Improving Pulse Oximetry Accuracy by Removing Motion Artifacts from Photoplethysmograms Using Relative Sensor Motion: A Preliminary Study

Wijshoff, Rwcgr Ralph; Mischi, Massimo; Woerlee, PH Pierre; Aarts, RM Ronald

doi:10.1007/978-1-4614-7411-1_55

Cited by 12 publications

(9 citation statements)

References 7 publications

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“…Several companies have developed techniques for the elimination of motion artifacts in pulse oximeters, and since the subject has been reviewed and discussed in several articles,7,30,66,67 it is not discussed in this review. Motion rejection is generally achieved using various algorithms for differentiation between pure PPG signals and those contaminated by motion noise, but also through the introduction of improved hardware.…”

Section: Limitations Of Pulse Oximetry and Technological Updatementioning

confidence: 99%

Pulse oximetry: fundamentals and technology update

Nitzan

Romem

Koppel

2014

MDER

284

252

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Oxygen saturation in the arterial blood (SaO2) provides information on the adequacy of respiratory function. SaO2 can be assessed noninvasively by pulse oximetry, which is based on photoplethysmographic pulses in two wavelengths, generally in the red and infrared regions. The calibration of the measured photoplethysmographic signals is performed empirically for each type of commercial pulse-oximeter sensor, utilizing in vitro measurement of SaO2 in extracted arterial blood by means of co-oximetry. Due to the discrepancy between the measurement of SaO2 by pulse oximetry and the invasive technique, the former is denoted as SpO2. Manufacturers of pulse oximeters generally claim an accuracy of 2%, evaluated by the standard deviation (SD) of the differences between SpO2 and SaO2, measured simultaneously in healthy subjects. However, an SD of 2% reflects an expected error of 4% (two SDs) or more in 5% of the examinations, which is in accordance with an error of 3%–4%, reported in clinical studies. This level of accuracy is sufficient for the detection of a significant decline in respiratory function in patients, and pulse oximetry has been accepted as a reliable technique for that purpose. The accuracy of SpO2 measurement is insufficient in several situations, such as critically ill patients receiving supplemental oxygen, and can be hazardous if it leads to elevated values of oxygen partial pressure in blood. In particular, preterm newborns are vulnerable to retinopathy of prematurity induced by high oxygen concentration in the blood. The low accuracy of SpO2 measurement in critically ill patients and newborns can be attributed to the empirical calibration process, which is performed on healthy volunteers. Other limitations of pulse oximetry include the presence of dyshemoglobins, which has been addressed by multiwavelength pulse oximetry, as well as low perfusion and motion artifacts that are partially rectified by sophisticated algorithms and also by reflection pulse oximetry.

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Section: Limitations Of Pulse Oximetry and Technological Updatementioning

confidence: 99%

Pulse oximetry: fundamentals and technology update

Nitzan

Romem

Koppel

2014

MDER

284

252

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“…This technology is now in widespread use in health watches for fitness consumer applications. Besides this technical progress we showed in pre-clinical CPR studies under controlled conditions [12,13] that PPG appears to have the potential to indicate when the heart resumes beating and should therefore be reconsidered as a tool in CPR decision support.…”

Section: Introductionmentioning

confidence: 94%

On detection of spontaneous pulse by photoplethysmography in cardiopulmonary resuscitation

