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da Costa, João Cordeiro, Paula Faustino, Ricardo Lima, Inês Ladeira, and Miguel Guimarães. "Research: Comparison of the Accuracy of a Pocket versus Standard Pulse Oximeter." Biomedical Instrumentation & Technology 50, no. 3 (May 1, 2016): 190–93. http://dx.doi.org/10.2345/0899-8205-50.3.190.
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Abstract Background: Pulse oximetry has become an essential tool in clinical practice. With patient self-management becoming more prevalent, pulse oximetry self-monitoring has the potential to become common practice in the near future. This study sought to compare the accuracy of two pulse oximeters, a high-quality standard pulse oximeter and an inexpensive pocket pulse oximeter, and to compare both devices with arterial blood co-oximetry oxygen saturation. Methods: A total of 95 patients (35.8% women; mean [±SD] age 63.1 ± 13.9 years; mean arterial pressure was 92 ± 12.0 mmHg; mean axillar temperature 36.3 ± 0.4°C) presenting to our hospital for blood gas analysis was evaluated. The Bland-Altman technique was performed to calculate bias and precision, as well as agreement limits. Student's t test was performed. Results: Standard oximeter presented 1.84% bias and a precision error of 1.80%. Pocket oximeter presented a bias of 1.85% and a precision error of 2.21%. Agreement limits were −1.69% to 5.37% (standard oximeter) and −2.48% to 6.18% (pocket oximeter). Conclusion: Both oximeters presented bias, which was expected given previous research. The pocket oximeter was less precise but had agreement limits that were comparable with current evidence. Pocket oximeters can be powerful allies in clinical monitoring of patients based on a self-monitoring/efficacy strategy.
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Pak, Ju Geon, and Kee Hyun Park. "Advanced Pulse Oximetry System for Remote Monitoring and Management." Journal of Biomedicine and Biotechnology 2012 (2012): 1–8. http://dx.doi.org/10.1155/2012/930582.
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Pulse oximetry data such as saturation of peripheral oxygen (SpO2) and pulse rate are vital signals for early diagnosis of heart disease. Therefore, various pulse oximeters have been developed continuously. However, some of the existing pulse oximeters are not equipped with communication capabilities, and consequently, the continuous monitoring of patient health is restricted. Moreover, even though certain oximeters have been built as network models, they focus on exchanging only pulse oximetry data, and they do not provide sufficient device management functions. In this paper, we propose an advanced pulse oximetry system for remote monitoring and management. The system consists of a networked pulse oximeter and a personal monitoring server. The proposed pulse oximeter measures a patient’s pulse oximetry data and transmits the data to the personal monitoring server. The personal monitoring server then analyzes the received data and displays the results to the patient. Furthermore, for device management purposes, operational errors that occur in the pulse oximeter are reported to the personal monitoring server, and the system configurations of the pulse oximeter, such as thresholds and measurement targets, are modified by the server. We verify that the proposed pulse oximetry system operates efficiently and that it is appropriate for monitoring and managing a pulse oximeter in real time.
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Barker, Steven J., and Nitin K. Shah. "Effects of Motion on the Performance of Pulse Oximeters in Volunteers." Anesthesiology 85, no. 4 (October 1, 1996): 774–81. http://dx.doi.org/10.1097/00000542-199610000-00012.
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Background Pulse oximetry is considered a standard of care in both the operating room and the postanesthetic care unit, and it is widely used in all critical care settings. Pulse oximeters may fail to provide valid pulse oximetry data in various situations that produce low signal-to-noise ratio. Motion artifact is a common cause of oximeter failure and loss of accuracy. This study compares the accuracy and data dropout rates of three current pulse oximeters during standardized motion in healthy volunteers. Methods Ten healthy volunteers were monitored by three different pulse oximeters: Nellcor N-200, Nellcor N-3000, and Masimo SET (prototype). Sensors were placed on digits 2, 3, and 4 of the test hand, which was strapped to a mechanical motion table. The opposite hand was used as a stationary control and was monitored with the same pulse oximeters and an arterial cannula. Arterial oxygen saturation rate varied from 100% to 75% by changing the inspired oxygen concentration. While pulse oximetry was both constant and changing, the oximeter sensors were connected before and during motion. Oximeter errors and dropout rates were digitally recorded continuously during each experiment. Results If the oximeter was functioning before motion began, the following are the percentages of time when the instrument displayed a pulse oximetry value within 7% of control: N-200 = 76%, N-3000 = 87%, and Masimo = 99%. When the oximeter sensor was connected after the beginning of motion, the values were N-200 = 68%, N-3000 = 47%, and Masimo = 97%. If the alarm threshold was chosen as pulse oximetry less than 90%, then the positive predictive values (true alarms/ total alarms) are N-200 = 73%, N-3000 = 81%, and Masimo = 100%. In general, N-200 had the greatest pulse oximetry errors and N-3000 had the highest dropout rates. Conclusions The mechanical motions used in this study significantly affected oximeter function, particularly when the sensors were connected during motion, which requires signal acquisition during motion. The error and dropout rate performance of the Masimo was superior to that of the other two instruments during all test conditions. Masimo uses a new paradigm for oximeter signal processing, which appears to represent a significant advance in low signal-to-noise performance.
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Smyth, R. J., A. D. D'Urzo, A. S. Slutsky, B. M. Galko, and A. S. Rebuck. "Ear oximetry during combined hypoxia and exercise." Journal of Applied Physiology 60, no. 2 (February 1, 1986): 716–19. http://dx.doi.org/10.1152/jappl.1986.60.2.716.
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Ear oximetry is widely used to detect arterial O2 desaturation during exercise in patients with cardiopulmonary disease. Although oximeters have been evaluated for accuracy, response time, and the influence of skin pigmentation, tests of their reliability have not been reported during strenuous exercise. Accordingly, we compared arterial O2 saturation (Sao2) measurements obtained by Hewlett-Packard (HP, model 47201A) and Biox II oximeters with those determined directly from arterial blood in six healthy volunteers during progressive exercise while rebreathing hypoxic gas mixtures. The relationship between the HP oximeter value and blood Sao2 was described by the equation: HP = 0.93 (Sao2) + 5.37 and for the Biox II: Biox = 0.55 (Sao2) + 38.97. With these equations, at a blood Sao2 value of 90%, the underestimation by both oximeters was less than 2%. At a blood value of 70%, the HP oximeter overestimated blood Sao2 by 0.7%, whereas the Biox II showed an overestimation of 10.7%. Below blood Sao2 of 83%, the Biox II tended to overestimate blood Sao2 by an amount greater than the error of the instrument, whereas the HP estimations were within the error of the instrument over all levels of blood Sao2 studied. We conclude that the HP oximeter provides valid estimates of Sao2 during exercise but that the Biox II oximeter, although reflecting qualitative changes in oxygenation that occur during exercise, does not provide accurate records of the degree of desaturation.
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Barker, Steven J., and Nitin K. Shah. "The Effects of Motion on the Performance of Pulse Oximeters in Volunteers (Revised publication)." Anesthesiology 86, no. 1 (January 1, 1997): 101–8. http://dx.doi.org/10.1097/00000542-199701000-00014.
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Background Pulse oximetry is considered a standard of care in both the operating room and the postanesthetic care unit, and it is widely used in all critical care settings. Pulse oximeters may fail to provide valid SpO2 data in various situations that produce low signal-to-noise ratio. Motion artifact is a common cause of oximeter failure and loss of accuracy. This study compares the accuracy and data dropout rates of three current pulse oximeters during standardized motion in healthy volunteers. Methods Ten healthy volunteers were monitored by three different pulse oximeters: Nellcor N-200, Nellcor N-3000, and Masimo SET (prototype). Sensors were placed on digits 2, 3, and 4 of the test hand, which was strapped to a mechanical motion table. The opposite hand was used as a stationary control and was monitored with the same pulse oximeters and an arterial cannula. Arterial oxygen saturation was varied from 100% to 75% by changing the inspired oxygen concentration. While SpO2 was both constant and changing, the oximeter sensors were connected before and during motion. Oximeter errors and dropout rates were digitally recorded continuously during each experiment. Results If the oximeter was functioning before motion began, the following are the percentages of time when the instrument displayed an SpO2 value within 7% of control: N-200 = 76%, N-3000 = 87%, and Masimo = 99%. When the oximeter sensor was connected after the beginning of motion, the values were N-200 = 68%, N-3000 = 47%, and Masimo = 97%. If the alarm threshold was chosen SpO2 less than 90%, then the positive predictive values (true alarms/total alarms) are N-200 = 73%, N-3000 = 81%, and Masimo = 100%. In general, N-200 had the greatest SpO2 errors and N-3000 had the highest dropout rates. Conclusions The mechanical motions used in this study significantly affected oximeter function, particularly when the sensors were connected during motion, which requires signal acquisition during motion. The error and dropout rate performance of the Masimo was superior to that of the other two instruments during all test conditions. Masimo uses a new paradigm for oximeter signal processing, which appears to represent a significant advance in low signal-to-noise performance.
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Cheatham, Scott, Morey J. Kolber, and Michael P. Ernst. "Concurrent Validity of Arterial Blood Oxygen Saturation Measurements: A Preliminary Analysis of an iPad Pulse Oximeter and Traditional Pulse Oximeter Using Bluetooth." International Journal of Athletic Therapy and Training 19, no. 3 (May 2014): 37–42. http://dx.doi.org/10.1123/ijatt.2014-0005.
