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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 em...
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Citations
... Several guidelines recommend to aim for an SpO 2 of 94-98% (or an SpO 2 of 88-92% in patients with chronic obstructive pulmonary disease (COPD) GOLD III or IV) [11,12]. Titration of oxygen based on SpO 2 readings however, requires a reliable and stable SpO 2 trace, which may not always be available, especially when patients have dysrhythmia's, when they are in shock, or when there are movement artefacts (as in the prehospital setting) [14]. This may affect the efficacy of SpO 2 guided oxygen administration. ...
Background
As iatrogenic hyperoxia has been related to adverse outcomes in critically ill patients, guidelines advise to titrate oxygen to physiological levels. In the prehospital setting where partial arterial oxygen (PaO 2 ) values are often not readily available, titration of oxygen is based on peripheral oxygen saturations (SpO2). In this study we aimed to investigate the efficacy of SpO 2 guided oxygen titration in the prevention of hyperoxia.
Methods
In a retrospective observational cohort study of patients included in the Acutelines data- and biobank of the University Medical Center Groningen between September 2020 and March 2023, we collected blood gas samples and triage data of sequentially included patients who received oxygen at the moment they were presented in the emergency department (ED). PaO 2 values were compared to (concurrently measured) SpO 2 values, and to patient- and treatment characteristics and P/F ratios were calculated in order to investigate the efficacy of SpO 2 based oxygen titration for various subgroups.
Results
Blood gas samples were obtained for 1042 patients, of which 178 (17.1%) had hyperoxia (PaO 2 levels > 13.5 kPa). SpO 2 readings were available for 170 of these, 68 of which (40%) had SpO 2 values above the recommended target range (94–98%; 88–92% for patients with COPD) whereas 102 patients (60%) had SpO2 values within- or even below the recommended target range. Many of these patients (44.1%) received oxygen through a low-flow device (nasal canula), and these patients almost invariably (84.4%) were not compromised in their ventilation (P/F ratio’s > 300).
Conclusion
When oxygen is titrated based on SpO 2 levels, this results in hyperoxemia in a significant proportion of the patients. Health care providers should especially be reluctant to administer (low flow) oxygen as a standard of care to patients who do not have clear respiratory compromise, as these patients are at a high risk of developing (occult) hyperoxia.
... In oximetry, two light beams are shined into the small blood vessels or capillaries of a person's finger, earlobe, or other tissue [170]. These beams of light are of two different wavelengths: one is red light and the other is infrared light [275]. ...
In Human-Computer Interaction (HCI) and Ubiquitous Computing, the objective of optimizing device interactions and personalizing user experiences has placed a new emphasis on accurately evaluating cognitive readiness using wearable devices. Interpreting cognitive readiness in real-world scenarios is complex due to the plethora of potential physiological measures, individual variability, and the limitations of wearable devices. In this review, we present a systematic overview of key physiological measures that can be used for an in-depth assessment of cognitive readiness. These measures can serve as proxies for detailed assessments of cognitive readiness. This review serves as a tool for assessing cognitive readiness for diverse applications, with special focus on in-the-wild research settings. In addition, due to the complexity of measurements and devices, we propose the development of robust catalog for cognitive readiness measurements.
... ; 100, preferably on the limb unaffected for 1 minute. At least two medical doctors will confirm the presence of arrhythmia [17]. ...
... The investigator will carry out a 12-lead ECG and is conversant with the manufacturer's guidelines [17] under the direction of a professional cardiologist on each participant. Before a 12-lead ECG is taken, the patient will be told about the procedure, their privacy will be protected, and the environment will be kept comfortable to help the patient feel at ease and . ...
Background
Survivors of strokes are prone to disabilities, especially in underdeveloped countries. Post-stroke depression (PSD) is a common neuropsychiatric condition that exacerbates symptoms and raises the danger of stroke recurrence, disability, and mortality. Nevertheless, little is documented about PSD’s incidence, predictors, and consequences.
This study aims to assess predictors and outcomes of post-stroke depression among patients admitted with the first stroke episode at referral hospitals in Dodoma, Tanzania.
Methods and analysis
The study is a prospective longitudinal observational design; a consecutive sampling technique will be used to attain the estimated sample size. Adults aged ≥18 years who have had their first stroke episode, within 14 days, and the stroke diagnosis will be verified through brain imaging using CT or MRI. The study will be conducted at referral hospitals in Dodoma region, Tanzania. At admission, baseline clinical parameters will be recorded, and PSD will be evaluated at one and three months after a stroke. Data will be summarised using descriptive statistics; continuous data will be reported as mean (SD) or median (IQR) while categorical data as frequencies and proportions. The PSD predictors will be determined using logistic regression analysis. The study will adhere to data-sharing guidelines and take ethical considerations into account.
