Assessment of Photoplethysmography Method in Extraction of Hemoglobin Concentration

Azarnoosh, Mahdi; Doostdar, H

doi:10.31661/jbpe.v0i0.400

Cited by 6 publications

(5 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…First, although the artifacts caused by respiratory motion and esophageal peristalsis hidden in the transesophageal dPPG signal were removed by a filter, the nonpulsatile DC component had contamination of background light absorption caused by surrounding tissues, such as the esophageal mucosa and smooth muscle between the transesophageal oximetry sensor and the descending aorta [ 12 , 27 , 28 ]. Similar to the principle of cerebral oxygen saturation monitoring, it may be possible to remove background light absorption contamination by setting both near and far photodetectors or adding different wavelengths related to Hb light absorption, but these require further investigation [ 22 , 29 , 30 ]. In addition, the infusion of colloids appears to affect the light absorption of hemoglobin [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

Feasibility and accuracy of noninvasive continuous hemoglobin monitoring using transesophageal photoplethysmography in porcine model

Peng,

Zhao,

Zhang

et al. 2024

BMC Anesthesiol

View full text Add to dashboard Cite

Background Continuous and noninvasive hemoglobin (Hb) monitoring during surgery is essential for anesthesiologists to make transfusions decisions. The aim of this study was to investigate the feasibility and accuracy of noninvasive and continuous Hb monitoring using transesophageal descending aortic photoplethysmography (dPPG) in porcine model. Methods Nineteen landrace pigs, aged 3 to 5 months and weighing 30 to 50 kg, were enrolled in this study. A homemade oximetry sensor, including red (660 nm) and infrared (940 nm) lights, was placed in the esophagus for dPPG signal detection to pair with the corresponding reference Hb values (Hbi−STAT) measured by blood gas analysis. The decrease and increase changes in Hb concentration were achieved by hemodilution and transfusion. Metrics, including alternating current (AC), direct current (DC), and AC/DC for both red and infrared light were extracted from the dPPG signal. A receiver operating characteristic (ROC) curve was built to evaluate the performance of dPPG metrics in predicting the Hb “trigger threshold” of transfusion (Hb < 60 g/L and Hb > 100 g/L). Agreement and trending ability between Hb measured by dPPG (HbdPPG) and by blood gas analysis were analyzed by Bland-Altman method and polar plot graph. Error grid analysis was also performed to evaluate clinical significance of HbdPPG measurement. Results The dPPG signal was successfully detected in all of the enrolled experimental pigs, without the occurrence of a continuous loss of dPPG signal for 2 min during the entire measurement. A total of 376 pairs of dPPG signal and Hbi−STAT were acquired. ACred/DCred and ACinf/DCinf had moderate correlations with Hbi−STAT, and the correlation coefficients were 0.790 and 0.782, respectively. The areas under the ROC curve for ACred/DCred and ACinf/DCinf in predicting Hbi−STAT < 60 g/L were 0.85 and 0.75, in predicting Hbi−STAT > 100 g/L were 0.90 and 0.83, respectively. Bland-Altman analysis and polar plot showed a small bias (1.69 g/L) but a wide limit of agreement (-26.02–29.40 g/L) and a poor trend ability between HbdPPG and Hbi−STAT. Clinical significance analysis showed that 82% of the data lay within the Zone A, 18% within the Zone B, and 0% within the Zone C. Conclusion It is feasible to establish a noninvasive and continuous Hb monitoring by transesophageal dPPG signal. The ACred/DCred extracted from the dPPG signal could provide a sensitive prediction of the Hb threshold for transfusion. The Hb concentration measured by dPPG signal has a moderate correlation with that measured by blood gas analysis. This animal study may provide an experimental basis for the development of bedside HbdPPG monitoring in the future.

show abstract

Section: Discussionmentioning

confidence: 99%

Feasibility and accuracy of noninvasive continuous hemoglobin monitoring using transesophageal photoplethysmography in porcine model

Peng,

Zhao,

Zhang

et al. 2024

BMC Anesthesiol

View full text Add to dashboard Cite

show abstract

“…First, although the artifacts caused by respiratory motion and esophageal peristalsis hidden in the transesophageal dPPG signal were removed by a lter, the nonpulsatile DC component had contamination of background light absorption caused by surrounding tissues, such as the esophageal mucosa and smooth muscle between the transesophageal oximetry sensor and the descending aorta [12,27,28]. Similar to the principle of cerebral oxygen saturation monitoring, it may be possible to remove background light absorption contamination by setting both near and far photodetectors or adding different wavelengths related to Hb light absorption, but these require further investigation [22,29,30]. In addition, the infusion of colloids appears to affect the light absorption of hemoglobin [4].…”

Section: Discussionmentioning

confidence: 99%

Feasibility and accuracy of noninvasive continuous hemoglobin monitoring using transesophageal photoplethysmography