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Context:Pulse oximetry has become mobile with the use of smartphone and Bluetooth wireless technology. This technology offers many benefits but has not been extensively studied. There is a need to further validate its clinimetric properties for health professionals to provide proper guidance to patients.Objective:This investigation assessed the concurrent validity of the iSpO2pulse oximeter against a traditional pulse oximeter in measuring short-term resting blood oxygen saturation (SpO2) and pulse rate.Design:Observational study of reliability.Setting:University kinesiology laboratory.Participants:Thirty healthy, recre-ationally active adults (18 men, 12 women; mean age = 25.7 ± 5.46 years, mean height = 170.3cm ± 9.51, mean body mass = 76.4 kg ± 19.33).Intervention:Resting measurement of SpO2and pulse rate using the iSpO2pulse oximeter with the iPad Mini and a traditional pulse oximeter with Bluetooth.Main Outcome Measure:Resting SpO2and pulse rate were concurrently measured over 5 min.Results:The concurrent validity between the iSpO2and traditional pulse oximeter was moderate for measuring SpO2, intraclass correlation coeffcient (ICC)(3, 1) = .73,SEM= 0.70%, and good for pulse rate, ICC(3, 1) = .97,SEM= 1.74 beats per minute (bpm). The minimal detectable change at the 95% confidence interval for both instruments suggests that there may be 1.94% disagreement for SpO2and 4.82 bpm disagreement between pulse oximetry methods. The 95% limits of agreement (LoA) for measuring SpO2suggests that the iSpO2and traditional pulse oximeters may vary -0.28 ± 1.98%, or approximately 2%. The 95% LoA for measuring pulse rate suggests that the iSpO2and traditional pulse oximeter may vary 1.74 ± 4.98 bpm, potentially upward of 6 bpm. On the basis of the results of the LoA, it appears that there may be a slight systematic bias between the two devices, with the traditional pulse oximeter producing higher pulse rates than the iSpO2.Conclusion:The findings suggest that both instruments may be beneficial for indirect short-term measurements of resting SpO2and pulse rate.
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Yossef Hay, Ohad, Meir Cohen, Itamar Nitzan, Yair Kasirer, Sarit Shahroor-karni, Yitzhak Yitzhaky, Shlomo Engelberg, and Meir Nitzan. "Pulse Oximetry with Two Infrared Wavelengths without Calibration in Extracted Arterial Blood." Sensors 18, no. 10 (October 15, 2018): 3457. http://dx.doi.org/10.3390/s18103457.
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Oxygen saturation in arterial blood (SaO2) provides information about the performance of the respiratory system. Non-invasive measurement of SaO2 by commercial pulse oximeters (SpO2) make use of photoplethysmographic pulses in the red and infrared regions and utilizes the different spectra of light absorption by oxygenated and de-oxygenated hemoglobin. Because light scattering and optical path-lengths differ between the two wavelengths, commercial pulse oximeters require empirical calibration which is based on SaO2 measurement in extracted arterial blood. They are still prone to error, because the path-lengths difference between the two wavelengths varies among different subjects. We have developed modified pulse oximetry, which makes use of two nearby infrared wavelengths that have relatively similar scattering constants and path-lengths and does not require an invasive calibration step. In measurements performed on adults during breath holding, the two-infrared pulse oximeter and a commercial pulse oximeter showed similar changes in SpO2. The two pulse oximeters showed similar accuracy when compared to SaO2 measurement in extracted arterial blood (the gold standard) performed in intensive care units on newborns and children with an arterial line. Errors in SpO2 because of variability in path-lengths difference between the two wavelengths are expected to be smaller in the two-infrared pulse oximeter.
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Lu, Chun-Hao, Jiun-Hung Lin, Han-Ming Huang, Cheng-Yang Huang, and Cheng-Chi Tai. "DESIGN OF A RING-TYPE REFLECTION PULSE OXIMETER WITH A PARABOLIC REFLECTOR." Biomedical Engineering: Applications, Basis and Communications 27, no. 01 (February 2015): 1550007. http://dx.doi.org/10.4015/s1016237215500076.
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A pulse oximeter is a noninvasive instrument used in clinical medicine to monitor arterial oxygen saturation. Fingertip-type pulse oximeters are popular, but their inconvenience for long-term monitoring in daily life means that other types of wearable pulse oximeters, such as a ring-type reflection pulse oximeter, needs to be developed. However, designing a ring-type pulse oximeter for measuring the oxygen saturation is difficult due to the complex tissue architecture of the finger base. This study used human tissue simulations to evaluate the practicability of a ring-type reflection pulse oximeter design. Moreover, given that the collection of diffusely reflected light can be enhanced by using a parabolic reflector, the efficacy of a ring-type reflection pulse oximeter with a parabolic reflector was also evaluated.
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Tverytnykova, Elena, Tatyana Drozdova, Yulia Demidova, and Nataliia Kuzmenko. "METROLOGICAL SUPPORT OF PULSE OXIMETERS." Advanced Information Systems 6, no. 1 (April 6, 2022): 75–80. http://dx.doi.org/10.20998/2522-9052.2022.1.13.
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The experience of the International Medical Device Regulators Forum in the use of products for oxygen therapy based on the study of guidelines, international and European regulations on medical devices is considered. Emphasis is placed on issues related to the metrological support of pulse oximeters. The global situation with the pandemic increases the relevance of selected topics. Continuous monitoring of blood oxygen saturation is one of the most important elements in the diagnosis and treatment of COVID-19. Despite the fact that the use of pulse oximeters does not require special medical knowledge, calibration and special maintenance, it is still necessary to control their reliability and accuracy of measurement. The study of pulse oximeter MD300M in accordance with the requirements of DSTU 8893:2019 "Metrology. Pulse oximeters. Calibration Method” 2020. Analysis of MD300M pulse oximeter calibration results revealed that this pulse oximeter was calibrated by the saturation and pulse measurement channel, as the maximum deviation of the measured saturation value from the pulse oximeter calibration measure does not exceed the pulse oximeter measurement documentation specified in the operating documentation. The discreteness of the MD300M pulse oximeter and the discreteness of the reference device MPPO-2, which are specified in the passports for the respective devices, have the greatest influence on the measurement uncertainty.
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Louie, Aaron, John R. Feiner, Philip E. Bickler, Laura Rhodes, Michael Bernstein, and Jennifer Lucero. "Four Types of Pulse Oximeters Accurately Detect Hypoxia during Low Perfusion and Motion." Anesthesiology 128, no. 3 (March 1, 2018): 520–30. http://dx.doi.org/10.1097/aln.0000000000002002.
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Abstract Background Pulse oximeter performance is degraded by motion artifacts and low perfusion. Manufacturers developed algorithms to improve instrument performance during these challenges. There have been no independent comparisons of these devices. Methods We evaluated the performance of four pulse oximeters (Masimo Radical-7, USA; Nihon Kohden OxyPal Neo, Japan; Nellcor N-600, USA; and Philips Intellivue MP5, USA) in 10 healthy adult volunteers. Three motions were evaluated: tapping, pseudorandom, and volunteer-generated rubbing, adjusted to produce photoplethsmogram disturbance similar to arterial pulsation amplitude. During motion, inspired gases were adjusted to achieve stable target plateaus of arterial oxygen saturation (SaO2) at 75%, 88%, and 100%. Pulse oximeter readings were compared with simultaneous arterial blood samples to calculate bias (oxygen saturation measured by pulse oximetry [SpO2] − SaO2), mean, SD, 95% limits of agreement, and root mean square error. Receiver operating characteristic curves were determined to detect mild (SaO2 < 90%) and severe (SaO2 < 80%) hypoxemia. Results Pulse oximeter readings corresponding to 190 blood samples were analyzed. All oximeters detected hypoxia but motion and low perfusion degraded performance. Three of four oximeters (Masimo, Nellcor, and Philips) had root mean square error greater than 3% for SaO2 70 to 100% during any motion, compared to a root mean square error of 1.8% for the stationary control. A low perfusion index increased error. Conclusions All oximeters detected hypoxemia during motion and low-perfusion conditions, but motion impaired performance at all ranges, with less accuracy at lower SaO2. Lower perfusion degraded performance in all but the Nihon Kohden instrument. We conclude that different types of pulse oximeters can be similarly effective in preserving sensitivity to clinically relevant hypoxia.
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Harrell, M. D., N. R. Dobson, C. Olsen, A. Ahmed, and C. E. Hunt. "Inpatient comparison of wireless and wired pulse oximetry in neonates." Journal of Neonatal-Perinatal Medicine 15, no. 2 (April 12, 2022): 283–89. http://dx.doi.org/10.3233/npm-210836.
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BACKGROUND: To compare oxygen saturation (SpO2) and heart rate (HR) recorded by a reference wired pulse oximeter to a wireless pulse oximeter in inpatient neonates. METHODS: Term infants born≥37 + 0 weeks and preterm infants born≤35 + 0 weeks gestation were enrolled and time-matched data pairs were obtained. The primary outcome was intraclass correlation coefficient and r-values between the two oximeters for heart rate and oxygen saturation. RESULTS: Thirty term and 20 preterm neonates were enrolled. There was a high degree of correlation between the two oximeters for HR (r = 0.926) among all 50 infants, and excellent interclass correlation (ICC = 0.961), but there were no bradycardia episodes in either term or preterm infants. There was a lesser degree of correlation for SpO2 values in the term and preterm groups (r = 0.242; 0.521, respectively) along with moderate interclass correlation (ICC = 0.719) but few episodes of hypoxemia≤90% occurred in enrolled subjects. CONCLUSIONS: There were no significant differences between the wireless and reference wired oximeters for assessing HR. There was less correlation between the two oximeters for monitoring SpO2 in both the term and preterm group. Wireless pulse oximetry may have practical advantages for use in inpatient neonates, but additional studies are needed that include bradycardia and desaturation events to delineate this question.
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DeSisto, Marie C. "Implementing Pulse Oximetry in the School Health Office." NASN School Nurse 27, no. 5 (August 20, 2012): 256–58. http://dx.doi.org/10.1177/1942602x12456432.