Ethics and dissemination
The University of Dodoma’s institutional Research Review and Ethical Committee has granted permission to conduct the study with reference number MA.84/261/02. The relevant authorities granted approval for the study to be carried out at DRRH and BMH.
... The APG provides information on a patient's arterial stiffness and other possible cardiovascular diseases [78]. These sensors can also provide non-invasive measurement of arterial oxygen saturation (SpO 2 ) percentage by passing two distinct light wavelengths through the tissue, in the transmission configuration [83]. In critical care scenarios SpO 2 is an essential parameter to monitor, and PPG sensors can provide continuous output of this measurement. ...
Prehospital medical care is a major challenge for both civilian and military situations as resources are limited, yet critical triage and treatment decisions must be rapidly made. Prehospital medicine is further complicated during mass casualty situations or remote applications that require more extensive medical treatments to be monitored. It is anticipated on the future battlefield where air superiority will be contested that prolonged field care will extend to as much 72 h in a prehospital environment. Traditional medical monitoring is not practical in these situations and, as such, wearable sensor technology may help support prehospital medicine. However, sensors alone are not sufficient in the prehospital setting where limited personnel without specialized medical training must make critical decisions based on physiological signals. Machine learning-based clinical decision support systems can instead be utilized to interpret these signals for diagnosing injuries, making triage decisions, or driving treatments. Here, we summarize the challenges of the prehospital medical setting and review wearable sensor technology suitability for this environment, including their use with medical decision support triage or treatment guidance options. Further, we discuss recommendations for wearable healthcare device development and medical decision support technology to better support the prehospital medical setting. With further design improvement and integration with decision support tools, wearable healthcare devices have the potential to simplify and improve medical care in the challenging prehospital environment.
... The relevant biometric to measure hypoxia is SpO 2 . SpO 2 is a proxy measurement of the percent of oxygenated hemoglobin in the arterial blood (Nitzan et al., 2014). SpO 2 measurements above 95% are considered healthy and values below 90% are generally considered hypoxic (American Thoracic SocietyAmerican College of Chest Physicians, 2003). ...
Insight into human physiology is key to maintaining diver safety in underwater operational environments. Numerous hazardous physiological phenomena can occur during the descent, the time at depth, the ascent, and the hours after a dive that can have enduring consequences. While safety measures and strict adherence to dive protocols make these events uncommon, diving disorders still occur, often with insufficient understanding of the factors that triggered the event. This review first examines the most common diving disorders and their incidence rates across recreational and US military dive activities. The review then identifies physiological biomarkers (e.g., heart rate, heart rate variability, blood pressure, respiration rate, temperature, oxygen saturation) that may provide a holistic view of the diver’s current physiological state and potentially detect the most concerning diving disorders (e.g., decompression illnesses, gas mixture-related disorders, barotraumas, and environment exposure). Although considerable research is still needed to verify the use of these biometrics in the diving environment, the research described in this review presents a promising path to developing a system that can detect pending diving disorders and provide divers and other necessary parties with an early warning before mishaps occur.
... The "p" in SpO 2 indicates that its measurement is based on the arterial "pulse," and it also points to the fact that it pertains to "peripheral" blood. Many helpful reviews have been written about pulse oximetry, including one that recounts its history, 1 one written in a way to convey the engineering principles to medical practitioners, 2 one that discusses the current technology and its limitations, 3 and one that provides a summary of the basic principles and possible sources of error. 4 Pulse oximeters operate in a diffuse optical regime. ...
... The absorption maxima are reported to occur between 525 nm and 575 nm as well as between 400 nm and 425 nm. 10 Bilirubin has its absorption maximum at 450.5 nm (see Figure 3). To detect the erythrocyte concentration, we choose the 535 nm and 560 nm detector channels as they are closest to the described absorption maxima. ...
... Biased measurements by pulse oximetry towards higher SpO 2 values in infants with higher HbF(%) may have confounded the evaluated associations between HbF(%) and indices of oxygen requirement. [14][15][16] We therefore evaluated the association between HbF(%) and SaO 2 in relation to PNA, GA at birth and pCO 2 , adjusted for pH and sex. There was no significant adjusted relationship between HbF(%) and SaO 2 at PND 1 and PND 4 with a moderately positive association at PND 7 corresponding to an average increase of 0.32% in mean aSO 2 with a 20% increase in HbF (figure 4, online supplemental table 4). ...
Objective
To investigate the relationship between the fraction of fetal haemoglobin (HbF(%)) and oxygen requirement as determined by the fraction of inspired oxygen (FiO 2 ) and alveolar–arterial gradient (A–a gradient). Increased alveolar exposure to oxygen may explain the association between decreased HbF(%) and the development of bronchopulmonary dysplasia (BPD).
Design
Longitudinal, retrospective, observational study.
Setting
Tertiary-level neonatal intensive care unit, referral centre for southern Sweden.
Patients
Four hundred forty very preterm infants born before gestational week 30, 2009–2015.
