Estimation of Venous oxygenation saturation using the finger Photoplethysmograph (PPG) waveform

Shafqat, K.; Langford, R. M.; Pal, Saurabh; Kyriacou, Panayiotis A.

doi:10.1109/embc.2012.6346571

Cited by 8 publications

(3 citation statements)

References 14 publications

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“…Largely based on the work of Shelley's [13] group, it is now increasingly appreciated that the photoplethysmographic waveform is susceptible to changes in peripheral tone [21 ] and, depending on the site of measurement, may include a significant component of venous blood [41]. The idea that photoplethysmographic signals may contain venous 'contamination' is not new [42], but is increasingly accepted [43][44][45]. We hypothesize that the under-appreciated venous contribution to the PPG waveform contributes to the poor agreement between the two.…”

Section: Discussionmentioning

confidence: 98%

Assessment of the agreement between photoplethysmographic and arterial waveform respiratory variation in patients undergoing spine surgery

Thiele

Colquhoun

Forkin

et al. 2013

Journal of Medical Engineering & Technology

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Respiratory variation in the arterial blood pressure and photoplethysmographic (PPG) waveforms have both been shown to predict the haemodynamic response to volume administration. Whether or not the two can be considered interchangeable is controversial. Twenty-three patients undergoing spine surgery received both a 20 gauge intra-arterial catheter and a Masimo adult adhesive SpHb sensor connected to a Radical-7 monitor. Pulse pressure variation (PPV) was calculated off-line at 1-min intervals. Pleth Variability Index (PVI) and Perfusion Index data were recorded. After exclusion of outliers, agreement between PPV and PVI was assessed using a repeated measures Bland-Altman approach. Concordance between changes in PPV and PVI was assessed using a four-quadrant plot with a 20% zone of exclusion. In total, 6549 min of data were collected. Repeated measures Bland-Altman analysis identified a bias of 2.2% and 95% confidence intervals of ±15.3% (limits of agreement -13.1 and +17.6%). The concordance rate between changes in PPV and changes in PVI was 51%. The agreement between respiratory variation in the arterial blood pressure and PPG waveforms is poor and these two should not be considered interchangeable. Changes in PPV are unrelated to changes in PVI. The data, combined with recently published work from other authors, suggests that the low frequency oscillations in the PPG waveform are not related to the low frequency oscillation in the systemic arterial blood pressure tracing and may be related to changes in venous pressure, peripheral tone or other physiologic phenomena yet to be described.

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Section: Discussionmentioning

confidence: 98%

Assessment of the agreement between photoplethysmographic and arterial waveform respiratory variation in patients undergoing spine surgery

Thiele

Colquhoun

Forkin

et al. 2013

Journal of Medical Engineering & Technology

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“…It is known that the location of the sensor, high motion artifact, and issues with implementation of skin contact may compromise the effectiveness of the PPG sensor measurements [4,12,15]. Tissue alterations, caused by both voluntary and involuntary movements, such as muscle contraction or dilation of tissues, can disrupt sensor readings, as physical displacement of the sensor from its original location can modify the PPG signal by changing the path of light [16,17]. Other factors influencing PPG reading accuracy include other anatomical or physiological differences such as skin color and amount of fluid retained by the tissues [15,18,19].…”

Section: Introductionmentioning

confidence: 99%

Investigation of Photoplethysmography Behind the Ear for Pulse Oximetry in Hypoxic Conditions with a Novel Device (SPYDR)

Bradke

Everman²

2020

Biosensors

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Photoplethysmography (PPG) is a valuable technique for noninvasively evaluating physiological parameters. However, traditional PPG devices have significant limitations in high-motion and low-perfusion environments. To overcome these limitations, we investigated the accuracy of a clinically novel PPG site using SPYDR®, a new PPG sensor suite, against arterial blood gas (ABG) measurements as well as other commercial PPG sensors at the finger and forehead in hypoxic environments. SPYDR utilizes a reflectance PPG sensor applied behind the ear, between the pinna and the hairline, on the mastoid process, above the sternocleidomastoid muscle, near the posterior auricular artery in a self-contained ear cup system. ABG revealed accuracy of SPYDR with a root mean square error of 2.61% at a 70–100% range, meeting FDA requirements for PPG sensor accuracy. Subjects were also instrumented with SPYDR, as well as finger and forehead PPG sensors, and pulse rate (PR) and oxygen saturation (SpO2) were measured and compared at various reduced oxygen profiles with a reduced oxygen breathing device (ROBD). SPYDR was shown to be as accurate as other sensors in reduced oxygen environments with a Pearson’s correlation >93% for PR and SpO2. In addition, SPYDR responded to changes in SpO2 up to 50 s faster than PPG measurements at the finger and forehead.

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“…In this work, they suggested the measurement of instantaneous saturation ('InstSat') to provide a moment-by-moment measurement of the average oxygen saturation of the blood in all vascular compartments in the vicinity of the probe. Shafqat et al [11] used a similar technique to estimate venous oxygen saturation from finger PPG signals cardiothoracic surgery and showed that the motion produced in the venous blood due to the positive pressure ventilation could be used for the non-invasive, continuous and real-time estimation of regional venous oxygen saturation. It should be noted that these methods depend on ventilator-induced modulation of PPG, which limits their application to anesthetized patients.…”

Section: Introductionmentioning

confidence: 99%

Venous pooling and drainage affects photoplethysmographic signals at different vertical hand positions

2015

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Citation: Hickey, M., Phillips, J. P. & Kyriacou, P. A. (2015). Venous pooling and drainage affects photoplethysmographic signals at different vertical hand positions. Optical Diagnostics and Sensing XV: Toward Point-of-Care Diagnostics, 9332, 93320I. doi: 10.1117/12.2076732 This is the accepted version of the paper.This version of the publication may differ from the final published version. Permanent ABSTRACTThe aim of the current work is to investigate the possibility of augmenting pulse oximetry algorithms to enable the estimation of venous parameters in peripheral tissues. In order to further understand the contribution of venous blood to the photoplethysmographic (PPG) signal, recordings were made from six healthy volunteer subjects during an exercise in which the right hand was placed in various positions above and below heart level. The left hand was kept at heart level as a control while the right hand was moved. A custom-made two-channel dual wavelength PPG instrumentation system was used to obtain the red and infrared plethysmographic signals from both the right and left index fingers simultaneously using identical sensors. Laser Doppler flowmetry signals were also recorded from an adjacent fingertip on the right hand. Analysis of all acquired PPG signals indicated changes in both ac and dc amplitude of the right hand when the position was changed, while those obtained from the left (control) hand remained relatively constant. Most clearly, in the change from heart level to 50cm below heart level there is a substantial decrease in both dc and ac amplitudes. This decrease in dc amplitude most likely corresponds to increased venous pooling, and hence increased absorption of light. It is speculated that the decrease in ac PPG amplitude is due to reduced arterial emptying during diastole due to increased downstream resistance due to venous pooling.

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Estimation of Venous oxygenation saturation using the finger Photoplethysmograph (PPG) waveform

Cited by 8 publications

References 14 publications

Assessment of the agreement between photoplethysmographic and arterial waveform respiratory variation in patients undergoing spine surgery

Assessment of the agreement between photoplethysmographic and arterial waveform respiratory variation in patients undergoing spine surgery

Investigation of Photoplethysmography Behind the Ear for Pulse Oximetry in Hypoxic Conditions with a Novel Device (SPYDR)

Venous pooling and drainage affects photoplethysmographic signals at different vertical hand positions

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