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Pulse oximetry can be a useful tool for professional school nurses who daily assess students with a variety of health issues and injuries. Pulse oximeters are now smaller and more affordable and, therefore, an option for school districts to purchase. Before implementing this new tool into their practice, school nurses must have an understanding of how pulse oximeters work and how they measure the oxygen saturation of arterial hemoglobin. A review of the literature will guide a nurse in developing clinical guidelines for practice and facilitating competency in using a pulse oximeter with the ultimate goal of improving student health assessments.
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Mahoney, J. J., H. J. Vreman, D. K. Stevenson, and A. L. Van Kessel. "Measurement of carboxyhemoglobin and total hemoglobin by five specialized spectrophotometers (CO-oximeters) in comparison with reference methods." Clinical Chemistry 39, no. 8 (August 1, 1993): 1693–700. http://dx.doi.org/10.1093/clinchem/39.8.1693.
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Abstract We measured total hemoglobin (CtHb) and carboxyhemoglobin (COHb) in 100 patients' blood samples by using five specialized spectrophotometers (CO-oximeters)--IL 482 CO-Oximeter, Corning 2500 CO-oximeter, Radiometer OSM 3 Hemoximeter, Corning 270 CO-oximeter, and the AVL 912 CO-Oxylite--and compared the results with those obtained with the manual cyanmethemoglobin method and a gas-chromatographic (GC) method, respectively. For the CtHb measurements, the differences between the cyanmethemoglobin method and the CO-oximeters were not clinically important for any model. For the blood COHb measurements, the direction of the bias relative to GC was dependent on COHb concentration. In general, the CO-oximeters underestimated COHb concentration for COHb > 2.5% of total hemoglobin but overestimated COHb concentration for COHb < or = 2.5%. We conclude that all five CO-oximeters compared favorably with the reference methods for CtHb and for high concentrations of COHb. However, the inaccuracy of CO-oximeters for low-concentration (< or = 2.5%) COHb measurements may make these instruments unsuitable for some applications.
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Harris, Bronwyn U., Sarah Stewart, Archana Verma, Helena Hoen, Mary Lyn Stein, Gail Wright, and Chandra Ramamoorthy. "Accuracy of a portable pulse oximeter in monitoring hypoxemic infants with cyanotic heart disease." Cardiology in the Young 29, no. 8 (July 15, 2019): 1025–29. http://dx.doi.org/10.1017/s1047951119001355.
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AbstractObjective:Infants with single ventricle physiology have arterial oxygen saturations between 75 and 85%. Home monitoring with daily pulse oximetry is associated with improved interstage survival. They are typically sent home with expensive, bulky, hospital-grade pulse oximeters. This study evaluates the accuracy of both the currently used Masimo LNCS and a relatively inexpensive, portable, and equipped with Bluetooth technology study device, by comparing with the gold standard co-oximeter.Design:Prospective, observational study.Setting:Single institution, paediatric cardiac critical care unit, and neonatal ICU.Interventions:none.Patients:Twenty-four infants under 12 months of age with baseline oxygen saturation less than 90% due to cyanotic CHD.Measurements and Results:Pulse oximetry with WristOx2 3150 with infant sensors 8008 J (study device) and Masimo LCNS saturation sensor connected to a Philips monitor (hospital device) were measured simultaneously and compared to arterial oxy-haemoglobin saturation measured by co-oximetry. Statistical analysis evaluated the performances of each and compared to co-oximetry with Schuirmann’s TOST equivalence tests, with equivalence defined as an absolute difference of 5% saturation or less. Neither the study nor the hospital device met the predefined standard for equivalence when compared with co-oximetry. The study device reading was on average 4.0% higher than the co-oximeter, failing to show statistical equivalence (p = 0.16). The hospital device was 7.4% higher than the co-oximeter and also did not meet the predefined standard for equivalence (p = 0.97).Conclusion:Both devices tended to overestimate oxygen saturation in this patient population when compared to the gold standard, co-oximetry. The study device is at least as accurate as the hospital device and offers the advantage of being more portable with Bluetooth technology that allows reliable, efficient data transmission. Currently FDA-approved, smaller portable pulse oximeters can be considered for use in home monitoring programmes.
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Stell, David, Jonathan James Noble, Rebecca Hazell Kay, Man Ting Kwong, Michael John Russell Jeffryes, Liam Johnston, Guy Glover, and Emmanuel Akinluyi. "Exploring the impact of pulse oximeter selection within the COVID-19 home-use pulse oximetry pathways." BMJ Open Respiratory Research 9, no. 1 (February 2022): e001159. http://dx.doi.org/10.1136/bmjresp-2021-001159.
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BackgroundDuring the COVID-19 pandemic, portable pulse oximeters were issued to some patients to permit home monitoring and alleviate pressure on inpatient wards. Concerns were raised about the accuracy of these devices in some patient groups. This study was conducted in response to these concerns.ObjectivesTo evaluate the performance characteristics of five portable pulse oximeters and their suitability for deployment on home-use pulse oximetry pathways created during the COVID-19 pandemic. This study considered the effects of different device models and patient characteristics on pulse oximeter accuracy, false negative and false positive rate.MethodsA total of 915 oxygen saturation (spO2) measurements, paired with measurements from a hospital-standard pulse oximeter, were taken from 50 patients recruited from respiratory wards and the intensive care unit at an acute hospital in London. The effects of device model and several patient characteristics on bias, false negative and false positive likelihood were evaluated using multiple regression analyses.Results and conclusionsAll five portable pulse oximeters appeared to outperform the standard to which they were manufactured. Device model, patient spO2 and patient skin colour were significant predictors of measurement bias, false positive and false negative rate, with some variation between models. The false positive and false negative rates were 11.2% and 24.5%, respectively, with substantial variation between models.
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Enoch, Abigail J., Mike English, and Sasha Shepperd. "Does pulse oximeter use impact health outcomes? A systematic review." Archives of Disease in Childhood 101, no. 8 (December 23, 2015): 694–700. http://dx.doi.org/10.1136/archdischild-2015-309638.
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ObjectiveDo newborns, children and adolescents up to 19 years have lower mortality rates, lower morbidity and shorter length of stay in health facilities where pulse oximeters are used to inform diagnosis and treatment (excluding surgical care) compared with health facilities where pulse oximeters are not used?DesignStudies were obtained for this systematic literature review by systematically searching the Database of Abstracts of Reviews of Effects, Cochrane, Medion, PubMed, Web of Science, Embase, Global Health, CINAHL, WHO Global Health Library, international health organisation and NGO websites, and study references.PatientsChildren 0–19 years presenting for the first time to hospitals, emergency departments or primary care facilities.InterventionsIncluded studies compared outcomes where pulse oximeters were used for diagnosis and/or management, with outcomes where pulse oximeters were not used. Main outcome measures: mortality, morbidity, length of stay, and treatment and management changes.ResultsThe evidence is low quality and hypoxaemia definitions varied across studies, but the evidence suggests pulse oximeter use with children can reduce mortality rates (when combined with improved oxygen administration) and length of emergency department stay, increase admission of children with previously unrecognised hypoxaemia, and change physicians’ decisions on illness severity, diagnosis and treatment. Pulse oximeter use generally increased resource utilisation.ConclusionsAs international organisations are investing in programmes to increase pulse oximeter use in low-income settings, more research is needed on the optimal use of pulse oximeters (eg, appropriate oxygen saturation thresholds), and how pulse oximeter use affects referral and admission rates, length of stay, resource utilisation and health outcomes.
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Bucher, Hans-Ulrich, Sergio Fanconi, Peter Baeckert, and Gabriel Duc. "Hyperoxemia in Newborn Infants: Detection by Pulse Oximetry." Pediatrics 84, no. 2 (August 1, 1989): 226–30. http://dx.doi.org/10.1542/peds.84.2.226.
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Pulse oximetry has been proposed as a non-invasive continuous method for transcutaneous monitoring of arterial oxygen saturation of hemoglobin (tcSO2) in the newborn infant. The reliability of this technique in detecting hyperoxemia is controversial, because small changes in saturation greater than 90% are associated with relatively large changes in arterial oxygen tension (PaO2). The purpose of this study was to assess the reliability of pulse oximetry using an alarm limit of 95% tcSO2 in detecting hyperoxemia (defined as PaO2 greater than 90 mm Hg) and to examine the effect of varying the alarm limit on reliability. Two types of pulse oximeter were studied alternately in 50 newborn infants who were mechanically ventilated with indwelling arterial lines. Three arterial blood samples were drawn from every infant during routine increase of inspired oxygen before intratracheal suction, and PaO2 was compared with tcSO2. The Nellcor N-100 pulse oximeter identified all 26 hyperoxemic instances correctly (sensitivity 100%) and alarmed falsely in 25 of 49 nonhyperoxemic instances (specificity 49%). The Ohmeda Biox 3700 pulse oximeter detected 13 of 35 hyperoxemic instances (sensitivity 37%) and alarmed falsely in 7 of 40 nonhyperoxemic instances (specificity 83%). The optimal alarm limit, defined as a sensitivity of 95% or more associated with maximal specificity, was determined for Nellcor N-100 at 96% tcSO2 (specificity 38%) and for Ohmeda Biox 3700 at 89% tcSO2 (specificity 52%). It was concluded that pulse oximeters can be highly sensitive in detecting hyperoxemia provided that type-specific alarm limits are set and a low specificity is accepted.
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Melnyk, Anatoliy, Yuriy Morozov, Bohdan Havanio, and Petro Hupalo. "Investigation of Wireless Pulse Oximeters for Smartphone-based Remote Monitoring of Lung Health." Advances in Cyber-Physical Systems 5, no. 2 (October 3, 2020): 70–76. http://dx.doi.org/10.23939/acps2020.02.070.
