated .DELTA.V.