Clinical applications of photoplethysmography in paediatric intensive care

Abstract

Photoplethysmography allows for monitoring pulse rate in patients with (possible) heart rate/pulse rate dissociation (pacemaker dependency, pulsatile ventricular assist device); monitoring sudden changes in heart beat volume, which are unrelated to respiration (pulseless electrical activity, pulsus alternans); and monitoring respiratory-dependent fluctuations of the plethysmographic wave (heart failure, hypovolaemia, asthma, upper airway obstruction, pericardial effusion). Deterioration, slowly evolving over time, may be detected by this method.

Development and testing of an artificial arterial and venous pulse oximeter

“…However, there are numerous shortcomings and limitations faced by conventional pulse oximetry [7,8,9], these include physiological-, signal processing-, substance interference-limitations and limited medical staff understanding and knowledge; all of which can cause inaccurate or incorrect readings. These limitations needed to be carefully considered and mitigated to ensure an effective device.…”

The Variability of Perfusion Index as a New Parameter in Different Types of Anaesthesia Techniques and Its Correlation with Surgical Stress and Recovery From Anesthesia: An Observational Clinical Study

“…Deterioration, slowly evolving over time, may be detected by this method. 28 Mowafi HA , Arab SA, Ismail SA, Al-Ghamdi AA, Al-Metwalli RR studied in 2008 on plethysmographic pulse wave amplitude is an effective indicator for intravascular injection of epinephrine-containing epidural test dose in sevoflurane-anesthetized pediatric patientsPlethysmographic pulse wave amplitude (PPWA) was effective in detecting intravascular injection of epidural test dose with 100% sensitivity and specificity in adults. We evaluated the efficacy of PPWA in detecting intravascular injection of a simulated epidural test dose during sevoflurane anesthesia in pediatric patients.Eighty infants and children were randomized to receive either 0.5 minimal alveolar concentration (MAC) or 1 MAC sevoflurane and nitrous oxide in oxygen.…”

Year in review in Intensive Care Medicine, 2008: III. Paediatrics, Ethics, outcome research and critical care organization, sedation, pharmacology and miscellanea

“…Many of these limitations are negated if serial measurements are used to derive trends in aortic flow rather algorithm-derived 'absolute' cardiac outputs. Frey et al [17] brought clarity to the interpretation of aspects of the photoplethysmographic wave which is displayed by most pulse oximeters. They demonstrate that it may be used to derive additional haemodynamic information in some selected situations when, for instance, arterial blood pressure monitoring is not available.…”