Hubner

Wijshoff

Muehlsteff

et al. 2020

The American Journal of Emergency Medicine

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This work investigates the potential of photoplethysmography (PPG) to detect a spontaneous pulse from the finger, nose or ear in order to support pulse checks during cardiopulmonary resuscitation (CPR). Methods: In a prospective single-center cross-sectional study, PPG signals were acquired from cardiac arrest victims who underwent CPR. The PPG signals were analyzed and compared to arterial blood pressure (ABP) signals as a reference during three distranaisco; Date: 2/2/2020; Time:18:44:23inct phases of CPR: compression pauses, ongoing compressions and at very low arterial blood pressure. Data analysis was based on a qualitative subjective visual description of similarities of the frequency content of PPG and ABP waveform. Results: In 9 patients PPG waveforms corresponded to ABP waveforms during normal blood pressures. During ABP in the clinically challenging range of 60 to 90 mmHg and during chest compressions and pauses, PPG continued to resemble ABP, as both signals showed similar frequency components as a result of chest compressions as well as cardiac activity. Altogether 1199 s of PPG data in compression pauses were expected to show a spontaneous pulse, of which 732 s (61%) of data were artifact-free and showed the spontaneous pulse as visible in the ABP. Conclusions: PPG signals at all investigated sites can indicate pulse presence at the moment the heart resumes beating as verified via the ABP signal. Therefore, PPG may provide decision support during CPR, especially related to preventing and shortening interruptions for unnecessary pulse checks. This could have impact on CPR outcome and should further be investigated.

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“…Prior research by some of the authors of this investigation has demonstrated promising application of a custom designed PPG sensor device in monitoring heart rate (HR), oxygen saturation (SpO 2 ) and total haemoglobin concentration (Hb) [3,4]. However, a drawback of this technology has been that the PPG signal is easily affected by motion artifact [5,6,7,8,9,10,11], requiring the subject (patient) to be motionless and lying or sitting down.…”

Section: Introductionmentioning

confidence: 99%

“…proposed finger motion in five different positions, e.g., horizontal movement of finger and waving hand [5], and Peng et al studied four types of finger motion, such as bending and pressing of the finger [6]. Methods used to minimize the impact of motion artefact include: adaptive noise cancellation algorithms (e.g., normalized least-mean-square) to recover signals corrupted due to body motion using acceleration data [7,8], relative sensor motion via self-mixing interferometry in a laser diode [9], periodic moving average filter [10], a method that uses synthetic noise reference signal without any extra hardware [11], etc.…”

Section: Introductionmentioning

confidence: 99%

An Experimental Study of the Effects of External Physiological Parameters on the Photoplethysmography Signals in the Context of Local Blood Pressure (Hydrostatic Pressure Changes)

Yuan

Poeggel

Newe

et al. 2017

Sensors

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A comprehensive study of the effect of a wide range of controlled human subject motion on Photoplethysmographic signals is reported. The investigation includes testing of two separate groups of 5 and 18 subjects who were asked to undertake set exercises whilst simultaneously monitoring a wide range of physiological parameters including Breathing Rate, Heart Rate and Localised Blood Pressure using commercial clinical sensing systems. The unique finger mounted PPG probe equipped with miniature three axis accelerometers for undertaking this investigation was a purpose built in-house version which is designed to facilitate reproducible application to a wide range of human subjects and the study of motion. The subjects were required to undertake several motion based exercises including standing, sitting and lying down and transitions between these states. They were also required to undertake set arm movements including arm-swinging and wrist rotation. A comprehensive set of experimental results corresponding to all motion inducing exercises have been recorded and analysed including the baseline (BL) value (DC component) and the amplitude of the oscillation of the PPG. All physiological parameters were also recorded as a simultaneous time varying waveform. The effects of the motion and specifically the localised Blood Pressure (BP) have been studied and related to possible influences of the Autonomic Nervous System (ANS) and hemodynamic pressure variations. It is envisaged that a comprehensive study of the effect of motion and the localised pressure fluctuations will provide valuable information for the future minimisation of motion artefact effect on the PPG signals of this probe and allow the accurate assessment of total haemoglobin concentration which is the primary function of the probe.

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Improving Pulse Oximetry Accuracy by Removing Motion Artifacts from Photoplethysmograms Using Relative Sensor Motion: A Preliminary Study

Cited by 12 publications

References 7 publications

Pulse oximetry: fundamentals and technology update

Pulse oximetry: fundamentals and technology update

On detection of spontaneous pulse by photoplethysmography in cardiopulmonary resuscitation

An Experimental Study of the Effects of External Physiological Parameters on the Photoplethysmography Signals in the Context of Local Blood Pressure (Hydrostatic Pressure Changes)

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