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Coronavirus has the greatest effect on the human lungs. This is why lungs of patients with COVID- 19 require constant medical monitoring. One of the tools for the lungs condition monitoring is based on the wireless pulse oximeters connected to smartphones. There is an attempt to analyze the types of pulse oximeters, their technical characteristics, principles of operation and basic requirements for these measuring instruments in the article. According to this study, the most effective pulse oximeters for 24/7 monitoring of lung function were selected. Principles of pulse oximeter functioning and mathematical basis of its operation have been described. The criteria for pulse oximeter selection have been determined, and comparative analysis of pulse oximeters with wireless communication has been conducted.
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Bickler, Philip E., John R. Feiner, and John W. Severinghaus. "Effects of Skin Pigmentation on Pulse Oximeter Accuracy at Low Saturation." Anesthesiology 102, no. 4 (April 1, 2005): 715–19. http://dx.doi.org/10.1097/00000542-200504000-00004.
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Background It is uncertain whether skin pigmentation affects pulse oximeter accuracy at low HbO2 saturation. Methods The accuracy of finger pulse oximeters during stable, plateau levels of arterial oxygen saturation (Sao2) between 60 and 100% were evaluated in 11 subjects with darkly pigmented skin and in 10 with light skin pigmentation. Oximeters tested were the Nellcor N-595 with the OxiMax-A probe (Nellcor Inc., Pleasanton, CA), the Novametrix 513 (Novametrix Inc., Wallingford, CT), and the Nonin Onyx (Nonin Inc., Plymouth, MN). Semisupine subjects breathed air-nitrogen-carbon dioxide mixtures through a mouthpiece. A computer used end-tidal oxygen and carbon dioxide concentrations determined by mass spectrometry to estimate breath-by-breath Sao2, from which an operator adjusted inspired gas to rapidly achieve 2- to 3-min stable plateaus of desaturation. Comparisons of oxygen saturation measured by pulse oximetry (Spo2) with Sao2 (by Radiometer OSM3) were used in a multivariate model to determine the interrelation between saturation, skin pigmentation, and oximeter bias (Spo2 - Sao2). Results At 60-70% Sao2, Spo2 (mean of three oximeters) overestimated Sao2 (bias +/- SD) by 3.56 +/- 2.45% (n = 29) in darkly pigmented subjects, compared with 0.37 +/- 3.20% (n = 58) in lightly pigmented subjects (P < 0.0001). The SD of bias was not greater with dark than light skin. The dark-light skin differences at 60-70% Sao2 were 2.35% (Nonin), 3.38% (Novametrix), and 4.30% (Nellcor). Skin pigment-related differences were significant with Nonin below 70% Sao2, with Novametrix below 90%, and with Nellcor at all ranges. Pigment-related bias increased approximately in proportion to desaturation. Conclusions The three tested pulse oximeters overestimated arterial oxygen saturation during hypoxia in dark-skinned individuals.
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Ajrina, Amalia. "PULSE OXIMETER USAGE IN PATIENT COVID-19 TREATMENT : AT A GLANCE." Journal of Vocational Health Studies 5, no. 1 (July 31, 2021): 53. http://dx.doi.org/10.20473/jvhs.v5.i1.2021.53-57.
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Background: The end of 2019, Wuhan experienced an insurgence of coronavirus within two months of this prolong pandemic. Patients with Covid-19 have chance in suffering a serious damage of respiratory system, which then lead to hypoxemia. The harmful of silent hypoxemia is that either the patients are remain untreated or they will not seek any treatment at all, though their blood oxygen levels (SpO2 levels) slowly decrease. Especially those who isolated at home. Pulse oximeter is a mini device that evaluate the level of arterial blood saturation. Purpose: This article gives a short review about the principle, application, advantage, and disadvantage of pulse oximetry in maintaining the Covid-19 patients with hypoxemia. Review: Two basic principles of pulse oximetry that are important: (a) to differentiate the oxyhemoglobin (HbO2 ) and deoxyhemoglobin (HHb), (b) to get the value of SpO2 from arterial compartment blood. How pulse oximeter detects SpO2 is based on the amount of red and IR light absorbed. Pulse oximeter can detect an abnormality of respiratory system in Covid-19 patients that may cannot be detected earlier. Pulse oximeter also helps diagnosing some severe pneumonia cases. It also can be realiable to diagnose an ARDS (Acute Respiratory Distress Syndroms) if the devices are found limited (WHO, 2020). Beside the advantages of pulse oximeter, there are some erroneous of readings. Conclusion: Pulse oximeter is a mini device which offers many advantages over its limitations. Limitation of pulse oximeter can be early detected and overcame with an introduction evaluation of clinical conditions of each patients.
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Cho, Hun, Edwin M. Nemoto, Howard Yonas, Jeffrey Balzer, and Robert J. Sclabassi. "Cerebral monitoring by means of oximetry and somatosensory evoked potentials during carotid endarterectomy." Journal of Neurosurgery 89, no. 4 (October 1998): 533–38. http://dx.doi.org/10.3171/jns.1998.89.4.0533.
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Object. Cerebral ischemia that occurs during carotid endarterectomy is commonly monitored by means of somatosensory evoked potentials (SSEPs) and electroencephalography (EEG). The authors conducted this study to determine whether cerebral ischemia could also be reliably detected by cerebral oximetry. Methods. Twenty-nine patients who underwent carotid endarterectomy were monitored by means of SSEPs, EEG, and cerebral oximetry with a model NIRO500 (20 patients) or INVOS3100A (nine patients) oximeter. Changes in amplitude of SSEPs were graded as follows: 0, no change; 1, decrease of less than 50%; 2, decrease of greater than 50%; and 3, 100% decrease. As measured with the NIRO500 oximeter, closing the common caro-tid artery decreased mean oxyhemoglobin levels twice as much (p < 0.005) in the group with SSEPs of 1 to 3 (−13.11 ± 5.59 µM [mean ± standard deviation], 12 patients) as in the group with SSEPs of 0 (−6.22 ± 5.59 µM, eight patients). The rise in deoxyhemoglobin was also greater (p < 0.05). Two of nine patients monitored with the INVOS3100A oximeter had SSEPs of 1 and 3, and their regional saturation of oxygen (rSO2) values fell by −11.50 and −11.51, respectively. In the remaining seven patients with SSEPs of 0, the rSO2 ranged between −2.00 and −6.10 with no overlap with the group with SSEPs of 1 to 3. The increase in oxyhemoglobin monitored using the NIRO500 oximeter and rSO2 monitored using the INVOS3100A machine after opening the external carotid artery was less than that seen after opening the internal carotid artery. Both types of oximeters could detect cerebral ischemia but whereas false negatives occurred with the NIRO500, none was observed with the INVOS3100A. Extracranial contamination was also four times less frequent with the INVOS3100A than with the NIRO500 monitor. Conclusions. The results indicate that at least as measured with the INVOS3100A instrument, a decrease in rSO2 of −10 or more or a decrease below an rSO2 of 50 is indicative of cerebral ischemia of sufficient severity to decrease the amplitude of SSEPs.
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Suga, H., S. Futaki, Y. Ohgoshi, H. Yaku, and Y. Goto. "Arteriovenous oximeter for O2 content difference, O2 saturations, and hemoglobin content." American Journal of Physiology-Heart and Circulatory Physiology 257, no. 5 (November 1, 1989): H1712—H1716. http://dx.doi.org/10.1152/ajpheart.1989.257.5.h1712.
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We combined two spectrophotometric oximeters to measure continuously and simultaneously arteriovenous O2 content difference (AVOD) as well as arterial and venous oxyhemoglobin saturations (SaO2, SvO2) and total hemoglobin concentration (Hb). AVOD of the flowing arterial and venous whole blood was determined by the method of Guyton et al. (J. Appl. Physiol. 10: 158-163, 1957) and Shepherd and Burgar [Am. J. Physiol. 232 (Heart Circ. Physiol. 1): H437-H440, 1977]. The new arteriovenous oximeter was tested in dog experiments in which SaO2, SvO2, Hb, and AVOD were variously changed by temporary suffocation, electric muscle stimulation, hemorrhage and transfusion, and hemodilution with saline. AVOD, SaO2, SvO2, and Hb were compared with the data of the arterial and venous blood sampled near the oximeter cuvettes and measured with an IL282 CO oximeter. In one dog experiment and one in vitro blood experiment, AVOD data of the same arterial and venous blood were compared by connecting the present oximeter in series with an A-VOX Systems oximeter developed by Shepherd and Burgar. The results showed that the new arteriovenous oximeter can continuously measure AVOD, SaO2, SvO2, and Hb over wide ranges with reasonable accuracy.
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Ramanathan, Rangasamy, Manuel Durand, and Carlos Larrazabal. "Pulse Oximetry in Very Low Birth Weight Infants With Acute and Chronic Lung Disease." Pediatrics 79, no. 4 (April 1, 1987): 612–17. http://dx.doi.org/10.1542/peds.79.4.612.