Peng,

Zhao,

Zhang

et al. 2023

Preprint

View full text Add to dashboard Cite

Background Continuous and noninvasive hemoglobin (Hb) monitoring during surgery is essential for anesthesiologists to make transfusions decisions. The aim of this study was to investigate the feasibility and accuracy of noninvasive and continuous Hb monitoring using transesophageal descending aortic photoplethysmography (dPPG) based on near-infrared spectroscopy (NIRS) technology. Methods Nineteen landrace pigs, aged 3 to 5 months and weighing 30 to 50 kg, were enrolled in this study. A customized oximetry sensor, including red (660nm) and infrared (940nm) lights, was placed in the esophagus for dPPG signal detection to pair with the corresponding reference Hb values (Hbi−STAT) measured by blood gas analysis. The decrease and increase changes in Hb concentration were achieved by hemodilution and transfusion. Metrics, including alternating current (AC), direct current (DC), and AC/DC for both red and infrared light were extracted from the dPPG signal. A receiver operating characteristic (ROC) curve was built to evaluate the performance of dPPG metrics in predicting Hb level. Agreement and trending ability between Hb measured by dPPG (HbdPPG) and by blood gas analysis were analyzed by Bland-Altman method and polar plot graph. Error grid analysis was also performed to evaluate clinical significance of HbdPPG measurement. Results A total of 376 pairs of dPPG signal and Hbi−STAT were acquired. ACred/DCred and ACinf/DCinf had moderate correlations with Hbi−STAT, and the correlation coefficients were 0.790 and 0.782, respectively. The areas under the ROC curve for ACred/DCred and ACinf/DCinf in predicting Hbi−STAT < 60 g/L were 0.85 and 0.75, in predicting Hbi−STAT > 100 g/L were 0.90 and 0.83, respectively. Bland-Altman analysis and polar plot showed a small bias (1.69 g/L) but a wide limit of agreement (-26.02–29.40 g/L) and a poor trend ability between HbdPPG and Hbi−STAT. Clinical significance analysis showed that 82% of the data lay within the Zone A, 18% within the Zone B, and 0% within the Zone C. Conclusion It is feasible to establish a noninvasive and continuous Hb monitoring by transesophageal dPPG signal. The AC/DC extracted from the dPPG signal provided a sensitive prediction for Hb < 60 g/L and Hb > 100 g/L. The Hb concentration measured by dPPG signal has a moderate correlation with that measured by blood gas analysis.

show abstract

“…Using NIR-spectroscopy and photodetectors, photoplethysmograms (PPG)-a measure of the variations in the volume of blood with each cardiac cycle applying optical properties of blood, can be generated. Various biomedical applications, including Hgb level measurement, use PPG signals captured from fingertips using a PPG probe, or a pulse-oximeter, or sensors [28]- [31].…”

Section: B Photoplethysmography (Ppg) Signal Based Methodsmentioning

confidence: 99%

Automated Cardiac Pulse Cycle Analysis From Photoplethysmogram (PPG) Signals Generated From Fingertip Videos Captured Using a Smartphone to Measure Blood Hemoglobin Levels

Aziz

Hasan²,

Mahmood

et al. 2021

IEEE J. Biomed. Health Inform.

View full text Add to dashboard Cite

Two billion people are affected by hemoglobin (Hgb) related diseases. Usual clinical assessments of Hgb are conducted by analyzing venipuncture-obtained blood samples in laboratories. A non-invasive, cheap, point-of-care and accurate Hgb test is needed everywhere. Our group has developed a noninvasive Hgb measurement system using 10-second Smartphone videos of the index fingertips. Custom hardware sets were used to illuminate the fingers. We tested four lighting conditions with wavelengths in the near-infrared spectrum suggested by the absorption properties of two primary components of bloodoxygenated Hgb and plasma. We found a strong linear correlation between our measured and laboratory-measured Hgb levels in 167 patients with a mean absolute percentage error (MAPE) of 5%. In our initial analysis, critical tasks were performed manually. Now, using the same data, we have automated or modified all the steps. For all, male, and female subjects we found a MAPE of 6.43%, 5.34%, and 4.85 and mean squared error (MSE) of 0.84, 0.5, and 0.49 respectively. The new analyses however, have suggested inexplicable inconsistencies in our results, which we attribute to laboratory measurement errors reflected in a non-normative distribution of Hgb levels in our studied patients, as well as excess noise in the specific signals we measured in the videos. Based on these encouraging results, and the promise of greater accuracy with our revised hardware and software tools, we now propose a rigorous validation study to demonstrate that this approach to hemoglobin measurement is appropriate for general clinical application.

show abstract

Assessment of Photoplethysmography Method in Extraction of Hemoglobin Concentration

Cited by 6 publications

References 9 publications

Feasibility and accuracy of noninvasive continuous hemoglobin monitoring using transesophageal photoplethysmography in porcine model

Feasibility and accuracy of noninvasive continuous hemoglobin monitoring using transesophageal photoplethysmography in porcine model

Feasibility and accuracy of noninvasive continuous hemoglobin monitoring using transesophageal photoplethysmography

Automated Cardiac Pulse Cycle Analysis From Photoplethysmogram (PPG) Signals Generated From Fingertip Videos Captured Using a Smartphone to Measure Blood Hemoglobin Levels

Contact Info

Product

Resources

About