Intervention
Regular clinical practice.
Main outcome measures
The FiO 2 and A–a gradient were determined at the time-point of 10 015 arterial blood gas analyses obtained during postnatal days 1–7. The relationship between HbF(%) and FiO 2 and A–a gradient and the modifying influence of other factors affecting haemoglobin oxygen affinity were evaluated.
Results
We found a significant relationship between a low fraction of HbF and an increase in FiO 2 and A–a gradient, respectively. These relationships remained significant after adjusting for pH, pCO 2 , postnatal age, gestational age and sex.
Conclusion
These high-resolution data show that decreased HbF(%) during the first postnatal week is associated with increased FiO 2 and A–a gradient in very preterm infants. Increased alveolar exposure to oxygen and resulting oxidative stress may, at least partly, explain the previously reported associations between decreased HbF, blood transfusions and the development of BPD in preterm infants.
... Пульсоксиметрия, как способ оценки насыщения артериальной крови кислородом (SpO₂), основана на фотоплетизмографии (PPG), измерении увеличения поглощения света в результате увеличения объема артериальной крови в фазу систолического сокращения сердца [2]. Ввиду простоты использования, точности получаемой информации, пульсоксиметрия является одним из основных способов непрерывного мониторинга витальных функций в отделениях интенсивного наблюдения. ...
While evaluating a new domestically produced pulse oximeter model in clinical practice, we discovered a lack of references in Russian-language publications on clinical trial methodologies to assess device reliability and performance.
The aim of the study is to create a methodology for conducting a multicenter, prospective, cohort, nonrandomized, controlled clinical trial evaluating a domestic pulse oximeter.
M ethods. Measurements were performed on 20 preterm infants in the neonatal intensive care unit with a mean birth weight of 2340 [1250; 3125] g and a gestational age of 35 [30; 37] weeks using a new model pulse oximeter simultaneously with the reference monitor. Multiple oxygen saturation measurements of varying duration were taken alternately from the upper and lower limbs, and the number of false desaturation alarms was recorded. Pulse oximeter saturation data were evaluated for correlation with clinical findings.
R esults. Attachment of sensors to the infant's feet was found to be optimal in terms of ease of use, minimal artifact generation, and minimal interference with routine medical procedures and neonatal care. To reduce motion-induced artifacts and false alarms, the optimal period of SpO₂ monitoring to detect desaturations and bradycardia was determined to be 120 min. Due to the high variability of pulse rate (PR) and saturation in neonates, two-second intervals were determined to be optimal for comparing records from the two monitors. Matching of ECG HR and pulse oximeter PR was required to eliminate artifacts. A mathematical software model required for accelerated analysis of data collected from all sensors during the study was approved.
C onclusion. The data analysis supported the proposed methodology for conducting a clinical trial to evaluate the performance and reliability of new pulse oximetry devices.
... These sensors are smaller and often include adhesive attachments to secure them to a child's finger, toe, or other appropriate site. Continuous improvement in sensor technology, sophisticated algorithms, and signal processing techniques have increased pulse oximeters' accuracy and reliability, even in challenging pediatric populations with low perfusion or motion artifacts [16]. As a standard tool for assessing oxygenation and respiratory function across diverse medical conditions, pulse oximeters seamlessly integrate into patient monitoring systems, facilitating continuous tracking alongside vital signs like heart and respiratory rates. ...
BACKGROUND
Pulse oximetry has become a cornerstone technology in healthcare, providing non-invasive monitoring of oxygen saturation levels and pulse rate. Despite its widespread use, the technology has inherent limitations and challenges that must be addressed to ensure accurate and reliable patient care.
AIM
To comprehensively evaluate the advantages, limitations, and challenges of pulse oximetry in clinical practice, as well as to propose recommendations for optimizing its use.
METHODS
A systematic literature review was conducted to identify studies related to pulse oximetry and its applications in various clinical settings. Relevant articles were selected based on predefined inclusion and exclusion criteria, and data were synthesized to provide a comprehensive overview of the topic.
RESULTS
Pulse oximetry offers numerous advantages, including non-invasiveness, real-time feedback, portability, and cost-effectiveness. However, several limitations and challenges were identified, including motion artifacts, poor peripheral perfusion, ambient light interference, and patient-specific factors such as skin pigmentation and hemoglobin variants. Recommendations for optimizing pulse oximetry use include technological advancements, education and training initiatives, quality assurance protocols, and interdisciplinary collaboration.
CONCLUSION
Pulse oximetry is crucial in modern healthcare, offering invaluable insights into patients’ oxygenation status. Despite its limitations, pulse oximetry remains an indispensable tool for monitoring patients in diverse clinical settings. By implementing the recommendations outlined in this review, healthcare providers can enhance the effectiveness, accessibility, and safety of pulse oximetry monitoring, ultimately improving patient outcomes and quality of care.