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With improved survival of very low birth weight infants, the incidence of bronchopulmonary dysplasia has significantly increased. Pulse oximetry appears to be an adequate alternative to transcutaneous Po2, for continuous arterial oxygen saturation (Sao2) monitoring in neonates; however, its usefulness has not been very well documented in very low birth weight infants. We studied 68 patients with birth weight < 1,250 g; 44 neonates had respiratory distress syndrome and 24 had bronchopulmonary dysplasia. Using a Nellcor N-100 pulse oximeter, we compared transcutaneous oxygen saturation with simultaneous arterial samples analyzed for Sao2 (range 78% to 100%) using an IL 282 co-oximeter. Fetal hemoglobin was measured in 66 patients. We also evaluated the accuracy of transcutaneous Po2 in reflecting arterial Po2 in patients with bronchopulmonary dysplasia. Over a wide range of Po2, Pco2, pH, heart rate, BP, hematocrit, and fetal hemoglobin, linear regression analysis revealed a close correlation between pulse oximeter values and co-oximeter measured Sao2 in patients with acute (r = .88, Y = 19.41 + 0.79X) and chronic (r = .90, Y = 9.72 + 0.92X) disease. Regression analysis of transcutaneous v arterial Po2 in infants with bronchopulmonary dysplasia showed an r value of .78. In addition, in these patients with chronic disease, the mean difference between pulse oximeter Sao2 and co-oximeter measured Sao2 was 2.7 ± 1.9% (SD); whereas the mean difference between transcutaneous and arterial Po2 was -14 ± 10.7 mm Hg. Our findings indicate that pulse oximetry can be used reliably in very low birth weight infants with acute and chronic lung disease, for Sao2 values greater than 78%. This technique is more advantageous than transcutaneous Po2 in infants with bronchopulmonary dysplasia. Additional studies are needed to evaluate the performance of the pulse oximeter in tiny infants with Sao2 values < 78%.
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Martin, D., S. Powers, M. Cicale, N. Collop, D. Huang, and D. Criswell. "Validity of pulse oximetry during exercise in elite endurance athletes." Journal of Applied Physiology 72, no. 2 (February 1, 1992): 455–58. http://dx.doi.org/10.1152/jappl.1992.72.2.455.
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Eleven highly trained male cyclists [maximal aerobic power (VO2max) = 70.6 +/- 4.2 ml.kg-1.min-1] performed both high intensity constant load (90–95% VO2max) and incremental cycle exercise tests with arterial blood sampling to evaluate the accuracy of pulse oximeter estimates (%SpO2) of arterial oxyhemoglobin fraction of total hemoglobin (%HbO2). Three subjects also performed an incremental exercise test in hypoxic conditions (inspired partial pressure of O2 = 89, 93, or 100 Torr). Arterial %HbO2 was determined via CO-oximetry and ranged from 72 to 99%. Three Ohmeda 3740 pulse oximeters were used to estimate %HbO2, one on each ear lobe and a finger probe. The finger probe tended to provide the best estimate of %HbO2 during exercise: the mean %SpO2 - %HbO2 difference for 232 exercise observations was 0.52 +/- 1.36% (SD). Finger probe %SpO2 and %HbO2 were highly correlated [r = 0.98, standard error of the estimate (SEE) = 1.32%, P less than 0.0001]. The accuracy of pulse oximeters has been questioned during high-intensity exercise. When aerobic power was greater than 81% of VO2max (n = 75), the finger probe's mean error was -0.01 +/- 1.40%. Finger probe %SpO2 and %HbO2 were highly correlated (r = 0.97, SEE = 1.32%, P less than 0.0001). These results indicate that this pulse oximeter is a valid predictor of %HbO2 in elite athletes during cycle exercise.
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Griksaitis, Michael J., Gemma E. Scrimgeour, John V. Pappachan, and Andrew J. Baldock. "Accuracy of the Masimo SET® LNCS neo peripheral pulse oximeter in cyanotic congenital heart disease." Cardiology in the Young 26, no. 6 (October 16, 2015): 1183–86. http://dx.doi.org/10.1017/s1047951115002188.
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AbstractIntroductionNon-invasive peripheral pulse oximeters are routinely used to measure oxyhaemoglobin saturation (SpO2) in cyanotic congenital heart disease. These probes are calibrated in healthy adult volunteers between arterial saturations of ~75 and 100%, using the gold standard of co-oximetry on arterial blood samples. There are little data to attest their accuracy in cyanotic congenital heart disease.AimsWe aimed to assess the accuracy of a commonly used probe in children with cyanotic congenital heart disease.MethodsChildren with cyanotic congenital heart disease admitted to the Paediatric Intensive Care Unit with an arterial line in situ were included to our study. Prospective simultaneous recordings of SpO2, measured by the Masimo SET® LNCS Neo peripheral probe, and co-oximeter saturations (SaO2) measured by arterial blood gas analysis were recorded.ResultsA total of 527 paired measurements of SpO2 and SaO2 (using an ABL800 FLEX analyser) in 25 children were obtained. The mean bias of the pulse oximeter for all SaO2 readings was +4.7±13.8%. The wide standard deviation indicates poor precision. This mean bias increased to +7.0±13.7% at SaO2 recordings <75%. The accuracy root mean square of the recordings was 3.30% across all saturation levels, and this increased to 4.98% at SaO2 <75%.ConclusionsThe performance of the Masimo SET® LNCS Neo pulse oximeter is poor when arterial oxyhaemoglobin saturations are below 75%. It tends to overestimate saturations in children with cyanotic congenital heart disease. This may have serious implications for clinical decisions.
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Schober, Andrew, John R. Feiner, Philip E. Bickler, and Mark D. Rollins. "Effects of Changes in Arterial Carbon Dioxide and Oxygen Partial Pressures on Cerebral Oximeter Performance." Anesthesiology 128, no. 1 (January 1, 2018): 97–108. http://dx.doi.org/10.1097/aln.0000000000001898.
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Abstract Background Cerebral oximetry (cerebral oxygen saturation; ScO2) is used to noninvasively monitor cerebral oxygenation. ScO2 readings are based on the fraction of reduced and oxidized hemoglobin as an indirect estimate of brain tissue oxygenation and assume a static ratio of arterial to venous intracranial blood. Conditions that alter cerebral blood flow, such as acute changes in Paco2, may decrease accuracy. We assessed the performance of two commercial cerebral oximeters across a range of oxygen concentrations during normocapnia and hypocapnia. Methods Casmed FORE-SIGHT Elite (CAS Medical Systems, Inc., USA) and Covidien INVOS 5100C (Covidien, USA) oximeter sensors were placed on 12 healthy volunteers. The fractional inspired oxygen tension was varied to achieve seven steady-state levels including hypoxic and hyperoxic Pao2 values. ScO2 and simultaneous arterial and jugular venous blood gas measurements were obtained with both normocapnia and hypocapnia. Oximeter bias was calculated as the difference between the ScO2 and reference saturation using manufacturer-specified weighting ratios from the arterial and venous samples. Results FORE-SIGHT Elite bias was greater during hypocapnia as compared with normocapnia (4 ± 9% vs. 0 ± 6%; P < 0.001). The INVOS 5100C bias was also lower during normocapnia (5 ± 15% vs. 3 ± 12%; P = 0.01). Hypocapnia resulted in a significant decrease in mixed venous oxygen saturation and mixed venous oxygen tension, as well as increased oxygen extraction across fractional inspired oxygen tension levels (P < 0.0001). Bias increased significantly with increasing oxygen extraction (P < 0.0001). Conclusions Changes in Paco2 affect cerebral oximeter accuracy, and increased bias occurs with hypocapnia. Decreased accuracy may represent an incorrect assumption of a static arterial–venous blood fraction. Understanding cerebral oximetry limitations is especially important in patients at risk for hypoxia-induced brain injury, where Paco2 may be purposefully altered.
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Smatlak, P., and AR Knebel. "Clinical evaluation of noninvasive monitoring of oxygen saturation in critically ill patients." American Journal of Critical Care 7, no. 5 (September 1, 1998): 370–73. http://dx.doi.org/10.4037/ajcc1998.7.5.370.
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OBJECTIVE: To examine the effect of abnormal cardiac index on the accuracy of measurement of oxygen saturation by pulse oximetry. METHODS: Forty-six patients (mean age, 49 years) in a 9-bed medical ICU were studied. Measurements of oxygen saturation obtained with pulse oximeters and with a functional cooximeter were collected at baseline and 4, 8, 16, 24, 32, 40, and 48 hours later. Hemodynamic and cardiopulmonary parameters were recorded. RESULTS: The Bland-Altman technique yielded upper and lower limits of agreement of 2.53% and -7.11%. Most (95.7%) of the differences between the measurements of oxygen saturation obtained with the 2 methods were within these limits, although some of these differences may be clinically unacceptable. The bias was -2.29%, and the precision was 2.41%. The clinical conditions associated with inaccurate tracking of saturation by pulse oximetry across the range of actual arterial oxygen saturation values were abnormal cardiac index, partial pressure of carbon dioxide, heart rate, and pulmonary capillary wedge pressure. CONCLUSIONS: In patients with abnormal cardiac index, the pulse oximeter measurements exceeded the actual oxygen saturation by up to 7%. Pending prospective studies, clinicians should be aware that when certain cardiopulmonary parameters are abnormal, the margin of error in measurements of oxygen saturation obtained with a pulse oximeter may be greater than when those parameters are normal.
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Barker, Steven J., Jeremy Curry, Daniel Redford, and Scott Morgan. "Measurement of Carboxyhemoglobin and Methemoglobin by Pulse Oximetry." Anesthesiology 105, no. 5 (November 1, 2006): 892–97. http://dx.doi.org/10.1097/00000542-200611000-00008.
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Background A new eight-wavelength pulse oximeter is designed to measure methemoglobin and carboxyhemoglobin, in addition to the usual measurements of hemoglobin oxygen saturation and pulse rate. This study examines this device's ability to measure dyshemoglobins in human volunteers in whom controlled levels of methemoglobin and carboxyhemoglobin are induced. Methods Ten volunteers breathed 500 ppm carbon monoxide until their carboxyhemoglobin levels reached 15%, and 10 different volunteers received intravenous sodium nitrite, 300 mg, to induce methemoglobin. All were instrumented with arterial cannulas and six Masimo Rad-57 (Masimo Inc., Irvine, CA) pulse oximeter sensors. Arterial blood was analyzed by three laboratory CO-oximeters, and the resulting carboxyhemoglobin and methemoglobin measurements were compared with the corresponding pulse oximeter readings. Results The Rad-57 measured carboxyhemoglobin with an uncertainty of +/-2% within the range of 0-15%, and it measured methemoglobin with an uncertainty of 0.5% within the range of 0-12%. Conclusion The Masimo Rad-57 is the first commercially available pulse oximeter that can measure methemoglobin and carboxyhemoglobin, and it therefore represents an expansion of our oxygenation monitoring capability.
