The detection of peripheral venous pulsation using the pulse oximeter as a plethysmograph

Shelley, Kirk H.; Dickstein, Marc L.; Shulman, Steven

doi:10.1007/bf02886699

Cited by 45 publications

(30 citation statements)

References 10 publications

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“…It is well known that the PPG waveform is influenced by both positive pressure ventilation [8] and the peripheral venous pulsations [1,9]. In the case of positive pressure ventilation, we hypothesize that the effect on the PPG waveform is mediated by volume changes in the venous compartment.…”

Section: Measuring Venous Oxygen Saturation Via Physiological Sourcesmentioning

confidence: 79%

“…The reasoning behind looking at this frequency is as follows. The central venous pulse waveform can be transmitted through the venous system, leading to peripheral venous pulsations and the appearance of a diastolic peak in the PPG signal [1]. When such a diastolic peak is superimposed on the systolic cardiac peak, the overall signal has peaks that occur at twice the cardiac frequency.…”

Section: Respdc and Respac: Respiratory Frequency Algorithmsmentioning

confidence: 99%

“…The movement of venous blood can be detected using the PPG. For the most part, this phenomenon has been seen as a source of artifact which interferes with the calculation of arterial saturation [1,2]. If venous saturation can be reliably measured, interesting new possibilities are opened.…”

Section: Introductionmentioning

confidence: 99%

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Measuring venous oxygenation using the photoplethysmograph waveform

Walton

Kyriacou

Silverman

et al. 2010

J Clin Monit Comput

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This is the accepted version of the paper.This version of the publication may differ from the final published version. ABSTRACT. Objective. We investigate the hypothesis that the photoplethysmograph (PPG) waveform can be analyzed to infer regional venous oxygen saturation. Methods. Fundamental to the successful isolation of the venous saturation is the identification of PPG characteristics that are unique to the peripheral venous system. Two such characteristics have been identified. First, the peripheral venous waveform tends to reflect atrial contraction. Second, ventilation tends to move venous blood preferentially due to the low pressure and high compliance of the venous system. Red (660 nm) and IR (940 nm) PPG waveforms were collected from 10 cardiac surgery patients using an esophageal PPG probe. These waveforms were analyzed using algorithms written in Mathematica. Four time-domain saturation algorithms (ArtSat, VenSat, ArtInstSat, VenInstSat) and four frequency-domain saturation algorithms (RespDC, RespAC, Cardiac, and Harmonic) were applied to the data set. Results. Three of the algorithms for calculating venous saturation (VenSat, VenInstSat, and RespDC) demonstrate significant difference from ArtSat (the conventional time-domain algorithm for measuring arterial saturation) using the Wilcoxon signed-rank test with Bonferroni correction (p < 0.0071). Conclusions. This work introduces new algorithms for PPG analysis. Three algorithms (VenSat, VenInstSat, and RespDC) succeed in detecting lower saturation blood. The next step is to confirm the accuracy of the measurement by comparing them to a gold standard (i.e., venous blood gas). Permanent repository linkKEY WORDS. pulse oximeter, waveform analysis, plethysmograph, non-invasive monitoring, venous oxygen saturation.

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Section: Measuring Venous Oxygen Saturation Via Physiological Sourcesmentioning

confidence: 79%

Section: Respdc and Respac: Respiratory Frequency Algorithmsmentioning

confidence: 99%

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Measuring venous oxygenation using the photoplethysmograph waveform

Walton

Kyriacou

Silverman

et al. 2010

J Clin Monit Comput

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“…78,79 Venous oxygenation Multiple authors have described the presence of venous ''interference'' in the PPG signal. 11,80,81 The venous contribution to the PPG signal should not, however, be thought of as interference. Rather, it provides additional information, the utility of which has yet to be fully understood.…”

Section: 6470-72mentioning

confidence: 99%

Advances in photoplethysmography: beyond arterial oxygen saturation

Bartels

Thiele

2015

Can J Anesth/J Can Anesth

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Purpose Photoplethysmography permits continuous measurement of heart rate and peripheral oxygen saturation and has been widely used to inform clinical decisions. Recently, a myriad of noninvasive hemodynamic monitoring devices using this same technology have been increasingly available. This narrative review aims to summarize the principles that form the basis for the function of these devices as well as to comment on trials evaluating their accuracy and clinical application. Principal findings Advanced monitoring devices extend photoplethysmography technology beyond measuring oxygen concentration and heart rate. Quantification of respiratory variation of the photoplethysmographic waveform reflects respiratory variation of the arterial pressure waveform and can be used to gauge volume responsiveness. Both the volume-clamp and physiocal techniques are extensions of conventional photoplethysmography and permit continuous measurement of finger arterial blood pressure. Finger arterial pressure waveforms can subsequently inform estimations of cardiac output. Conclusions Although respiratory variations of the plethysmographic waveform correlate only modestly with the arterial blood pressure waveform, fluid responsiveness can be relatively consistently assessed using both approaches. Continuous blood pressure measurements obtained using the volume-clamp technique may be as accurate as conventional brachial noninvasive blood pressure measurements. Most importantly, clinical comparative effectiveness studies are still needed in order to determine if these technologies can be translated into improvement of relevant patient outcomes. RésuméObjectif La photopléthysmographie permet la mesure continue de la fréquence cardiaque et de la saturation en oxygène périphérique, et elle est largement utilisée pour les prises de décisions cliniques. Depuis peu, un très grand nombre de dispositifs non invasifs de surveillance hémodynamique utilisant la même technologie envahit le marché. Cette synthèse narrative vise à résumer les principes à la base du fonctionnement de ces dispositifs et à commenter les essais évaluant leur exactitude ainsi que leurs applications cliniques. Constatations principales Les dispositifs de surveillance avancée étendent la technologie de photopléthysmographie au-delà de la mesure de la concentration en oxygène et de la fréquence cardiaque. La quantification de la variation respiratoire du tracé photopléthysmographique reflète la variation respiratoire du tracé de pression artérielle et peut servir à jauger la réactivité au volume. Les deux techniques de compression volumique (volume-clamp) au doigt et la technique physiocal sont des prolongements de Author contributions Karsten Bartels wrote approximately 50% of the manuscript and critically edited the remainder. Robert H. Thiele wrote approximately 50% of the manuscript and critically edited the remainder.

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“…The PPG is also affected by changes in the volume of venous blood in the tissue vasculature. Shelley et al [13] published several case studies that showed small peaks appearing in the diastolic part of the recorded PPG waveforms. These peaks were not present in the arterial pressure waveform but were shown to coincide with peaks in the simultaneously recorded peripheral venous pressure wave.…”

Section: Effect Of Venous Pulsation On the Photoplethysmographic Wavementioning

confidence: 99%