Finger-oximeters are ubiquitously used for patient monitoring in hospitals worldwide. Recently, remote measurement of arterial blood oxygenation (SpO2) with a camera has been demonstrated. Both contact and remote measurements, however, require the subject to remain static for accurate SpO2 values. This is due to the use of the common ratio-of-ratios measurement principle that measures the relative pulsatility at different wavelengths. Since the amplitudes are small, they are easily corrupted by motion-induced variations. We introduce a new principle that allows accurate remote measurements even during significant subject motion. We demonstrate the main advantage of the principle, i.e. that the optimal signature remains the same even when the SNR of the PPG signal drops significantly due to motion or limited measurement area. The evaluation uses recordings with breath-holding events, which induce hypoxemia in healthy moving subjects. The events lead to clinically relevant SpO2 levels in the range 80–100%. The new principle is shown to greatly outperform current remote ratio-of-ratios based methods. The mean-absolute SpO2-error (MAE) is about 2 percentage-points during head movements, where the benchmark method shows a MAE of 24 percentage-points. Consequently, we claim ours to be the first method to reliably measure SpO2 remotely during significant subject motion.

Abstract. Vital signs monitoring is ubiquitous in clinical environments and emerging in home-based healthcare applications. Still, since current monitoring methods require uncomfortable sensors, respiration rate remains the least measured vital sign. In this paper, we propose a video-based respiration monitoring method that automatically detects respiratory Region of Interest (RoI) and signal using a camera. Based on the observation that respiration induced chest/abdomen motion is an independent motion system in a video, our basic idea is to exploit the intrinsic properties of respiration to find the respiratory RoI and extract the respiratory signal via motion factorization. We created a benchmark dataset containing 148 video sequences obtained on adults under challenging conditions and also neonates in the neonatal intensive care unit (NICU). The measurements obtained by the proposed video respiration monitoring (VRM) method are not significantly different from the reference methods (guided breathing or contact-based ECG; p-value=0.6), and explain more than 99% of the variance of the reference values with low limits of agreement (−2.67 to 2.81 bpm). VRM seems to provide a valid solution to ECG in confined motion scenarios, though precision may be reduced for neonates. More studies are needed to validate VRM under challenging recording conditions, including upper-body motion types.