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Vreman, H. J., and D. K. Stevenson. "Carboxyhemoglobin determined in neonatal blood with a CO-oximeter unaffected by fetal oxyhemoglobin." Clinical Chemistry 40, no. 8 (August 1, 1994): 1522–27. http://dx.doi.org/10.1093/clinchem/40.8.1522.
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Abstract Measurements of carboxyhemoglobin (COHb) for clinical purposes are routinely made with CO-oximeters. However, fetal hemoglobin (HbF) interferes with this spectrophotometric method. The manufacturer (Ciba Corning Diagnostics) of a new CO-oximeter (CCD 270) claims that COHb measurements with this instrument are insignificantly affected by HbF. We examined this claim through CO-oximeter analysis of cord blood/adult blood mixtures and compared the results with those obtained by gas chromatography (GC). We also studied the influence of oxygen and bilirubin concentrations. Measurements of COHb with CCD 270 were significantly lower than the GC measurements, but the differences were not clinically important. Linear regression analysis of HbF and COHb measurements (n = 68) showed significant correlation (P < 0.0001) between the two factors for the older CCD 2500 CO-oximeter (R2 = 0.56), but not for the CCD 270 (R2 = 0.06) or GC (R2 = 0.02). Bilirubin concentrations, which affected COHb measurements with CCD 2500, did not significantly affect CCD 270 measurements. We conclude that COHb measurements with CCD 270 CO-oximeter are not affected by HbF or bilirubin concentrations.
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Estefanía, Macian Canto. "Design of a Portable Pulse Oximeter." Clinical Cardiology and Cardiovascular Interventions 4, no. 7 (April 8, 2021): 01–09. http://dx.doi.org/10.31579/2641-0419/144.
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Oximetry is a technique that allows the evaluation of oxygen levels in the blood in patients who suffer from a pulmonary disorder or present a respiratory pathology. The main objective of this research is the design of a portable pulse oximeter, which corrects the problems of the oximeter previously developed by the ICID, due to the module used at defined low perfusion levels (modulation index of 0.4% and lower), It had difficulties to synchronize with the patient's pulses and for severe low perfusion conditions (signals with a modulation index of 0.2% and less), the module did not operate. With respect to past designs, this project incorporates an oximetry module produced by recognized companies in this field, thus eradicating the deficiencies of the previous models. The components were updated, using, for example, an LCD screen, a DC / DC converter, optocouplers and the MSP430F2618 microcontroller which is very suitable for this design, as it contains sufficient resources in data and program memory. The design of the schematics of each circuit that makes up the oximeter is carried out. As well as the development of firmware programming, based on the graphic design of the algorithms of the main functions of the equipment.
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Melton, James D., Michael B. Heller, Richard Kaplan, and Karen Mohan-Klein. "Occult Hypoxemia During Aeromedical Transport: Detection by Pulse Oximetry." Prehospital and Disaster Medicine 4, no. 2 (December 1989): 115–20. http://dx.doi.org/10.1017/s1049023x00029861.
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AbstractThe use of pulse oximetry as an adjunct to clinical evaluation of oxygenation during aeromedical transport by helicopter and fixed-wing aircraft was evaluated. As evidenced by an oxygen saturation of 90% or less, 29 of 150 patients (29%) were hypoxemic in the presence of the flight team. Airway interventions were carried out by the flight team in 17 of these 29 hypoxemic patients. In 11 of these 17 instances, desaturation noted by pulse oximeter was the first evidence that airway interventions were indicated. In the other 12 cases of hypoxemia, no new airway interventions were carried out despite oximeter evidence of desaturation. Three of these patients subsequently required aggressive airway interventions following their arrival at the receiving emergency department. Of the 32 patients transported by fixed-wing aircraft, 27% had evidence of unsuspected hypoxemia detected only by the pulse oximeter. The hypoxemia seemed related to increasing altitude in eight of this latter group. Pulse oximetry is a valuable and feasible technique for monitoring patients during aeromedical transport. Its use may allow detection of physiologic hypoxemia before such becomes apparent clinically.
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Rimbi, Mary, Immaculate Nakitende, Teopista Namujwiga, and John Kellett. "How well are heart rates measured by pulse oximeters and electronic sphygmomanometers? Practice-based evidence from an observational study of acutely ill medical patients during hospital admission." Acute Medicine Journal 18, no. 3 (July 1, 2019): 144–47. http://dx.doi.org/10.52964/amja.0767.
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Background: heart rates generated by pulse oximeters and electronic sphygmomanometers in acutely ill patients may not be the same as those recorded by ECG Methods: heart rates recorded by an oximeter and an electronic sphygmomanometer were compared with electrocardiogram (ECG) heart rates measured on acutely ill medical patients. Results: 1010 ECGs were performed on 217 patients while they were in the hospital. The bias between the oximeter and the ECG measured heart rate was -1.37 beats per minute (limits of agreement -22.6 to 19.9 beats per minute), and the bias between the sphygmomanometer and the ECG measured heart rate was -0.14 beats per minute (limits of agreement -22.2 to 21.9 beats per minute). Both devices failed to identify more than half the ECG recordings that awarded 3 NEWS points for heart rate. Conclusion: Heart rates of acutely ill patients are not reliably measured by pulse oximeter or electronic sphygmomanometers.
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Kristjansdottir, Jona Valgerdur, Sveinn Hakon Hardarson, Andrew R. Harvey, Olof Birna Olafsdottir, Thorunn Scheving Eliasdottir, and Einar Stefánsson. "Choroidal Oximetry With a Noninvasive Spectrophotometric Oximeter." Investigative Opthalmology & Visual Science 54, no. 5 (May 7, 2013): 3234. http://dx.doi.org/10.1167/iovs.12-10507.
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Jennis, Michael S., and Joyce L. Peabody. "Pulse Oximetry: An Alternative Method for the Assessment of Oxygenation in Newborn Infants." Pediatrics 79, no. 4 (April 1, 1987): 524–28. http://dx.doi.org/10.1542/peds.79.4.524.
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Continuous monitoring of oxygenation in sick newborns is vitally important. However, transcutaneous Po2 measurements have a number of limiations. Therefore, we report the use of the pulse oximeter for arterial oxygen saturation (Sao2) determination in 26 infants (birth weights 725 to 4,000 g, gestational ages 24 to 40 weeks, and postnatal ages one to 49 days). Fetal hemoglobin determinations were made on all infants and were repeated following transfusion. Sao2, readings from the pulse oximeter were compared with the Sao2 measured in vitro on simultaneously obtained arterial blood samples. The linear regression equation for 177 paired measurements was: y = 0.7x + 27.2; r = .9. However, the differences between measured Sao2 and the pulse oximeter Sao2 were significantly greater in samples with > 50% fetal hemoglobin when compared with samples with < 25% fetal hemoglobin (P < .001). The pulse oximeter was easy to use, recorded trends in oxygenation instantaneously, and was not associated with skin injury. We conclude that pulse oximetry is a reliable technique for the continuous, noninvasive monitoring of oxygenation in newborn infants.
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Vaughan, Laura, Lauren E. Eggert, Andrea Jonas, Arthur Sung, and Sara Singer. "Use of home pulse oximetry with daily short message service messages for monitoring outpatients with COVID-19: The patient's experience." DIGITAL HEALTH 7 (January 2021): 205520762110676. http://dx.doi.org/10.1177/20552076211067651.
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Studies have shown COVID-19 patients may have a low oxygen saturation (SpO2) independent of visible respiratory distress, a phenomenon termed “silent hypoxia.” Silent hypoxia creates uncertainty in the outpatient setting for clinicians and patients alike. In this study, we examined the potential for pulse oximeters in identifying early signs of clinical deterioration. We report descriptive results on COVID-positive patients’ experiences with a comprehensive home monitoring tool comprised of home SpO2 measurements with a novel symptom-tracking short message service/text messaging application. Of patients who required hospitalization, 83% sought care as a result of low pulse oximeter readings. Nearly all patients who did not require hospitalization reported that having a pulse oximeter provided them with the confidence to stay at home. Essentially all patients found a home pulse oximeter useful. Keeping COVID-19-positive patients at home reduces the potential for disease spread and prevents unnecessary costs and strain on the healthcare system.
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Macnab, Andrew J., Lark Susak, Faith A. Gagnon, Janet Alred, and Charles Sun. "The Cost-Benefit of Pulse-Oximeter Use in the Prehospital Environment." Prehospital and Disaster Medicine 14, no. 4 (December 1999): 41–46. http://dx.doi.org/10.1017/s1049023x00027710.
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AbstractIntroduction:Pulse-oximetry has proven clinical value in Emergency Departments and Intensive Care Units. In the prehospital environment, oxygen is given routinely in many situations. It was hypothesized that the use of pulse oximeters in the prehospital setting would provide a measurable cost-benefit by reducing the amount of oxygen used.Methods:This was a prospective study conducted at 12 ambulance stations (average transport times >20 minutes). Standard care protocols and paramedic assessments were used to determine which patients received oxygen and the initial flow rate used. Pulse-oximetry measurements (oxygen-saturation measured by pulse oximetry) were then taken. If oxygen-saturation measured by pulse oximetry fell below 92% or rose above 96% (except in patients with chest pain), oxygen (O2) flow rates were adjusted. Costs of oxygen use were calculated: volume that would have been used based on initial flow rate; and volume actually used based on actual flow rates and transport time.Methods:A total of 1,907 patients were recruited. Oximetry and complete data were obtained on 1,787 (94%). Of these, 1,329 (74%) received O2 by standard protocol: 389 (27.5%) had the O2 flow decreased; 52 had it discontinued. Eighty-seven patients (6%) not requiring O2 standard protocol were hypoxemic (oxygen-saturation measured by pulse oximetry < 92%) by oximetry, and 71 patients (5%) receiving oxygen required flow rate increases. Overall, O2 consumption was reduced by 26% resulting in a cost-savings of $0.20 / patient. Prehospital pulse-oximetry allows unncessary or excessive oxygen therapy to be avoided in up to 55% of patients transported by ambulance and can help to identify suboptimally oxygenated patients (11%).Conclusion:Rationalizing the O2 administration using pulse-oximetry reduced O2 consumption. Other health care savings likely would result from a reduced incidence of suboptimal oxygenation. Oxygen cost-saving justifies oximeter purchase for each ambulance annually where patient volume exceeds 1,750, less frequently for lower call volumes, or in those services where the mean transport time is less than the 23 minute average noted in this study.
