Determination of saturation, heart rate, and respiratory rate at forearm using a Nellcor™ forehead SpO2-saturation sensor

Abstract

Alterations in arterial blood oxygen saturation, heart rate (HR), and respiratory rate (RR) are strongly associated with intra-hospital cardiac arrests and resuscitations. A wireless, easy-to-use, and comfortable method for monitoring these important clinical signs would be highly useful. We investigated whether the Nellcor™ OxiMask MAX-FAST forehead sensor could provide data for vital sign measurements when located at the distal forearm instead of its intended location at the forehead to provide improved comfortability and easy placement. In a prospective setting, we recruited 30 patients undergoing surgery requiring postoperative care. At the postoperative care unit, patients were monitored for two hours using a standard patient monitor and with a study device equipped with a Nellcor™ Forehead SpO sensor. The readings were electronically recorded and compared in post hoc analysis using Bland-Altman plots, Spearman's correlation, and root-mean-square error (RMSE). Bland-Altman plot showed that saturation (SpO) differed by a mean of -0.2 % points (SD, 4.6), with a patient-weighted Spearman's correlation (r) of 0.142, and an RMSE of 4.2 points. For HR measurements, the mean difference was 0.6 bpm (SD, 2.5), r = 0.997, and RMSE = 1.8. For RR, the mean difference was -0.5 1/min (4.1), r = 0.586, and RMSE = 4.0. The SpO readings showed a low mean difference, but also a low correlation and high RMSE, indicating that the Nellcor™ saturation sensor cannot reliably assess oxygen saturation at the forearm when compared to finger PPG measurements.

A Comparison of Reflective Photoplethysmography for Detection of Heart Rate, Blood Oxygen Saturation, and Respiration Rate at Various Anatomical Locations

“…We also found that obtaining heart rate, SpO 2 , and respiration within an acceptable degree of accuracy was also possible at a single tested anatomical location at rest, the finger. The use of both reflective and transmissive PPG for pulse oximetry on the finger is well accepted and has been demonstrated in numerous publications [12,22,23]. The results in this study for the finger pulse oximetry at rest concur with the literature.…”

“…While many studies have been previously conducted into the placement of PPG sensors for pulse oximetry [5,10,11,12,13,14,15,16,17], few studies have been conducted for a suitable location to collect heart rate, SpO 2 , and respiration. Kramer et al [10] developed a new pulse oximeter for use at non-traditional anatomical locations for the measurement of heart rate, SpO 2 , and respiration.…”

Sensors and Functionalities of Non-Invasive Wrist-Wearable Devices: A Review

“…The application of wrist-wearable devices are possible in different domains: medicine—to monitor a patient’s health (as well as activity and environmental parameters) in order to prevent injuries and allow for the early detection of illnesses and/or disorders as well as early interventions, offer preventive actions to avoid the deterioration of a health condition [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ]; risky professions (such as construction, firefighting, aviation, and military)—to monitor a person’s vital health functions (as well as activity and environmental parameters) to prevent potential risky situations such as accidents and injuries and offer corrective or preventive actions to be undertaken to avoid further deterioration or risk [ 10 , 33 , 34 , 35 , 36 , 37 , 38 ]; education—monitoring stress levels and health conditions to offer personalized learning plans, time management recommendations, the scheduling and development of classroom activities, and establishing students’ working groups [ 2 , ...…”

“…medicine—to monitor a patient’s health (as well as activity and environmental parameters) in order to prevent injuries and allow for the early detection of illnesses and/or disorders as well as early interventions, offer preventive actions to avoid the deterioration of a health condition [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ];…”

Monitoring of heart rate and inter-beat intervals with wrist plethysmography in patients with atrial fibrillation

“…Recent development in wrist-based fitness monitors and their improved measurement capability also during movements makes it tempting to target their use to hospital patients (El-Amrawy and Nounou 2015). Some reports exist on the use of such devices on hospitalized patients (Harju et al 2017), but the evidence on their reliability and accuracy in association to rhythm abnormalities is still very limited. The performance of sensors based on the use of green wavelengths seems most promising during movement (Lee et al 2013a, Matsumura et al 2014.…”