Pulse oximetry for vascular monitoring in upper extremity replantation surgery

Graham, Braun H.; Paulus, David A.; Caffee, H. Hollis

doi:10.1016/s0363-5023(86)80013-2

Cited by 64 publications

(22 citation statements)

References 19 publications

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“…Reflective plethysmography takes advantage of the back-scattering of light to the surface (i.e., forehead). Published studies using these techniques to determine tissue perfusion have been performed on small bowel (20), reimplanted fingers (21), and free flaps (22). …”

Section: Pulse Analysismentioning

confidence: 99%

Photoplethysmography: Beyond the Calculation of Arterial Oxygen Saturation and Heart Rate

Shelley

2007

Anesthesia &Amp; Analgesia

382

223

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In this article, I examine the source of the photoplethysmograph (PPG), as well as methods of investigation, with an emphasize on amplitude, rhythm, and pulse analysis. The PPG waveform was first described in the 1930s. Although considered an interesting ancillary monitor, the "pulse waveform" never underwent intensive investigation. Its importance in clinical medicine was greatly increased with the introduction of the pulse oximeter into routine clinical care in the 1980s. Its waveform is now commonly displayed in the clinical setting. Active research efforts are beginning to demonstrate a utility beyond oxygen saturation and heart rate determination. Future trends are being heavily influenced by modern digital signal processing, which is allowing a re-examination of this ubiquitous waveform. Key to unlocking the potential of this waveform is an unfettered access to the raw signal, combined with standardization of its presentation, and methods of analysis. In the long run, we need to learn how to consistently quantify the characteristics of the PPG in such a way as to allow the results from research efforts be translated into clinically useful devices.

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Section: Pulse Analysismentioning

confidence: 99%

Photoplethysmography: Beyond the Calculation of Arterial Oxygen Saturation and Heart Rate

Shelley

2007

Anesthesia &Amp; Analgesia

382

223

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mentioning

confidence: 99%

A comparison of pulse oximetry and laser Doppler flowmetry in monitoring sequential vascular occlusion in a rabbit ear model

Hallock

Rice

2003

Canadian Journal of Plastic Surgery

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The ultimate success of any free flap transfer depends not only on the experience of the given surgical team, but also requires constant vigilance in the perioperative period to assure continued anastomotic patency. Clinical acumen remains the 'industry' standard, but adjunctive monitoring devices are important to reinforce these subjective evaluations. We routinely use laser Doppler flowmetry in spite of known drawbacks, including expense. On the other hand, we know that pulse oximetry is a possible and readily available alternative. The efficacy of these two monitoring systems was directly compared in a New Zealand white rabbit central artery and vein ear model. Arterial occlusion was immediately recognized by a precipitous drop in flow and oxygen saturation (SaO 2 ). A rapid drop in flow after venous occlusion with a trend to zero was also noted with laser Doppler flowmetry. The SaO 2 had a very slow but steady gradual decline, but values remained in the range of normoxemia for a prolonged time. Because a minimum threshold of SaO 2 for predicting venous occlusion was elusive, the usefulness of pulse oximetry for monitoring microsurgical composite tissue transfers is limited.

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“…Pulse oximetry values greater than 95% have been associated with a viable digit and decreasing values have been suggestive of arterial or venous occlusion. 5 Pulse oximetry, however, requires pulsatile flow for accurate readings, which is not always detectable in the immediate postoperative setting. Surface thermometry is easy and inexpensive but measurements are influenced by other factors and thus are not very reliable.…”

Section: Discussionmentioning

confidence: 99%

“…No currently available device has become accepted widely for routine monitoring because of complexity or poor sensitivity and specificity. [5][6][7][8] Serial quantitative fluorescence is a minimally invasive, reliable technique for digit monitoring; however, it is labor intensive. 9,10 It also carries the risk for adverse effects, although these are infrequent.…”

mentioning

confidence: 99%

Detection of Perfusion Disturbances in Digit Replantation Using Near-Infrared Spectroscopy and Serial Quantitative Fluoroscopy

Colwell

Buntic

Brooks

et al. 2006

The Journal of Hand Surgery

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Pulse oximetry for vascular monitoring in upper extremity replantation surgery

Cited by 64 publications

References 19 publications

Photoplethysmography: Beyond the Calculation of Arterial Oxygen Saturation and Heart Rate

Photoplethysmography: Beyond the Calculation of Arterial Oxygen Saturation and Heart Rate

A comparison of pulse oximetry and laser Doppler flowmetry in monitoring sequential vascular occlusion in a rabbit ear model

Detection of Perfusion Disturbances in Digit Replantation Using Near-Infrared Spectroscopy and Serial Quantitative Fluoroscopy

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