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Powers, S. K., S. Dodd, J. Freeman, G. D. Ayers, H. Samson, and T. McKnight. "Accuracy of pulse oximetry to estimate HbO2 fraction of total Hb during exercise." Journal of Applied Physiology 67, no. 1 (July 1, 1989): 300–304. http://dx.doi.org/10.1152/jappl.1989.67.1.300.
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The accuracy of two pulse oximeters (Ohmeda 3700 and Biox IIa) was evaluated during cycle ergometer incremental exercise in 10 healthy subjects. The exercise protocol began at 30 W with the power output being increased 15 W.min-1 until volitional fatigue. Ear and finger probe pulse oximetry measurements of available hemoglobin (%Spo2) were compared with arterial oxyhemoglobin fraction of total hemoglobin (%HbO2) measured directly from arterial blood samples using a CO-oximeter. To provide a wide range of %HbO2 values, four subjects exercised under hypoxic conditions [inspired partial pressure of O2 (PIo2) = 107 Torr], while the remaining six subjects exercised under normoxic conditions (PIo2 = 150 Torr). Because carboxyhemoglobin (HbCO) or methemoglobin (MetHb) is not measured by pulse oximeters, %HbO2 was corrected for HbCO and MetHb and expressed as percent arterial O2 saturation of available Hb (%Sao2). Small and insignificant differences (P greater than 0.05) existed between SpO2 (all 3 instruments) and %SaO2 at the lowest work rate and the highest power output achieved. Regression analyses of %SpO2 vs. %SaO2 produced correlation coefficients of r = 0.82 [standard error of the estimate [(SEE) = 1.79], r = 0.89 (SEE = 1.48), and r = 0.93 (SEE = 1.14) for the Biox IIa, Ohmeda 3700 (ear), and the Ohmeda 3700 (finger) pulse oximeters, respectively. We conclude that pulse oximetry, within the above limits of accuracy, is useful in estimating %SaO2 during exercise in healthy subjects.
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Leasa, David J., and Jacqueline M. Walker. "Bedside Pulse Oximeters with a Clinical Algorithm Make Economic Sense in the Intensive Care Unit." Canadian Respiratory Journal 3, no. 1 (1996): 47–51. http://dx.doi.org/10.1155/1996/783141.
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OBJECTIVE:To determine the effect on arterial blood gas (ABG) and hospital resource use by introducing a strategy of using bedside oximeters with a clinical algorithm, based on the argument that bedside pulse oximeters make economic sense in the intensive care unit (ICU) if safe patient oxygenation can be ensured at a lower cost than that of existing monitoring options.DESIGN:A before and after design was used to examine the consequences of a pulse oximeter at each bedside in the ICU along with a pulse oximeter clinical algorithm (POCA) describing use for titrating oxygen therapy and for performing ABG analysis.SETTING:A 19-bed multidisciplinary ICU with a six-bed extended ICU (EICU) available to function as a 'step-down' facility.PATIENTS:All patients admitted to the ICU/EICU over two 12-month periods were included.RESULTS:The strategy yielded a 31% reduction in the mean number of ABGs per patient after POCA (20.0±26.1 versus 13.8±16.7, mean ± SD; P<0.001) as well as a potential annual cost savings of $32,831.CONCLUSIONS:Bedside oximeters within the ICU, when used with explicit guidelines, reduce ABG use and result in hospital cost savings.
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Yamaya, Yoshiki, Harm J. Bogaard, Peter D. Wagner, Kyuichi Niizeki, and Susan R. Hopkins. "Validity of pulse oximetry during maximal exercise in normoxia, hypoxia, and hyperoxia." Journal of Applied Physiology 92, no. 1 (January 1, 2002): 162–68. http://dx.doi.org/10.1152/japplphysiol.00409.2001.
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During exercise, pulse oximetry is problematic due to motion artifact and altered digital perfusion. New pulse oximeter technology addresses these issues and may offer improved performance. We simultaneously compared Nellcor N-395 (Oxismart XLTM) pulse oximeters with an RS-10 forehead sensor (RS-10), a D-25 digit sensor (D-25), and the Ivy 2000 (Masimo SETTM)/LNOP-Adt digit sensor (Ivy) to arterial blood oxygen saturation (SaO2 ) by cooximetry. Nine normal subjects, six athletes, and four patients with chronic disease exercised to maximum oxygen consumption (V˙o 2 max) under various conditions [normoxia, hypoxia inspired oxygen fraction (Fi O2 ) = 0.125; hyperoxia, Fi O2 = 1.0]. Regression analysis for normoxia and hypoxic data was performed ( n = 161 observations, SaO2 = 73–99.9%), and bias (B) and precision (P) were calculated. RS10 offered greater validity than the other two devices tested ( y = 1.009 x − 0.52, R 2 = 0.90, B±P = 0.3 ± 2.5). Finger sensors had low precision and a significant negative bias (D-25: y = 1.004 x − 2.327, R 2 = 0.52, B±P = −2.0 ± 7.3; Ivy: y = 1.237 x − 24.2, R 2 = 0.78, B±P = −2.0 ± 5.2). Eliminating measurements in which heart rate differed by >10 beats/min from the electrocardiogram value improved precision minimally and did not affect bias substantially (B±P = 0.5 ± 2.0, −1.8 ± 8.4, and −1.25±4.33 for RS-10, D-25, and Ivy, respectively). Signal detection algorithms and pulse oximeter were identical between RS-10 and D-25; thus the improved performance of the forehead sensor is likely because of sensor location. RS-10 should be considered for exercise testing in which pulse oximetry is desirable.
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Shepherd, A. P., V. T. Randal, J. M. Steinke, and J. L. Schmalzel. "An oximeter for measuring hemoglobin concentration and oxygen content." American Journal of Physiology-Heart and Circulatory Physiology 257, no. 5 (November 1, 1989): H1705—H1711. http://dx.doi.org/10.1152/ajpheart.1989.257.5.h1705.
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We have developed an oximeter that measures both the total hemoglobin concentration in whole blood and the percentage of the hemoglobin saturated with oxygen. The oximeter uses red and infrared light-emitting diodes to illuminate a capillary tube filled with a sample of whole blood. Light scattered by the blood travels a short distance down the length of the capillary tube and reaches a photodetector, the output of which is amplified, digitized, and fed into a microprocessor. The microprocessor computes the total hemoglobin concentration as a nonlinear function of the infrared light intensity. Oxyhemoglobin saturation is computed from the ratio of the logarithms of the intensities of red and infrared light. Our instrument has the following advantages over existing oximeters: 1) it provides a measurement of total hemoglobin concentration, 2) it is immune to the calibration shifts that fluctuations in total hemoglobin concentration cause in other oximeters, 3) it is accurate over a wide range of oxygen saturation, and 4) the blood samples are not diluted and can thus be preserved for further analysis. A detailed parts list and circuit diagram are presented, and sources of error are discussed.
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Sidhartha, G. "IoT Based Pulse Oximeter." International Journal for Research in Applied Science and Engineering Technology 9, no. 8 (August 31, 2021): 2946–51. http://dx.doi.org/10.22214/ijraset.2021.37782.
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Abstract: In recent times, we have realized the importance of vital signs such as Oxygen saturation and heart rate i.e beats per minute (BPM) due to the covid-19 situation worldwide. SpO2 and BPM are being used as preliminary indicators for testing a person’s health, the drop in the oxygen saturation is perceived as one of the symptoms of a person suffering from coronavirus. Oximeters are portable devices that are used to measure the SpO2 and BPM of a person. Timely measurements of oxygen saturation can aid in taking preventive measures. This paper discusses the construction and development of an IoT-based pulse oximeter that is capable of transmitting the reading obtained to any remote location wirelessly. The proposed system uses Arduino as the microcontroller which is used for signal processing and Esp-01 as the Wifi platform to enable remote data transmission. The data is communicated remotely through Blynk mobile application. This project is aimed at reducing the manual effort undergone in regularly updating the oxygen saturation to the doctor, in the case of a person undergoing home treatment. Though an oximeter is not a screening te st, it is a primary indicator of a person’s health. Keywords: Heart rate, SpO2, IoT, Arduino, BLYNK server, Red, IR.
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Denninghoff, Kurt R., Katarzyna B. Sieluzycka, Jennifer K. Hendryx, Tyson J. Ririe, Lawrence DeLuca, and Russell A. Chipman. "Retinal oximeter for the blue-green oximetry technique." Journal of Biomedical Optics 16, no. 10 (2011): 107004. http://dx.doi.org/10.1117/1.3638134.
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Grabliauskienė, Živilė, Roberta Zamaliauskienė, and Greta Lodienė. "Pulp Vitality Testing with a Developed Universal Pulse Oximeter Probe Holder." Medicina 57, no. 2 (January 23, 2021): 101. http://dx.doi.org/10.3390/medicina57020101.
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Background and Objectives An accurate determination of the pulp status is relevant for a proper endodontic diagnosis. Objectives: The aim was to develop a universal pulse oximeter probe holder for measuring the oxygen saturation and to evaluate the use of pulse oximetry as a test for pulp vitality, by comparing the levels of oxygen saturation in the index finger and in the healthy dental pulp. Materials and Methods The universal holder was designed with software and printed with a 3D printer. The study was carried out on 128 healthy teeth. They were divided into eight groups according to tooth type. Ten root canal treated teeth served as a negative control group. For each patient, a pulse oximeter was first applied on the tooth followed by the index finger. The significance level (α) was set at 0.05. Results: The developed and manufactured universal pulse oximeter probe holder was suitable to measure the pulp vitality of all types of teeth. The handle allowed for holding the pulse oximeter on the tooth in parallel, firmly and securely. Significantly higher oxygen saturation was observed in the index finger (97.22%) compared to the dental pulp (93.17%) (p < 0.001). No correlation was observed between the maxillary teeth and index finger oxygen saturation values (r = 0.05, p = 0.72), whereas, between the mandibular teeth and index finger, a positive correlation was detected (r = 0.29, p = 0.02). There were no significant differences in the pulp oxygen saturation values between different teeth groups. Conclusion: The newly developed universal pulse oximeter probe holder is an effective device for pulp vitality testing.
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Kannan Loganathan, Prakash, Joyce E. O'Shea, Chidambara Harikumar, John C. Brigham, Yacov Rabi, and Samir Gupta. "Effect of opaque wraps for pulse oximeter sensors: randomised cross-over trial." Archives of Disease in Childhood - Fetal and Neonatal Edition 106, no. 1 (July 1, 2020): 57–61. http://dx.doi.org/10.1136/archdischild-2020-319049.
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BackgroundEvidence is lacking as to whether ambient light or phototherapy light could interfere with pulse oximeter performance.MethodsIn this randomised cross-over trial, we recruited neonates of gestation >24 weeks. Consented infants were randomly assigned to either pulse oximeter sensor with opaque wrap or without opaque wrap. Nellcor and Masimo sensors were applied simultaneously to different feet for 10 min of recording. Infants were crossed over to the other intervention for a further 10 min, totalling 20 min recording per infant. Primary outcome was faster acquisition of data with shielding of pulse oximeter sensor as compared with not shielding.ResultsA total of 96 babies were recruited. There was no difference in primary outcome of time taken to display valid data between the two groups (opaque wrap: 12.73±3.1 s vs no opaque wrap: 13.16±3.3 s, p=0.27). There was no difference in any of the secondary outcomes (percentage of valid data points, percentage of time saturation below target, and so on) between the two groups in both pulse oximeters. Masimo sensor readings displayed a higher mean oxygen saturation (mean difference of 2.85, p=0.001) and lower percentage of time saturation below 94% (mean difference of −27.8, p=0.001) than Nellcor in both groups. There was no difference in any of the outcomes in babies receiving phototherapy (n=21).ConclusionIn this study, shielding the pulse oximeter sensor from ambient light or phototherapy light did not yield faster data acquisition or better data quality.Trial registration numberISRCTN10302534
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Cheung, P., J. G. Hardman, and R. Whiteside. "The Effect of a Disposable Probe Cover on Pulse Oximetry." Anaesthesia and Intensive Care 30, no. 2 (April 2002): 211–14. http://dx.doi.org/10.1177/0310057x0203000215.
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The re-use of pulse oximeter probes presents the possibility of between-patient contamination. Use of a disposable polyethylene cover may reduce this risk. In a controlled, prospective study we examined the effect of such a cover on the accuracy of pulse oximetry. Each of ten volunteer subjects was monitored simultaneously by two identical Nellcor pulse oximeters, one with a plastic cover and the other, without a cover, used as a control. The pulse oximetry (SpO 2 ) reading for each probe was recorded while subjects breathed 21% O 2 and again while they breathed 10% O 2. The probe cover was then swapped onto the other probe and the recordings were repeated. Ninety-five per cent limits of agreement in SpO 2 (mean difference in SpO 2 (1.95 x standard deviation of difference) between covered and non-covered probes were -0.6% to 0.6% while breathing 21% oxygen and -2.0% to 2.9% while breathing 10% oxygen. We conclude that a protective plastic sheath may induce a small error in pulse oximetry reading that is most marked during hypoxaemia. This error is unlikely to be of clinical significance.
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Imad, Abdulrahman, Noreha Abdul Malik, Belal Ahmed Hamida, Gan Hong Hong Seng, and Sheroz Khan. "Acoustic Photometry of Biomedical Parameters for Association with Diabetes and Covid-19." Emerging Science Journal 6 (February 7, 2022): 42–56. http://dx.doi.org/10.28991/esj-2022-sper-04.
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Because of their mortality rate, diabetes and COVID-19 are serious diseases. Moreover, people with diabetes are at a higher risk of developing COVID-19 complications. This article therefore proposes a single, non-invasive system that can help people with diabetes and COVID-19 to monitor their health parameters by measuring oxygen saturation (SPO2), heart rate, and body temperature. This is in contrast to other pulse oximeters and previous work reported in the literature. A Max30102 sensor, consisting of two light-emitting diodes (LEDs), can serve as a transmission spectrum to enable three synchronous parameter measurements. Hence, the Max30102 sensor facilitates identification of the relationship between COVID-19 and diabetes in a cost-effective manner. Fifty subjects (20 healthy, 20 diabetic, and 10 with COVID-19), aged 18-61 years, were recruited to provide data on heart rate, body temperature, and oxygen saturation, measured in a variety of activities and scenarios. The results showed accuracy of ±97% for heart rate, ±98% for body temperature, and ±99% for oxygen saturation with an enhanced time efficiency of 5-7 seconds in contrast to a commercialized pulse oximeter, which took 10-12 seconds. The results were then compared with those of commercially available pulse oximetry (Oxitech Pulse Oximeter) and a thermometer (Medisana Infrared Thermometer). These results revealed that uncontrolled diabetes can be as dangerous as COVID-19 in terms of high resting heart rate and low oxygen saturation. Doi: 10.28991/esj-2022-SPER-04 Full Text: PDF
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King, Carina, Nicholas Boyd, Isabeau Walker, Beatiwel Zadutsa, Abdullah H. Baqui, Salahuddin Ahmed, Mazharul Islam, et al. "Opportunities and barriers in paediatric pulse oximetry for pneumonia in low-resource clinical settings: a qualitative evaluation from Malawi and Bangladesh." BMJ Open 8, no. 1 (January 2018): e019177. http://dx.doi.org/10.1136/bmjopen-2017-019177.
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ObjectiveTo gain an understanding of what challenges pulse oximetry for paediatric pneumonia management poses, how it has changed service provision and what would improve this device for use across paediatric clinical settings in low-income countries.DesignFocus group discussions (FGDs), with purposive sampling and thematic analysis using a framework approach.SettingCommunity, front-line outpatient, and hospital outpatient and inpatient settings in Malawi and Bangladesh, which provide paediatric pneumonia care.ParticipantsHealthcare providers (HCPs) from Malawi and Bangladesh who had received training in pulse oximetry and had been using oximeters in routine paediatric care, including community healthcare workers, non-physician clinicians or medical assistants, and hospital-based nurses and doctors.ResultsWe conducted six FGDs, with 23 participants from Bangladesh and 26 from Malawi. We identified five emergent themes: trust, value, user-related experience, sustainability and design. HCPs discussed the confidence gained through the use of oximeters, resulting in improved trust from caregivers and valuing the device, although there were conflicts between the weight given to clinical judgement versus oximeter results. HCPs reported the ease of using oximeters, but identified movement and physically smaller children as measurement challenges. Challenges in sustainability related to battery durability and replacement parts, however many HCPs had used the same device longer than 4 years, demonstrating robustness within these settings. Desirable features included back-up power banks and integrated respiratory rate and thermometer capability.ConclusionsPulse oximetry was generally deemed valuable by HCPs for use as a spot-check device in a range of paediatric low-income clinical settings. Areas highlighted as challenges by HCPs, and therefore opportunities for redesign, included battery charging and durability, probe fit and sensitivity in paediatric populations.Trial registration numberNCT02941237.
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Kosturkov, D., and Ts Uzunov. "Pulse Oximetry and Electric Pulp Test in Intact Teeth and Teeth with Hyperaemia Pulpae." Acta Medica Bulgarica 44, no. 2 (October 1, 2017): 10–13. http://dx.doi.org/10.1515/amb-2017-0012.
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Abstract The pulp hyperaemia is associated with increased blood flow in the pulp. Diagnosis of this condition is very important for the outcome of a dental treatment. There are new methods, which can detect the pulp blood flow. Such method, gaining increasing popularity nowadays, is pulse oximetry. In this study, intact teeth and teeth with diagnosis of hyperaemia pulpae are examined by pulse oximeter and electric pulp test. The results show that the threshold of irritation is decreased in teeth with hyperemia, and the saturation of the pulp is increased by 12.34% in frontal teeth and 7.27% in distal teeth. There is a statistically significant difference (p < 0,05) in the values measured with pulse oximeter in the intact frontal and distal teeth and the teeth with hyperemia. Pulse oximetry can detect changes in pulp microcirculation in state of hyperemia. It is an extremely valuable method for early, objective diagnosis of pulp blood flow, as well as for its monitoring in dynamics.
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Shah, N., N. Trivedi, J. Hyatt, and S. Barker. "CEREBRAL OXIMETER." Journal of Neurosurgical Anesthesiology 7, no. 4 (October 1995): 302. http://dx.doi.org/10.1097/00008506-199510000-00029.
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Demers, Bob. "The Oximeter." Chest 126, no. 5 (November 2004): 1399–401. http://dx.doi.org/10.1378/chest.126.5.1399.
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